ON THE TREATMENT
PARALYSIS  BY   ELECTRIZATION,
WITH AN EXPLANATION OF A
NEW GALVANIC APPAKATUS.
BEING A PAPER READ BEFORE THE N. Y. ACADEMY OF MEOICINE, NOV. 19TH, 1868.
         BY   r
K  D. ROCKWELL, M.D.
FELLOW OF THE ACADEMY.

,   fc
>s
v
PRINTED BY THE NEW YORK PRINTING COMPANY,
          Nos. 8i, 83, & 85 Centre Street.
                   i860. 
 
ON THE  TREATMENT
OF
PARALYSIS  BY  ELECTRIZATION,
WITH AN EXPLANATION OF A
NEW GALVANIC APPARATUS.
BEING A PAPER READ BEFORE THE N. Y. ACADEMY OF MEDICINE, NOV. 19TH, 1868.
         BT is'
A.  D. ROCKWELL, M.D.,
    FELLOW OF THE ACADEMY.
wniXLVRT.i
i<M V* £y
/.J
PRINTED BY THE NEW YORK PRINTING COMPANY,

          Nos. 81, 83, & 85 Centre Street.

                  1869. 
 
ON THE TREATMENT  OF  PARALYSIS,


                WITH AN EXPLANATION OF A
NEW  GALVANIC  APPARATUS.

       Read before the New York Academy of Medicine, November 19th, 1868.
   Mr. President and Gentlemen :—The chief aim of the paper
 which I am to present to you to-night, will be to call your atten-
 tion to the treatment of paralysis, by the scientific use of the
 galvanic and  farad aic currents.   But in the brief time that is al-
 lowed on this occasion, it will be manifestly impossible for me to
 enter into anything like a full or complete  detail of the operations
 that I shall describe, or to answer even a tithe of the various que-
 ries that  will  very naturally arise, concerning a system of treat-
 ment at once so  complicated and unfamiliar.   I shall  therefore
 not attempt to be exhaustive, but shall confine myself to general
 principles—illustrated by special cases—content  if I only succeed.
 in making  clear to you what I regard as the  true scientific basis
 for the employment of electricity in the very frequent and  dis-
 tressing affection that we call paralysis.  And in order to accom-
 plish  this  important and  special  object, it will  be necessary  to
 waive all  mere theorizing  concerning pathology, and  to avoid
 all discussion of words and  names, to omit all elaborate descrip-
 tions  of apparatus, and to confine myself to  that which I  regard as
 thoroughly established and  of direct practical importance.
   The name paralysis (derived from itapa. and Xuw, to loosen) of it-
 self means  nothing, and conveys but little idea of the nature of the
 affection it is designed to express.  It sprang up, like most of the
 names—especially of  our nervous diseases—in dark and ignorant
 times, when men knew so little of pathology  or  physiology, that
 they were  obliged to designate all mysterious affections by some
 predominant symptom.
   The attitude of the profession toward paralysis has, thus far, been
 that of neglect and discouragement.
   The paralytic has been suffered to endure  his affliction as though
it were a special judgment from Heaven, against which to invoke
 the aid of  science  would  be sacrilege.  The reasons for this  dis- 
4            On  the  Treatment of Paralysis.
couragement and neglect on the  part of the profession  and the
people, are threefold :
  In the first place, there have been very few who have attempted
to make any differential diagnosis in the various forms of paraly-
sis. We have forgotten that paralysis is merely a name, a symptom,
or an effect of many diverse pathological conditions.
  Cases  of  paralysis  dependent on  myelitis, congestion  of the
spinal cord, meningitis, effusions on the brain, and  those caused
by reflex action, or  by nervous exhaustion, have been grouped to-
gether, and  have all  received the same prognosis  and the same
treatment.  The tendency has been to content ourselves with the
vague diagnosis—paralysis—which is really no diagnosis at all, and
conveys no idea whatever of the indications for treatment.
