CASES ILLUSTRATING 
THE 
DIRECT ACTION OF REMEDIES 
ON THE 
NERVOUS SYSTEM. 
BY J 
FREDERIC D. LENTE, M. D., 
MEMBER OF THE HEW YORK NEUROLOGICAL SOCIETY; OF THE HEW YORK 
. COUNTY MEDICAL SOCIETY; OF THE BOARD OF MANAGERS OF THE 
HUDSON RIVER STATE HOSPITAL; OF THE AMERICAN PUBLIC 
HEALTH ASSOCIATION; CORRESPONDING MEMBER OF 
THE MEDICO-LEGAL SOCIETY OF NEW YORK ; 
AND HONORARY MEMBER OF THE MEDICAL SOCIETY OF NORTH CAROLINA, 
BTC., ETC., ETC. 
FROM MAY NO. RICHMOND AND LOUISVILLE MEDICAL JOURNAL, 1875. 
LOUISVILLE, KY.: 
RICHMOND AND LOUISVILLE MEDICAL JOURNAL PRINT. 
1875. CASES ILLUSTRATING 
THE 
Direct Action of Remedies 
ON THE 
NERVOUS SYSTEM.fr 
[From May No. Richmond and Louisville Medical Journal.] 
Case I.—This case occurred last Summer, and as I kept no 
notes, I must depend on the report of my friend, Dr. S. P. 
Church, who called me in consultation, and with whom I saw 
the patient, day after day, as long as the danger was imminent. 
The age of the child was fifteen months. Some weeks before 
the recent severe illness, she had had measles, which had been 
prevailing in New York in a severe, and in some cases, a fatal 
form. The prominent symptoms, says Dr. Church, were cough, 
high fever, rapid respiration (ranging at one time to 80); 
pulse 125 to 135 (at one time 180); head hot; great restless- 
ness. The child continued to grow gradually worse, and a 
thin, greenish diarrhoea was added to the other symptoms. I 
first saw the little patient on the 2d of April, six days after 
Dr. Church was called in. The child had been in an uncon- 
scious state for some time previous to my visit; possibly a 
couple of days or more. The pupils were much contracted, 
although no opiate, in sufficient dose to produce such a condi- 2 
tion, had been given ; there was evidently no vision ; pulse 
130, and very feeble; respiration frequent; temperature 105° 
in axilla. Swallowed fluids with avidity, and of course took a 
sufficiency of nourishment. Bromide of potassium in doses of 
three grains every two hours (thirty-six grains in twenty-four 
hours) was ordered, in addition to the remedies already pre- 
scribed. The next day, April 3d, at our consultation, matters 
had not mended, and I advised the attending physician to 
abandon the routine treatment of such cases, and try remedies 
which would act directly on the nerves supplying the capil- 
laries of the brain, thus causing their contraction and a dimin- 
ished supply of blood. Accordingly, we ordered the bromide 
to be continued as before; Squib’s fluid extract of ergot in m. 
ijss. every hour, with one-quarter of a minim of tincture of 
belladonna every hour. The latter to be continued until a 
(manifest dilatation of the pupil was observed. At our next visit, 
April 4th, the child’s symptoms were all decidedly improved. 
’The father, a very intelligent gentleman, had wratched the 
effect of the belladonna, and observed that as soon as dilatation 
of the pupil was decided, the child seemed to manifest some 
consciousness, and became more quiet; the pulse was less fre- 
quent, and fuller; the temperature 103; the child less restless, 
and the diarrhoea checked. The belladonna was now directed 
to be given pro re nata, so as to maintain the pupil in a natural 
state ; the other remedies to be continued as before. I do not 
endeavor to give the daily details of the case, as the progress 
was perfectly uniform ; the intelligence of the child, from its 
dawn, the first morning after commencing the treatment, con- 
tinued to exhibit slow but gradual and progressive develop- 
ment from day to day, first noticing familiar objects, in a lan- 
guid way, then raising her little hands to seize them, and letting 
them fall from sheer weakness. The temperature and pulse 
continued to improve pari passu, and the heat of head dimin- 
ished ; the diarrhoea did not return, and the discharges assumed 
a healthy character within twenty-four hours after the treat- 
ment was commenced. The belladonna was continued at inter- 3 
vals of two, three or four hours, for four days; the ergot was 
continued in the same doses, and at the same intervals as at 
first, for five days; as was also the bromide. At this time 
there was an apparent relapse; this was the information I got 
from the parents on the morning of my sixth visit. On exam- 
ining the child, I found that the restlessness had increased ; 
the pulse had run up to 120 and 130, was decidedly more fee- 
ble ; child more languid, but perfectly conscious; temperature 
below 98°; head preternaturally cold. The parents, under the 
impression that the small amount of stimulant, which had been 
given for two or three days, was doing harm, had intermitted it 
during the night. It was evident that the constringing effect 
of the remedies on the capillaries had been pushed too far, and 
the stimulant not far enough. The former were all stopped at 
once, and the stimulant decidedly increased, and codeia was 
ordered to allay restlessness. The next day the child was like 
a different patient. The cough, which had all along, indeed 
ever since the attack of measles, been more or less troublesome, 
was considerably allayed by the codeia; and in addition, we 
now directed cod-liver oil in emulsion, and the child continued 
to improve gradually until the cough disappeared, and Dr. 
Church now writes that she is entirely well. 
I think the above case needs no comment, I would only call 
attention to the fact that the diarrhoea was checked, and the 
characteristic greenish evacuations converted into healthy very 
promptly, after failure of the ordinary remedies which had been 
employed. This was no accident, I have observed it before in 
treating cases for fibrous tumor and other diseases with ergot. 
And we know that belladonna also has the effect of relieving 
both diarrhoea and constipation ; that is by restoring a healthy 
tone to the capillary circulation of the intestinal canal. Brom- 
ide of potassium is also relied upon by some physicians to fulfill 
the same indications. 
Case II.—While upon this subject of the action of reme- 
dies on the nervous system, I am induced to present another 
case in illustration, but of a totally different character in every 4 
respect, which fell under my care about the same time—that is, 
in the early part of May last. The subject was the widow of a 
well-known physician of New York, not long deceased. She 
is nearly eighty years of age, usually in good health, but has 
had several severe attacks of disease, one affecting the chest, a 
year ago, of an alarming character, for which she was attended 
by her physician, my friend, Dr. Learning. She had been ail- 
ing slightly with a cold, and some cough; when, one day, on 
returning from a ride, during which the weather had turned 
colder, was attacked with sudden dyspnoea; and her daughters 
noticed that her finger-nails turned blue, and her lips and face 
became also somewhat livid. I was immediately sent for, but did 
not arrive until 9 o’clock in the evening, when another messen- 
ger had been dispatched for me. On my arrival, I found that the 
very urgent symptoms had temporarily subsided. But it was 
evident that I had to deal with a case of general capillary bron- 
chitis, and that some remedy which would afford speedy relief 
was absolutely necessary. Only one remedy presented itself to 
my mind as likely to meet the emergency, and it is probably 
the last one which would have presented itself to the minds of 
most physicians of the present day. I placed thirty grains of 
calomel on her tongue and let her wash it down with a draught 
of cold water. She was taking a very mild expectorant mix- 
ture of muriate of ammonia and ipecac, which had been pre- 
scribed for her grandchild, three years of age; and I let her 
continue this as a placebo. The next morning I was at the 
house as early as possible; found that, at 12 o’clock, two hours 
after taking the dose, she fell into a quiet slumber, and slept 
for four hours. The medicine then operated three or four 
times very gently, the evacuations being of a normal appear- 
ance. She was greatly relieved, and although she was confined 
to the bed for several days, she had no recurrence of any 
serious symptoms, and took very simple remedies. 
To those whose attention has never been called to the seda- 
tive action of calomel in disease, this practice must seem extra- 
ordinary. But I hope that enough has been said on the subject 5 
within the past few years to convince some, at least, that the 
action of this potent remedy is totally different on the nervous 
system, according to the mode in which it is prescribed. Doses 
of one grain every hour in this case, or a dose of five or ten 
grains would undoubtedly have disturbed the stomach and 
alimentary canal unpleasantly, and have aggravated the disease 
by adding other sources of irritation. But, like the remedies 
prescribed in the preceding case, it acted through the gangli- 
onic system on the minute vessels of the parenchyma of the 
lungs, checking the inflammation at once, and probably saving 
the patient’s life. For no more dangerous form of disease can 
attack a very old ora very young subject. So it acts in Asiatic 
cholera, in dysentery in its worst or epidemic form, in mem- 
branous croup, and many diseases in which danger is imminent, 
and the number of available resources from which we may 
choose, are very few indeed. The first physician whom I have 
ever known to prescribe the sedative dose of calomel in these 
desperate conditions of thoracic disease, was Dr. Cammann, the 
proposer of the binaural stethoscope. Dr. Learning, once his 
assistant, followed his treatment in some cases ; and in the case 
of this very patient, as she subsequently informed me, relieved 
her almost like magic, as she expressed it, with calomel placed 
on her tongue; how much, I know not; but certainly a sedative 
dose. In dysentery, in cholera, in croup, the remedy acts too 
quickly (in fifteen minutes sometimes) to be explained through 
any other medium than a direct influence on the nervous sys- 
tem. 
