_Spinal Congestion._――This is one of the varieties of disease-pictures that call for a deviation in management, and is, perhaps, as common as any of the special types, and may be recognized by the following symptoms: pain in the back, as if from long stooping, not increased by pressure; also a dull, aching sensation, as after prolonged exercise. This pain is aggravated by the recumbent posture; hence the sleeplessness so common in many of these cases. Fainting sensations are produced by standing long upon the feet: a misstep, or a sudden jolt in a wagon or car, causes much suffering. Intense burning is often felt along the cord and base of the brain, which is not influenced by pressure; hyperæsthesia of the skin of one or both legs and feet, and the scrotum; testes and penis are often too sensitive to touch; at times, neuralgic pains in the genitals, with herpes præputialis, periodically appearing; great tenderness of the anus, with herpetic eruptions _ab margine ani_. Again, anæsthesia may take the place of exalted sensibility, with formication――or tingling, or sensation of “pins and needles”――of the feet and legs. Sometimes they complain of a sensation of fullness of tissue, as if they were swollen, with no signs of any puffy or œdemic condition present. I have often observed both anæsthesia and hyperæsthesia at the same time, in different localities, upon the same patient. Shooting, neuralgic, or knife-cutting pains often emanate from the spinal cord and pass into the limbs, testes or penis. Sometimes a tight belt is felt constricting the limbs, thorax or abdomen; again a choking sensation, as in globus hystericus, with a sensation of drawing in the spermatic cord and testes; pain in the heart, lungs, abdominal viscera and genitals, is of common occurrence. Irregularities in cardiac movements are not uncommon, with troublesome erections of the penis in the morning, even when erections were impossible at night. Such erections are commonly without erotic desire, and with the bladder empty. They are more troublesome after lying upon the back during the night, which seems to aggravate the engorged spinal cord. As these cases advance paralysis may intervene, more or less profound, generally in the form of paraplegia. The above, under treatment, will be referred to as the congestive type of spinal cord disease, where the direct adaptation of agents to conditions will be pointed out, founded on the only principle that can lead to ultimate satisfaction――“specific medicine and specific diagnosis.”