  Secondly—We have been in the habit of deferring the treatment
of paralysis  until too  late.  The custom  has been to do nothing
until the eleventh hour, and  then oftentimes to do just the wrong
thing. The palsied patient does not usually suffer the great pain
that is connected with  many other affections, and therefore is more
easily tempted to put  off all  remedial measures until the  muscles
have become so atrophied, and the general system so exhausted,
that recovery is  impossible.
  In the third place, our discouragement in the treatment of pa-
ralysis is largely due to our want of skill, adaptation and  perseve-
rance in the application  and administration of remedies.
  We have  left the details of our rubbing, or passive movements,
or electrization,  to  hireling attendants or careless servants, who
know nothing of any subject, and least of all of the science or prac-
tice of medicine.  We have prescribed batteries, as  we have pre-
scribed boluses, to be used at bedtime, and with even less supervi-
sion of the practical details.
  These  three reasons are, I  think, sufficient to account for the
present unsatisfactory  state of  the therapeutics  of paralysis.
There are two very strong arguments why the profession  at the
present time should give more direct and special attention  to the
treatment of this affection.
  1st. It is certainly increasing in frequency.   We think that all
our older practitioners agree  that hemiplegia, paraplegia, and what
has been termed infantile paralysis, are much more  frequent now
than they were  30  years ago.  The same is probably true of all
phases of nervous diseases.
  2d. With  our present  means  and  appliances for  treatment,
paralysis is much more relievable and curable than formerly.
  The principles on which the recent and more successful methods
of treatment of paralysis are  based are, 1st, internal remedies di-
rected to the removal of the cause ; and 2d, external  applications
designed to  counteract the effects, to improve the nutrition of the
palsied muscles, and to give tone  to the  benumbed nerves.  Ac-
cordingly we give strychnine in paralysis dependent on ansemia or
exhaustion of the nervous centres; ergot, belladonna, and iodide of 
On the  Treatment of Paralysis.              5
 potassium in the opposite conditions  of congestion and  inflam-
 mation.
   We give bromide of potassium to calm the irritated nerve-cen-
 tres and to reduce the volume of blcod in the cranium, and phos-
 phorus as chemical food for the brain.
   In order to fulfil the second indication, the prevention of mus-
 cular atrophy and the restoration of nutrition in the affected parts,
 we employ rubbing, passive movements, and electrization.   The
 latter remedy meets both of these indications better than any other
 that we know of.  It is a tonic to the nervous system, and, like all
 other tonics, exercises a calming, soothing, and quieting influence
 on the brain and spinal cord.
   Like other tonics, also, it increases the appetite, quickens the cir-
 culation, and makes the sleep more profound and refreshing.  It is
 by virtue of these tonic effects that it is so markedly efficacious in
 paralysis.
   Electricity, in some form or other, has been used for paralysis
 for more than a century.  Authenticated cases  of perfect cures
 have been reported, that have resulted from a stroke of lightning.
 In its earlier  days, the voltaic pile worked wonders in this depart-
 ment, but the current it afforded was unreliable and inconstant, and
 therefore it caused more failures than  successes.  Until the dis-
 covery  of the faradaic current by Faraday,  a convenient appa-
 ratus for  electro therapeutical purposes was impossible to  be
 obtained ; and the most trying  annoyances that Ave have expe-
 rienced in all our investigations in the department  of electro-the-
 rapeutics, have been our repeated failures to obtain a convenient
 and satisfactory galvanic  apparatus.  This beautiful combination,
 which I now present to the Academy, was manufactured  for us by
 Messrs. Chester &  Co.  It was not completed  until  after con-
 siderable labor and investigation, and many annoying details that
 can  only  be  appreciated by those who  have attempted  similar
 experiments.   The apparatus may be composed of any number of
 elements  that may be desired.   Seventy-five or  one hundred, or
 at most one hundred and  fifty cells, will  be sufficient for nearly
 all the  ordinary purposes of electro-therapeutics.  The  cells  are
 each three inches long and are  inserted in a wooden block.   Each
 glass is provided with a zinc cover, from which a projection runs
 clown into the glass, thus forming a  zinc element.   The other
 element is  carbon, carefully connected with platinum,  and well
 insulated  from  the zinc cover.  Between this  cover and  the
 glass top,  a piece of soft  rubber is interposed, and the  packing
 is  made completely air-tight and water-tight  by the pressure  of
 two rubber sponges that pull the cover firmly down.