I present the three following cases as additional evidence of 
this action, and of the correctness of the views on this subject 
expressed in part first, of this paper. I am indebted to Dr. J. 
E. Learning for the notes of the first two. 
Case III.—Saw this case in consultation; daughter of Mr. 
P.; four years and a half old; had been ill one day. May 18, 
1872, 3 P. M., found her moaning, apparently suffering great 
pain; head moving up and down, and from side to side; pupils 
dilated; apparently in great pain; seemed to be unconscious; 6 
could probably neither see nor hear; pulse very frequent. We 
diagnosed cerebro-spinal meningitis. Twelve grains of calomel 
were placed upon ber tongue. 9:30, motion of head much less; 
answers when spoken to; pulse less frequent; temperature lower; 
There was some stiffness of the back of the neck; an approach 
to opisthotonos. The characteristic eruption fully developed. 
From this time improvement was rapid, and convalescence 
established. 
The above particulars were given from memory, and some 
months after the occurrence of the case. 
Case IV.—Saw Mr. V. B., in consultation with Dr. Kissam, 
of New York, December 13, 1872; had previously had two 
attacks of cerebral compression, with an interval of several years. 
At this time, he again became unconscious, and fell. After a 
couple of days, signs of thoracic inflammation became manifest. 
It was at this juncture I was called in. Breathing oppressed; 
pulse 60 and feeble. Plastic rhles over lower part of both lungs, 
mostly in right side; pericardial pleural r&les could be distin- 
guished. Small doses of blue mass and extract of conium were 
prescribed, with external stimulating applications. 
December 14th.—Patient apparently better. 
December 15th.—Symptoms much worse; urgent dyspnoea. 
It was found that the plastic interpleural exudation* had in- 
creased, with the addition of pericardial friction, to and fro 
movement. It was concluded, in consultation, to do what was 
not done at first, on account of the weakness and slowness of 
the pulse—that is, to give him a sedative dose of calomel. Con- 
sequently, thirty grains were placed upon his tongue. The next 
day the pleural r&les were greatly diminished, and the pericar- 
dial friction murmur had disappeared. Pulse stronger. In the 
course of two or three days the plastic rhles had disappeared, 
and, with the exception of the cerebral trouble, the patient had 
recovered. 
* Dr. Learning, as many of the Profession are aware, regards the r&les, at- 
tributed by most of us to mingled air and moisture within the lungs, to 
plastic deposit on the pleura. 7 
Case V.—Pneumonia Apparently Arrested by a Sedative 
Dose of Calomel.—D. M., the father of the child, whose history 
will presently be related, aged forty, while running about in the 
rain to get necessary articles for his sick child, took cold, had a 
violent chill November 29, 1874, followed by fever, severe pain 
in the right side and shoulder, with severe “ stitch ” in breathing, 
also pains “ all over,” and cough. At the date of my visit, 
30th, had not noticed his sputa. On physical examination, 
find marked dullness, right side, posteriorly over middle and 
lower lobe; respiratory murmur distant and muffled ; no rales; 
temperature 100J°; pulse 90. Appears to be suffering a great 
deal. Diagnosis—pleuro-pneumonia, perhaps accompanied by 
intermittent fever, as his family have been much affected by it. 
Gave 30 grains of calomel on the tongue, and 8 grains of qui- 
nine to be taken in an hour, and the same do3e six hours after. 
December IsA—Rather better, except headache ; temperature 
and pulse the same ; physical signs just the same ; but expec- 
torates well-marked rusty sputa. Says he felt better very soon 
after taking the calomel, but not so well after the other pow- 
ders. The calomel commenced acting twenty-five minutes after 
it was taken, and operated four times mildly. No disturbance 
of bowels since; evacuations very dark. He vomited slightly 
once after the second quinine powder, eight hours after the cal- 
omel. To take ant. tart., gr. 1-16, q. 2 h.; small doses of mor- 
phine, if needed (gr. 1-20); turpentine stupes to right side of 
chest. 
December Sth.—Have not been able to see the patient until 
to-day. Four days since, he sent a message to the effect that 
he felt well, but had a troublesome cough. He was ordered 
“ Cammann’s mixture,” a tonic expectorant. To-day, find him 
looking and feeling well enough to go out. Cough much bet- 
ter. Says he noticed the peculiarity of his sputa for two or 
three days, and that it gradually disappeared. There is now 
only a shade of dullness over the lower lobe. The respiratory 
murmur is good, but still “ muffled,” as if from pleuritic fibrin- 
ous effusion; no r&les. 8 
December 10th.—Patient came up to the village (five miles) 
to-day. Feels well, but is weak; is, however, rapidly gaining 
strength as he exercises. Examined carefully by Dr. J. C. 
Young and myself; find the same physical signs. 
In this case the pneumonia was probably central, and evi- 
dently did not pass through its ordinary stages. 
Case VI.—Convulsions in Children Threatening Immediate 
Death Treated by the Hypodermic Injection of Morphia.—A 
girl, aged three years, child of D. M., seized suddenly with 
convulsions November 28th, at 1 P. M. I saw the child at 5 
P. M. The convulsions have continued uninterrupted and se- 
vere. They affected first one side, then the other, then both at 
once. Pupils now widely dilated and immovable, pulse feeble 
and irregular, estimated at 180; mucous rales in throat, and 
frothy mucus flowing from nose occasionally; respiration about 
50. The head was thrown back, the spine in a state of opis- 
thotonos, the bowels greatly distended with gas. On Thanks- 
giving day she had eaten freely of nuts, but had had febrile 
symptoms every afternoon for several days previously. The 
mother, the day before the attack, had given a dose of oil, and 
the child passed a quantity of fragments of chestnuts this morn- 
ing. The convulsions were, therefore, probably due to abdom- 
inal irritation, and perhaps also to malaria. No time was to 
be lost. I immediately gave two minims and a half of a solu- 
tion of morphia and atropia, and immediately followed it by 
chloroform inhalation. Within fifteen minutes the convulsions 
had ceased; but, for a few moments, the mucus flowed so freely 
from both nose and mouth, that the issue appeared doubtful. 
By turning her on her side, she soon breathed easier, and so 
did I. The pupils contracted down in a few minutes to less 
than their normal size, and the face was much flushed. The 
pulse improved, and the respirations were 44. I then injected 
about a quart of warm water into the bowels, and as no re- 
sponse followed, and having no long tube at hand, I introduced 
a long female silver catheter, and a large quantity of fluid and 
gas were evacuated. I left this in situ, and within half an 9 
hour the belly was very much reduced iu size. I then applied 
flannel turpentine stupes to the whole abdomen and epigas- 
trium ; and, as soon as I could get the teeth apart with the 
handle of a tooth-brush, placed upon the tongue a few grains 
of calomel rubbed up with sugar (“ saccharated calomel ”). 
The temperature was now noted at 102°. In half an hour, the 
carpo-pedal spasm was noticed returning, and the limbs stiffen- 
ing occaisonally, and the opisthotonos increasing. I therefore 
injected another minim of the solution, making in all l-9th of 
a grain of morphia and l-180th of a grain of atropia. In a 
few minutes, the thumb and fingers, from being clenched into 
the palm, became well extended, but soon fell into a natural po- 
sition and remained so. The opisthotonos was not entirely 
relieved. Cold applications were kept to the head, which was 
hot, but not excessively so. Pulse pretty weak. Injected, per 
rectum, three drachms of brandy in warm water, and directed 
this to be repeated every two hours until the pulse improved. 
No attempt to arouse the child to consciousness was allowed, as 
it was important to avoid all sources of irritation. 
November 29th.—Child able to be up about the floor, but 
feeble. Soon after my departure, and about three hours after 
I first saw her, she called “ papa ! ” but did not open her eyes. 
An hour later, she became conscious, and has remained in a 
natural condition since, and able to eat, though vomiting now 
aud then. The medicine operated three times. The opisthot- 
onos continued for about an hour after my departure. 
November SOth.—Has undoubted malarial fever, lb—Quin, 
sulpb., gr. iij., q. 4 h. From this time she gradually regained 
her normal condition. 
