ck, and from this date to
that of his admission had been under the care of a local physician
without any sign of improvement. At the time of his admission he
weighed but 98 pounds, his weight previous to the injury being 145. He
exhibited entire loss of motion in the lower extremities, with the
exception of very slight movement in the toes of the left foot;
sensation was almost nil up to the hips, above which it was normal; he
had complete retention of urine, with a severe cystitis. His tongue was
heavily coated, the bowels constipated, and there was marked anorexia,
with considerable anemia. His temperature varied from 99 degrees to 100
degrees in the morning, and from 101 degrees to 103 degrees in the
evening. The time which had elapsed since the accident precluded any
attempt at reduction, and his anemic condition would not warrant a more
radical method.

"He was put on light, nourishing diet, iron and strychnin were given
internally, and electricity was applied to the lower extremities every
other day; the cystitis was treated by irrigating the bladder each day
with Thiersch's solution. By August his appetite and general condition
were much improved, and his weight had increased to 125 pounds, his
temperature being 99 degrees or less each morning, and seldom as high
as 100 degrees at night. The cystitis had entirely disappeared, and he
was able, with some effort, to pass his urine without the aid of a
catheter. Sensation in both extremities had slightly improved, and he
was able to slightly move the toes of the right foot. This being his
condition, an operation was proposed as the only means of further and
permanent improvement, and to this he eagerly consented, and,
accordingly, on the 25th of August, the 9th dorsal vertebra was
trephined.

"The cord was found to be compressed and greatly congested, but there
was no evidence of laceration. The laminae and spinous processes of the
8th and 9th dorsal vertebrae were cut away, thus relieving all pressure
on the cord; the wound was drained and sutured, and a plaster-of-Paris
jacket applied, a hole being cut out over the wound for the purpose of
changing the dressing when necessary. By September 1st union was
perfect, and for the next month the patient remained in excellent
condition, but without any sign of improvement as to sensation and
motion. Early in October he was able to slightly move both legs, and
had full control of urination; from this time on his paralysis