   Connection between the cells is readily made by means of spiral
 springs.  The battery is charged by filling the glasses half full of
 water, adding some bisulphate of mercury.
  A small bit of cloth is interposed between the plates so as to re-
tain moisture.  To use the battery we invert it, thus allowing the 
s
On the  Treatment of Paralysis.
fluid to flow over the plates and moisten the cloth.   It should be
kept inverted but for a short time, and then it should be restored
to its natural position.   While the apparatus is inverted, and for
some time afterward, the current of electricity may be felt by tak-
ing hold of the electrodes.  The strength of  the current, and the
length of time it can be felt after the immersion, will depend on
the number of cells of which the apparatus is composed.    In an
apparatus composed  of 100 cells, a powerful current has been felt
for  many hours after inversion.  In any apparatus all the cells may
be used, or only a part of them, according as a strong  or weak cur-
rent is desired.
  The first  question we are  to ask ourselves, when one  is  pre-
sented to be treated by electrization for the relief  of paralysis,
should be, Will this method of treatment do harm ?  It has been
commonly supposed, and  so taught by some  of the  European
writers on electro-therapeutics, that the faradaic current is harm-
ful  in  hemiplegia  following cerebral effusion, until many months
have elapsed from the date of the attack.
  When extensive laceration  of cerebral tissue has taken place,
it is obvious that the  paralysis will, in all  probability, remain
permanent, and that electricity will be of but little value.   But
when there  has been merely an effusion of blood, the symptoms
are caused by a clot which has formed and  which separates and
compresses the cerebral substance, without  producing great de-
struction of brain tissue.  In such a case the health of the patient
may be approximately  if not  completely restored.   As  a rule,
however,  we  should not wait  six  months,  or even six weeks,
before resorting to electrization, but begin the treatment almost
immediately, and direct  it  especially to the paralyzed  motor
nerves and  muscles.   Benedict of Vienna, the best German
authority in electro-therapeutics, treats hemiplegia by localizing
the galvanic current directly  through that side  of  the brain in
which the clot or other lesion is supposed to exist.
  Another German writer also reports  some quite favorable
results with the same method of treatment.  We  have for some
time been accustomed to apply both the galvanic and the faradaic
currents through the head in  cases of hemiplegia, and with appa-
rently beneficial results.  It is by no means  impossible that the
current, when thus used, may hasten the absorption of the  clot.
  In these cases, however, nature  is the great restorer, and it is
only in a very humble way that our services can be of value.  The
absorption of the  offending clot is a painfully slow process.  A
long time may elapse  before there is  the slightest  indication of
improvement, and months, and even years, frequently pass before
nature has so completed her work that the paralyzed, extremities
are of any considerable service.  While  the process of  absorp-
tion is going  on, the muscles  of the affected  limbs, from disuse
and the want  of the usual brain stimulus, suffer  from  slow but
certain atrophy and degeneration, and when the great nervous 
On the  Treatment of Paralysis.             1
centre is in a  great  measure  restored to its normal condition
the extremities may have been  irreparably injured.  The electric
currents undoubtedly prevent muscular atrophy and fatty degen-
eration of tissue, and a  considerable  experience  teaches that
if used  promptly,  persistently, and  effectively, after cerebral
effusions, we should see fewer permanently crippled conditions as
sequels to paralysis.   As illustrative of  the above principle,  I
will briefly mention a case  that is still under observation.  The
patient is  a stout, plethoric man, somewhat past  the prime of
life.  For  years it  had been his custom to drink five or six times
of brandy daily, although he rarely became intoxicated.
