Carboneum Sulfuratum

Authorities. 24 to 47, A. Delpech, Nouv. Recherches sur Intoxication Special que determine le Suture de Carbone ITndustrie du Caoutcbouc Souffle, Paris, 1863, twenty-four new cases among workers in rubber factories; 48, J. B. Tavern, These de Intoxication par le Suture de Carbone, Paris, 1865, a woman worker in a rubber factory ; 49, same, case of a man ; 50 to 52, Gordon, These de Intoxication par le Suture de Carbone, Pari.s, 1867, effects on men ; 53 to 55, Abel March, These de Intoxication par le Suture de Carbone, Paris, 1876; (56 and 57, Berridge. Collection in Appendix in Brit. Journ. of Horn.); 56, Wutzer and Pellengham, Journ. de Chim. (Lancet, 1830-1 (2), 329), general effects; 57, Dr. Geo. Venison, Med. Times and Gaz., 1868 (2), 77, effects of external application; 58, Dr. Davidson, ibid., 1878 (2), 350, W. G., set. thirty-three years, took a quantity.

Mind

Delirium, with incoherent talking

On two occasions he had nervous attacks analogous to hysteria; the face was affected by convulsive movements, but he did not lose consciousness; laughed involuntarily and irrepressibly

At one time during the night he seemed to be surrounded by enemies; persons were coming to harm him; he heard imaginary voices and saw strange objects; this continued for four days, and he was taken to the hospital

Hallucinations of vision and hearing, he seemed to see splendid spectacles of carriages, with magnificent objects, talked of the emperor, of money, and of grandeur, often incoherently

Violent cerebral excitement, so that he had to be put into a straitjacket

It seems to him as if he were constantly in a state of iutoxicaj-jyu

Beat his wife

Violent and irascible

Incessant desire to prattle and laugh without cause

Excessive gayety, followed by sadness and moroseness

At first he was excessively gay, but with the progress of the poisoning he became extremely sad, and lost all energy

Exaggerated gayety, changing to profound sadness and absolute indifference

Screaming,'A

Extreme loquacity

Excessive loquacity, but he cannot think of the words he wishes to use ; he searches in vain for an expression, and an attempt to speak results in stainraering,^h

The patient was sad, preoccupied

Preoccupation, with sad, melancholy ideas, indifferent to all about her

When interrogated he replied by monosyllables or by signs with the hands; his intellect was greatly impaired, he sought solitude, and like a child was occupied by the objects immediately about him; when not amused he was inactive, seemed distrait

Unable to fix the attention

Oppression

Profound sadness,’®*’, etc.

Profound sadness> with irritable desire to weep

His mood is completely changed ; there is now profound sadness, with excessive impatience ; at times absolute indifference gives place to the most violent anger, when he manifests great energy

Wept with great facility

Irritable

Great irritability

Excessive irritability, intolerance of contradiction

Became exceedingly irritable and violent

He became extremely irritable, violent, and intolerant of contradiction

His character changed entirely, at first he became irritable, afterward sombre and sad

Complete indifference

Memory profoundly impaired '’®.

This man, usually intellectual, has now lost all desire for study; his imagination is wholly occupied with the most absurd reveries

Unable to find words to express his thoughts

Incoherence of ideas

Loss of memory,’'’’®, etc.

Progressive loss of memory

Weak memory, especially for recent events

Loss of memory, with difficulty in expressing ideas

His memory became defective, and he found it very difficult to formulate his ideas, or express them by words

Complete loss of memory

Stupid; cannot fix his thoughts upon any object, cannot express his thoughts

Loss of consciousness, lasting several minutes

On two occasions the patient fell suddenly with loss of consciousness

One day he fell down, lost consciousness, had an epileptic attack, followed by paralysis of the limbs

Complete loss of consciousness at one time

Head p. 446

Vertigo,'’®”, etc.

Intense vertigo

Frequent intense vertigo

Attacks of vertigo, so that he could scarcely stand, with partial loss of consciousness

Sudden vertigo, during which he nearly fell to the ground, and had to betaken home

Intense vertigo, with loss of smell; vision was attected in that all objects seem larger than they really are

Violent vertigo, reeling so that he was obliged to stop at almost every step

Heaviness of the head

Headache '’®, etc.

Intense headache,’®*’, etc.

