Case XXX.*Mercurial Stomatitis.Mr. S., about 35 years of age, came to me for treatment in the fall of 1872. He then had indurated chancre, two buboes and syphilitic sore throat. He had had the chancre for six weeks before applying to me, but had been, he said, ashamed to consult a physician. Before medication had had time to make any impression on the disease, roseola appeared. The syphilis was very obstinate in this patient, compelling me to keep him under the influence of mercury for a long time. In October 1873, the patient presented himself with a very aggravated mercurial stomatitis. The customary remedies, internal as well as external, made little or no impression on the affection. On November 11th, I discontinued all other treatment, and ordered a course of galvanic baths. He took his first bath on the same day. This was repeated every alternate day until six baths had been taken, when all symptoms of the disease had disappeared. He has had no mercurial trouble since then. The descending galvanic current from a zinc-carbon battery was used throughout.
Case XXX.*Mercurial Stomatitis.Mr. S., about 35 years of age, came to me for treatment in the fall of 1872. He then had indurated chancre, two buboes and syphilitic sore throat. He had had the chancre for six weeks before applying to me, but had been, he said, ashamed to consult a physician. Before medication had had time to make any impression on the disease, roseola appeared. The syphilis was very obstinate in this patient, compelling me to keep him under the influence of mercury for a long time. In October 1873, the patient presented himself with a very aggravated mercurial stomatitis. The customary remedies, internal as well as external, made little or no impression on the affection. On November 11th, I discontinued all other treatment, and ordered a course of galvanic baths. He took his first bath on the same day. This was repeated every alternate day until six baths had been taken, when all symptoms of the disease had disappeared. He has had no mercurial trouble since then. The descending galvanic current from a zinc-carbon battery was used throughout.
Were it not for the remarkable results obtained in the following case, I should not have felt justified in devoting any space to an allusion to this formidable disease. I insert the case as it was published in No. 216 of the “Medical Record.” I have to add that the patient, some six months ago, suffered a relapse, which however is not nearly as aggravated as his former condition, nor are the symptoms so pathognomonic. I had a letter from him about a week previous to my writing this, in which he states that he intends soon to come to the city for the purpose of taking another course of treatment. Even if the treatment however has not had the effect of curing the disease—and this I do not claim for it, it has been of sufficient importance if it has resulted in arresting for a time its progress, giving the patient temporary comfort, and prolonging life. Further trial may possibly have better results—in more recent cases—with respect to permanency.
Case XXXI.* Mr. W., aet. 48, came to consult me January 12th, 1874. He had then felt the symptoms of locomotor ataxia for about six years. Had been unable for several years to walk without the aid of a cane. When walking he draggedhis right leg along in a semicircle, and was able to accomplish very short distances only. There were almost complete anæsthesia and great paresis of the bladder. The same conditions were observable in regard to the bowels. Anæsthesia of both lower extremities existed, complete in every respect in the right leg, almost so in the left. Dyspepsia and general debility and emaciation accompanied the disease. Treatment was begun on January 15th. I prescribed phosphorus and cod-liver oil, and passed a strong galvanic current through the spine for probably ten minutes. January 16th, a galvanic bath was administered. Towards the close of the bath (which occupied twenty minutes), patient thought he felt some sensation in his legs. The baths were taken every two or three days, alternating with strong galvanizations of the spine. While taking his second bath, patient remarked that “his right leg felt warm for the first time in six years.” The treatment as described was continued for about six weeks, during the latter part of which the local applications were gradually diminished in frequency, the baths being continued regularly. Medication was discontinued about this time. About the middle of March. Mr. W. was enabled to resume his occupation (paymaster’s assistant on the Erie Railway). His improvement had been rapid and steady. All the symptoms gradually disappeared, and in the beginning of April the patient was, with the exception of some feebleness, consequent on his protracted illness, as well as ever. He continues so to the present day.[17]He still takes two or three baths a month, but has had no other treatment since May (1874). He walks freelywithout a cane, and talks jocosely of running footraces. All functions are performed normally.Although in this case the baths were not employed exclusively, yet they predominated in the treatment; and if the judgment of the patient, a very intelligent gentleman, is to be relied on, a large share of the success is due to the baths.