  During  the early part of  the present year, while stepping from
a Third Avenue car, he became  unconscious and fell to the ground,
and, although  he  arose  by his own unaided efforts,  and walked
several blocks to his own house, he remembered nothing  of the
act.   His  reason  returned several hours  subsequently, when
his  right  side was completely paralyzed.  He remained per-
fectly  helpless for several   weeks, when a certain  .degree of
strength gradually  returned, so that, by the aid of a cane, he was
able  to walk short distances.   He first observed some  decrease in
the size of the limb about six  weeks after the  attack, and when
he was sent for treatment by electrization, the thigh had decreased
in circumference one inch.  There was considerable diminution of
electro-muscular contractility in the affected leg, besides a marked
decrease of the normal temperature.  The faradaic current alone
was  used, and in  six weeks' time, after  receiving  twenty appli-
cations, the  limb had increased in  circumference half an inch, the
muscular contractions were  normal, and but little difference could
be noticed between  the temperature  of the two limbs.   In the
treatment of this case it was not supposed that we should be able
to remove the cause.
   The process of  absorption goes on so  slowly, that  the  clot still
 remains, and it will be many months, if ever, before he regains his
 previous strength and vigor.  The atrophy of the muscles was, how-
 ever, at once  arrested.  The normal electro-muscular  contrac-
 tility was restored,  the temperature of the limb  was increased
 several degrees,   and  its  nutrition  generally was much im-
 proved.
   The efficacy of  the galvanic current in paralysis resulting from
 spinal congestion, and its superiority over the faradaic, were illus-
 trated in  a most decided manner in a case that is now under the
 treatment of Dr. Beard.  The history of the  case was that gen-
 eral debility had   produced spinal exhaustion, and spinal exhaus-
 tion had  extended to congestion, which  had resulted in paralysis
 of  both  the  upper  and lower  limbs.   When first seen  with
 Dr. Alexander, of Staten Island,  she  could not move her lower
 limbs  at  all, and  had very little power over her arms and hands.
 The interossei were beginning to atrophy.  The faradaic current
 had been used with  slight benefit to the upper limbs, but with 
8              On the  Treatment of Paralysis.
none whatever to the lower extremities.  Five or six applications
of the galvanic current, from Chester's air-tight galvanic battery
of sixty cells, produced  immediate results.  She could  raise her
feet and bring her arms to her head.  After six weeks of treatment
the atrophied muscles are  returning  to their normal condition.
She is beginning to feed herself, which she had not attempted
to do for several  months  before.   She can sit  for  an  hour
in a nearly natural  position, and  with assistance can  stand for a
moment in an upright position.   The patient is still under treat-
ment.                                   #        ...
   But there are paralytic conditions in which electrization is not
only useless, but may result in positive injury to the patient.  The
contra-indicationsfor its use were very marked in the case of a wo-
man who consulted us eighteen months  since.   In  the  morning,
while dressing,  she was prostrated instantly, and for several hours
remained unconscious.
   Her intelligence returned only partially after the lapse of twenty-
four hours, but  the paralysis of the right side was complete.  Four
weeks subsequently, when some  slight power of motion  had re-
turned, an application of the faradaic current was  made to the
affected parts.
   The diseased limbs were remarkably susceptible to the influence
of electrization.  A current of very ordinary intensity, and suf-
ficient to produce contractions on the healthy side, would instantly
cause the muscles of the paralyzed limbs to become violently con-
vulsed.
   An application of a few moments only was invariably followed
for the time being by a complete loss of the little power regained
by the paralyzed muscles.
