ARTICULAR EFFUSIONS.
It would appear at a first glance as though local galvanization of affected joints should be more directly and powerfully instrumental than electric baths in promoting the absorption of morbid deposits. To suppose so would however be a mistake—even where a single joint is concerned. Where many joints are involved, the advantages over local galvanization of the baths is sufficiently obvious. Where but a single joint is involved, the current can by means of the surface board be concentrated on the affected joint, while by the general galvanization a stimulus is furnished to the absorbents, that in itself is probably fully as important as any local treatment could be. In this manner absorption is made to progress much more certainly and rapidly, and this course is therefore to be given the preference in all cases where no special contra-indication exists.
The ascending general galvanic current should be employed for from 5 to 10 minutes. The surface board, connected with the negative pole, should then be applied for a few minutes successively to each of the affected joints. Iodine in some form should be added to the baths.
Case XXIV.* Specific synovitis of knee-joint, with considerable articular and peri-articular effusion. Mr. C., from the practice of Dr. Sheppard, aet. about 35. First saw patient at his house on Nov. 9th, 1873, in consultation with Dr. S. and Dr. Hutchinson, of Providence, R. I. Had been on mercury and iodide of potassium for a long time. When I first saw him, he had been incapacitated from work for about a year. Had been unable to leave the house for three months. The affected joint was very much enlarged, with little or no mobility, the condition being practically the same as true ankylosis. It was decided to substitute tonics for the specific treatment, and to administer galvanic baths. On Nov. 11th the first bath was administered, another on the 15th, and a third on the 19th. Considerable improvement in motility was then apparent. Two more baths, taken respectively on the 22d and 29th, effected some reduction in the size of the knee. The baths were continued to January 3d, 1874, when the effusion had become almost entirely absorbed, and the joint perfectly mobile. The patient then had been for some time taking daily walks, unassisted. He now (Jany. 3d) walks without any difficulty, has regained his normal vigor, and is perfectly well.