In part first, I gave the particulars of a remarkable case of 
convulsions caused by abdominal irritation, extracted from a 
letter from the parent, and published in the “ Boston Medical and 
Surgical Journal.” The case has since been published in full 
in the “ London Medical Times and Gazette,” November 21st, 
by Sir John Bose Cormack, with “ Remarks on the Treatment 
of Infantile Convulsions of Reflex Origin.” He says, in con- 10 
elusion, “the quantity of morphia which can be safely injected 
into the cellular tissue of children, I am unable to state, either 
from my own experience or from inquiries addressed by me to 
several friends in large practice. The subject requires the 
careful clinical study of several competent observers.” “ If the 
hypodermic method of employing morphia can be formulated 
for safe use in the treatment of convulsions of children, it is 
obviously preferable on account of its much greater certainty 
and rapidity of effect.” 
This is only the third case in which I have used anodynes 
hypodermically in young children; once in a hopeless case of 
tubercular meningitis; once in poisoning by stramonium, with 
prompt relief. But, as the dose can just as well be graduated 
to the child’s age, using a fraction of a drop, if necessary, and 
as the danger of “ cumulative ” action is not so great in this 
method as in the enemata per rectum, when large doses are re- 
quired, I shall hereafter resort to the former in preference to 
the latter method. 
Sir John, in remarking on the many important points of his 
case, says: “ The great clinical interest of this case in respect 
of treatment belongs to the large amount of hydrochlorate of 
morphia which was hypodermically injected, and the signal 
success which attended the practice. The fifth of a British 
grain is a large amount of the salt to be injected into the cellu- 
lar tissue of a boy of seven years of age. For this reason I 
have been careful to describe with minuteness the exact condi- 
tion of the patient before, at, and after the injection. The re- 
sult of the experiment made in this case militates against the 
opinion of Dr. Charles West, of London, so far as a single case 
can be allowed to weigh against a conclusion arrived at by one 
of the most experienced and accomplished physicians of the 
day.” 
In my case, the amount of morphia in proportion to age was 
greater. 
Cases Illustrating the Effects of Electricity in the Treatment 
of Disease.—There has been so much skepticism exhibited as 11 
to the alleged extraordinary, not to say miraculous, effects of 
electricity, when systematically and scientifically applied, that 
it may not prove uninteresting or uninstructive to the general 
practitioner, who has probably not had the time or opportunity 
to satisfy himself, by direct experiment, of the correctness of 
these reports, to give a few clinical histories, coming as they do 
from one who has no claim to be called a specialist, and who 
has not very long ago emerged from the domain of skepticism 
himself. 
Some of the most beneficial results of electricity were ex- 
hibited in the prompt relief of vomiting from various causes, 
but these cases, originally intended to form a part of the pres- 
ent series, were published, at the request of the editor, in the 
second number of the “ Archives of Electrology and Neurol- 
ogy,” just issued from the Press. 
Case VII.—This patient has presented for several years a 
series of most remarkable and anomalous nervous symptoms. 
She is thirty years of age, very intelligent, and remarkably 
well educated. Among other neuralgic symptoms, she has had 
for several years severe pains in the knees without any symp- 
tom of inflammation. Latterly, she has become feeble and 
anaemic in consequence of an attack of fever in the South. Be- 
sides the pains, for which I was especially called in, she had 
various symptoms of cerebral and spinal anaemia, for which 
various remedies had been prescribed in vain. She had nausea 
and vomiting of her meals. The Faradaic current from a 
G&iffe’s sulphate of mercury battery was applied every night 
to the knees, and also from the upper part of the spine to the 
epigastrium, to relieve the dyspeptic symptoms and to act as a 
general tonic. In conjunction with pepsin and the acid phos- 
phate, the electricity soon relieved this trouble. The pain in 
the knees was promptly and almost entirely relieved tempora- 
rily, so that she could sleep with the aid of ten grains of chlo- 
ral, sometimes repeated. The pain recurred each afternoon, 
but always in a mitigated degree; and, after eight or ten 
sbances, disappeared altogether. The galvanic or constant cur- 12 
rent from twenty-four cells was used twice, but the other bat- 
tery was more effectual. 
The three following cases illustrate the rapidly beneficial 
effect of electricity in paralysis of sensation and motion when 
applied early in the disease: 
Case VIII.—Mrs. S. D. M., a lady of delicate constitution 
and numerous ailments; lately called my attention to a paraly- 
sis of the right thumb, affecting the muscles and integument 
as far as the wrist. It had developed slowly for several months, 
and was now rendering her thumb comparatively useless; that 
is, she could not feel a small object between her thumb and fin- 
ger, and could with difficulty hold her needle in sewing. One 
application of the Faradaic current from Gaiffe’s little appa- 
ratus relieved her very much, and two more to such an extent 
that she thinks further treatment unnecessary. 
Case IX.—James C., aged forty-eight, applied to Dr. Mur- 
dock September 13, 1874. Had had a severe attack of inter- 
mittent fever, and awoke one morning with complete paralysis 
of sensation affecting only the distal half of the thumb, index, 
and middle fingers of the right hand. Had not had anything 
to do with lead. Dr. M. applied the galvanic current from 
twenty-four cells with no effect. On the 14th, I tried Gaiffe’s 
battery, but, with its full power and the wire brush, could pro- 
duce no sensation in the affected parts. With a Kidder bat- 
tery and the brush, produced a slight effect, but none with wet 
electrodes. To-night, 15th, he is better; very slight sensation. 
Applied Gaiffe’s battery with brush, but he could only bear the 
full strength in the palps of the fingers; that is, where the 
paralysis had been most intense. After a twenty minutes’ 
stance, substituted the wTet electrodes, which produced soon a 
decided effect; and after a stance of three-quarters of an hour, 
he wTas very much better, the sensation being almost normal 
up to the first phalanx. A very slight numbness remained for 
some days, but yielded to three more short applications. 
Case X.—P. M., aged forty, a stout and remarkably healthy 
plumber, awakened a week ago and found rather more than the 13 
distal half of the index, middle, and ring fingers of the right 
hand were numb. He got up and rubbed them with kerosene, 
but they got no better. They remain in precisely the same 
condition now. There is also slight paralysis of motion, which 
effects the muscles of the forearm to some extent. Use of the 
hammer tires the hand very soon. He is undoubtedly poisoned 
with lead, from his own account. No line on the gums. 
January 9th.—Tried galvanic current with interruptions, 
twenty-four cells. No impression without the interruptions. 
Stance half an hour. 
January 10th.—Patient states that the hand seems stronger ; 
that the fingers feel more natural. Applied the galvanic or 
constant current with slow interruptions, twenty-four cells, 
half an hour. Muscles respond much more readily to the cur- 
rent. Afterwards applied the Faradaic current, which now, as 
it had not done before, acted w’ell on the muscles. 
January 11th.—Repeat Faradization. 
January 15th.—Application yesterday and to-day. Paraly- 
sis has almost entirely disappeared, although he has worked 
hard. 
January Vlth.—Has now the full strength of his hand, and 
only feels a slight numbness in the palp of the index finger. 
January 19th.—Almost well; apply battery. 
January 21st.—All right. 
The following cases illustrate the effect of the galvanic, or as it 
is sometimes, not very accurately, called the constant current: 
Case XI.—Obstinate Insomnia—Failure of all Ordinary 
Remedies—Prompt Relief by Galvanism.—Mrs. E. P., aged 
thirty-five, feeble, nervous, neuralgic, and obstinately sleepless, 
with occasional hysterical attacks; has also a painful, probably 
neurotic trouble in one knee-joint, for which various treatment 
has been tried. All the various anodyne mixtures have caused 
nausea or hysteria. A teaspoonful of Hoffman's anodyne 
caused a violent hysterical attack the moment it was swallowed. 
The only sleep she gets is when she takes a large draught of 
brandy at bedtime. 14 
December 28, 1873.—Applied the galvanic current this 
evening to the knee-joint for the pain, and from the nape of 
the neck to epigastrium, wet electrodes for the insomnia, 
having repeatedly noticed the marked drowsiness induced when 
applying the current for other purposes, and also from the Fara- 
daic current. A metallic taste and a sense of choking was pro- 
duced by six or eight cells of a Stoehrer’s battery. 
December 29th.—Did not sleep any better; but feels decidedly 
stronger; knee not so well. Applied the galvanic current to 
knee, also to neck, back and front, and to vertex, keeping one 
electrode always on the epigastrium. 
December 30th.—Applied again, with an application of Fara- 
dization to knee. The brandy has been discontinued for two 
nights. She slept better last night, and expresses herself as 
much better in every way since the applications. 