   After the experiment  had been tried a number of times, it was
evident that  the patient  had lost rather than gained strength, and
the treatment  was  discontinued.   According to the experiments
and researches  of Dr. Todd, the marked  exaltation of the nervous
force in this case doubtless depended upon an irritative lesion of
the brain. Dr. Althaus and others relate cases similar to the above,
caused by repeated attacks of apoplexy, by a tumor pressing upon
the brain, and in some instances—as in the case just related—by a
single apoplectic seizure. When, therefore, in a case of hemiplegia,
the   electro-muscular contractility of  the paralyzed  limbs  is
greatly increased, we may conclude that the patient is  suffering
from an irritative lesion of the cerebral tissue, and electrization in
any form is contra-indicated.   Another question that arises in the
treatment of paralysis by electrization, concerns the kind of current
to be used, whether the faradaic  or galvanic.
   ~No. 42, Vol. 2d  of the N. Y.  Medical Record contains an ar-
ticle  on  Reflex and Organic Paralysis, by Dr. Geo. M. Beard  and
myself, in which is detailed  a case illustrating so  decidedly  the
varying effects of the two currents, that I beg leave to  refer to it.
 Miss P----, a stout, vigorous young  lady of fifteen, was sent to us 
On the  Treatment of Paralysis.              9
by Dr. F. Elliot, to be treated for paralysis of the 7th pair on the left
side, caused by exposure to a draught of air two months previous.
The paralytic symptoms came on  suddenly and in full force imme-
diately after the exposure, and at  first she experienced great diffi-
culty in speaking.  She  gradually became so accustomed to the
abnormal condition of her lips and face that she was able to con-
verse almost as clearly as before, but the improvement in the con-
dition of the paralyzed muscles was very slow, and at the time she
came to us the affection appeared to be almost stationary.  At the
time she received the first application at our hands she presented
most  of the  usual symptoms of paralysis of the 7th pair.   Her
mouth was drawn over toward the healthy side so violently as to
produce considerable deformity when she laughed or conversed,
and even  when she smiled.  When she attempted to frown the left
brow remained as smooth as that of a child.
   Her left eye rolled up, and when she  attempted  to close it the
lids would not approach nearer than £ of an  inch  to each other.
A powerful faradaic  current localized in the affected  muscles pro-
duced very feeble or imperfect contractions ;  while on  the sound
side a very mild current, applied with the hand, produced active
contractions  of all the principal muscles.
   The patient was so well in all other respects that we decided to
use only partial or localized electrization over all the muscles on
the leftside of the face.   Two vigorous  applications made  in this
way—one electrode  being placed firmly below  the ear, and  the
other passed over the ramifications of the 7th pair,  as well as over
the individual muscles—did not seem to increase, to any appreciable
extent, the electro-muscular contractility, and accordingly we re-
solved to  adopt an entirely different  method of warfare.   The
next time we localized the galvanic stream through the left side
of the face, and with most charming results.   Contractions of the
paralyzed muscles were at once produced that were as vigorous as
those caused by the  faradaic current on the healthy side.    The
patient began at  once to improve, and after ten visits, distributed
over a period of six  weeks, she was  dismissed as  approximately
cured.  There still remained some deficiency of action of the mus-
cles concerned in frowning and in winking, but the expression of
her face, both in repose and in conversation, was normal.   The
very little that remains  nature ought to accomplish unaided.
   The interesting points in this case are as  follows :
   First—The galvanic current produced contractions and wrought
a cure, when the  induced or faradaic utterly failed.   This impor-
tant fact  with regard to the galvanic current, viz.: its power of
causing contractions in paralyzed muscles that do not appear to be
affected by the faradaic, was first pointed out by the late Prof.
Remak, of Berlin, whose original and able researches in electro-
therapeutics* really  made him the  father of a distinct  school of
electricians in Germany, as  Duchenne has long  been in France.
     * Ueber Method. Electrisirung Gelahmter Muskeln.  Berlin, 1865. 
10
On the  Treatment of Paralysis.
