“At this juncture, as a forlorn hope, it was decided to essay galvanism, hoping that its great vitalizing power might aid in restoring tone to the exhausted nerve centres. At my suggestion, Collis Brown’s chlorodyne was given in place of laudanum, and produced the same effect with an ounce per diem that the four ounces of the former had done.
“Central galvanism was applied, with a twenty-four cell Bartlett battery, using six cells from the cilio-spinal centre to the forehead, with a downward current; then from the cervical vertebræ to the solar plexus, with an ascending current, each lasting six minutes, or until the skin was thoroughly reddened under the negative carbon point. For the first few days applications were made morning and night. In a week the vomiting had ceased and consciousness returned, and the evening sitting was omitted. After a month the dose of anodyne was gradually decreased, but with every diminution the nausea returned, and nothing but a return to the old dose would avail. But her condition was very much improved. She slept better, the eyes were normal as to color and the palms were no longer dry. At the close of the second month she was able to sit up, and the dose of anodyne was steadily cut down without the patient’s knowledge, by adding to the chlorodyne a sufficient quantity of flavored treacle to replace each dose taken, until at that time an ounce would last three days.
“Her general condition was greatly improved, and she began to take interest in her surroundings. In two months more she commenced to go out, and came to my office for treatment, when I changed the current to the Siemens and Halske cabinet cell, which, with its low tension and perfect capability of control, I regard as the ideal battery for central galvanism. There was no further trouble, and to-day, June 21st, the lady is quite well, attending to all her household duties, not having tasted opium in any form for seven weeks, and expressing unbounded delight at being free from the terrible habit which had so long been her master.
“The rationale of the action of galvanism in this case is difficult to understand. When the circuit was closed over the superior sympathetic ganglion, Dr. Wiggin and myself distinctly observed a sudden wave-like contraction of the distended retinal veins, which resumed their size in a few moments after the stimulus was removed. But, after some weeks’ treatment, these veins became normal, and the intraocular congestion had disappeared pari passu with the cerebral symptom, and having repeatedly witnessed the same phenomenon in other cases, I am led to believe that the galvanic current has a direct tonic influence upon the vaso-motor system, which accounts for the occasional surprising results obtained in cases of cerebral congestion. With the advent of increased nerve circulation came an absolute horror for the drug, and it is not easy to know to what to attribute the increase of strength of will up to the point of totally dispensing with it of her own accord, unless it be to some change in mental power, due to increased nerve tone, the direct result of what I have before termed the vitalizing power of the galvanic current. Faradism was not at any time employed.
“Dr. Wiggin gives full credit to the special treatment for the cure of the case.”
DRUGS.
The bromides I have found to be very valuable, especially where there is a hysterical tendency. The bromide of sodium is said to disorder the stomach less than any of the others. To be of any service they must be given in large doses. Dr. J. B. Mattison gives sixty grains, three times a day. I have given as high as three hundred and thirty grains in one hour and a half, and often in one hundred grain doses, and have never yet seen the least harm result, but very decided good. Wyeth’s elixir of the bromide of potassium is an elegant preparation. Its strength may be increased at will. Where there is too decided irritation of the stomach I give the drug by the rectum, in milk. Occasionally a large dose of the bromide will quiet persistent nausea. It certainly modifies the excitement and reflex irritability, as also the headache and salivation.
Coca I have tried in several cases, but cannot agree with Prof. Palmer as to its peculiar adaptability to these cases. As a nerve tonic it is a valuable adjunct to other treatment, but beyond that nothing.
Strychnia, capsicum and belladonna I use in large doses, or small doses often repeated. They are all heart stimulants, and the two former decided nerve tonics, aside from their action on the stomach. I vary the quantity of each ingredient to suit each case. The use of capsicum was first suggested by its successful employment in delirium tremens. A nervous tonic may at the same time be a sedative to nervous irritability. I gradually increase the dose as the symptoms are wont to increase, during three or four days, and the drugs thus given seem to have a better effect.
If the nervous irritability is extreme, especially if there are hysterical symptoms or twitching of muscles, or spasm of the rectal or vesical sphincter, I add lobelia and stramonium, which, besides relieving these symptoms, are excellent in allaying the nausea and vomiting.