December 31st.—Slept soundly all night, and after having 
been aroused at 7 A. M., went into a sound sleep again; the 
knee trouble rather increases. 
January 10, 1874.—Has slept soundly and refreshingly 
every night without a resort to any stimulant. Has improved 
remarkably in strength ; much less nervous. 
January 12th.—Was obliged to apply an immovable appa- 
ratus to the affected limb, notwithstanding the inconvenience of 
which, the patient’s sleep was undisturbed. 
Case XII.—This was a case of obstinate epilepsy, and is only 
alluded to on account of the influence of the galvanic current 
on his sleeplessness. It was applied every evening, and inva- 
riably produced a quiet sleep, whereas his wife was constantly 
disturbed by his restlessness previously. It also had the singu- 
lar effect of causing an evacuation of the bowels within half 
an hour in addition to his usual morning action. 
Case XIII.—In this case the galvanic current, applied for 
the relief of uterine pains, produced marked drowsiness. On 
one occasion, the first, to such an extent as to alarm her hus- 
band seriously. He aroused her with difficulty and gave 15 
brandy. She had never exhibited any nervous or hysterical 
symptoms. 
Case XIV.—This is my own case. I had suffered for sev- 
eral winters with chilblains affecting the toes of one foot; and 
last winter they assumed the usual purplish-red appearance, 
with the accompanying horrible sensations. I applied the gal- 
vanic current for ten minutes, and had no trouble the remainder 
of the winter. Some very successful cases of this kind are re- 
lated in an Italian journal (“ Gaz. Med. Ital. Prov. Venete ”) 
by Dr. Santopadre. He used Faradaic electricity. The chil- 
blains are, of course, due to vaso-motor paralysis, and it is not 
strange that electricity should be the proper means of relief, 
since the effect of the galvanic current is to contract the minute 
vessels. 
Case XV.—Miss G., aged eighteen, the subject of leucor- 
rhoea and severe dysmenorrhcea, had been on tonics and other 
treatment with considerable relief to all her symptoms, except 
the dysmenorrhcea, and an almost constant backache of a se- 
vere character. Applied the galvanic current, from eight to 
ten cells, the most she could bear, to the lower spine, on alter- 
nate days. Five applications. After the third, was relieved of 
all pain. Has continued free from pain ever since. Her dys- 
menorrhoea is also much better. 
Case XVI.—M. A. B., a girl twenty-six years of age, the 
subject of repeated attacks of malarial fever, was seized Jan- 
uary 19, 1874, with a severe pain extending from the right 
temple across the ramus of the jaw to anterior edge of sterno- 
mastoid. Applied the galvanic current to seat of pain for 
seven minutes, when she declared that the pain w7as all gone. 
January 20th.—Said the pain recurred at the end of four 
hours for a short time, and that she had felt none since. 
Case XVII.—V. McC., a delicate young girl, always com- 
plaining of dyspeptic and anaemic symptoms, and much re- 
duced from inability to eat proper food, applied to me for a 
swelling in the left arm-pit, wdiich had been there for over two 
years, and had given her pain for several months, and latterly 16 
to such an extent that she can not sleep, and can not even bear to 
let the arm press against it, whether lying or sitting. The pain 
has gradually extended down the arm and forearm to the hand, 
and there is a hard swelling along the radius almost like a peri- 
ostitis. Sometimes the pain extends to the pectoral muscle and 
above the clavicle. It is hard, and has the feel of an indurated 
and hypertrophied axillary gland, but is more irregular, as if 
two or three were welded together. Handling is quite painful. 
Commenced to-day, January 22, 1874, the application of the 
galvanic current, one electrode on the tumor, the other moving 
from the adjacent mamma to a little above it; also from the 
sixth cervical vertebra to arm and forearm for a few minutes. 
The pain in both localities entirely relieved in thirty minutes. 
January 25th.—No shooting pains in tumor, and no recur- 
rence of arm pain ; tumor still painful; repeat. 
January 27th.—No pain anywhere, and very little soreness 
in the tumor. No trouble in sleeping in any position. 
January 29th.—Free from pain or soreness; the tumor 
seems softer. She thinks it is decidedly smaller. Is laboring 
under a malarial affection. 
February 4th.—The electricity has been regularly continued. 
February 18th.—Until the 12th, felt no pain, and she thought 
that the tumor was diminishing; but she was then called upon 
to use the arm a good deal and for some days, and the pain has 
recurred, and is now as bad as ever, being of a stabbing char- 
acter. Applied galvanism as before; pains all relieved in fif- 
teen minutes. 
February 20th.—Pain much relieved, but can not lie on the 
affected side. Applied galvanism. 
February 26th.—Made application to-day, the second since 
last date. Can now lie on the affected side and has no pain. 
March ls£.—Says she is all right. 
March 8th.—Felt entirely relieved until the 5th, when, on 
making some unusual motion with the arm of the affected side, 
felt a sudden pain in the axilla, and the old pain in the tumor, 
in the arm, forearm, and hand returned. A stance of twenty 17 
minutes relieved all pain, and she could not induce it by any 
motion of the arm. She has continued well, avoiding the 
causes which have produced the relapses. 
Case XVIII.— Various Affections Relieved by the Faradaic 
Current.—This was a woman suffering from intense “ bilious 
colic,” her suffering being so great as to prevent her lying 
down, or taking any but very short inspirations; had also intense 
headache and constant vomiting. One electrode was applied 
to the lower dorsal region of spine, the other to the epigastrium. 
Almost immediately after the full strength of a Kidder’s electro- 
magnetic battery was applied, she could breathe easier. In 
eight minutes all abdominal pain was relieved. One pole was 
now shifted over the seventh cervical vertebra, and within ten 
minutes the headache and vomiting were entirely relieved. 
Case XIX.—Herpes Zoster.—This man met me in the street, 
May 29, 1874, complaining of a very severe pain over a spot 
the size of the palm, on the right side of the thorax. Over 
this spot is observed a roughness, and a slight redness. Diag- 
nosed herpes and predicted vesiculation. The pain had com- 
menced four days ago. 
May 30th.—Can not endure the pain, and came to the office 
for relief. It is now a perfectly typical case; a perfect girdle 
of vesicular eruption two inches broad, extending from the 
median line in front precisely to the median line behind. The 
pain has not allowed him to sleep. Applied the galvanic cur- 
rent for eight minutes from the posterior end of the girdle to 
the painful spot on the side. Within four minutes the pain 
had disappeared; 12 to 18 cells. Patient was wonderfully 
pleased and astonished. 
Evening.—Pain has returned. Dr. Murdock applied the 
battery, and relieved the pain in five minutes. 
June 4th.—No pain for five days. It recurred last night, 
and is now worse than ever, in the same spot. Dr. M. applied 
the current for fourteen minutes. At the end of eight min- 
utes, the pain was almost entirely relieved, and completely so 
at the termination of the stance. Has had no effect on the 18 
eruption. I am now successfully applying it to another case. 
Both forms of electricty seem to relieve, but the galvanic is 
preferable. One electrode should be placed below and one put 
above the portion of the spine adjacent to the disease, as well 
as the painful points. 
Case XX.—M. Ii., a single lady, of uncertain age, of a very 
delicate and nervous organization, attacked suddenly last 
Spring with a burning sensation in the right foot, and the 
appearance of a circular, erythematous patch, the size of a 
half-dollar, on the instep. This was more painful than the rest 
of the foot. The discoloration disappeared at the end of three 
or four weeks, but the symptoms have rather increased ; and 
there is a portion of integument on the inner side of instep, 
which is “ numb.” The pain has extended to the sole of the 
foot and a little up the leg, sometimes darting to the hip. She 
walks with difficulty, and can scarcely sleep at all, and some- 
times not without sticking the foot out to avoid the pressure of 
the bed-clothes. Applied the interrupted current from a Gaiffe 
battery for twenty minutes. The painful symptoms were 
markedly relieved ; the numbness much less so. 
December 1, 1874, (Third Day After.)—Much less pain and 
numbness. Has slept the last two nights without difficulty ; 
feels stronger also ; repeat application. 
December 19th.—No further treatment; was entirely free 
from pain until the past week; has walked more than usual; 
the pain is trifling, however. Applied the current again, with 
complete relief. The paralysis of sensation is not much better 
apparently. 