Case XXXI.* Mr. W., aet. 48, came to consult me January 12th, 1874. He had then felt the symptoms of locomotor ataxia for about six years. Had been unable for several years to walk without the aid of a cane. When walking he draggedhis right leg along in a semicircle, and was able to accomplish very short distances only. There were almost complete anæsthesia and great paresis of the bladder. The same conditions were observable in regard to the bowels. Anæsthesia of both lower extremities existed, complete in every respect in the right leg, almost so in the left. Dyspepsia and general debility and emaciation accompanied the disease. Treatment was begun on January 15th. I prescribed phosphorus and cod-liver oil, and passed a strong galvanic current through the spine for probably ten minutes. January 16th, a galvanic bath was administered. Towards the close of the bath (which occupied twenty minutes), patient thought he felt some sensation in his legs. The baths were taken every two or three days, alternating with strong galvanizations of the spine. While taking his second bath, patient remarked that “his right leg felt warm for the first time in six years.” The treatment as described was continued for about six weeks, during the latter part of which the local applications were gradually diminished in frequency, the baths being continued regularly. Medication was discontinued about this time. About the middle of March. Mr. W. was enabled to resume his occupation (paymaster’s assistant on the Erie Railway). His improvement had been rapid and steady. All the symptoms gradually disappeared, and in the beginning of April the patient was, with the exception of some feebleness, consequent on his protracted illness, as well as ever. He continues so to the present day.[17]He still takes two or three baths a month, but has had no other treatment since May (1874). He walks freelywithout a cane, and talks jocosely of running footraces. All functions are performed normally.
Although in this case the baths were not employed exclusively, yet they predominated in the treatment; and if the judgment of the patient, a very intelligent gentleman, is to be relied on, a large share of the success is due to the baths.
After what has been said in a preceding chapter of the tonic effects of electric baths, it would scarcely appear necessary to introduce the subject of cachexiæ. If I do so nevertheless, it is only to be afforded the opportunity of relating the following case, which possesses sufficient interest to render its introduction here desirable. The first portion of it has already been published (Med. Record, No 216), but to this I have to add what occurred subsequently.
Case XXXII.*Mercurio-syphilitic Cachexia.—Mr. L., aet. 27, had primary syphilis about four years ago. Subsequently had inveterate constitutional symptoms, for which he was under medical treatment both here and in Europe. When he had sojourned in the latter country some time, he was pronounced cured by his physicians. He married, and returned to this country in the fall of 1872. A few weeks after his return he fell into a gradual decline, which confined him to the house—and part of the time to bed—for eight months, during the latter portion of which he had discontinued all medical treatment. It was with difficulty that, assisted by his wife, he managed toreach my office. I found him terribly enfeebled; greatly emaciated; sallow complexion. He was much annoyed by rheumatic pains, which I considered specific. His condition was so exceedingly low, that I decided to postpone all medication until he should be stronger. I ordered galvano-faradic baths, i.e. the galvanic current in the bath as an eliminative, the faradic as a tonic. The first bath was taken on November 20th, 1873. For one month he took the baths, and nothing else. He was then so much stronger, that I felt justified in instituting a mild specific course of treatment, the baths being continued as theretofore. At the end of two months the patient was nearly as strong as ever, was able to resume his occupation, and had gained twenty-seven pounds in weight.Thus far this case was published as above stated. For the sake of the interest attaching to it, I will now proceed to give its further history. Mr. L. remained to all appearances well until July, 1874, when he commenced to suffer from headache and constipation. On the 23d of August following, while I was absent from the city, he presented himself to the gentleman who attended to my practice during my absence, with paralysis of the external rectus muscle of the left eye. He also consulted a specialist, who pronounced