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ollowed movements of the upper extremities。 Tenderness and hyperesthesia over the spinous processes of the 4th； 5th； and 6th cervical vertebrae led to the application of the thermocautery； which； in conjunction with the administration of ergot and bromide； was attended with marked benefit； though not by complete cure。 Barlow mentions a man with a rheumatic affection of the shoulder who hiccoughed when he moved his joints。 Barlow also recites a case of hiccough which was caused by pressure on the cicatrix of a wound in the left hand。
Beilby reports a peculiar case in a girl of seventeen who suffered an anomalous affection of the respiratory muscle； producing a sound like a cough； but shriller； almost resembling a howl。 It was repeated every five or six seconds during the whole of the waking moments； and subsided during sleep。 Under rest and free purgation the patient recovered； but the paroxysms continued during prolonged intervals； and in the last six years they only lasted from twenty…four to forty…eight hours。
Parker reports four rebellious cases of singultus successfully treated by dry cups applied to the abdomen。 In each case it was necessary to repeat the operation after two hours； but recovery was then rapid。 Tatevosoff reports a brilliant cure in a patient with chronic chest trouble； by the use of common snuff； enough being given several times to induce lively sneezing。 Griswold records a successful treatment of one case in a man of fifty； occurring after a debauch； by the administration of glonoin； 1/150 of a grain every three hours。 Heidenhain records a very severe and prolonged case caused； as shown later at the operation and postmortem examination； by carcinoma of the pancreas。 The spasms were greatly relieved by cocain administered by the mouth； as much as 15 grains being given in twelve hours。 Laborde and Lepine report the case of a young girl who was relieved of an obstinate case of hiccough lasting four days by traction on her tongue。 After the tongue had been held out of the mouth for a few minutes the hiccoughs ceased。 Laborde referred to two cases of a similar character reported by Viand。
Anomalous Sneezing。In the olden times sneezing was considered a good omen； and was regarded as a sacred sign by nearly all of the ancient peoples。 This feeling of reverence was already ancient in the days of Homer。 Aristotle inquired into the nature and origin of the superstition； somewhat profanely wondering why sneezing had been deified rather than coughing。 The Greeks traced the origin of the sacred regard for sneezing to the days of Prometheus； who blessed his man of clay when he sneezed。 According to Seguin the rabbinical account says that only through Jacob's struggle with the angel did sneezing cease to be an act fatal to man。 Not only in Greece and Rome was sneezing revered； but also by races in Asia and Africa； and even by the Mexicans of remote times。 Xenophon speaks of the reverence as to sneezing； in the court of the King of Persia。 In Mesopotamia and some of the African towns the populace rejoiced when the monarch sneezed。 In the present day we frequently hear 〃God bless you〃 addressed to persons who have just sneezed； a perpetuation of a custom quite universal in the time of Gregory the Great； in whose time； at a certain season； the air was filled with an unwholesome vapor or malaria which so affected the people that those who sneezed were at once stricken with death…agonies。 In this strait the pontiff is said to have devised a form of prayer to be uttered when the paroxysm was seen to be coming on； and which； it was hoped； would avert the stroke of the death…angel。
There are some curious cases of anomalous sneezing on record； some of which are possibly due to affections akin to our present 〃hay fever；〃 while others are due to causes beyond our comprehension。 The Ephemerides records a paroxysm of continual sneezing lasting thirty days。 Bonet； Lancisi； Fabricius Hildanus； and other older observers speak of sneezing to death。 Morgagni mentions death from congestion of the vasa cerebri caused by sneezing。 The Ephemerides records an instance of prolonged sneezing which was distinctly hereditary。
Ellison makes an inquiry for treatment of a case of sneezing in a white child of ten。 The sneezing started without apparent cause and would continue 20 or 30 times； or until the child was exhausted； and then stop for a half or one minute； only to relapse again。 Beilby speaks of a boy of thirteen who suffered constant sneezing （from one to six times a minute） for one month。 Only during sleep was there any relief。 The patient recovered under treatment consisting of active leeching； purgation； and blisters applied behind the ear； together with the application of olive oil to the nostrils。
Lee reports a remarkable case of yawning followed by sneezing in a girl of fifteen who； just before； had a tooth removed without difficulty。 Half an hour afterward yawning began and continued for five weeks continuously。 There was no pain； no illness； and she seemed amused at her condition。 There was no derangement of the sexual or other organs and no account of an hysteric spasm。 Potassium bromid and belladonna were administered for a few days with negative results； when the attacks of yawning suddenly turned to sneezing。 One paroxysm followed another with scarcely an interval for speech。 She was chloroformed once and the sneezing ceased； but was more violent on recovery therefrom。 Ammonium bromid in half…drachm doses； with rest in bed for psychologic reasons； checked the sneezing。 Woakes presented a paper on what he designated 〃ear…sneezing；〃 due to the caking of cerumen in one ear。 Irritation of the auricular branch of the vagus was produced； whence an impression was propagated to the lungs through the pulmonary branches of the vagus。 Yawning was caused through implication of the third division of the 5th nerve； sneezing following from reflex implication of the spinal nerves of respiration； the lungs being full of air at the time of yawning。 Woakes also speaks of 〃ear…giddiness〃 and offers a new associate symptomsuperficial congestion of the hands and forearm。
A case of anomalous sneezing immediately prior to sexual intercourse is mentioned on page 511。
Hemophilia is an hereditary； constitutional fault； characterized by a tendency to uncontrollable bleeding； either spontaneous or from slight wounds。 It is sometimes associated with a form of arthritis （Ogler）。 This hemorrhagic diathesis has been known for many years； and the fact that there were some persons who showed a peculiar tendency to bleed after wounds of a trifling nature is recorded in some of the earliest medical literature。 Only recently； however； through the writings of Buel； Otto； Hay； Coates； and others； has the hereditary nature of the malady and its curious mode of transmission through the female line been known。 As a rule the mother of a hemophile is not a 〃bleeder〃 herself； but is the daughter of one。 The daughters of a hemophile； though healthy and free from any tendency themselves； are almost certain to transmit the disposition to the male offspring。 The condition generally appears after some slight injury in the first two years of life； but must be