self, and it had only come out when she could conceal it no longer, the arm having become useless. Supposing that, somehow, the first operation had been the cause of the cure, we repaired to the house as requested, and, after Dr. Peaslee had etherized her, I operated by stretching: the contracted muscles. I found the shoulder in much the same plight as the other had been three years before, though the muscles were not quite so rigid, and I could overcome them without much difficulty. But the shoulder-joint had been held in an immovable position so long that the articulating surfaces had become united by bands of fibrous adhesions in various places, and the snapping of these adhesions, as they were torn asunder when the arm was moved about in different directions, made reports which could be heard at a considerable distance. But the muscles were completely relaxed by the operation, motion was restored to the joint, and we congratulated ourselves on having made no mistake and having had a successful case this time. Thus she was left—Peaslee going to Europe, and I about my business. Just one month afterward I was requested to visit the lady. I found that she had been prostrated by the anæsthetic as before, but that her arm and shoulder were in exactly the same situation as before the operation. Not the slightest benefit had been experienced from it. The shoulder was drawn up and immovable, the arm was held firmly to the side, and that extremity was entirely helpless and useless.
It was evident that the mystery of the case had not been fathomed, and I requested her to come to my house so that I might study it. To this suggestion she readily assented, and for the next few weeks I was vainly striving to find remedies for a state of things which I could not comprehend, and to locate a disease which had no existence. At the end of a month, and after calling a well-known surgeon to my assistance without avail, I resolved to try another operation by force brisée. Laughing-gas was being used in minor operations at that time, and, as ether made her so very sick, I resolved to use the nitrous oxide. This was administered twice with an interval of four days, when the muscles relaxed, motion was restored to the shoulder-joint, and there has been no recurrence of the condition described during the intervening thirteen years. A case precisely similar to the foregoing was brought to me two years later.
Still under the impression that the force used in the former case had, in some mysterious manner, been the means of cure, and concluding that nitrous oxide was the most favorable anæsthetic, I set to work to cure this case according to such views. After seven entirely successful operations there was not the least improvement in my patient, and I concluded that I had again mistaken the case. I kept her under observation several months, attempting various means, experimentally, which were of no avail, when, on a careful review of this and many other similar cases, I at last came to the conclusion that the whole difficulty was mental and only mental. Having settled the question of