the paralysis rheumatic. When I returned from the country he presented himself for treatment. I commenced a series of daily electric applications to the affected muscle, which failed to respond to the faradic current, but contracted very readily when the slowly interrupted galvanic current was employed. As I had strong suspicions that syphilis was at the bottom of the trouble, I also administered iodide of potassium in gradually increasing doses—not however until electrization and strychnia employed for some weeks had failedto do any good. The administration of the iodide met with no better success. The patient’s general health gradually declined. On October 22d, he complained of numbness in the left leg, which gradually increased, the leg at the same time becoming paretic, so that the patient required the aid of a cane for ordinary locomotion. His condition now became rapidly worse. His movements became ataxic. Anæsthesia of the bladder, paresis of this and the intestine, with obstinate constipation, loss of appetite, emaciation, etc., rapidly supervened. I suspected the development ofgummataon the meninges of the brain and cord, and advised him to use the inunction cure, and to remain at home until he should be well. This, on account of the business losses which it involved, he was very much averse to doing. He consequently proposed a consultation with an eminent physician, which was had. This gentleman pronounced the case one of spinal (either multiple or posterior) sclerosis, and discarded the syphilitic theory. A consultation two days subsequently with another physician had a like result. In deference to the opinion of these gentlemen, I treated the patient in accordance with their diagnosis. This was in the second week of November. The patient became rapidly worse. He soon ceased to walk—he tumbled about. After six days’ treatment, considering his life in imminent danger, I reiterated my advice to institute the inunction cure, and the patient then acquiesced. Nov. 24th I ordered a drachm of Unguent Hydrarg. to be used every evening; I could not however prevail on the patient to remain at home during the treatment. He continued to grow worse. Nov. 26th he had complete retention from vesical paralysis, and sent for me at night to relieve him. Thenceforth until he got nearly well he was obliged to use the catheter regularly. A few daysafter this, fortunately for himself, he fell down as he was leaving a horse car, and sprained his ankle. I sayfortunately, for this accidentcompelledhim to remain at home. From this time he began to improve. December 2d I substituted for the ointment a twenty per cent solution of the oleate of mercury, of which he used a drachm morning and evening. The improvement from this day was exceedingly rapid. On the 4th of December he had regained control of the bladder. The constipation, which had been very obstinate, also began to yield. From this date he used the oleate only once daily, and discontinued it entirely on the 14th. On the 10th he had already resumed his avocation, and the same month absolutely danced at a ball. He took iodide of potassium for a time after his mercurial course. He has since been and is now in perfect health.
Case XXXII.*Mercurio-syphilitic Cachexia.—Mr. L., aet. 27, had primary syphilis about four years ago. Subsequently had inveterate constitutional symptoms, for which he was under medical treatment both here and in Europe. When he had sojourned in the latter country some time, he was pronounced cured by his physicians. He married, and returned to this country in the fall of 1872. A few weeks after his return he fell into a gradual decline, which confined him to the house—and part of the time to bed—for eight months, during the latter portion of which he had discontinued all medical treatment. It was with difficulty that, assisted by his wife, he managed toreach my office. I found him terribly enfeebled; greatly emaciated; sallow complexion. He was much annoyed by rheumatic pains, which I considered specific. His condition was so exceedingly low, that I decided to postpone all medication until he should be stronger. I ordered galvano-faradic baths, i.e. the galvanic current in the bath as an eliminative, the faradic as a tonic. The first bath was taken on November 20th, 1873. For one month he took the baths, and nothing else. He was then so much stronger, that I felt justified in instituting a mild specific course of treatment, the baths being continued as theretofore. At the end of two months the patient was nearly as strong as ever, was able to resume his occupation, and had gained twenty-seven pounds in weight.