Cases of Various Forms of Myalgia.—It is well known to 
most practitioners who make a frequent use of electricity, and 
to some who do not, that it is a specific against certain painful 
affections, commonly called muscular rheumatism, but which 
has received various designations from different authors; some of 
the latest writers still attributing it to neuralgia. But Anstie, 
in his “ Neuralgia and the Diseases which Resemble it,” clearly 
shows, I think, that it is not neuralgia, since it never follows 19 
the course of any particular nerve. It has no affiliation to 
rheumatism whatever in its manifestations, its causes, or its 
effects. Since we do not understand its pathology, we may as 
well adopt Dr. Inman’s term myalgia, as it signifies merely pain 
in the muscle, or rather in the tendinous and aponeurotic attach- 
ments of the muscle. Sometimes you may cover the painful 
spot, as a single attachment of one muscle, with the tip of the 
finger, sometimes with a half-dollar, and this, not seldom, leads 
to a wrong diagnosis with those who look for muscular pain. 
Spinal irritation, attributed by different authors to many dif- 
ferent causes, is attributed by Inman to myalgia affecting the 
attachments of the erector spinm muscles to the spinous pro- 
cesses ; also the “ backache ” characteristic of the female sex of 
the present age, or the wearing pain, and dragging weakness 
over the upper part of the sacrum, is attributed by him to a 
strain on a weakened muscle in maintaining the erect posture, 
and consequent myalgia. This pain is often, no doubt, partially, 
and sometimes wholly due to this cause, though not generally; 
irritation of the sacral plexus from uterine disease being the 
important factor. The so-called “ growing pains ” of children 
are doubtless cases of myalgia, their weak muscles being over 
worked during the day by the undue amount of exercise to 
which they are subjected. Myalgia, in fact, is apt to be induced 
in all cases of overwork of a muscle in a normal condition, or 
when any work is exacted of a muscle imperfectly nourished, 
or sometimes when it is called upon to act at a disadvantage, 
as when one in perfect health stoops, and rises with severe lum- 
bago, which may last for hours or days; the same thing happens 
to the muscles of the neck sometimes. 
Two principal reasons impel me to ask your particular atten- 
tion to the following cases of this disease. One is, that 
although every physician meets with and treats myalgia, under 
one name or another, as no uncommon affection, very few 
recognize the obscurer forms, which are constantly occurring 
under various circumstances, but often, as pointed out in 
Inman’s excellent work, during the convalescence from tedious 20 
or wasting disease, thus often causing unnecessary alarm, as 
well as inflicting no small amount of unnecessary suffering ; it 
being almost always susceptible of prompt and permanent relief 
under appropriate treatment. Another reason is, that even the 
latest authors who describe the disease, scarcely allude to elec- 
tricity as a remedy—not even Anstie. This is very remark- 
able, since the prompt, almost magical relief which induced 
electricity affords in the most violent cases is pretty generally 
known, and, to some extent, even among non-professional per- 
sons. In my own neighborhood there has been, during the past 
two years, an unusual prevalence of it, a sort of epidemic, and 
some of its most singular phases have fallen under my treatment. 
Many of these would scarcely have been recognized had they 
occurred singly. In Inman’s work, almost every variety is 
described except one, of which I shall present three instances. 
This unusual prevalence was probably connected with the pre- 
valence of malarious fever. It is of the greatest importance 
that we should be on thequi vive for this affection, both because 
it is so common and because its diagnosis will save our patients 
so much distress, and obtain for us so much 6clat, since its 
relief is so easy of attainment, and perhaps after all sorts of 
remedies have been tried in vain. Since the remarkable results 
of the galvanic or constant current in the relief of pain, and in 
the cure of a great variety of diseases, have become known 
through Eemak and his followers, Duchenne’s important labors 
have somewhat been thrown into the shade, and the Profession 
have been disposed to place less reliance on the induced or 
interrupted or Faradaic current. A reviewer of Althau’s in a 
late number of the “ London Medical Times and Gazette ” thus 
speaks of it: “ Though Faradization is not without its uses, 
these seem in the meantime to be—perhaps from the reaction of 
opinion— somewThat under eclipse, but if any one wishes to 
read a glorification of this mode of applying electricity to the 
cure of disease, let him peruse Duchenne’s great work; which 
might almost be described as a work for the laudation of inter- 
rupted electricity.” 21 
These are the terms in which we constantly hear and see 
electrical treatment referred to by high authorities, in other 
matters, but by men who have had little personal experience evi- 
dently in the startling and seemingly incredible results of both 
forms of electricity. For the relief of myalgia, however, espe- 
cially as it affects the more superficial muscles, any, in fact, but 
the deepest seated muscles, I have found faradization, locally 
applied, more prompt and effectual than galvanization. Meyer 
recommends that wre should use the metallic electrodes here, 
and even the metallic brush, or electric moxa. Following him, 
I did so in my first essays, but it is painful, especially the 
brush, and I do not think any more effectual than the wet elec- 
trodes, which are rather pleasant wrhen properly graduated. G. 
Vivian Poore, the latest writer on the subject, in his lectures 
published in the “London Lancet” for 1874, recommends, in 
certain cases, that, while the electrodes are applied, the affected 
muscles should be kept in action. When the affection is 
chronic, and when a certain amount of rigidity exists, this 
may be worthy of trial, when some improvement does not fol- 
low the first or second trial. When the affection seems to be 
undoubtedly muscular, and the wet electrodes fail, which will be 
very rare, it is well to try the metallic disk or brush, and, when 
faradization fails, to try the galvanic current from a large 
number of cells. The latter will, now and then, give permanent 
relief, when the relief from the former is only temporary. Be- 
sides, the failure of the interrupted current is a strong argu- 
ment against the existence of myalgia, and the pain, being more 
deeply seated, or congestive, the galvanic is the proper current, 
as it passes more deeply into the tissues and organs of the body 
than the Faradaic. 
Case XXI.—G. M., aged fifty-five. I introduce this case 
first, because it illustrates what has just been said about the 
two forms of electricity in myalgia, and some of -the minor dif- 
ficulty in diagnosis. I was called to him about a week ago; he 
had then been ailing and confined to his room for some days 
with slight fever; malaise; cough ; but principally pain in 22 
right side of thorax, shooting up to shoulder; almost complete 
inability to help himself in any way, and to draw a full breath; 
symptoms clearly resembling those of pleuritis; physical exam- 
ination failed to detect any thoracic disease; and the pulse was 
not accelerated; the temperature 102°. When muscular rheu- 
matism accompanies the development of thoracic disease, as it not 
unfrequently does, and the inspirations are thereby rendered so 
shallow as to make it difficult to catch abnormal sounds on aus- 
cultation, it is easy to make a wrong diagnosis and to give a 
too favorable prognosis. The battery usually settles the matter 
at once, by removing promptly the muscular complication. I 
gave a hypodermic injection of morphia, having no battery at 
hand, and a solution of morphia to be taken pro re nata. The 
following day he was no better, and I applied the interrupted 
current from Gaiffe’s battery. The pain had, however, shifted 
somewhat, and had settled fiercely in the shoulder. The pain 
in the side was very much relieved, so that he could get up and 
down, and walk about with but little difficulty. The pain in 
the shoulder was not so much affected. I also ordered a full 
dose of quinine, twenty-two grains. The next day, although 
the temperature was much lower, the pain was as bad as ever, 
and I requested Dr. J. C. Young to apply the galvanic current, 
which he did from twenty-four cells, and with almost complete 
relief. This has continued permanent. 
Case XXII.—This case occurred yesterday, December 21. 
The patient is a lawryer, young, and enjoying excellent health, 
except a little dyspepsia and nervousness now and then from 
sedentary habits. Attacked rather suddenly in the morning 
with severe pains in upper part of back, shoulders, across chest, 
and down the arms; a feeling of oppres-ive weight at epigas- 
trium ; dull heavy feeling in head ; pains shooting occasionally 
across temples, and nausea now and then, with considerable 
alarm. He could not move without great pain. Pulse normal, 
temperature 102°. Feeling of great chilliness although roast- 
ing before a hot fire. The pain was so general that he could 
not locate it in any particular muscle. I applied one of the 23 
wet electrodes of a Faradaic battery of the Galvano-Faradaic 
Company’s make to the seventh cervical vertrebra and below it, 
the other in succession to points from this spot to middle of 
right arm. In three minutes, by watch, the patient was sur- 
prised to find the suffering wonderfully better, for he had not 
attached much faith to this mode of treatment. The second 
electrode was then moved across the pectoral muscle, and to 
left shoulder and arm, and in eight minutes he was free from 
all pain on motion, except the head; a very mild current was 
then passed over the scalp and temples, and the head symptoms 
were almost entirely relieved. He was ordered twelve grains 
of quinine and ten minims of elixir McMunn. One hour and a 
half after, during which time he slept, the same symptoms 
recurred, if possible, worse than ever, for the pain was so 
severe as to induce vomiting. I now considered that the affec- 
tion was probably confined to the trapezius muscle, and that 
the recurrence was due to the fact that the current was applied 
to only a small portion of the muscle. I accordingly com- 
menced at its occipital attachment, passed down the spine to its 
lowest limit, then over the scapulae (then touching the middle of 
this region, on either side, nausea was induced), then over the 
clavicle, deltoid, biceps, etc. The relief was as prompt as before. 
