36 



are presented with .similar harriers when we try to draw (•(inclusions from elinicaP 

 eases. We are never quite certain of the mischief that may result from the di.- 

 ease or injury. 



Realizing fully some of the dangers that confront us, it will lead me to \nkv 

 a conservative position upon some of the points tiiat I siiall put forth in this 

 paper. 



I will now present some facts that 1 iiave heen able to ohtain from the study 

 of a clinical case. I lielieve observation nnide in this way may in some respects 

 be more valuable than experiments upon dumb animals in a laboratory, from the 

 fact that we have an intelligent being to convey to us many valuable points, espe- 

 cially when it comes to the interi>retation of sensations. 



The following is a brief history of tlie case, as near as I have been al)le to 

 ascertain : 



In the summer of 18SS a man in Lajiorte County, Indiana, while trying to fix 

 a binding pole on a load of hay, suddenly fell to the ground, striking Avith the 

 greatest force upon what corresponds Avith the twelfth dorsal region. As a result 

 the man was totally paralyzed below the point of injury both as to sensations and 

 movement. He remained in this condition for ten months, wiien he was taken to 

 Chicago and was operated upon by a distinguished surgeon. I have never been 

 able to obtain the nature of the operation. At any rate the patient recovered to 

 a certain extent. After this, however, there was no improvement up to the time 

 the case came under my observation, which was four years after the accident and 

 al)out three years after the ojieration. 



The first time that I visited the patient I obtained all the data possible of the 

 past history, and made cfuite a thorough examination to find the condition as it 

 then existed. As a result 1 obtained the following facts: 



There was total ])aralysis below the point of injury, except the inner side of 

 ])oth thighs as far down as the knees, and in the left lindj down to the ankle: 

 also, on a jiortion of the right side of the abdomen below the navel. 



I did not see the patient again for about four weeks. In the meantime 1 

 consulted a phvsician. and we decided to try the effect of massage upon the par- 

 alyzed portions of the body. This treatment was kept up daily for about two 

 weeks, when marked improvement was noted. The next time I investigated I 

 found that the sensation of touch and temperature had been restored to the out- 

 side, as well as an increased amount on the inside of each limb. The sensations. 

 however, were below the normal ; as, for instance, the points of the dividers had 

 to be placed from four to five inches apart in order to bring about a double .sensa- 

 tion. 