Thus far this case was published as above stated. For the sake of the interest attaching to it, I will now proceed to give its further history. Mr. L. remained to all appearances well until July, 1874, when he commenced to suffer from headache and constipation. On the 23d of August following, while I was absent from the city, he presented himself to the gentleman who attended to my practice during my absence, with paralysis of the external rectus muscle of the left eye. He also consulted a specialist, who pronounced the paralysis rheumatic. When I returned from the country he presented himself for treatment. I commenced a series of daily electric applications to the affected muscle, which failed to respond to the faradic current, but contracted very readily when the slowly interrupted galvanic current was employed. As I had strong suspicions that syphilis was at the bottom of the trouble, I also administered iodide of potassium in gradually increasing doses—not however until electrization and strychnia employed for some weeks had failedto do any good. The administration of the iodide met with no better success. The patient’s general health gradually declined. On October 22d, he complained of numbness in the left leg, which gradually increased, the leg at the same time becoming paretic, so that the patient required the aid of a cane for ordinary locomotion. His condition now became rapidly worse. His movements became ataxic. Anæsthesia of the bladder, paresis of this and the intestine, with obstinate constipation, loss of appetite, emaciation, etc., rapidly supervened. I suspected the development ofgummataon the meninges of the brain and cord, and advised him to use the inunction cure, and to remain at home until he should be well. This, on account of the business losses which it involved, he was very much averse to doing. He consequently proposed a consultation with an eminent physician, which was had. This gentleman pronounced the case one of spinal (either multiple or posterior) sclerosis, and discarded the syphilitic theory. A consultation two days subsequently with another physician had a like result. In deference to the opinion of these gentlemen, I treated the patient in accordance with their diagnosis. This was in the second week of November. The patient became rapidly worse. He soon ceased to walk—he tumbled about. After six days’ treatment, considering his life in imminent danger, I reiterated my advice to institute the inunction cure, and the patient then acquiesced. Nov. 24th I ordered a drachm of Unguent Hydrarg. to be used every evening; I could not however prevail on the patient to remain at home during the treatment. He continued to grow worse. Nov. 26th he had complete retention from vesical paralysis, and sent for me at night to relieve him. Thenceforth until he got nearly well he was obliged to use the catheter regularly. A few daysafter this, fortunately for himself, he fell down as he was leaving a horse car, and sprained his ankle. I sayfortunately, for this accidentcompelledhim to remain at home. From this time he began to improve. December 2d I substituted for the ointment a twenty per cent solution of the oleate of mercury, of which he used a drachm morning and evening. The improvement from this day was exceedingly rapid. On the 4th of December he had regained control of the bladder. The constipation, which had been very obstinate, also began to yield. From this date he used the oleate only once daily, and discontinued it entirely on the 14th. On the 10th he had already resumed his avocation, and the same month absolutely danced at a ball. He took iodide of potassium for a time after his mercurial course. He has since been and is now in perfect health.
The remedies for this disease are unfortunately so numerous, there is so much temptation to try another where one remedy has failed, that it is seldom or never that an uncomplicated case of dyspepsia applies for electrical treatment. As a rule, the disease that furnishes cause for referring a case to the specialist, is some nervous trouble secondary to the dyspepsia.
In regard to the influence of electric baths on dyspeptic conditions, whether complicated or not, I can however speak unqualifiedly in their favor. I know of no one other remedy that can at all approachthem in this respect. Whatever the secondary or other troubles of patients, any co-existing dyspepsia was in every instance either cured or greatly ameliorated. The improvement usually begins at once—after the first or second bath, and continues steadily. As I have not had occasion to treat by means of electric baths any uncomplicated cases of dyspepsia, I can adduce none. I may safely claim however for the baths a reliability and bespeak for them a confidence that I might claim or bespeak for no other remedy or plan of treatment whatsoever—assertions which would appear rash and venturesome, had I not at my command abundant clinical evidence to warrant my making them.
A case of melancholia, highly illustrative of the effects in this condition of electric baths, came under my notice very recently. It may serve as a guide in the treatment of this and kindred conditions.