Though the ideas advanced by Remak were at first scouted and
despised by the profession, as indeed has ever been the case with
all original suggestions  in science, and although his own impetu-
osity and extravagance hurled him into generalizations that could
not have stood the test of investigation, yet his leading idea in re-
gard to the superiority of the  galvanic over the faradaic current,
in some forms of paralysis, is now as fully  established as any fact
of science among those  who are practically familiar with electro-
therapeutics.  These  observations of Remak have recently been
confirmed in a very striking manner by Prof. Ziemssen,* of Ber-
lin, by Schulz, Meyer,f  Baierlacher, Neumann, and Hammond.
   Second—The  paralyzed  muscles were at first brought to con-
traction by a galvanic stream  of small quantity, but  of consider-
able intensity, that had  no effect whatever  on the muscles  of the
healthy side.  As the patient improved, however, it became neces-
sary to use a  stronger galvanic  stream  in  order  to produce  the
contractions.  Toward the close of the  treatment the muscles of
the paralyzed side began to  respond  to  the faradaic current.
These  apparent inconsistencies had also been previously observed
by a number of  the German electricians already mentioned.  The
late P. Victor BazireJ has recorded an experience almost precisely
similar.
   It does  not follow from these facts that the relative value of
the two currents is  entirely  undecided.  On the other hand, it
may well be questioned whether we do not  know nearly as much of
the indications of their  use and the rationale of the operation of
their currents as of any of the internal remedies that  are styled
specifics.  In  general electrization, for the purpose of producing
a constitutional tonic influence; in partial electrization, with a view
to calmative or  absorbent effects, and for  most cases of localized
electrization, we use the faradaic current.
   On  the  other hand,  for those  exceptional cases of paralysis
where  the faradaic current will not produce contractions, and
when it is desired to affect the retina, we use the galvanic.
   We have now under  treatment three cases of infantile paralysis,
two of which are evidently reflex in character, caused  respec-
tively  by exposure to cold during the irritative process of teeth-
ing, and by persistent digestive disorder.  In both cases  the pa-
ralysis was complete.   No intensity of the faradaic  current which
we felt justified in applying  to the affected arms produced the
slightest effect,  but when  a galvanic current of moderate power
was made use of, the muscles of the paralyzed responded almost
as readily as those of the healthy side.   The improvement in the
condition of the little patient, whose paralyzed limbs resulted from
the combined causes of cold and teething, has been very satisfac-
   * Die Electricitat in der Mediein. Berlin, 1866.
   + Die Electricitat in ihrer Anwendung auf Pract. Med. Berlin,  1861.
   % Notes to Translation of Tiousseau's Lectures  on Clinical Medicine.'  Part II
ip. 331 
On the  Treatment  of Paralysis.             11
tory.   He has regained  full power  over the  hand and forearm,
but is still  unable to raise the arm readily from the side.  Not-
withstanding the  approximation to a perfect cure, the faradaic
current will as yet produce only feeble contractions, while under
the influence  of the galvanic  current  the electro-muscular con-
tractility is vigorous.
  In the other case the improvement is far less rapid.
 ^ There is  not  the  slightest evidence of reflex movement in the
diseased arm, and the faradaic current is entirely inoperative in
its effects.  The  galvanic  current will, however, produce  some
considerable contraction of the muscles, and it is  evident  that
whatever favorable  results are to be  obtained by electrization
must  come from the persevering use of this form of electricity.
  The third case of infantile  paralysis to which I referred, oc-
curred in the person of an infant aged fourteen  months.
  The left leg was  entirely powerless,  and although the muscles
responded with  impaired vigor  to the galvanic stimulus, the  fara-
daic current produced no contractions whatever.  The paralysis
had  existed eight weeks, but  in this case the  galvanic current
produced results quite unexpected, and I think unusual, for in
ten days the child was approximately cured.