The superficial pain of the head was also relieved by applica- 
tion to the occipito-frontalis. The seance in both cases lasted 
half an hour. To-day, find patient entirely free from pain, 
temperature 100|°; says, in the night, when changing his posi- 
tion, he feft a slight twinge here and there. 
December 24th.—Although his temperature keeps rather high 
(102°), has had no pain. 4 
This muscle is very prone to myalgia, and frequently the pain 
is confined to only small portions, and owing to its cranial 
attachment, causes headache, which spreads from this muscle 
over the occipito-frontalis, and thus is apt to lead one astray. 
When one attachment of the muscle, or of any muscle, is 
affected, it is, therefore, better to pass the current through 
every portion of it. The general malaise, cerebral and gastric 24 
symptoms accompanying these affections, and especially the my- 
algia of the trapezius, appear to be due to something more than 
the effect of severe pain, and is possibly attributable, in the case 
of this muscle, to the fact that the spinal accessory nerve is 
freely distributed to it, and also freely communicates with the 
pneumogastric nerve, though generally considered only motor 
in its influence. 
Case XXIII.—Cases of Myalgia Affecting a Very Limited 
Locality.—Mr. B., a young mechanic, in excellent health, came 
to my office January 11, 1874, much alarmed on account of a 
most intense pain in the head, which, from its character, he sup- 
posed to indicate cerebral disease, and from its sudden and 
unprovoked attack. He said he arose as well as ever, and on 
going to the breakfast table, was attacked first with a pain at a 
small spot in the centre of his spine, which was quickly trans- 
ferred to an equally small spot at the back of the occiput; but, 
as the pain increased, it gradually spread over the top of the 
head. I immediately recognized it as myalgia commencing in 
the lowest attachment of the trapezius, and passing to the 
highest, thence spreading over the occipito-frontalis. On ques- 
tioning him as to what he did after dressing, he said, nothing, 
except to use his dumb-bells, as he did daily. Here was a clue 
then to the trouble. I predicted that he would be relieved in 
a few minutes. Applied the Faradaic current from a Kklder 
battery, wet electrode to the head, metallic disk to the back of 
neck. In two minutes and a half, by the watch, the pain was 
all gone, and there was no recurrence. 
Case XXIV.—Mr. M., a stout, healthy farmer, addicted to 
no bad habits except occasional attacks of intermittent fever, 
came into the office July 24, 1874, complaining of what he 
called colic. The pain, which is confined to a spot not larger 
than the hand, just below the epigastrium, commenced suddenly 
this morning, and has continued all day. It is not severe 
enough for colic, and on bending his body in different direc- 
tions, it is rather increased. Faradization for ten minutes 25 
completely and permanently relieved him, and settled the diag- 
nosis. 
Case XXV.—A young and healthy man came in September 
8, 1874, with a pain in left side of thorax, incapacitating him 
for work, for walking in the erect position, or even standing 
erect. Has existed for several days. Applied the induced 
current for about fifteen minutes with the wire-brush; complete 
relief and no recurrence. 
Case XXVI.—John F., a stout, muscular man, came in Sep- 
tember 10, 1874, with a most severe pain over a spot not larger 
than a two-cent piece, just below the lower border of the left 
pectoralis major muscle, preventing work. Faradization with 
the wire-brush for fifteen minutes. Patient much astonished 
on being made to go through with various gymnastics with his 
affected arm, to find himself without pain or inconvenience. 
December 13th—Three Months After.—Has been perfectly 
well since application until three days ago, when he was attacked 
in precisely the same manner. In ten minutes the same treat- 
ment drove the pain to a spot a little higher, and five minutes 
longer relieved him entirely. This shifting of the pain, under 
the influence of the current, is not uncommon, sometimes it has 
to be driven from point to point until it is finally vanquished. 
Case XXVII.—Cases of Myalgia of the Tongue and its 
Muscles, Affecting Speech and Deglutition.—J. A., a stout man, 
in excellent health, except a slight malarial attack now and 
then, came into the office April 6, 1874, articulating with great 
difficulty, but able to give the following account of himself: 
That while eating his breakfast, with a good appetite, he felt a 
difficulty in moving the morsel, which he had chewed, back into 
the fauces, his tongue refusing to perform this duty, and also 
became affected with a sharp pain “ at its root.” There was 
nothing abnormal in the appearance of the member, and no 
pain on pressure, except on pressing deeply on either side of 
the os hyoides, principally on the right side. By exclusion I 
diagnosed myalgia, and requested Dr. Murdock to apply the 
galvanic current to these two points. In a few minutes he 26 
expressed liimself as relieved. But, a few hours later, a mes- 
sage was sent to say that he was much worse. Dr. M. saw him. 
All the muscles attached to the hyoid bone seemed now to be 
more or less affected. The whole tongue was very painful on 
pressure to the very tip; he shrank some from the approach of 
the finger to it; it is also decidedly swollen. Soon after leaving 
the office, he had a regular chill, with nausea and vomiting, 
followed by fever. Dr. M. applied an electrode of the galvanic 
(primary or constant current) battery over the sub-occipital 
region, and making an electrode of a silver spoon wrapped in 
wet cloth, he attached this and applied it as far back on the 
base of the tongue as possible; then from either side of the 03 
hyoides to the tongue, for'thirty minutes. The pain was almost 
entirely relieved. He also injected six grains of quinine hypo- 
dermically in the arm. It should have been mentioned that 
one of his greatest annoyances was a great accumulation of 
mucus in his throat, and the difficulty in getting it up or down. 
April 7th.—Pain not so severe, and confined to the left side of 
the tongue; can swallow very little food though very hungry. 
Electricity applied in the same manner with almost complete 
relief. 
April 8th.—To-day slight soreness on pressure on the left 
side of the tongue towards the base, and on pressure, and also 
in swallowing, over the hyoid bone on left side. But he swal- 
lows soft nourishment pretty well, and feels almost well. 
April 9th.—Scarcely any traces of his trouble. No recur- 
rence. 
Case XXVIII.—Mr. C., farmer, a delicate and over-worked 
man, who has suffered more or less from malaria for a year, 
though travelling about the country a good deal, sent for me 
August 30, 1874, in a great hurry, with the message that he 
was choking to death. Last night was attacked with what he 
calls a cramp in the right thigh, which subsided, but causes a 
halt in his gait to-day. Was eating his dinner, or had but just 
commenced, with a good appetite, when he suddenly found that 
his tongue refused to assist him in deglutition. Then pain of a 27 
severe character attacked the base of the tongue, and soon 
extended to the parts below the base of the lower jaw, all 
around from angle to angle; lie soon lost all power of articu- 
lating distinctly, and could swallow nothing, and thought he 
would choke with the mucous accumulation. He was in this 
condition when I saw him ; his tongue felt to him as if greatly 
swollen, but it was not at all so. The tongue and fauces ap- 
peared perfectly healthy; rather pale; pressure towards the 
base of the tongue very painful. Externally the principal pain 
on pressure was over the posterior portion of the os hyoides, on 
the right side; just behind the symphysis monti it was again 
severe; that is, at the attachment of the genio glossus and genio 
hyoglossus; head hot; extremities cold; patient feels very 
chilly, although the day is warm ; pulse 100, small and feeble; 
temperature 102°; drowsy. His suffering, mental and physical, 
was so great that I gave him, at once, a hypodermic injection of 
morphia, one-third of a grain. Finding that, after an interval of 
twenty minutes, he got no relief, I commenced the application 
of the induced (Faradaic) current, pressing the wet electrodes as 
firmly as he could bear over the painful parts on either side ex- 
ternally, and then from the nape to these parts. In ten minutes 
he could articulate with considerable distinctness, and in twenty 
minutes he was considerably relieved of pain, and could swallow 
with pain and by a great effort. Believing that the deeper 
parts could only be effectually reached by the galvanic current, 
I left with the promise to return the following day and apply it. 
