RHEUMATISM 225 



rheumatism, chorea, cardiac, diplococcal, pneumococcal, 

 and other invasion, with, it may be, pulmonary, gastric, 

 and other abdominal complications, besides a large number 

 of frequently associated and anomalously related morbid 

 symptoms and diseased conditions. 



The case of A. A. referred to, again came under our ob- 

 servation in a little more than fifteen months from being 

 last seen, and complained as follows : About six weeks 

 ago, on the occurrence of a few days of rather warmer 

 weather than had for some time prevailed, I slightly 

 lightened my clothing, and shortly began to experience 

 in my lower limbs, but more especially in my right from 

 the knee downwards, a feeling of vague rheumatic pain 

 and a loss of tactile sense over the anterior aspects of the 

 lower half of the leg and the upper aspect of the foot, 

 with some loss of muscular control of three first toes. 

 Elsewhere there were no such phenomena, and the general 

 health was good. The condition, therefore, was akin to 

 his former attack, and was determined locally by the 

 existence of the same predisposition and the local incidence 

 of exciting causes sufficient to precipitate a renewal of 

 the morbid phenomena as above narrated. It was essenti- 

 ally one of limited incidence, and consisted of neural 

 circulatory stasis and consequent blockage of the motor 

 and sensory neural channels, with paralysis of the efferent 

 and afferent nervature to the extent of the incidence of 

 the local causation. 



The condition did not seriously cripple its subject, and 

 continues gradually to disappear from both nervatures as 

 the phenomena of neural circulation and the materio- 

 dynamic needs of the muscles and skin were met by 

 properly adjusted nutrition and metabolism. 