  A  marked  feature in the effect of electrization with the fara-
daic current on very young children, is the difficulty with which
muscular contractions are produced.   Not infrequently we find
it impossible to cause the muscles to respond in the slightest de-
gree to the  stimulus of an induced current of sufficient intensity
to excite powerfully the  electro-muscular  contractility of  the
limbs of an  adult person.  This phenomenon is  due, probably, in
part,  to the great quantity of adipose tissue which surrounds and
covers the muscular substance of infants, as  well as to the insus-
ceptibility of the undeveloped muscular and nervous tissue to the
influence of the electric current.
  The leading  ideas that I have sought to advance in this essay
to-night may be summed up in the following propositions :
  1st. Paralysis is not a disease, per se, but is merely a symptom
of some disturbance of the central or peripheric nervous system.
Our treatment  of paralysis, whatever  system  we adopt, should
have  reference  not alone to the  affected parts, but also to the
general condition of which it  is the result, or  with which  it is
associated.
  2d. Paralysis—throwing  aside the  toxic, traumatic, and  local
varieties—is pre-eminently a symptom of exhaustion or weakness of
the nervous system.  Therefore it is increasingly frequent under
the pressure, and haste, and nervous strife of our high civilization.
  It occurs  most frequently among the  cultivated and  the  intel-
lectual.   Therefore, als6, we should naturally expect  it  is most
liable  to  attack those constitutions that exhibit  a tendency to
nervous  disorders, and at  the  period  of life when the  nervous
system is most  susceptible to disease.  Accordingly we find that 
12             On the Treatment of Paralysis.
paralysis, though it  may and does attack all ages, is peculiarly a
malady of the two extremes of life—infancy and old age.
   3d. The two  cardinal principles of treatment of paralysis are,
in the first place, to  administer remedies directed to the removal
of the cause, that is, the condition of the system, or the local in-
jury of which the paralysis is a symptom; and in the second place
to restore the tone  and  nutrition  of the affected  parts.  _ The
first condition is  met by the administration of strychnine (inter-
nally or hypodermically)  when  the  central nervous  system  is
anaemic ; in the use of iodide of potassium, ergot, belladonna, and
bromide of potass., when the spine or brain  is congested or in-
flamed ;  and by the use of  general  tonics, such as bark, iron,
phosphorus, arsenic,  and oxide of zinc.
  The second condition is met by rubbing, shampooing, &c.
  Electrization,  general or localized, with the varying  use of the
galvanic or faradaic  currents, by the consent of nearly all our mod-
ern  neurologists,  fulfils these indications better than  any  other
method of treatment.  It benefits paralysis by virtue of its tonic
effects on the nervous and muscular system.  This is indeed the
only scientific basis for the employment of electrization, not only
in paralysis, but  in every other form of nervous disorder.
  General electrization,  like the other tonics—strychnine, bark,
iron, sunlight, &c.—is  primarily stimulating, but, like these other
tonics  also, its permanent effects are  to  strengthen, to calm,  to
soothe, to sharpen the appetite, to increase the digestive capacity,
to lengthen  and sweeten repose, to restore the languid  circula-
tion, to improve nutrition, and consequently to cause increase  in
size and weight.
   It is by virtue of  those constitutional tonic properties that elec-
trization benefits paralysis.
   4th. In the treatment of paralysis by electrization, the distinc-
tion between the effects of the galvanic and faradaic currents is of
radical and indispensable importance.  An intense, penetrating
galvanic current, from 50 or 100 cells of  Chester's air-tight bat-
tery, will overcome  far greater resistance than the  faradaic ; will
produce muscular contractions in paralyzed limbs where the far-
adaic  is powerless ;  and  will also  more directly and  positively
affect  the great sympathetic.
   A neglect of these vital distinctions  is one of the many causes of
our failures in the use of electricity for paralysis.
   The  magneto-electric machines, in  which the electricity is gen-
erated by turning a crank, are inconvenient and unreliable, and,
especially when unscientifically used, have done the cause of elec-
tro-therapeutics almost irreparable injury.
