i27o THE JOURNAIv OF PHARMACOLOGV. 



plegia. Both legs were entirely paralyzed and anesthetic; there was 

 paralysis of the sphincter ani, through which feces, mostly very thin, 

 passed involuntarily; the detrusor vesicae did not functionate, though 

 the sphincter vesicae seemed to do its work at first. A large part of the 

 intestinal tract was also paralyzed, as was shown by the permanent and 

 severe tympanites. The absence of thermic and tactile sensibility ex- 

 tended upwards from the thighs to just under the navel. Sensibility to 

 pain was still present at first over the lower half of the abdomen, though 

 reduced in acuity. At the time of his reception the patient had two 

 superficial losses of epithelium upon his buttocks. 



I shall give only a short synopsis of the course and complications of 

 this grave affection. Fever was at first constant, but later apparent 

 only in the evening. Cardiac weakness was a permanent condition. 

 The sensorium became dulled. Then there appeared trophic distur- 

 bances on the most varied portions of the body ; edemas and sanguin- 

 eous bullae developed; and the formation of several extensive gan- 

 grenous areas could not be prevented by the most careful prophylactic 

 measures. In fact the disease took its usual and downward course. 

 Finally, without any external lesion, there appeared on the right thigh 

 the signs of an extensive, deep-seated phlegmon, over which a large 

 area of skin became gangrenous upon the surface. The "patient's con- 

 dition was a dreadful one ; and his nursing became a most difficult task. 

 The sick man himself, however, had not the slightest sensation of any- 

 thing being wrong during the entire course of the disease. 



The patient was in the medical clinic for six weeks. In contra- 

 distinction to the unfavorable and relatively slow course of his symp- 

 toms above mentioned, the abnormal conditions of the urinary appar- 

 atus soon began to improve in the most satisfactory manner; and we 

 might almost say that this improvement became even more marked 

 during the treatment. The urine was drawn with the catheter twice 

 daily, a Nelation being employed at first and a metallic instrument 

 later on. Its amount was normal and its reaction acid from the first. 

 It showed a distinct albuminous cloudiness when tested with acetic 

 acid and potassium ferrocyanide ; and the microscope revealed numer- 

 ous leucocytes and bacteria. All this was not remarkable in view of the 

 nature of the disease ; and it became less so when it was shortly observed 

 that an abundant amount of sanguinolent pus was voided from the 

 urethra, the quantity of which could be much increased by the exercise 

 of ascending pressure from the root of the penis to the glans. The dis- 

 charge contained no gonococci. The abscess whose presence was shown 

 by this symptom was believed to be in the prostatic urethra, a con- 

 clui-ion which was confirmed by further investigation by other methods. 



