excite the feeling of painful weariness, but no palpitation or other
unpleasant symptom has occurred during the five or six years which
have since passed.

The commencement, progress, and termination of this attack; with the
success attending the mode of treatment, and the symptoms which
followed, seem to lead to the conjecture, that the proximate cause of
the disease, in this case, existed in the medulla spinalis, and that
it might, if neglected, have gradually resolved itself into that
disease which is the object of our present inquiry.

Some few months after the occurrence of the preceding case, the writer
of these lines was called to a female about forty years of age,
complaining of great pain in both the arms, extending from the
shoulder to the finger ends. She stated, that she was attacked in the
same manner as is described in the preceding case, about nine months
before; that the complaint was considered as rheumatism, and was not
benefited by any of the medicines which had been employed; but that
after three or four weeks it gradually amended, leaving both the arms
and hands in a very weakened and trembling state. From this state they
were now somewhat recovered; but she was extremely anxious, fearing
that if the present attack should not be soon checked, she might
entirely lose the use of her hands and arms.

Instructed by the preceding case, similar means were here recommended.
Leeches, stimulating fomentations, and a blister, which was made for
sometime to yield a purulent discharge, were applied over the cervical
vertebrae; and in the course of a very few days the pain was entirely
removed. It is regretted that no farther information, as to the
progress of this case, could be obtained.

On meeting with these two cases, it was thought that it might not be
improbable that attacks of this kind, considered at the time merely as
rheumatic affections, might lay the foundation of this lamentable
disease, which might manifest itself at some distant period, when the
circumstance in which it had originated, had, perhaps, almost escaped
the memory. Indeed when it is considered that neither in the ordinary
cases of Palsy of the lower extremities, proceeding from diseased
spine, nor in cases of injured medulla from fractured vertebrae, any of
the peculiar symptoms of this disease are observable, we necessarily
doubt as to the probability of its being the direct effect of any
sudden injury. But taking all circumstanc