mployed
with success: and even, if unfortunately deferred to a later period,
they might then arrest the farther progress of the disease, although
the removing of the effects already produced, might be hardly to be
expected.

From a review of the changes which had taken place in the case of
Count de Lordat, it seems as if we were able to trace the order and
mode in which the morbid changes may proceed in this disease. From any
occasional cause, the thecal ligament, the membranes, or the medulla
itself, may pass into the state of simple excitement or irritation,
which may be gradually succeeded by such a local afflux and
determination of blood into the minute vessels, as may terminate in
actual but slow inflammation. The result of this would be a
thickening of the theca, or membranes, and perhaps an increase in the
volume of the medulla itself, which would gradually occasion such a
degree of pressure against the sides of the unyielding canal, as must
eventually intercept the influence of the brain upon the inferior
portion of the medullary column, and upon the parts on which the
nerves of this portion are disposed.

From this review, and assuming that the morbid changes in this disease
may not be widely dissimilar from those which occurred in the case of
Count de Lordat, the chance of relief from the proposed mode of
treatment may appear to be sufficient to warrant its trial.

In such a case then, at whatever period of the disease it might be
proposed to attempt the cure, blood should be first taken from the
upper part of the neck, unless contra-i(n)dicated by any particul(ar)
circumstance. After which vesicatories should be applied to the (sa)me
part, and a purulent discharge obtained by appropriate use of the
Sabine Liniment; having recourse to the application of a fresh
blister, when from the diminution of the discharging surface, pus is
not secreted in a sufficient quantity. Should the blisters be found
too inconvenient, or a sufficient quantity of discharge not be
obtained thereby, an issue of at least an inch and a half in length
might be established on each side of the vertebral columna, in its
superior part. These, it is presumed, would be best formed with
caustic, and kept open with any proper substance[16].

[Footnote 16: Cork, which has been hitherto neglected,
appears to be very appropriate to this purpose. It possesses
lightness, softness, elasticity and sufficient firmness; and
is also