Case XXXIII.Mr. F., aet. 22, single, butcher, consulted me Oct. 21st, 1875, for melancholia and loss of memory, from which he had suffered for upwards of a year. He had frequently entertained the idea of suicide. A thorough examination revealed no trouble of any of the viscera. All functions appeared normal. He had never masturbated. There were nocollateral symptoms to furnish any evidence of organic cerebral trouble. I prescribed phosphorus and strychnia, and galvanized the brain twice a week. Two weeks of this treatment had completely negative results. I then ordered electric baths. Four baths resulted in a complete cure.
Case XXXIII.Mr. F., aet. 22, single, butcher, consulted me Oct. 21st, 1875, for melancholia and loss of memory, from which he had suffered for upwards of a year. He had frequently entertained the idea of suicide. A thorough examination revealed no trouble of any of the viscera. All functions appeared normal. He had never masturbated. There were nocollateral symptoms to furnish any evidence of organic cerebral trouble. I prescribed phosphorus and strychnia, and galvanized the brain twice a week. Two weeks of this treatment had completely negative results. I then ordered electric baths. Four baths resulted in a complete cure.
As a very fruitful source of morbid conditions of almost every nature, abnormities of the circulation of the blood are well worthy our attention. As is the case with dyspepsia, so here likewise patients seldom present themselves for treatment unless some definite secondary pathological condition has supervened. We find these patients complaining of cold hands and feet, irregular and disturbed sleep, occasional local congestions, with vague, usually slight pains here and there, etc., etc. Where organic cardiac disease is at the bottom of the trouble, we cannot of course expect much permanent improvement. Although even here considerable relief is often afforded while the baths are being used, their discontinuance will in all probability be soon followed by a return of the former condition. Where, however, cases are not complicated by organic disease, where we have a “sluggishness” of the circulation, due either to vasomotor inertia or atony of the muscular coats of vessels, the electric bath will be foundreliably efficient. I have already (p. 55) alluded to this subject, and explained the probable “mode of action” here of the baths. I will now offer some suggestions as to the best method of administering them with a view to equalizing the circulation.
We must here seek to stimulate the vasomotor system, both central and peripheral; to give tone to the coats of vessels, both by direct and indirect electric influence; through counter-irritation to relieve internal congestions, by causing an afflux of blood to the skin. These objects are best attained by means of the galvanic current, which should be employed of sufficient intensity to produce a rubefacient effect. The faradic current acts in the same direction, but far less energetically, if we except the vessels near the surface, the muscular coats of which are probably more efficiently tonicised by this than by the constant current. The faradic current however is applicable here in another way, and for a very important object. I refer to themechanicalcounter-action of a sluggish circulation, through the agency of prolonged muscular contraction. This mechanical effect is not of course peculiar to the faradic current; it is shared by gymnastic and other exercises; but obtained in any other way whatsoever (with the exception, perhaps, ofmassage, which is howevermuch more troublesome as well as inferior, and moreover not always admissible) it involves, in order to produce perfect results, a considerable amount of bodily exertion, often beyond the physical power of persons who are in ill health, and bringing with it the risk of positive injury, through over-exertion, which with thepassivecontractions obtained by means of the faradic current, is entirely obviated. By administering thegeneralfaradic current in the bath, of sufficient intensity tomaintainmuscular contraction as long as the circuit remains closed, any stagnant blood in the lower extremities will be efficiently forced into the general circulation. After from three to five minutes of this faradization, the surface board may be successively applied for a minute or two each to the arms, abdomen, pectoral and dorsal muscles. I believe thebestresults can be obtained by first going through the faradic process, then subjecting the patient to general galvanization, as above indicated, and concluding by another but brief faradization.
