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ciated as hot or cold, but merely as touch. Thus, water at 70" F. and water at 100° F.. were recognized as cool and warm, whereas a test tube filled with ice and one filled with boiling water could not be distinguished. As to his pain in the amputated hand, he said on the 19th: "'I still feel some pain in the fingers; it is really not a pain, but is more as if the hand were bound tight ; it feels entirely different from what it did for- merly; the stump feels sore, as if it were healing; I have no pain in the neck." On the 22nd he expressed himself as having " no pain whatever in the hand or fingers for the first time in seventeen years." On the 29th of December he complained of weak- ness in the femara tablets neck, of general lassitude (he had lost about purchase femara twelve pounds in femara mg weight); and of pain to the touch and pressure in the end of the stump over the bulbous buy femara online thickening. He had no pain in the hand or fingers. Sensory examinations were the same as on November 19th and 2pth. January 21, 1907: He had been in the country and had done well ; there was some soreness in the shoul- der, and severe soreness in the stump persisted un- changed. Of this he said : " If I had to, I could worry along with it the rest of my life, but I should hate generic femara to." There was no pain in the hand. All the psychic symp- toms previously described had disappeared : he no longer drea(^ed being left alone, did not feel like get- ting away from himself, and was anxious to go to work. The study of vasomotor changes was of course pre- cluded b}' the absence of the greater part of the ex- tremity ; no such changes were observable in the stump. A point of minor interest In the study of this case is the effect of heat upon the pulse and respiration, when applied directly to the cord. Here the pulse rate and the tension buy femara were directly increased by each application of the sort, and the respiratory move- ments were also decidedly increased thereby, both in strength and in frequency. It buy cheap femara is of interest to note that in Bennett's the cutting of each nerve root, purchase femara online lumbar and sacral, was immediately followed femara price by a sudden cessation of the pulse, which, however, almost immediately returned upon a little gentle pressure with a warm sponge. It would thus ap- pear from both these cases that the application of heat to the exposed cord, at any part, has a stimu- lating effect upon the heart's action. Greater interest, however, centres order femara online around the ef- fect upon sensation produced by the section of a large number of nerve roots. The first impression made femara cost by the sensory examination, forty-eight hours after the resection of all the posterior I'oots that go Aiifust:!. 10U7.] JACOBY: RESECTION OF VERVES. 197 to make up the brachial plexus, was one of astonish- ment at the small amount of sensory defect which could be demonstrated. Yet a moment's reflection showed us that it could not have, been otherwise, for while the fifth, sixth, seventh, and eighth cervical and the first dorsal roots had been resected, the parts available for ex- order femara amination were, in consequence of the amputation, reduced to those which are supplied by the fourth and fifth cervical and the second dorsal (Figs. 5 and 6 showing the line of amputation), and of these only the fifth cervical had been resected, thus for purposes of physiological study reducing the ques- tion to that of section of a single posterior root. Now. it is a well known fact that section of such a single root does not cause complete anaesthesia, but that this is produced only if the adjoining roots are also implicated. Sherrington has shown by experi- ments upon the monkey that the sensibility of a posterior dorsal root territory is dependent, not only upon that root, but also upon the adjacent upper and lower roots, and poSsibH' also upon more dis- tant ones. That this fact is directly applicable to man is shown by Case X of my table, cheap femara in which merely the eighth cervical was resected, and the only sensory change was a femara online transitory hypersesthesia of forty-eight hours' duration ; by Case V, in which, although three roots were resected, there was produced mere- ly a slight hyperzesthesia. which passed away in twenty-four hours ; and by McCosh's case, in which two roots were resected without any anaesthesia fol- lowing. In the case which we are now consider- ing there was in the entire area supplied by the fifth cervical root complete sensibility except over a small area in which the pain sense and limited tempera- ture sense were lost. •

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