I have now under my care a gentleman who was sent to me by Sir James Paget. Five months ago, as the result of a stab which probably divided the supra-scapular and circumflex nerves; there was complete loss of power in the deltoid and supra and infra-spinatus muscles. Two months afterwards, when I first saw the patient, these muscles had almost completely wasted away. The electro-sensibility of the little muscular tissue that remained was greatly diminished, the contractility to faradism abolished, but that to the interrupted voltaic current from thirty cells of the BeckerMuirhead battery was retained. For the past two months I have daily applied the current from fifty cells; holding the sponge from the positive pole stationary upon the centre of the deltoid, and painting, as it were, every part of the affected muscles with the sponge from the negative pole for ten minutes. There has been a considerable return of power; the development of the wasted muscles is remarkable and the result of the treatment most satisfactory.

Duchenne strongly advocates faradization in the essential paralysis of infancy, a disease to which he has devoted much attention. Under the term "infantile paralysis" many different forms of paralysis are liable to be included, but the variety now to be considered has the following history. It is characterized chiefly by motor paralysis occurring suddenly, by greater or less diminution of farado-contracti

lity, by simple atrophy in various degrees of the paralyzed muscles, by degeneration of the muscular tissue, and by secondary contractions and consequent club feet. The sensation is unaffected or increased, and there is usually increased reaction to the interrupted voltaic current.

Duchenne gives the following as a typical case: A child 11 years old. At three years of age loss of consciousness, convulsions,

and paralysis of both legs occurred. In a month he could sit up, but there was no return of power in the legs and they rapidly wasted. There was never any affection of the bladder or rectum. The state of the child eight years after the onset of the disease was as follows:-The skin literally adhered to the bones, as shown in figs. 51 and 52, engraved from photo

graphs. No reaction to faradism. He could neither move his toes, feet, or legs, and if he were set up

upon his feet the joints flexed one upon another, as

seen in fig. 51. But like all similar cases, the child began to get along by sitting down and pushing or dragging himself with the aid of his hands, and he

soon found out a more rapid mode of progress. Propping himself, as in fig. 52, he seized his feet

FIG. 55.

Infantile Paralysis.

with his hands and carried them forward one after

the other.

The subsequent deformity of the limbs in infantile paralysis depends less upon the number than on the functional importance of the paralyzed muscles. The foot is less deformed and the movements of the leg less affected by the loss of all the motor muscles of the foot than by the paralysis only of certain amongst them. Figs. 53 and 54 are from photographs of a foot all of whose muscles were paralyzed and atrophied. The side view, fig. 54, is almost normal, and in a front view, fig. 53, the only deformity is a less development than the sound foot. Whereas a single muscle only being atrophied, greater deformity results, as in fig. 55, in which the gastrocnemius alone is paralyzed.

Duchenne states that faradization applied in good time, when atrophy is but commencing, is calculated to abridge the duration of the paralysis, diminish if not arrest the wasting, and perhaps prevent the fatty transformation of the muscles. Those muscles, although paralyzed, whose reaction to faradism is retained, will under its application quickly regain their power. There is no ground for the feeling of natural repugnance that exists against subjecting children of such tender years, sometimes indeed hardly three months old, to such excitation. Used with slow intermissions, children as a rule betray no sign of pain, if the precaution is taken of gradually inuring them to the strange but not painful sensation which accompanies muscular contraction, and before long the operation even amuses them.