406 Historical 



sponge fishing; he was forty years old. The day before, after he had 

 come up from the bottom, he had fallen into a state of coma; when I 

 saw him, he was in his last moments, his face puffed up and bluish, 

 as if he were dying of asphyxia. 



Observation II. In 1867, I observed another patient; he had gone 

 down three times in one day to fish, he said; the third time, he had 

 felt an oppression in his chest at the bottom of the sea, and he had 

 hardly had time to give the signal to be raised. When he was in the 

 boat, he had fallen into a state of coma, quite insensible, from which 

 he had recovered after three hours. He then had dyspnea, complete 

 paralysis of the lower limbs and the bladder, constipation, incomplete 

 paralysis (paresis) of the upper limbs, on one side especially. The 

 dyspnea had soon disappeared; they were forced to empty the bladder 

 with a catheter. The progress of the patient had been followed for a 

 month, there was an improvement, then they lost sight of him. 



Observation III. N. B., attended by another colleague; for some 

 months he had had a paralysis of the lower limbs and the bladder, 

 with constipation; the urine was always drawn with a catheter. There 

 was only a slight flexion of the coxofemoral articulation and that of 

 the knee; more or less advanced paralysis of sensitivity. When the 

 patient had been drawn up from the bottom, he remained for several 

 hours in a state of coma; when he had recovered from this, he had 

 dyspnea and his members were paralyzed. 



Observation IV. N. A., a sturdy young man, aged 25, in good 

 health till now; for some time he had been connected with a company 

 of sponge fishermen, and he was diving in a suit. I had been sum- 

 moned to attend him July 20, 1870, and he told me that two days 

 before, he had worked too long, because he had stayed, he said, for 

 five hours on the bottom, collecting sponges, and consequently he had 

 had a sort of fainting fit. However he had gone down again to work; 

 but after working a half -hour, he felt ill, gave the signal to be drawn 

 up, and was pulled up very quickly, as usual, when there is a sign 

 of danger; the diving suit was also taken off him very quickly, and 

 after that, he fell into a state of insensibility. He had felt a numbness 

 of the limbs and dizziness, and his mouth foamed, he said. They had 

 not called a doctor, because the divers had had such symptoms several 

 times, and had recovered after several hours through the use of 

 frictions and revulsives on the extremities. He too had recovered 

 from this comatose state after five hours, after he had vomited several 

 times; but for twenty-four hours he was dizzy whenever he opened 

 his eyes; the lower limbs and the bladder were paralyzed. At the 

 beginning there was also a sort of paresis of the upper limbs, which 

 quickly disappeared, but the complete retention of the urine persisted, 

 and that is why they called me on the third day. 



I found the bladder rising as far as the navel; there was consti- 

 pation and the lower limbs were paralyzed; on the right side there 

 was complete paralysis of movement and sensitivity; on the left, sensi- 

 tivity was partly present with weak flexion of the coxofemoral 

 articulation; there was no other disturbance, no pain in the spinal 

 column. We emptied the bladder with the catheter; the next day a 

 purge with castor oil gave evacuations. We continued to catheterize the 



