ear; hence the movements of expression are regulated by it, they being associated with speech. This nerve, with the ninth and the spinal accessory, enable the mind to control the muscles of the face, tongue, and neck in all efforts to use the physical properties of the air respired, for the purpose of producing sound. The close relation of the portio dura to the portio mollis is but a repetition of the connection between the origins of the third and the optic already pointed out, and marks the tendency to unite the muscles associated in function with the organs of sense directing that function.

There was some reason for Bell's styling the above the superadded functions; while the original sense of touch regulates the ingress and egress of air, and of all substances which may modify or interfere with the respiratory process. Consequently the ganglionic portion of the fifth pair subserves this purpose in the passage of the air through the nostrils in ordinary inspiration and expiration, as well as in sneezing. In like manner, the par vagum, through its pharyngeal and superior laryngeal branches, regulates the passage of air through the throat and larynx; and by its lower branches, through all the ramifications of the bronchial tubes. All contractions of the windpipe arising from direct impressions on any part of its surface, whether from air, mucus, or any foreign substances, all reflected irritations, coughs, asthmas, etc., are through this medium; while its connection with the spinal cord renders it the sensitive nerve to call into exercise the external muscles of respiration. On the other hand, the spinal accessory, of which the inferior laryngeal are branches, renders the same muscles subservient to the voice, and is the connecting medium between the ear and those muscles.

The glosso-pharyngeal, instead of being what Dr. John Reid would have us believe, the sensitive nerve of the tongue and pharynx, is both sensitive and motor. It is the nerve of deglutition, and connects the surface on which the direct impressions of the food are made with the muscles necessary to that act. The pharyngeal branches of the par vagum, to which this office is assigned by him, serving to associate the pharynx in the respiratory and vocal movements regulated through the remaining branches of that nerve and the spinal accessory.

The hypoglossal nerve is distributed to the muscles of the tongue for the purpose of articulation; it connects these muscles with the ear, the organ of the guiding sensations. On the other hand, the

lingual is not only the gustatory and the common sensitive, but the motor nerve for direct impressions of both kinds; it is, therefore, the masticatory nerve of the tongue. By this arrangement alone can we understand how the tongue can be palsied to one of these functions only, or that the hypoglossal may be cut and it still be protruded at will.

I think it will be admitted that the outline above given is consistent and harmonious with physiological and pathological facts, and presents a contrast with the received doctrine in this respect. It also gives a meaning to certain anatomical facts which before were without significance. It was my intention to compare the phenomena of locomotor ataxia with these principles, in order to point out that it essentially consisted in a loss of power of regulating motions by the sense of touch, and that it was a matter of little consequence whether its anatomical seat was in the posterior. columns of the cord or in the cerebellum, as they both participate in that function. In the Medical News and Library for August, 1865, is a remarkable case of anaesthesia and analgesia of the left half of the body, in which the dependence of motion on sensation is strikingly illustrated, and to which I would refer as presenting in a single case that impairment of motor power in the pupil of the eye, corner of the mouth, and the tongue, characteristic of paralysis of the fifth nerve. Presenting, as it does, no less than six points either antagonistic to Bell's views or confirmatory of those now set forth, I am only prevented from copying it entire by having already exceeded the limits proposed to myself at the commencement of this paper.

HEALTH IN COUNTRY AND CITIES.

ILLUSTRATED BY TABLES OF THE DEATH-RATES, SICKNESS-RATES, ETC. ETC, IN COUNTRY AND CITIES.

BY

W. F. THOMS, M. D.,

NEW YORK.