“Pressure upon the medulla spinalis of the neck, by coagulated blood, produced paralytic affections of the arms and legs; all the functions of the internal organs were carried on for thirty-five days, but the urine and stools passed involuntarily[12]. [Footnote 12: A coagulum of blood, the thickness of a crown-piece, was found lying upon the external surface of the dura-matral covering of the medulla spinalis, extending from the fourth vertebra colli to the second vertebra dorsi. The medulla spinalis itself was uninjured.] “Blood extravasated in the central part of the medulla, in the neck, was attended with paralytic affection of the legs, but not of the arms[13]. [Footnote 13: The sixth and seventh vertebra colli were dislocated, the medulla spinalis, externally, was uninjured; but in the centre of its substance, just at that part, there was a coagulum of blood nearly two inches in length.] “In a case where the substance of the medulla was lacerated in the neck, there was a paralysis in all the parts below the laceration, the lining of the œsophagus was so sensible, that solids could not be swallowed, on account of the pain they occasioned[14]. [Footnote 14: The seventh vertebra colli was fractured, and the medulla spinalis passing through it, was lacerated and compressed.] “When the medulla of the back was completely divided, there was momentary loss of sight, loss of memory for fifteen minutes, and permanent insensibility in all the lower parts of the body. The skin above the division of the spinal marrow perspired, that below did not. The wounded spinal marrow appeared to be extremely sensible[15].” _Philosophical Transactions_, 1816, p. 485. [Footnote 15: The spinal marrow, within the canal of the sixth vertebra dorsi, was completely destroyed by a musket ball. The person lived four days.] In two of the cases already noticed, symptoms of rheumatism had previously existed; and in Case IV. the right arm, in which the palpitation began, was said to have been very violently affected with rheumatic pain to the fingers ends. The consideration of this case, in which the palpitation had been preceded, at a considerable distance of time, by this painful affection of the arm, led to the supposition that this latter circumstance might be the cause of the palpitations, and the other subsequent symptoms of this disease. This supposition naturally occasioned the attention to be eagerly fixed on the following case; and of course influenced the mode of treatment which was adopted.