Last, but not least, I have some remarks to offer on the treatment by the electric bath of certain affections of the sympathetic nerve. While I do notin any such cases accord to the baths the rank of an exclusive remedy or even a specific, their importance as an adjuvant is sufficient to entitle them to special consideration in this connection. In those neuroses of the sympathetic where electricity (galvanism) is indicated, thegreatestbenefit can be obtained from local applications. On the other hand the baths, employed in addition to local applications, will be found a very important factor in the treatment, possessing, as they do, two advantages, viz:first, by their means, the electric influence is brought to bear—in a much less concentrated form it is true—on the entire sympathetic system, from theganglion imparto theganglion cervicale supremum, and, by derived currents, on the cephalic ganglia also, at one and the same time;second, the rest of the body participates in the general nutrient and tonic effects of the bath equally with the sympathetic, the latter thus receiving a reflex benefit which local applications fail to furnish. There are, moreover, cases where hyperæsthetic conditions of the nerve do not admit of local applications, and where yet electricity is urgently called for. Thus I have at present under treatment a lad sixteen years of age, in whom both supreme cervical sympathetic ganglia as well as the ganglion impar were until recentlyso susceptible that the mere adjustment of the electrodes caused him great pain, while on the other hand he bore the baths exceedingly well. In such cases, electric baths, suitably administered, frequently constitute in conjunction with proper medication, the most useful treatment.
As to the mode of administration in sympathetic neuroses of the baths, the most direct manner in which to influence the diseased nerve, is by connecting one pole of agalvanicbattery (I consider the faradic current next to useless here) to the head electrode, the other to the surface board, the latter applied portion of the time to the epigastrium (solar plexus), the balance to the coccyx (ganglion impar). This will include in the direct circuit the main portion of the sympathetic, the position in the tub of the bather bringing the cilio-spinal centre very close to the head-electrode. The direction of the current must be determined by the individual features presented by each case, as also the duration of the bath.
Case XXXIV.Mr. S., aet. 31, merchant, was referred to me April 3d 1874, by Dr.Krehbiel. In January, 1874, Mr. S., until then in the enjoyment of good health, woke up one morning to find, as he expressed it, “everything dark before his eyes.” He groped his way to the window, in order to open the blinds. When at the window, he felt as though about to fallout—probably vertigo. He soon returned to an apparently normal condition, and went about his business as usual. A week after, he had a much more serious attack, which he describes as follows: “I had been playing whist during the evening (several hours), when suddenly, without premonition, I felt as though a champagne cork popped against the top of my head, inside. Accompanying this was an indefinable sensation about the heart as though the blood all rushed thence down to the feet. I did not lose consciousness; did not fall. I trembled all over, and a great fear came over me. Felt very weak all night; my pulse was very slow.” About two months subsequently, patient was referred to me, as above stated. He then had an uneasy look; an indefinable continual sense of fear; was excessively nervous in the forepart of the day; had brief attacks of tremor—usually every alternate morning, but not typical as to time of occurrence. The history exhibited neither syphilis, malaria nor intemperance. Had never had headache. Sleep good; appetite likewise. The most pathognomonic symptom, however, related to his pulse. This was abnormally slow, ranging from 44 to 54 (the latter only when standing or after walking) per minute. It was full and regular. There was no organic heart trouble. In the absence of any other symptom whatsoever pointing to irritation of the pneumogastric or spinal accessory, I was justified in excluding this as the possible cause of the cardiac infrequency. On the other hand, the pathogenetic manifestations appeared all to point to “asthenia of the sympathetic”—at any rate the portion of this whence the cardiac nerves take their origin, and I formed my diagnosis accordingly. In the beginning, the treatment consisted of bilateral ascending (from cilio-spinal centre to both mastoid fossæ) galvanizations of the sympathetic, and galvanicbaths (head electrode negative, surface board positive, to epigastrium) on alternate days. Improvement in every respect was steady, though not rapid. At the end of three weeks, I supplemented this treatment by the administration of ergotin and nux vomica. At the expiration of two more weeks, the patient being nearly recovered, I discontinued these medicaments, substituting the valerianates of zinc and iron, and steadily maintaining meanwhile the electrical treatment as above indicated. After a short time recovery appeared complete, and patient was discharged from treatment. He returned however a few months subsequently, complaining of “faint spells” in the mornings, accompanied with excessive nervousness, and a renewed though moderate cardiac infrequency. Electrical treatment, similar to that above described, soon restored him. One or two more slight relapses occurred during the next six months. For over a year past however Mr. S. has been in the enjoyment of perfect and undisturbed health. His normal pulse ranges from 72 to 80.
