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Diphtheritic angina by kissing the mouth of one of his Paralysis. children who died from the disease. After having

passed through the period of the formation of false membranes, which put his life in danger by obstructing the bronchi, and when making progress towards convalescence, he was attacked by paralytic symptoms. There was paralysis of the soft palate and pharynx, diplopia, and slight hemiplegia of the fifth, seventh, hypoglossal, and inferior laryngeal nerves. Suddenly on the twentyeighth day, the intrinsic expiratory muscles became paralysed, and at the same time there was formed a considerable quantity of mucus, which obstructing the bronchi, and not being expelled, threatened to produce asphyxia. Electro-cutaneous excitation of the posterior region of the thorax rapidly re-established the respiratory power and procured the immediate expulsion of the bronchial mucus, but it required to be continued for several days in order completely to overcome the paralysis of the lung.

In another instance, a little girl four months old, who had suffered from diarrhoea for several days became the subject of a rather large ulceration in the neighbourhood of the umbilicus. Some days later she was attacked by general paralysis, which continued for forty-eight hours, and was followed by complete aphonia, with extreme difficulty of respiration and deglutition. Every attempt at sucking brought on cough and choking,

Paralysis.

and there were also symptoms of paralysis of the Diphtheritic diaphragm. Faradization of the phrenic nerves was entirely successful in establishing normal respiration. After faradization of the soft palate, the pharynx, and the anterior surface of the neck at the laryngeal level, the infant sucked better and its voice improved. It was completely cured by a few applications.

Micturition.

Difficulty of micturition, may in many paraplegic Difficulty of cases be largely relieved by faradization. It is not always symptomatic of paralysis of the bladder, but may be the result of paralysis of the abdominal muscles, and be removed by their faradization. Failing this, the rectal rheophore should be introduced, as described at page 72, and a well wetted sponge connected with the second pole promenaded over the hypogastric or lumbosacral region; or the double vesical rheophore may be employed. The continuous voltaic current will often relieve vesical spasm, and has been successfully employed in painful spasmodic contraction of the bladder upon a calculus. Lesser degrees of spasm will often give way to cutaneous faradization of the perineum or hypogastric region. Anæsthesia of the bladder sometimes exists independently of any paralysis. The patient feels no desire to micturate, the bladder fills and if not emptied at regular intervals ends by becoming paralysed from the constant distension. Internal faradization with the double vesical rheophore is superior to any other treatment.

Impotence.

Constipation of
Paraplegia.

Electrolysis.

Impotence is not unfrequently found to be accompanied by anesthesia of the genitals, and to be removed by cutaneous faradization. In those cases in which it is due to seminal emissions, and prior treatment has been of no avail faradization should be given a trial. Introduce the urethral rheophore to the verumontanum, and apply a second rheophore (a well-wetted sponge in a cylinder) to the perineum. Use a low power, and with the pedal rheotome regulate the intermissions at about the rate of two to a second. When the emissions are better pass a mild and slowly intermitting current through the testicles, applying a well-wetted conductor on each side of them.

Obstinate paraplegic constipation is often relieved by faradization of the abdominal muscles. When it results from paralysis of the rectum, act directly upon it as described at page 72. In intussusception introduce the rectal rheophore and apply about once in a second (regulated by the pedal rheotome) an intense faradic current upon each point of the abdominal walls. Several successful cases that had resisted all prior treatment are on record. Prolapsus ani from atony of the sphincter may not unfrequently be removed by faradization.

Electrolysis. In certain cases in which a tumour rapidly increasing may threaten life, and where from its position, or for other reasons, a surgical operation is inadmissible, the catalytic or resorbent action of the continuous voltaic current may be of

benefit. In preference to the insertion of needles, Electrolysis. mould a very thin sheet of copper, hardly thicker than paper, to the entire surface of the tumour. Cover this copper with a flannel and fix it by a binding screw to the conductor from the negative pole of the battery. Before use, soak the flannel well in a saturated solution of salt in water, and when applied to the tumour, place the positive pole with a well-wetted sponge as near as possible to it, and allow a current as strong as the patient can bear without pain to pass for from twenty minutes to an hour daily, or every second day. The same treatment is occasionally useful in ganglionic tumours and in chronic articular affections with nodosities, which have not been benefited by prior treatment. If needles are used, introduce two or three, or even four, of steel gilt, into the most prominent part of the tumour to a depth of two or three inches, and connect them with the negative pole of about ten cells. Apply the positive pole as already directed.

tions to the

tricity.

Contra-indications to the use of Electricity.-In ac- Contra-indicatual softening of brain or spinal cord; in active or use of Elecsevere inflammations or congestions, whether central or peripheral; in great exaltation of reflex action, after recent paralytic seizures, and in those conditions generally in which active medication is contra-indicated, electricity, except as a mild continuous voltaic current, should not be employed.

Concluding
Remarks.

In the foregoing pages I have endeavouredassuredly not to exhaust my subject-but, eschewing debatable ground, to indicate the prominent landmarks in the wide and unexhausted field of electrotherapeutics. My object will have been answered if I have succeeded in clearly describing the different modes of applying electricity, and the apparatus by which the application is best made; also in specifying those cases in which the use of some one or other of the different varieties of electricity is imperatively demanded; and those cases again where other remedies having been tried and failed-we may hopefully resort to this agent, and in which it were surely a neglect of duty to let the disease run on without giving the patient the benefit of its thorough trial.

In conclusion I would state that the medical practitioner who prescribes electricity, should either administer it himself, or cause it to be administered by a skilled operator. The experience of the National Hospital for the Paralysed and Epileptic, and my own experience in private practice, show conclusively that when patients themselves apply electricity, the result has been very unsatisfactory. The most explicit directions will often be misunderstood, or fail in being correctly carried out, the treatment getting undeserved discredit. The rule of practice here laid down is particularly applicable to the localized application of electricity.

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