Isaac Ott.-Bromide of Ethyl, its Physiological Action. Detroit Lancet, April, 1880. H. C. Wood.-Notes on Anæsthetics, Chloride and Bromide of Ethyl. Philadelphia Medical Times, April 24, 1880. Lawrence Wolff.-Ethyl Bromide. American Journal of Pharmacy, May, 1880. A. W. Adams.-An Almost Fatal Case from the Use of the New Anæsthetic, Bromide of Ethyl. Medical Gazette, May 1, 1880. Editorial. Medical Gazette, New York, May 1, 1880. Editorial. Clinical News, May 15, 1880. F. Woodbury-The New Anæsthetic, Hydrobromic Ether. Boston Medical and Surgical Journal, vol. ci. p. 892. Medical Record, April 17, 1880, p. 439. G. F. Souwers.-Cases Operated on under the Influence of Bromide of Ethyl, by R. J. Levis, M.D. Medical and Surgical Reporter, 1880, vol. xlii. p. 92. C. H. Wilkinson.-Case, with Dangerous Symptoms. Medical Record, May 15, 1880, p. 554. G. B. Bullard.-Case. Medical Record, May 15, 1880, p. 555. Isaac Ott.-Bromide of Ethyl: Its Toxicological Action. Detroit Lancet, June, 1880. Case. College and Clinical Record, Feb. 1880. Frank Woodbury.-The New Anæsthetic. College and Clinical Record, Feb. 1880, p. 26. E. D. Spear, Jr.-Anæsthesia by Ethyl Bromide. Boston Medical and Surgical Journal, 1880, vol. cii. p. 214. R. J. Levis.-Clinical Report: Amputation of Thigh under Amæsthesia from Bromide of Ethyl. Medical Record, 1880, vol. xvii. p. 251. Laurence Turnbull.-On Pain and Anæsthetics. Medical and Surgical Reporter, 1880, vol. xlii. p. 199. Laurence Turnbull-On the Use of Hydrobromic Ether as an Anæsthetic for 19, 1880. M. Terrillon.-Bulletin de Thérapeutique, vi. 1880. Carl Jungk.-Examination of Various Samples of Bromide of Ethyl. Therapeutic Gazette, June, 1880, p. 156. Laurence Turnbull.-Hydrobromic Ether, or Bromide of Ethyl as an Anæsthetic. Medical Bulletin, June, 1880. W. H. Hingston.-Certain Anæsthetics. Canada Medical Record, June, 1880. Editorial. College and Clinical Record, June 15, 1880. John B. Roberts.-Case of Death Occurring during the Administration of Bromide of Ethyl. Philadelphia Medical Times, July 17, 1880. John B. Roberts.-The Bromide of Ethyl, as an Anæsthetic in Practical Surgery. Transactions Medical Society of the State of Pennsylvania, May, 1880. J. T. Clover.-Sims on Bromide of Ethyl. London Medical Record, June 15, 1880. Communication to the St. Louis Courier of Medicine, March, 1880. Laurence Turnbull.—Hydrobromic Ether, or Bromide of Ethyl as an Anæsthetic. Leonard's Illustrated Medical Journal, July, 1880. THREE CASES OF PROGRESSIVE MUSCULAR DEGENERATION. BY I. N. KERLIN, M.D., Superintendent of the Pennsylvania Institution for Feeble-Minded Children, AND CHARLES K. MILLS, M.D., Neurologist to the Philadelphia Hospital. THE three patients discussed in this paper are three brothers, who have been for several years inmates of the Pennsylvania. Institution for Feeble-Minded Children at Media. CASE I.-J. M., the eldest of the brothers, was, when examined in January, 1880, twenty-eight years old. At the time of his birth, the age of his father was only twenty-one years, and that of the mother eighteen years. He showed signs of deficient animation at birth. He was the first-born of the family. When between four and five months old he had convulsions, but not afterwards. During infancy he was troubled with indigestion and diarrhoea. His parents noticed that his limbs. seemed weaker than those of other babies of the same age. He could not walk until he was four years old. He was admitted to the Pennsylvania Institution for Feeble-Minded Children in 1873. Unfortunately, no facts of value in regard to the condition during childhood, of either this patient or his brothers, could be obtained. His weight was 83 pounds; height, 5 feet 4 inches. He had almost the appearance of a living skeleton, except in the gluteal regions and the calves, which were better developed than other portions of the body. The muscles of the back, and of the chest and abdomen, were very much atrophied; those of the shoulders, arms, and forearms were also wasted, but not quite so markedly; in the lower extremities the wasting was most pronounced in the thighs. His mouth was full and firm. His hands were well shaped. The face, eyes, and limbs showed no localized paralyses, and no deformities or contractures. The wasted muscles were, however, weak, the weakness varying in different muscular groups. Both grips were poor, the left better than the right. The extensor muscles of the thighs were extremely weak; lying in bed, he could flex the thighs on the pelvis, but not readily; and he could only extend them again by a wriggling, downward movement, performed with great effort. The following measurements were made: right semi-circumference of the chest, 13 inches; left, 13 inches; right semicircumference of abdomen, 123 inches; left, 12 inches; length of the right arm, 26 inches; of left, 27 inches; circumference of middle of right arm, 73 inches; of left, 7 inches; right forearm, 5 inches; left, 7 inches; length of right leg, 33 inches; of left, 334 inches; circumference of right thigh, 101 inches; of left, 10 inches; right calf, 10 inches; left, 103 inches. In standing, his feet were planted widely apart, one in advance of the other. The upper part of the trunk was thrown far backward, and the belly forwards, producing a characteristic lordosis, the scapula assuming a wing-like appearance. The upper part of the spinal columu showed a slight lateral curvature to the left. Without support he could stand only for a few minutes. In walking he carried himself in the same position as when standing, lifting himself forwards with a twisting and swinging movement on the balls of his feet. He could only move along very slowly, assisting himself by taking hold of anything within reach. Nu Farado-contractility was retained in varying degree, being least in those muscles which were weakest and most wasted. It was diminished in all. Fibrillary tremors were not observed during any of the examinations. Good reflex responses could be brought out from the skin. The patellar reflexes, however, were abolished. His hands and feet, on slight exposure, rapidly became cold and blue, but this condition did not remain. merous yellowish patches were scattered over his chest and abdomen. Hair was scanty on his head and face, but comparatively abundant on his body. He complained sometimes of sensations of numbness, and frequently of feelings of fatigue and soreness in his limbs and body. Cutaneous sensibility— tested for touch, pain, pressure, heat, and cold-was found to be |