Most intense headache, with a sensation of painful pressure in the temples (first day)

Violent headache, with distressing throbbing at the temples, aggravated towards evening

Violent intense headache, characterized by compressing pain from one temple to the other, associated with vertigo and great agitation

Constrictive headache

Compressing headache

Headache like the painful pressure of a tight cap

Very intense compressible headache, especially in the root of the nose, and in the temples ; it consisted of a sensation of most violent constriction in the temples, without throbbing; it was associated with extreme stiffness of the neck ; this painful stiffness, especially over the posterior portion of the neck, was accompanied by a local sensation of very great coldness; the patient experienced great pain in turning the head; the pain in the neck was associated with very distressing ver-

Sensation as if a band of iron were compressing the head,^f

Violent intermittent pain in the head and frontal region

Lancinating pain in the head

Intense frontal headache

Violent frontal headache, especially in the evening, with vertigo and ringing in the ears

Temporal headache

Compressing headache through the temples

Violent compressive headache through the temples, aggravated hy walking, so that each step caused a violent, painful shock in the head

Intense compressive headache, occupying the temples and occiput

Violent pain in the right side of the head

At one time was seized with violent inflammation of the right eye, kerato-iritis, treated hy Calomel and Atropia

Eyes fixed, without expression ; pupils dilated, especially the left, but very sluggish ; the patient, however, coidd not see with the right eye as with the left; the ophthalmoscope showed in the former very slender retinal veins, extravasations of blood into the vitreous, extremely fine filaments and points floating in the vitreous

Ophthalmoscopic examination showed the papillae very pale and deeply excavated, after several months

Progressive atrophy of the ophthalmic papilla3 of the left eye

Pupils mobile, moderately dilated; the field of vision normal; ophthalmoscopic examination revealed a slight paleness of the internal segment of the optic nerve of both sides ; there was marked excavation of the papillas, which were less transparent than normal; the optic nerve had the appearance of a smoked glass

Pupils sluggish, rather dilated. Ophthalmoscopic examination of the fundus of the eye showed depigmentation and some dilatation of the retinal veins

Pupil incompletely dilated (he had lost his right eye by getting a drop of the vulcanizing mixture into it, followed by intense pain and ophthalmia, and formation of a staphyloma of the cornea and iris)

Sensation of heat and pricking in the eyes

Marked anaesthesia of the cornea, which was insensible to pricking with a pin

Marked anaesthesia of the cornea

Lids. Lids affected by spasmodic trembling

Pupil. Pupils dilated

Vision. Vision at first very clear

Great susceptibility to light

Dimness of vision

Mist before the eyes

Vision dim, as through a veil

Vision dim, as though objects were enveloped in a mist

Amblyopia ; all objects seem covered with a mist

Reading was impossible, for though the left eye distinguished objects, the right seemed covered with a mist

Vision became dim. Permanent and i)progressive alteration of vision ; pupils contracted, insensible, sensitive to Belladonna; the ophthalmoscope showed that the optic was congested

Vision became remarkably affected ; there was diminished clearness of objects, which seemed enveloped in mist; on attempting to read the letters moved and trembled ; the use of a glass was of no avail

Vision is distinct for a limited distance, but beyond that everything is enveloped in a mist

Vision impaired, so that it was difficult to distinguish objects

Vision became disturbed ; a portion of the field of vision was obscured, so that he no longer saw the concluding letters

Vision feeble, was unable to read the names of the streets

Vision impaired ; all objects seemed to tremble

Tremulous vision ; all objects seem enveloped in mist

Difficulty in fixing the vision upon any ob-

Loss of vision of the right eye

Vision completely lost

Double vision

Eyes p. 447

Very painful pricking in the external meatus auditorium

Impaired hearing

Hearing very much impaired; it seems as though something were stuffed into the ears

Hearing in the left ear entirely lost

Ringing in the ears/®.