Case XXXIV.Mr. S., aet. 31, merchant, was referred to me April 3d 1874, by Dr.Krehbiel. In January, 1874, Mr. S., until then in the enjoyment of good health, woke up one morning to find, as he expressed it, “everything dark before his eyes.” He groped his way to the window, in order to open the blinds. When at the window, he felt as though about to fallout—probably vertigo. He soon returned to an apparently normal condition, and went about his business as usual. A week after, he had a much more serious attack, which he describes as follows: “I had been playing whist during the evening (several hours), when suddenly, without premonition, I felt as though a champagne cork popped against the top of my head, inside. Accompanying this was an indefinable sensation about the heart as though the blood all rushed thence down to the feet. I did not lose consciousness; did not fall. I trembled all over, and a great fear came over me. Felt very weak all night; my pulse was very slow.” About two months subsequently, patient was referred to me, as above stated. He then had an uneasy look; an indefinable continual sense of fear; was excessively nervous in the forepart of the day; had brief attacks of tremor—usually every alternate morning, but not typical as to time of occurrence. The history exhibited neither syphilis, malaria nor intemperance. Had never had headache. Sleep good; appetite likewise. The most pathognomonic symptom, however, related to his pulse. This was abnormally slow, ranging from 44 to 54 (the latter only when standing or after walking) per minute. It was full and regular. There was no organic heart trouble. In the absence of any other symptom whatsoever pointing to irritation of the pneumogastric or spinal accessory, I was justified in excluding this as the possible cause of the cardiac infrequency. On the other hand, the pathogenetic manifestations appeared all to point to “asthenia of the sympathetic”—at any rate the portion of this whence the cardiac nerves take their origin, and I formed my diagnosis accordingly. In the beginning, the treatment consisted of bilateral ascending (from cilio-spinal centre to both mastoid fossæ) galvanizations of the sympathetic, and galvanicbaths (head electrode negative, surface board positive, to epigastrium) on alternate days. Improvement in every respect was steady, though not rapid. At the end of three weeks, I supplemented this treatment by the administration of ergotin and nux vomica. At the expiration of two more weeks, the patient being nearly recovered, I discontinued these medicaments, substituting the valerianates of zinc and iron, and steadily maintaining meanwhile the electrical treatment as above indicated. After a short time recovery appeared complete, and patient was discharged from treatment. He returned however a few months subsequently, complaining of “faint spells” in the mornings, accompanied with excessive nervousness, and a renewed though moderate cardiac infrequency. Electrical treatment, similar to that above described, soon restored him. One or two more slight relapses occurred during the next six months. For over a year past however Mr. S. has been in the enjoyment of perfect and undisturbed health. His normal pulse ranges from 72 to 80.
Whoever is familiar with the physiological effects of electric baths, will readily concede their great utility in a variety of conditions that I have not thus far specially alluded to. Of such I would mentionASTHENIÆ, ATONIC AND DEBILITATED CONDITIONS GENERALLY,including the state ofCONVALESCENCE FROM ACUTE DISEASESand theDECLINE OF ADVANCING AGE; many cases ofCHRONIC HEADACHE; someINCLASSIFIABLE CONDITIONS OF MARASMUSandMALNUTRITION, etc., etc. In all such cases, when purely functional and uncomplicated by incurableorganic disease, good results may be confidently looked for.