August Slsif.—The relief lasted only a few hours, and he is 
to-day suffering from the same symptoms, if possible, in a more 
aggravated degree. Pulse 99, small and feeble; tongue now 
decidedly swollen, soft and pale; the tenderness has now 
extended to the lips ; the mucus troubles him very much; he 
is very drowsy ; temperature 102°; can not articulate a word, 
and can swallow nothing. Complains of pain behind the left 
trochanter increased by pressure over the sciatic nerve; also of 
some pain about the muscles of the left shoulder. Applied the 
wet electrode of a zinc carbon battery to the affected parts 28 
externally for ten minutes with considerable relief as far as 
articulation was concerned, and with some relief to pain. Ap- 
plied then one electrode to the nape, and a suitable one to the 
base of the tongue, or as far back in the mouth as possible ; 
used seven to nine cells only. Application twenty minutes to the 
tongue. Could articulate better, but could swallow very little 
better. It wTas accordingly reapplied to the external parts, in- 
creasing the number of cells to eighteen, and then to twenty-four. 
Finding that the improvement, though decided, was not satisfac- 
tory, I applied the Faradaic current first to the external parts, 
and then to the tongue itself for ten minutes. Improvement 
less than from the galvanic. After the whole sfiance, which 
lasted over an hour, the patient swallowed two large cupsfull of 
thick gruel without much pain, and could articulate quite dis- 
tinctly, notwithstanding the swollen condition of the tongue, 
nor wTas he so much annoyed by mucus. His drowsiness was 
remarkable, falling asleep while sitting up and while the elec- 
trode was on his tongue. Ordered beef-tea, brandy, etc., freely, 
and gave hypodermic injection of quinine. 
September 1st.—Although his temperature has risen to 103°, 
and he is no better in other respects, his tongue and throat 
symptoms have entirely disappeared. They did not recur. 
Case XXIX.—W. D. G.,a gentleman doing business in New 
York, was attacked suddenly, while walking in the lower part 
of the city, with deep-seated pain in the cervical spine and ex- 
cessive pain in attempting to talk or to swallow; no other 
symptoms. He got to his place of business with some difficulty, 
and immediately telegraphed me to meet him at his residence 
in the country. Not being able to go, Dr. Murdock saw him ; 
found him free from fever, pulse good, skin pleasant. Could 
rotate his head without pain, but any attempt to change his 
position in bed induced severe suffering. Pain seemed to be 
confined to the line of the spinous processes, and a little to 
either side. Deep pressure over the spine behind and in front 
produced more pain than on the sides. Attempts at degluti- 
tion caused a pain passing from the front of the neck to the 29 
back, “ as if the top of the head was being lifted off.” Dr. M. 
could not arrive at a positive diagnosis, but thought the fibrous 
tissues about the vertebral column might be affected by inflam- 
mation. Gave a hypodermic injection of morphia, and a solu- 
tion to be taken for pain pro re nata. 
April 3d.—I saw him to-day. The pain recurred about an 
hour after the injection, and, though he took the anodyne 
through the night, it only made him “wild,” and gave no relief. 
Talking and swallowing still more painful. My suspicions are 
confirmed. The pain has extended to the trapezius muscle, the 
deep muscles at the nape, and the left scalenus. I had no bat- 
tery with me, and I therefore requested Dr. Murdock to visit 
him in the afternoon and apply the Faradaic current. He did 
so, with the effect of relieving all the symptoms except the pain 
on swallowing, which was mitigated ; talking was not painful. 
April 4th.—The pains in the external parts have returned in 
a mitigated degree; the scalenus is free from pain ; but the 
pain on talking, and especially on swallowing, is very severe. 
Applied the Faradaic current for twenty minutes, wet elec- 
trodes to nape, metallic disk to front of neck. The muscular 
pains were entirely relieved and the pain in talking, but that 
on swallowing is no better. The pharyngeal muscles are doubt- 
less affected, —Potass. Iodid., grs. v., q. 3 h. 
April 5th.—The relief obtained yesterday has been perma- 
nent; could not take much of the medicine; deglutition is so 
difficult that he can not take nutriment enough to sustain his 
strength, and he is excessively depressed. I suggested the gal- 
vanic electricity in place of the Faradaic, and Dr. M. applied 
it, placing an electrode on the neck, the other between the 
sterno-mastoid and trachea, pressing as deeply as possible. 
While the current was passing, he could immediately swallow 
without difficulty, and advantage was taken of this to get him 
to take a dose of quinine and some beef-tea. On removing the 
sponge, the pain would return, but in a milder degree. After 
a seance of twenty-five minutes, there was no return. 
April 7th.—To-day, received the following note : “ I am so 30 
relieved of my throat trouble as to be able to eat anything, all 
pains have stopped, and only a soreness of the limbs remains. 
I shall, if all goes well, go to my business to-morrow morning.” 
And he did so. It would seem that the Faradaic current did 
not extend deep enough to reach the pharyngeal muscles. It 
would also seem that, without the aid of electricity, these cases 
could not have been relieved ; even the hypodermic injection of 
morphia failing. 
Case XXX.—P. K., a rather feeble man of fifty-five, fell 
across a lathe in the foundry, injuring seriously the whole of 
the lower ribs on the right side, fracturing at least two of them. 
He suffered a great deal for a week, only partially relieved by 
a body bandage, and afterwards by a double broad band of ad- 
hesive plaster extending quite around the chest, and drawn 
very tightly. It is now April 21, 1874, five weeks since the 
injury, and he has severe pain in breathing, but especially 
in coughing, sneezing, etc. The pain is now quite severe 
at two points on the abdomen, below and inside of the 
false ribs, and these points are very tender on pressure. 
Moving his right arm or turning in his chair increases the 
pain. Applied the galvanic current of a Stoehrer battery, 
first with twelve, then with sixteen cells. Within six min- 
utes he could draw a comfortable breath for the first time, 
and as the current passed, he drew breath after breath, in- 
creasing the depth of the inspirations apparently with the 
greatest satisfaction. In another five minutes he expressed 
himself as feeling “like a different man.” Not even on cough- 
ing did the pain recur. On rising, however, and moving his 
body from side to side, he discovered some painful points, and 
the electrodes were applied as indicated. The pain, as is often 
the case, was driven, as it were, from above downwards until it 
had arrived nearly at the pubes, leaving one spot to attack 
another, until after the lapse of twenty-five minutes all pain on 
any motion or position of the body had disappeared. May 17th 
(over three weeks since last date) no return of pain sufficient 
to call for interference. 31 
Case XXXI.—Mrs. R., aged seventy-three years, a feeble 
old lady, who is frequently sick with what she calls dyspeptic 
and bilious symptoms, was attacked rather suddenly August 
19, 1874, with vomiting, epigastric pain, debility, etc. Dr. Mur- 
dock, who saw her, prescribed quinine. The following day I 
was sent for hurriedly to see her, and found her suffering in- 
tensely, and very feeble, and very much jaundiced. She was 
nauseated, and had the most severe pains across the scapulse 
and in the epigastrium, breathing and movement of any kind 
gave her great pain. I applied the wet electrodes of a Gaiffe’s 
induction battery across the back over the seat of pain, and the 
relief was almost immediate; after a few minutes it wTas ap- 
plied from the spine to the epigastrium, and very soon all her 
pains were relieved, and she could lie easily in any position. 
There was no recurrence. 
Chronic Myalgia.—Myalgia is very generally an acute affec- 
tion, but it frequently assumes the chronic form if not recog- 
nized and treated. There is a form which comes on very slowly, 
almost imperceptibly, around the joints, which I have not 
seen noticed, and is very apt to lead to a suspicion of disease 
in the joint, or of the periosteum covering the articular ex- 
tremities of the bones. If it affects the knee-joint in a child, 
it may be mistaken for disease of the hip-joint, as there is also 
slight lameness from the pain. In a case now under observa- 
tion, the first sensation was of soreness on pressure over the 
internal condyle of the right os brachii; this remained 
in that locality for perhaps two weeks, then very gradually 
spread around to the external condyle, and finally to the other 
parts about the joint not well cushioned by muscles. It was 
worse on wraking in the morning, and on some days than on 
others. Both currents of electricity relieved the pain almost 
entirely (it was never severe), but the patient neglected to apply 
regularly, and only came again when the pain threatened to 
increase, and on being partially relieved, did not apply again 
for a week or two. It has now existed for several months, but 
is only a very trifling annoyance to him at present. 32 
Case XXXII.—Cases of Chronic Myalgia.—Mr. A. W., aged 
fifty-one, in good health except a soreness and chill, roaring 
sort of pain just around the lower border of the ribs and over 
the epigastrium. Does not feel it so much when walking about 
the house, or while at work (he is a house-painter) as when he 
sits still, especially when writing. He has had it more or less 
for several years, but it is latterly increasing, and seeing the 
benefit of the electricity in his wife’s case (localized galvanization 
for severe and chronic uterine pains), he desired a trial. There 
is no other evidence than the pain of lead poison. Applied the 
Faradaic current April 26,1874. At the end of fifteen minutes, 
most of the pain had disappeared, that over the epigastrium 
being the most obstinate. At the end of half an hour, he was 
perfectly free from all pain, and could not induce it by any 
movement. May 14th, eighteen days after, the pain has not 
recurred at all in the old localities, but the day after the appli- 
cation returned, to a moderate extent, at a higher point; it 
soon disappeared, and it has not since troubled him but in a 
trifling degree. 