Insupportable tinkling in the ears

Nose p. 448

Profuse bleeding of the nose at times

Pain in the nasal fossae, as though he had inhaled Sulphuric acid

Impaired smell

At one time his face became very red, but soon afterwards was very pale

He has the aspect of astonishment, with hesitating speech and loss of memory

Countenance expressive of the most profound sadness

Convulsive movements of the lips,®l

The lips were stith/b

Mouth p. 448

Stiffness of the tongue

Complete paralysis of the tongue

Salivation

Constant desire to spit

Constant salivation

Salivation, with constant desire to spit

Constant spitting on account of excessive secretion of saliva

Taste impaired

Difficult speech

Speech became embarrassed

It was with difficulty that he could articulate his words, it seemed difficult to move the tongue

Extreme difficulty in expressing his ideas, the patient said his tongue would not work

Experienced great difficulty in articulating words, because he could not move his tongue; the tongue seemed rigid and awkward, causing a kind of stammering

Loss of power of expressing his ideas; his tongue seemed to refuse its office

Stool p. 448

Increased appetite

Appetite increased, digestion difficult, irregular, with colic, vomiting, and congestion

Enormous and insatiable appetite

Appetite ravenous

Enormous a})petite and voracious eating

Ravenous appetite; the patient said lie could eat all day long

Marked diminution of appetite

Appetite very irregular

Complete loss of appetite

Anorexia without vomiting

Great thirst

Great desire to drink

Constant nausea,®k

Nausea without vomiting

Vomiting

Vomiting of food and glairy mucus

Violent vomiting at once on taking food

Acute pains in the stomach

Frequent cramps in the stomach

Abdomen p. 448

Fetid flatus

Profuse fetid intestinal flatus

Colic

Frequent colic

Violent colic

Violent colic and diarrhoea for three months

Very acute pain in the groin

Stool p. 448

Profuse diarrhoea

Fetid diarrhoea

Constant fetid diarrhoea

Diarrhoea with colic

Frequent diarrhoea, with sensation of smarting in the anus

Alternations of constipation and diarrhoea

Intense constipation

Stool and Anus p. 448

Intense pain in the kidneys

Violent cutting in the urethra during micturition

Tenesmus of the bladder and frequent urgent efforts to urinate, and emission of two or three drops at a time

Micturition slow and painful

Micturition, associated with cutting pain in the urethra

Micturition painful, accompanied by acute burning pain

Micturition excessively painful, with tenesmus and frequent desii-e to urinate ; urine bloody

Smarting during micturition

Frequent eflints to urinate; the urine was passed giiitutim, accompanied by burning in the urethra, and tenesmus of the neck of the bladder

Urine highly colored

Urine turbid

Urine pale and turbid

Urine slightly albuminous, very red and turbid

Urine red, containing an abundance of carbonate and phosphate of lime

Sexual Organs p. 448

Erections difficult, the patient says he reaches no result in five times

The testicles are very small

Diminished size of the testicles, with diminished sensation on pressure

Testicles not painful to pressure

Sexual excitement

Excessive sexual excite-

Excessive sexual excitement, constant fatiguing erections giving place speedily to complete iinpoteucy

Sexual excitement sometimes amounting to the greatest intensity ; at night in particular, he was often taken with veritable rage, during which he had coition with real fury

Sexual excitement at first, followed after a time by complete loss of power; two or three times his wife became pregnant, but miscarried

He became very amorous; erections, however, were seldom, coition much too long, and ejaculation short and incomplete

The sexual appetite at first increased, but afterwards diminished, until there was complete absence of desire ; at times an incomplete erection resulted in indefinite coition without emission ; or at times an ejaculation was obtained with great difficulty, but was very profuse

Sexual excitement, with loss of power

Sexual excitement after a time gave place to complete indifference,®®®’, etc.

At first sexual instincts were very much excited, but afterwards they disappeared, and at last there was complete impotency

Complete loss of sexual power

Sensation as though the genital organs were completely chilled

Symptoms of uterine catarrh

Profuse menstruation

Menses arrested ; at the same time she became very large, and had the appearance of being pregnant; after awhile she was seized with violent haemorrhage, which lasted six months, and was only arrested b}’the use of ergotin,®®.t

All sexual sensation entirely disappeared; there was complete indifference to her husband

Respiratory Organs p. 449

Voice feeble

Deep bass voice

During the last two months the sounds of his voice became altered in tone

Tormenting cough and irritation of the bronchi

Breath fetid

Very great difficulty of respiration on ascending stairs

Prolonged expiration

The form of the chest was not at all altered, but expiration was more prolonged than normal

Constant depression of breath

Gets out of breath easily

Chest p. 449

Auscultation of the lungs showed prolonged expiration over the posterior portion

Some emphysema of the lungs

Heart and Pulse p. 449

The murmur of the first sound of the heart extended along the great vessels

The volume of the heart was normal, but with the first sound there was a prolonged murmur, which extended along the vessels of the neck

