In chronic rheumatism it is not necessary to use the baths daily. Two or three times a week is quite sufficient. Indeed, the daily use of strong currents, as employed here, might in some instances be productive of evil rather than good. Although transient benefit may be experienced from a few baths—sometimes even from one bath, permanent progressive improvement need never be looked for from less than about a month’s treatment—more or less, according to the nature etc. of the case.
I regret that I have no cases of acute rheumatism to offer. As a rule, a person suffering from this disease is not in a condition to leave the house; and in the cases that have occurred to me in private practice, the difficulty of introducing an electric bath at the patient’s residence has been in every instance sufficiently great to induce me to forego this plan of treatment. While I have thus had frequent occasion here to employ local electrization, I have had but one case of acute rheumatism where I had the opportunity to employ the baths. The local symptoms in this case being limited to one arm and shoulder, the patient was enabled to locomote, and thus became an office-patient. At present the case is still under treatment; and although the results thus far have been eminently satisfactory, it would yet be premature to cite it before I shall be able to state the final result.[12]
Case I.*[13]—Subacute Rheumatism. Mr. F., from the clientele of Dr. Alexander Murray, about 32 years of age, of robust appearance, large, vigorous frame, had an attack of acute inflammatory rheumatism in the spring of 1873, from which he recovered in a short time. In the winter of 1874 he experienced a second attack, for which he had had treatment for about two months prior to coming under Dr. M.’s care. After treating him by other methods, including local galvanic applications to the affected parts (joints as well as muscles were involved) for two weeks, Dr. M. sent patient to take electric baths. On May 25th Mr. F. was brought in a carriage. He was unable to walk; had to be assisted up the steps by two attendants. His arms were in a scarcely better condition, the wrist joints especially being exceedingly tender and painful. The first and second baths, administered respectively on May 25th and 29th, did not effect much change in his condition. The third bath was taken May 30th, with the happiest results. On June 1st patient was able to come for his fourth bath alone and on foot, and thenceforth his recovery was very rapid. The seventh bath, taken June 7th, left him perfectly cured, not a trace of the disease remaining. He has been free from rheumatism since. In the first three baths the galvanic current was employed exclusively, the muscles and tendons being in too tender a condition to bear the contractions induced by the faradic current. In the subsequent baths both currents were used, according to indications.
Case II.*—Subacute Rheumatism. Mr. B—y, aet. 22, came for treatment on August 27th, 1874. Had subacute rheumatism, with considerable swelling of ankle-joints. The acute attack dated back six weeks. Locomotion was very painful, and could be accomplished only with the aid of a cane. A galvanic bath on the 27th and one on the 28th of August were sufficient to remove both swelling and pain, enabling the patient to resume his avocation.
Case III.—Subacute Rheumatism. J. H. K., aet. 29. In the summer of 1873 had a very severe attack of cephalalgia, which, judging from his subsequent history, was probably of rheumatic origin. The attack confined him to bed four days, after which it troubled him continuously for three months. It then abruptly left him, to make way, apparently metastatically, for enteralgia coupled with diarrhœa. This clung to him for five months—until May, 1874. He was then well for a time. Late in the summer of 1874 he began to experience pain in the soles of the feet, which shortly culminated in a more pronounced rheumatic attack than any to which he had previously been subject. It affected chiefly the lower extremities. When he first came under my observation (7th October, 1874) he had been confined to the house five weeks. The left knee and both feet and ankle joints were much swollen. The affected joints were exquisitely sensitive. Both legs were very feeble, and coupled with this was great general debility. Locomotion was rendered difficult to such an extent that even the aid of two stout canes did not enable him to dispense with additional help in mounting my doorsteps. The first bath (Oct. 7th) was followed by no favorable results. Indeed, the patient thought he felt worse, if anything. He followed my directions, however, to take a bath every other day. From the first three baths he received little or no benefit. The fourth bath however had a very marked beneficial effect. Immediately after it he was able to dispense with one of his canes, and thenceforth improved steadily and rapidly. He took his last bath Nov. 10th 1874, having taken in all fourteen baths. He made a perfect recovery. At present (December 1875) he has had no return of the disease, nor any other illness; says he never felt better in his life.
Case IV.—Chronic Rheumatism. Mr. K., from the clientele of Dr. Lusk, had been a sufferer from chronic rheumatism for a long time. As far as I could gather, the disease originated in an acute attack some two years ago. He came for his first bath on June 21st, 1875. Between that date and July 16th following he took twelve baths, which resulted in a complete cure.
Case V.—Chronic Rheumatism. Mr. L., aet. 60, had been subject to chronic rheumatism for many years. When he presented himself for treatment (19th June, 1874) his health in other respects was fair. The flexor tendons of the fingers of both hands were more or less contracted, the result of previous rheumatic attacks. I ordered him the baths, without any adjuvant treatment whatsoever. His improvement was rapid. Between June 19th and July 15th he took fifteen baths, a perfect and (thus far) permanent cure resulting. Mr. L. has frequently taken baths since then, solely however for the sake of their general tonic effects.
CHOREA.
The utility in this disease of electricity has been for some time past almost universally conceded. While some vaunt the faradic, others prefer the galvanic current in its treatment. It appears that thus far the best results have been obtained on the one hand by galvanization of the spine, on the other by general faradization. It occurred to me, when I began to devote myself to electro-balneological treatment, that a method which combines the electrical procedures alluded to, must needs also combine their virtues. Accordingly, I discontinued my previous practice of spinal galvanization in this disease, and had recourse to the baths in almost every case that applied to me for treatment. I am happy to state that in no instance where the baths were employed was anything short of a perfect result obtained. I will state on the other hand, that in every case medicinal treatment was had recourse to at the same time. It is equally true however, that in all the cases medicinal treatment without the baths had proved of no avail. The best method of employing the bath is as follows: For the first ten minutes a constant current of medium intensity should be passed, one pole communicating with the head-electrode, the other connected with the surface board, applied for five minutes to the epigastrium, five minutes to the sacral region. In anæmic persons the current should be descending, in all others, ascending. This concluded, a strong general[14] faradic current should be employed for five minutes. By this means all the muscles of the lower extremities will be very thoroughly contracted. The pole of the battery attached to the foot-electrode should now be transferred to the surface board, and the hands of the patient made to hold this, under water, an additional five minutes. In routine cases this method of administering the baths will be found very efficient. In special cases it may be modified as expedient in the judgment of the practitioner.
Case VI.* Hugh O—l, aet. 12 years, from the clientele of Dr. J. O. Farrington, came for treatment February 5th, 1874. This was one of the most severe and obstinate cases of chorea that I have ever met with. Internal medication, ether spray, change of air etc. had been of no avail. Between the date above mentioned and March 23d the boy had seventeen baths, steadily improving. He made a complete and (thus far) permanent recovery. His intellect, which had been somewhat impaired, was considerably improved.