   5th.  In the treatment of paralysis by electricity,  we  should
first of all make a differential diagnosis, and then studiously adapt
our treatment to  each individual case.  Fresh recent attacks of a
local character are sometimes very quickly relieved and cured by
the faradaic current alone,  but long-standing  and severe  cases, 
               On the Treatment of Paralysis.             13

that constitute the majority, demand the varying and persevering
use of both the  galvanic and faradaic currents for  weeks and
months.
  We feel the necessity of ever keeping in mind the expressive
words of the great Trousseau :  " Chronic diseases demand chronic
treatment."
  6th. The prognosis of paralysis, taking  the cases as they run,
without reference to their pathology, is  far more favorable, at
least when treated on  the principles here  indicated, than is com-
monly supposed.   None need  be injured  by the treatment here
described, while many cases are decidedly ameliorated, and a re-
spectable  minority are permanently cured.  During the past two
years we have treated by electrization, general and local, and  by
the varying use of the faradaic and galvanic  currents, 70 cases of
paralysis,  resulting from a variety of causes, and manifesting itself
in different parts of the body.  It may be interesting to sum up
briefly, and in a  general way, the results of the treatment.   Of
these 70 cases, 16 were supposed to result from cerebral effusion,
causing hemiplegia; of this number 11  suffered from  paralysis of
the right, and 6 of the left side.
  Three of the cases  were approximately and two  completely
cured ;  three  were very markedly benefited ; three discontinued
treatment after a few visits ;  in three cases only slight ameliora-
tion was  evident, while  two failed to receive  any benefit  what-
ever.
  Four cases of complete facial paralysis, two of which involved
the right side, one the left, and one both sides of the face.
  With the exception  of the case involving the 7th pair on  either
side, and  which probably resulted from organic change, following
syphilis, they  were all  quickly  and completely cured.  Anaesthesia
occurred 20 times.   In nine cases the cure was complete ; nine of
the patients were approximately cured, while  two discontinued
treatment before any result could be seen.
  Four cases  of complete paraplegia, three of which received no
benefit  whatever, while one  was  approximately cured after a
protracted course of treatment.  One of the patients died while
under treatment. The myelitis from which she suffered gradually
extended  upward, and paralyzed the vital organs.
  Eight cases of infantile paralysis, probably of a reflex character.
Four of these patients were  completely and rapidly cured, and
two were approximately cured,  while  two  received no benefit
whatever.                                 ,,.,.,•    ,   *>
  We have treated 12 cases of paralysis,  each of which involved
but one limb of the body.  One of these was approximately, and
five completely cured; four derived marked  benefit,  while two
discontinued treatment before any result was noticed.
  Four cases  of palsy agitans, but in one  case only have we suc-
ceeded as yet  in obtaining even a slight amelioration of the symp-
toms.  Writer's  cramp  occurred  twice.  One patient recovered 
14
On the  Treatment of Paralysis.
considerable power in  the  affected hand, while the  other  expe-
rienced no relief worthy of mention.
  This aggregate result, though perhaps not brilliant, is certainly
most  encouraging, and will, "I think, compare not  unfavorably
with the record of treatment of any other severe type of chronic
disorder.
  The old and familiar Roman  maxim,  "Principiis  obsta "—
" Stop the beginnings "—is of pre-eminent importance in the treat-
ment of paralysis.  If  we could at once and forever discard the
error that electrization  is merely an irritant and a stimulant, and
rise to a  clear and full appreciation  of its tonic  and soothing
powers; if we could remember to begin our treatment of para-
lysis in its earlier stages, before  weeks and months of  neglect
have exhausted the general tone of the patient, and shrivelled his
palsied muscles, then I am sure that a new history and a new era
would open for one of the most  common  and  most distressing
maladies of our time. 
 
J 
 
I