Slight murmur of the first sound of the heart,®’.t

Anaemic murmur of the heart

Anaemic murmur in the large vessels

It excites powerfully the activity of the heart and arterial system. Its internal use causes acceleration of the pulse, increased heat, and sanguineous congestion towards the skin and genito-urinary organs. The next remarkable secondary symptoms are abundant diaphoresis, increase of the urinary secretion and of the menstrual discharge

Palpitation

Violent palpitation

Pulse moderately accelerated

Pulse feeble, compressible

Neck and Back p. 449

Pain and tension in the nape of the neck, followed by development of anthrax, which made rapid progress, was arrested by crucial incision, followed by extremely profuse su[)duration ; this was followed by improvement and complete cure of the paralysis and general condition

Pains in the back

Pains in the loins

Upper Extremities p. 449

Trembling of the limbs

Trembling of all the

-}• Miscarriii<?es are frequent among the women who work in rubber factories.

J A short time afterwards the patient died from the rupture of a small aneurism of the aorta. limb?, especially of the right side

Rigidity of the limbs/

Rigidity of the limbs; this rigidity made rapid progress, involving all the principal articulations of the limbs

INIarked rigidity and pains in the joints

The ti|)s of the fingers and toes became rigid and insensible

Stiffness of the limbs

Pronounced paraplegia, so that the limbs would not support the body

Paralysis and atrophy of the extensor muscles

Feebleness of the limbs

Walking was difficult; it was possible to stand upon the left leg with support of the hands, but not upon the right; while in bed the movements of the lower extremities were slow but perfect: motility of the hands was impaired, the fingers were in a state of semiflexion with contraction, but he was unable to extend them without a feeling of stiffne.«s; attempts to grasp anything caused pain

Pains in the limbs,®® ’®. •

Deepseated pains in the limbs, apparently in the bones and in the muscles

Deepseated pains in the limbs

Violent pains in the muscles of the limbs

Fulgurating pains and sensations as of girdles about the limbs and body

Very acute pains in the limbs, especially in the thick muscular portions, associated with cramps, especially in the lower extremities and in the feet

Extremely acute pains, sudden, lightninglike, in the limbs, aggravated by pressure; these flashes of pain accompanied the cramps; at night the intensity of the pains rendered sleep impossible

Cramps in the extremities

Cramps in the right leg and arm

Frequent desire to stretch the limbs

Limbs feel tremulous

Very peculiar and pronounced sensation of prickling in the extremities

Very marked numbness of the extremities

Loss of sensibility coincident with very acute pains in the articulations and along the limbs, aggravated by movement

Superior Extremities p. 450

The upper extremities were feeble ; the pressure of the hand was diminished in force

Terrible pains in the upper extremities, especially at night

Very acute pains in the upper extremities, especially in the shoulder-joints

Anaesthesia extended over the upper limbs into the thorax

Marked anesthesia of the arms and hands

Prickling and tingling in the arms

Extreme rigidity of the hands

Rigidity or insensibility of the hand

The hands became rigid and contracted

While lying in bed, the hands were habitually in a state of semiflexion, and could not be completely extended

The hands became rigid, painful, awkward ; extension and flexion were equally difficult

Rigidity and awkwardness of the hands

Diminished motility and sensibility of the right hand

Sensation on the backs of the hands very obtuse; the hands felt as if covered with a glove; the right was worse than the left

Painful prickling and numbness of the hands

Anaesthesia, numbness, and feebleness of the hands

The fingers became swollen, insensible, and difficult to flex or extend

The fingers seemed rigid and insensible ; she could not button her clothes

The index finger was partially paralyzed with cramps

The digits became insensible, stiff, and awkward, unable to take hold of small objects

Numbness of the digits, so that it is difficult to take hold of small objects

Insensibility and awkwardness of the fingers

Inferior Extremities p. 450

Trembling of tbe lower extremities

Gait hesitating

Gait unsteady

Great feebleness of the lower extremities, so that walking was A-^ery difficult

Walking became very difficult

While lying down he could move the lower limbs with considerable energy, but on attempting to rise found it very difficult to move them, especially the left

Walking very difficult, the left limb being more feeble than the right/

Loss of power in the lower extremities,A

Great loss of power of the lower extremities

Very great rigidity of the lower extremities

Tormented by cramps of the thighs and soles, often lasting half an hour

Very painful cramps in the thighs and feet,'A

Pains in the lower extremities,™

Prickling in the lower extremities

Sensibility of the lower limbs impaired ; the hands, forearms, and arras, especially at the insertion of the deltoid ; this loss of sensibility is not found on the body or in the face

Diminished sensibility of the lower extremities,™.

