from scrofulous ulceration of the ankle joint, there appeared (after some exposure to cold) a gradual inability to rotate or to perform the nodding motions of the head upon the atlas. It was considered, in the first instance, to be nothing more than a stiff neck, and was treated, accordingly, with liniments, warm fomentations, &c. The symptoms, however, gradually assumed a more aggravated form, and on pressing the spinous processes of the third and fourth cervical vertebræ, pain was felt, and on the right side of the neck a considerable prominence was visible The neck inclined to the right side, and the chin, at one time, almost touched the centre of the right clavicle. The treatment consisted in the application of leeches to the back of the neck, followed by emollient cataplasms, and subsequently a succession of blisters. By long perseverance in this plan, some diminution of the pain and swelling of the integuments occurred, and the rotatory and nodding motions of the head were performed with greater facility. In this case there was no pain in any other portion of the spinal column, but the morbid process seemed confined to the cervical vertebræ Whether there is any disease in the osseous structure of the vertebræ, or only in the intervertebral cartilages, it is difficult to decide, but the tout ensemble of the symptoms, and other concomitant circumstances, induced us to refer the development of the disease in so uncommon a form, to the predominance of a strumous diathesis. The insertion of a seton, aided by the external, as well as internal, use of the hydriodate of potass, has latterly been of considerable service; but the most fortunate termination
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