With these remarks I conclude my subject. Whichever the errors that a too limited experience may have engendered—and I doubt not there are many, I cannot on reviewing my work accuse myself of lack of candor nor yet of undue enthusiasm. I have cited but a small proportion of the successful cases whereof I possess records; still I believe that I have adduced amply sufficient clinical proof of the great value as a remedial agent of electric baths, and of the desirability of their more general adoption. I would more especially call attention to the inappropriateness of deferring their employment until almost all other remedies have been exhausted; and when I reflect that pretty much all those cases that had been referred to me by other physicians had already had the doubtful benefit of almost every other conceivable treatment, while many of those who came of their own accord, had in addition made the rounds of all the quacks, and exhausted nearly all the nostrums that are to be found advertised in the columns of our daily papers, the wonder seems that the results obtained were as good as they have been. I sincerely trust that in the future physicianswill avail themselves more frequently than heretofore of a remedy that is certainly capable of accomplishing much good; and I hope that in addition to myself there will be found others, more competent, to devote themselves to the study of the subject. To these, and perhaps to myself at a future time, I relegate the task of correcting my errors and promulgating hitherto undiscovered truths.
Footnotes:[10]Centralblatt für die medicinischen Wissenschaften, No. 17, 1875.[11]The apparatus used in these experiments was that of Du Bois-Reymond, with a Grove’s element.[12]Since writing the above, this case has had an entirely favorable termination.[13]The cases distinguished by an asterisk were published in No. 216 of the “Medical Record.”[14]Wherever I use the word “general” as descriptive of an electric current used in the bath, it is not as a characteristic, but merely to distinguish it from the instances where the surface board is employed.[15]Austin Flint, M.D. A Treatise on the Principles and Practice of Medicine. Philadelphia, 1873. 4th ed. pp. 63 and 64.[16]See Beard and Rockwell, op. cit., 2d ed. p. 472.[17]This was written a year ago. See remarks preceding the case.
Footnotes:
[10]Centralblatt für die medicinischen Wissenschaften, No. 17, 1875.
[10]Centralblatt für die medicinischen Wissenschaften, No. 17, 1875.
[11]The apparatus used in these experiments was that of Du Bois-Reymond, with a Grove’s element.
[11]The apparatus used in these experiments was that of Du Bois-Reymond, with a Grove’s element.
[12]Since writing the above, this case has had an entirely favorable termination.
[12]Since writing the above, this case has had an entirely favorable termination.
[13]The cases distinguished by an asterisk were published in No. 216 of the “Medical Record.”
[13]The cases distinguished by an asterisk were published in No. 216 of the “Medical Record.”
[14]Wherever I use the word “general” as descriptive of an electric current used in the bath, it is not as a characteristic, but merely to distinguish it from the instances where the surface board is employed.
[14]Wherever I use the word “general” as descriptive of an electric current used in the bath, it is not as a characteristic, but merely to distinguish it from the instances where the surface board is employed.
[15]Austin Flint, M.D. A Treatise on the Principles and Practice of Medicine. Philadelphia, 1873. 4th ed. pp. 63 and 64.
[15]Austin Flint, M.D. A Treatise on the Principles and Practice of Medicine. Philadelphia, 1873. 4th ed. pp. 63 and 64.
[16]See Beard and Rockwell, op. cit., 2d ed. p. 472.
[16]See Beard and Rockwell, op. cit., 2d ed. p. 472.
[17]This was written a year ago. See remarks preceding the case.
[17]This was written a year ago. See remarks preceding the case.
Transcriber’s Notes:The table below lists all corrections applied to the original text.p. 29: [normalized] the sub-acute symptoms → subacutep. 56: GENERAL COUNTER IRRITANT → COUNTER-IRRITANTp. 56: [normalized] the use of the surface-board → surface boardp. 59: does ... became apparent → become apparentp. 67: [normalized] acute, sub-acute and chronic → subacutep. 73: [normalized] bi-carbonate of soda or potassa → bicarbonatep. 107: ordered by their physicians: → physicians;
Transcriber’s Notes:The table below lists all corrections applied to the original text.