Complete insensibility of the lower extremities

At one spot on the upper portion of the let leg there is complete insensibility ; over the whole extremity sensibility is impaired

Rigidity of the knees,™.

Contractions and pain in the muscles of the calves, especially of the right,™.

Cramps in the calves and legs,™.

Oedema of the ankles,™.

Insensibility of the skin of the feet, so that he did not know when the feet touched the ground

Generalities p. 451

Pale and emaciated,'™.

Great awkwardness

The patient is very awkward in her movements,™.

Constant twitching of the muscles

Habitual trembling, often lasting twenty-four hours, in a very aggravated form,'™.

Trembling of the whole body, especially of the upper extremities

Total Io.«s of power,™.

Loss of motion and sensibility of the whole right side of the body,*k

Rigidity of the muscles

analgesia of the right side, the patient could be pinched freely without sensation

Hemiplegia became very pronounced ; sensibility of the right side of the body very slight; muscular contractility completely lost, but the paralysis was associated with a very pronounced degree of contraction, especially of the arm ; every effort to extend it caused pain

Suddenly one day the face became very much congested, covered with perspiration, expression anxious, uncertain, the whole body covered with sweat, the hands trembled, pulse 120, hard ; there were profuse diarrhoea, intense headache, vertigo, erratic pains, great muscular feebleness rendering the gait unsteady, very dim vision, rigidity of the hands, with prickling and diminished sensibility and very pronounced oppression of the chest,™.

On admission was lying on chair with all the muscles relaxed, face pale and covered with clammy sweat; lips blue and moist, with saliva and frothy mucus. Eyelids closed ; conjunctiva slightly sensitive to touch ; pupils dilated and insensible to light. Breathing deep and laborious, almost stertorous; and the breath had a very strong odor of bisulphide of carbon. Pulse 110, regular, but very weak. On the next day, giddiness and slight headache

Loss of ail energy

Extreme lassitude

Great feebleness,'™ ™ ®®.

Easily fatigued,'™.-General weakness

Great muscular feebleness

General muscular weakness, with a certain incoordination of the movements, like motor ataxia,™.

Tendency to faintness,™.

Partial syncope, with convulsive movements of the extremities

Syncope, in which he fell to the ground, lost consciousness, and did not recover for a long time,™.-Cutaneous hyperesthesia over the whole body except the fingers and toes

She seemed to herself enormously swollen over her whole body,™.

General pains, especially acute in the knees

Cramps in the muscles

The administration of Phosphorus seems to restore nearly all the cases; it seems almost a specific for this poisoning; but often at first there is an aggravation from very small doses,'™.

The patient got out of the house, took a long walk, and returned home in complete disorder

Skin p. 451

After it has been applied externally for a minute or two, a sensation is felt as if several leeches were biting the part, and after the lapse of two to four minutes more the smarting and pain become rather severe. It is very seldom that any redness of skin is produced

Development of a very large number of furuncles

Very acute irritation of the skin, itching and smarting over the chest, thighs, and especially on the scrotum,'''h

Very violent itching of the scrotum

Formication of the limbs,“h

Painful prickling and formication over the hands and feet

Sleep p. 452

Constant sleepiness; often during the night sleep disturbed by sad dreams

Sleepy during the day, sleepless during the night

Sleep prolonged and deep

Sleep heavy and profound

Sleep profound, it was difficult to awaken him

lusomnia ", etc.

Alternations of constant sleepiness and wakefulness

Sleep restless, interrupted by starts

Sleep disturbed by starting and constant waking; in the morning he was sleepy and difficult to rouse

Sleeplessness or sleep with distressing dreams,'

Sleep restless, tormented by distressing dreams

Sleep interrupted by dreams

Sad, fatiguing dreams, with a kind of hallucination that she was swollen and enormously distended

Terrible dreams of crimes committed under her eyes

Distressing dreams during sleep

Fever p. 452

Sensation of general coldness, especially over the lower limbs

Intense chilliness at night, followed by heat and profuse sweat

F frequent horripilation

Great sensitiveness to cold

Fingers cold, rigid, with little sensation

Sensation of icy coldness in the lower extremities

Habitual coldness of the feet

Icy coldness of the feet and lower extremities

Very profuse sweat

Habitual cold sweats

Additions: Introduction p. 653

Authority. 59, T. Wilson, M. R. C. S., Brit. Journ. of Horn., vol. xvii, p. 274, effects of vapor.