Case XXXIII.—Mr. E., for twenty-six years a conductor 
on the Hudson Eiver railroad, for several years has been an- 
noyed by occasional pains in the sacrum, resembling the 
woman’s backache. It has constantly increased, until it now 
troubles him almost all the time, especially in stooping. It 
extends also now around the hips, and now and then down the 
thighs; otherwise, he is in excellent health. He states that it 
is a common affection among conductors, and one may well 
imagine that their occupation is just the one to induce myalgia 
of this part. Applied the primary or galvanic current, com- 
mencing with twenty-four cells, but as the current became too 
strong, reduced it to eighteen. In fifteen minutes the pain was 
all gone; he could not bring it on by any movement. 
April 26, 1874, the day after the application, very slight 
pain in the hips, none at all in the thighs. Applied the same 
current for fifteen minutes, all pain had then disappeared. 33 
June lsi.—Has had no further trouble sufficient to require 
any treatment. 
Case XXXIV.—This is the wife of Case XXII. Mrs. C. 
F., a healthy lady of thirty-seven or eight years. For more 
than two years has suffered from pain and soreness on pressure, 
or on any motion of the head, over a space extending from the 
seventh cervical vertebra to the base of the skull, and affecting 
the muscles attached to the occiput, on either side of the spinous 
processes. The pain over the vertebra prominens has been 
such that even the pressure of her dress has always been un- 
comfortable. When the soreness is greatest, it passes up over 
the occiput above the protuberance. It is frequently so severe 
as to induce a nausea and faintness. She has never had any 
relief except from painting it with strong tincture of iodine, 
and now this fails her. Has also hypogastric pains, and as she 
has formerly been under treatment for uterine congestion, they 
may be exerting some influence. Applied the galvanic current 
April 9, 1874, twelve to sixteen cells, from the neck to the hy- 
pogastrium. A seance of twenty-five minutes relieved all pain. 
April Wth.—Was relieved for twenty-four hours ; the pain 
then returned for three hours quite severely. The pain in the 
vertebra prominens, the most troublesome spot, did not recur, 
and there is only moderate pain anywhere. Applied the same 
current for twenty minutes, when all soreness was relieved. 
April loth.—Very much better; no pain anywhere until this 
afternoon, when it recurred, to a slight extent, in the deep 
muscles of the nape, on either side of their insertion in the 
skull. Applied the current to these parts; could only bear ten 
to twelve cells. 
April 1 Qth.—On the day succeeding the last application, had 
a severe pain in the sides of the neck, but none where it has 
always been most troublesome; but it may be, in part, due to a 
severe sick headache, to which she is subject. Applied the 
current from twelve cells from the nape to the temples, and 
from one temple to the other, with great relief to the headache; 
th (n across the neck, with relief to the pain there. 34 
Apr il 21 st.—The headache did not recur after the seance, 
and the other pains have almost entirely disappeared. Applied 
the Faradaic current for fifteen minutes, to finish up the treat- 
ment. Until this date, December 20, 1874, the pains have not 
recurred. 
Case XXXV.—Mr. W., a man somewhat addicted to the 
bottle, but not to any extent for some months, has suffered at 
times terribly from dyspepsia, urinary difficulty, etc. For 
nine years he had a dull pain in the left side of the thorax 
anteriorly, and for nine months a constant pain on both sides, 
quite sharp at times; and, after walking up hill, spreading to 
middle of the sternum, where it is quite painful. Is now 
well, he says, in other respects. Applied the Faradaic current 
to-day, March 26,1874, for twenty minutes, from one side to the 
other, with the effect of giving him almost complete relief. 
March 27th.—No pain all night; has now pain in leftside 
and under the sternum, none on right side (that last attacked). 
The pain is, however, less severe; has also, he says now, had 
a “ numbness and weakness ” in the left upper extremity for a 
year past, only felt when he is idle, or at night. The current 
relieved the pain in the breast in six minutes, and in five min- 
utes that in the sternum also, so that a forced inspiration could 
not induce it. Applied the current to left arm and forearm. 
April 2d.—Have not happened to be in the office when the 
patient called since last date. Dr. Murdock applied the Fara- 
daic current, and as the pain recurred to some extent, substi- 
tuted the galvanic current, twenty to twenty-four cells, with 
relief. 
April Ath.—The pains now trouble him but very little. He 
says that after the Faradaic current was applied to the upper 
extremity, the pain was worse there than it had ever been; but 
it is now better. Applied the galvanic current, twenty-four 
cells, to painful parts and to the arm. 
April 5th.—No pain ; arm better. Repeat application. 
April 7th.—Arm much better. Repeat. 
April 18th.—On the 14th, came in complaining of a slight 35 
pain below the original seat; arm was better. Dr. M. applied 
the battery. To-night, has still some of this pain remaining; 
arm still steadily improving. Applied galvanization with com- 
plete relief, and from this date he required no further treat- 
ment. 
The two following cases, occurring in the persons of mother 
and daughter, illustrate the superiority of the galvanic over 
the Faradaic current: 
Case XXXVI.—Miss L. DeR.; patient has been very ill for 
several months with thoracic disease, and is much reduced in 
strength and greatly emaciated, was improving very much, 
and being over ambitious in walking, two weeks ago, was at- 
tacked with pains around the knee-joints, and with severe pains, 
on slight pressure, over several of the spinous processes of the 
upper dorsal vertebrae. It is impossible for her to lean back in 
a chair, and her mother endeavored to contrive a sort of sad- 
dle-pillow or cushion, so as to relieve the spinous processes of 
pressure, and thus enable her to relieve herself by leaning 
back when sitting. When sitting, it was with considerable 
difficulty and pain that she arose, and her gait was that of an 
extremely old woman. The trouble was evidently myalgia, in- 
duced by ordinary exercise in muscles not sufficiently nour- 
ished. Finding liniments, frictions, etc., unavailing, and the 
trouble increasing, notwithstanding several days of complete 
rest, to-day, August 1, 1874, I applied the Faradaic current 
for over half an hour, with no appreciable effect. 
August 2d--Applied the galvanic current, with no imme- 
diate effect. 
August 3d.—Thinks she is a little better, and sends for me 
to try again. Repeat application to spine and knees. 
August \.th.—Decidedly better. Repeat. 
August 5th.—Pains have almost entirely disappeared. Repeat. 
August 12th.—No return of soreness, and she walks as much 
as she feels inclined. 
Case XXXVII.—Mrs. DeR.; patient is not in good health, 
and over exerted herself yesterday, August 12th, in the city 36 
while shopping. Was attacked suddenly to-day with what she 
calls lumbago; but the pain is confined to the tendinous expan- 
sions of the erector spinse muscle between the sacro-iliac 
joints. She can scarcely get about, and only with great pain ; 
wishes to set out for Saratoga with her invalid daughter to- 
morrow, and is anxious for speedy relief. Applied the Fara- 
daic current, but with only moderate relief. Being engaged 
in the afternoon, I desired Dr. J. 0. Young, then of Bellevue 
Hospital, to apply the galvanic current for me, which he did, 
with complete relief. She set out on her journey, and had no 
further trouble. 
This paper has become so extended, that I am compelled to 
omit some very striking cases of rapid relief following the use 
of the induced or interrupted current. When the diagnosis is 
correct, failure to obtain complete and permanent, sometimes 
almost instantaneous relief, is rare, which is the more import- 
ant, as, in these very cases, the action of all other remedies, 
even of the hypodermic injection of anodynes, is very uncertain, 
very slow, and not so likely to be permanent. 
Allusion has been made as to the probable connection of the 
unusual prevalence of myalgia with that of malaria. But this 
connection is of sufficient importance to merit more than a 
passing allusion. Malarious myalgia does not differ in its 
symptomatology from its other forms. The immediate effect of 
electricity is the same, but the pain is more prone to recur 
again and again, though often in a mitigated degree; some- 
times, however, in an aggravated form. When malarious fever 
is prevailing, this recurrence should at once attract attention, 
and quinine should be administered in a full dose night or 
morning, when the pain will usually disappear until the mala- 
rious element again gathers strength; but quinine alone will 
not cure the myalgia. Whether it is possible to trace any 
malarious complication or not, if the pain is clearly mvalgic, 
and neither form of electricity will afford permanent relief, full 
doses of quinine should be exhibited.