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nation of the system by the poisonous influence of lead or mercury, or to rheumatic paralysis of the radial nerve (a most important question as affecting the treatment). In lead palsy the reaction to faradism is greatly diminished or abolished, and that to interrupted voltaism increased. In rheumatic palsy the reaction remains normal, or is increased to both currents.
In paralysis from disease of the brain, Duchenne declares that farado-contractility is always unaltered; but Dr. Althaus, as the result of the examination of upwards of one hundred cases, states that he found the excitability in some diminished and the muscles flaccid, in others increased (these being cases of early rigidity and irritative lesion), and in others normal.
There is no doubt that in the great majority of cases the reaction to all forms of electricity remains unaltered.
In paralysis from disease of the cord there is almost invariably diminution of reaction in the affected muscles to all varieties of electricity.
In hysterical paralysis, electro-contractility is, as a rule normal, but electro-sensibility (the sensation of muscular contraction) is absent or much lowered.
In progressive muscular atrophy (Cruveilhier's atrophy) the farado-contractility is normal in the remaining muscular tissue. Its abolition in this disease proves complete degeneration of the muscle.
In the so-called “essential” infantile paralysis, farado-contractility is abolished and voltao-contractility increased. Other forms of paralysis affecting children correspond as regards their electrical reaction to the same disease in the adult.
The condition of muscular irritability, as tested by electricity, will in some cases largely aid us to distinguish between real and pretended disease. I was enabled to solve this question at once in a case in which simulation was believed to exist, and where I was requested by a railway company, in consultation with Drs. Ramskill and Maclure, to make an electrical examination. In the case in question the muscles of the left leg responded freely to faradism, while the same muscles of the right leg exhibited not a trace of reaction to the full strength of a Stöhrer's induction instrument.
Considered solely as an aid to diagnosis, we can get little more assistance from electricity than I have noted above.
THERE is too much belief and too much unbelief in the therapeutic power of electricity. The men who estimate it fairly are quite the minority. It is generally either much undervalued, or else believed to be a sort of modern elixir vitæ, capable of curing a hopeless hemiplegia from destruction of brain tissue, or a paralysis agitans from senile degeneration. Although it will do neither of these impossibilities, yet, considered as a remedy, it is of great value in a wide margin of diseases. It will either stimulate or soothe both nerve and muscle, according to its variety and mode of application; it will frequently restore voluntary movement, it will relieve pain, heighten temperature, recall sensation, coagulate the blood, and dissolve or slowly cause the absorption of tumours.
Besides its local and immediate action, it exerts also general effects, especially upon nutrition. Sir James Paget, in his Surgical Pathology, quotes an experiment in which the nerves of a frog's hind legs were divided, and while one limb was left inactive the muscles of the other were called into frequent action by faradizing the lower end of its nerve; the result was that at the end of two months these muscles retained their weight and texture, and their capacity of contraction, while the others were degenerated in texture, and had also lost some of their power of contracting. Legros and Onimus electrized with the voltaic current some puppies for a quarter of an hour every day, by placing one of the fore paws and one of the hind ones in tepid water connected with electrodes. At the end of six weeks those that had been electrized weighed more and had grown larger than those of the same litter that had not been electrized. Heidenheim found that the prolonged action of a continuous current upon an exhausted muscle produced a restoration of it; that is, that the depressed excitability increased, and that even in a dead muscle the lost excitability was again established.
Besides effects upon nutrition, electricity may increase the secretions—in amenorrhoea it may reestablish the catamenia—and it acts generally upon nerve and muscle as a stimulus, putting both into a condition which has been termed electrotonus. Its modification of the natural state of the electricity of the human body does not cause, as a rule, any appreciable effect; but in certain pathological conditions of the nerves it is otherwise. Some persons even are extremely sensitive to electric changes in the atmosphere, and Duchenne cites the case of a
lady who was invariably during a thunderstorm stricken for some hours with general paralysis. In many of these exceptional instances a feeling of faintness, giddiness, headache, nausea, even vomiting may result-a fact which it is well to bear in mind.
Electricity has been, and indeed is still, advocated by some writers as of great benefit in a multitude of diseases. I have had no experience of its application in any other than in disorders of the nervous system, and chiefly in paralysis, neuralgia, and other painful affections, and in some disorders in which tremor or spasm is a prominent symptom.
Before discussing its localized action, I may refer to a methodical application to the whole surface of the body, which is advocated by Drs. Beard and Rockwell under the name of General Electrization, They state that they have had experience in more than ten thousand applications, and they speak very highly of its remarkable effects administered in this way in conditions of debility. Their method rests, they say, upon the two principles,—“1. That electrization, besides being merely a local stimulant, also exercises an influence over general and local nutrition, at once unique and unrivalled, and that entitles it to the highest rank among constitutional tonics. 2. That the system of making the application exclusively local is both illogical and inconsistent; that in the use of electricity, as of