April 15th, 1857. In good health, aged thirty-eight years. Yesterday I Avas exposed in a small room to the vapor of the Sulphuret of carbon, for half an hour, in the evening. To-day, in the afternoon, pain commenced suddenly in the right lower eyelid, as if bruised, first observed on touching the eyelid, and near to the outer angle; after a short time the same bruised feel in the upper eyelid came on, over the region of the lachrymal gland ; the globe of the eye at the upper and inner part has the same bruised feeling; the pains are all aggravated by movement of the eye or lids, also by pressure; the eyelids of the same eye feel as if swollen, but are not so ; the conjunctiva of the lower eyelid redder than usual, at the outer margin of the lid ; sensation as if a stye would begin. Humming noise in left ear. The above feelings were all new to me, never having had anything of the sort before.

16th. The same lower eyelid hot, painful, sore, slightly swelled, rather red near the outer angle of the eyelid.

17th. Since yesterday, continued humming in left ear, extending to the back of the head ; stye forming on right lower eyelid, hot and painful.

18th. Loud humming, like wind in the distance; left ear. Lower eyelid very red and swollen, more so at the outer edge; punctured the stye with a lancet, a small quantity of muco-purulent discharge came away. When talking, I feel obliged to raise the voice on account of the loudness of the noise in the ear.

In the evening and during the night, always a feeling of fulness at back of head, with humming noise there; these sensations gone in the morning.

Yesterday took Pul. 3d without relief.

Drowsy day aud night ever since exposed to the vapor of the Sulphuret of carbon.

Yesterday after dinner, and during dinner, feeling of deafness in the left ear, as if obstructed by a thick substance.

19th. Noise continues, worse after food ; left ear rather deaf, and feels obstructed. Lower eyelid discharges yellow thick pus; this morning not so painful.

Took tincture of Belladonna 1st dil., a few drops yesterday, with slight relief to the noise in the ear; it returned, however, in the evening as bad as ever, with oppression at the back of the head. To-day took a few drops of tincture of Belladonna jV^h, without the slightest relief

20th. Noise in the ear not quite so loud. Vertigo this morning felt at the back of the head. Severe laryngeal, tracheal, and bronchial cough came on yesterday, continues to day, with soreness in the chest; expectoration of thick mucus this morning.

Took Merc, sol., 3d trit., gr. ii, aud Phos. 3d, three hours afterwards.

22d. Cough continues, but not so severe ; sneezing, running at the nose, with profuse discharge of thick mucus, lachrymation, aud headache in the forehead aud back part. Headache worse yesterday, this evening nearly gone. Noise in the ear much less, but still continuing slightly. Symptoms of the last two days like influenza.

Took Merc, viv., 2d trit.; Kali hydr., 1st dil., gtt. iv ; Hep. sul., 3d trit.; one dose of each at various periods. Eyelid about well.

27th. No noise in the ear to-day, except a little before rising in the morning. No deafness ; this is the first day since the noise in the ear commenced that I have been free from it. Still running at the nose, and cough first thing in the morning, getting easier by bedtime; ceasing entirely when lying; mucous rattle in u[)per part of left lung a few inches above the nipple. The right nostril bled a little yesterday and the daybefore.

30th. Rather loud noise in left ear, like gusts of wind through a funnel or hollow tube. Influenza continues; herpetic eruption on the upper lij).

May 3d. Noise in left ear has continued since last date, more intermitting, and not so loud. Cough, with expectoration of mucus. Mucous rale in the upper part of the left lung on first waking in the morning.

Took one dose of tincture of Bell., m. 1st, to day.

12th. Noise in left ear continues, other symptoms about gone. Very lowspirited from the first symptoms till yesterday.

20th. Noise in left ear, but less severe.

25th. Noise in the ear about gone.

28th. Another stye forming on right under eyelid. Noise in the ear heard slightly at times.

June 14th. Occasionally noise in the left ear.

July 5th. Noise in left ear returned yesterday, it has continued at intervals ever since; same noise as before.

The left ear continued affected for some months after this time by the morbid sound, but less in degree, and it finally ceased altogether,^®.