Case VII. J. G., aet. 9 years, was sent for electrical treatment on September 22d, 1874, by Dr. Krehbiel. He had been under medicinal treatment for a long time, the choreic manifestations dating back upwards of a year. When I first saw him, the choreic movements were so continuous and violent as to preclude the possibility of administering electric baths. The attempt was indeed made; but no sooner had we managed to place the boy in the tub, than he splashed the water freely about, and by the violence of his movements bid fair to injure himself. I therefore deferred for a time the electro-balneological treatment, and had course to ordinary spinal galvanizations. These, together with internal medication—which Dr. K. attended to—had by the 8th of October diminished sufficiently the violence of the movements to admit of the administration of the baths. Accordingly the local applications were discontinued, and from Oct. 8th to Nov. 27th the boy had seventeen baths, when, all traces of the disease having disappeared, treatment was discontinued.
HYSTERICAL AFFECTIONS.
If there is any one disease that more frequently than any other tempts the physician to have recourse to empirical treatment, it surely is hysteria. The obscurity, in many cases, of its etiology, as well as its frequent obstinacy under the most diverse methods of treatment, successively employed, are alone sufficient to warrant us in having recourse to electricity, where this has not already been employed. Where we can establish the etiology of a given case, we cannot of course be in doubt as to the remedy; and in many instances of this kind we find in electricity our most potent curative agent. But even where we are in doubt or positively ignorant as to the origin of the symptoms, we are justified in giving preference empirically to electricity, not only because, the disease being essentially of a nervous character, we find in electricity the most powerful of neurotics, but also because recent statistics, those that embrace a period when electricity has been permitted to participate, if not duly, at least more largely than heretofore, in the treatment of disease, go to show that by means of this remedy better average results have been obtained than with any other. Again, where there are no positive indications to employ any special method of electrization, either central or local, it appears rational to give the preference to a method that is at the same time central and peripheral, that admits of the application of either current with the utmost facility, and is susceptible of so many modifications that, with at best two or three tentative applications, it can be suitably adapted to almost any given case. The results I have thus far obtained justify me in asserting that, of the cases that are merely functional in their nature, by far the greater majority will yield completely to judicious electro-balneological treatment.
As to the mode of administration in this affection, I can suggest nothing. There is so little uniformity in the manifestations of hysteria, that it were idle to even attempt to establish anything like a routine electro-balneological treatment. Each case must make its own laws.
Case VIII.* Mrs. A., aet. 28, married, sterile, from the clientele of Dr. Kremer, was referred to me on June 12th, 1874. She had been a sufferer from hysteria for a number of years. Among the more prominent symptoms were intense pruritus, transient flushing and heat of the entire surface, with pricking sensations and headache. Six baths, in each of which both currents were employed, sufficed to effect a complete and permanent cure.
Case IX.* Mrs. E., from the clientele of Dr. Krehbiel, aet. 28, married, of an exceedingly nervous temperament, had suffered from excessive nervous irritability and prostration since her last confinement (about a year previous to my seeing her). There was no organic trouble, the symptoms pointing to pure functional hysteria. She was sent for electro-balneological treatment April 21st, 1874. Six baths, in which both currents were employed, restored her to perfect health.
NEURASTHENIA.
(Nervous Exhaustion.)
Those who are familiar with the pre-eminent qualities as a neurotic of electricity, will not be surprised to be told of the beneficial effects in the condition under consideration of electric baths. It is not only in general nervous exhaustion, however, that electric baths exercise this salutary influence, but in the condition known as cerebral exhaustion likewise. Judging from my own experience, their efficacy in this latter condition is far greater than that of local applications, whilst they are unattended with any of the irritant and other disagreeable effects that even with the greatest care and caution we cannot always disassociate from galvanization of the brain. They no doubt act here in two ways, i.e., first and chiefly, through reflex influence from the entire periphery; second, by derived currents on the brain directly. Whatever their mode of action, the results obtained are of the most gratifying kind. The pitiable condition in which some patients of this class present themselves, is familiar enough to every physician; but it appears that the greater the degree of exhaustion and the more prostrate the various functions, the more striking are the effects of the baths. The patients seem to live up anew under their influence. While in many if not most other complaints that come under electro-balneological treatment, a certain number of baths are requisite in order to get discernible effects, in the disease under consideration each bath, except perhaps the first, is followed by more or less immediate improvement, which, if the treatment is persevered in, remains permanent.
It is almost unnecessary to say, that in the more advanced cases great care is requisite in the administration of the baths. By over-stimulation at first, much harm may be done, and the patient, instead of getting better, get worse. In such cases very mild currents should be employed in the beginning. As recuperation advances, stronger currents may be gradually introduced. The intensity of the currents should be carefully regulated to keep pace with the gradually increasing capacity of the various organs to respond to the electric stimulus without detriment. Both currents may be used from the first. The galvanic current should precede the faradic, and be employed for not more than ten minutes. Where irritability is a feature of the case, the current should be descending; otherwise ascending. This may be followed by the faradic current, not of sufficient intensity for the first few baths, however, to cause any but slight muscular contractions. In most of these cases iron may be advantageously added to the bath. The duration of the baths should at first not exceed fifteen minutes; in some cases this even is too long, the patient complaining of being fatigued perhaps after the lapse of ten minutes. When this is the case, the bath should be at once terminated. It is in these instances not the electric current, but the warm water bath, that gives rise to the sense of fatigue. Later on in the treatment, the duration of the baths may be from twenty to twenty five minutes, according to indications.
Case X. Cerebral Exhaustion.—K. S., aet. 42, lawyer. First consulted me on June 2d, 1874. The salient points in the history of this most interesting case are as follows: Ten years prior to his calling on me he was engaged in some very heavy law cases and other duties requiring intense mental application. At that time he began to manifest occasional symptoms of cerebral exhaustion; was unable to endure mental exertion with same force as theretofore. These attacks, commencing in 1864, supervened at various times until 1868, sometimes incapacitating him for business for a few days at a time, and accompanied by intestinal catarrh, flatulence and gastric disturbances—probably the results of loss of nerve-power. In 1868, having been subject for a time to extra heavy mental strain, he was completely prostrated, and compelled to retire from the pursuit of his profession. By the advice of his physician he went to the country. There, without any premonitory symptom whatsoever, he suffered an attack of (left) hemiplegia. I quote from his recital as follows: “While standing in the office of the hotel registering my name in the book, I suddenly dropped down, retaining full consciousness. I lost the power of speech for some hours. After twenty-four hours the paralysis began to recede, and in a few days I had made a spontaneous recovery. I then went further into the interior. Two weeks subsequently I had a similar, but milder attack; retained full consciousness and mental control. Returned to city (New York) two weeks after this, in a very debilitated condition. On the third day after my return, I had a more violent attack than either of the preceding—again on the left side. I felt as if a line were drawn perpendicularly through my body, dividing it in halves. My stools were clay-colored. With this attack for the first time I became unconscious, and passed into a delirious state. So far as I know, no diagnosis of my condition was made. I was confined to bed for a month, at the end of which I was in a very feeble state. I then went to Europe, where I spent some years. While there I consulted the first physicians of London and Paris, with but little benefit, however. Both mind and body remained feeble. My normal weight is upwards of 120 pounds, but has for a long time past been in the neighborhood of 90 pounds.”