These remarks only apply to those who are compelled to continue moderate work during treatment.
Electricity.—The majority of the later writers unite in considering electricity as one of the most important agents in the treatment of these affections: the form and the manner in which it is applied are, however, all important.
The faradic or secondary current has often been tried in undoubted cases of copodyscinesia, and in the majority has failed. It may be of great service in the paralytic group, where the affected muscle shows signs of atrophy and of being temporarily deprived of nerve-influence; it may be also of service in those apparent cases of the spastic group due to contracture of the unopposed muscles, but in the vast majority, where there is a true spasm of the affected muscles or a tendency in that direction, as evinced by rigidity more or less pronounced during work, or even where there is only a quantitative increase to either current (faradic or galvanic), the application of this form of electricity is contraindicated, as the muscular contraction is already excessive, and should this extra stimulus be applied the muscle may be exhausted, for we know how readily this effect may be produced by a too strong or a too lengthy application in a perfectly healthy subject.
It is hardly necessary to mention that the manner of applying electricity so often followed by individuals—viz. holding the electrodes in the palms of the hands—is unscientific and productive of no good. The proper method of application in the suitable cases is to place one electrode of the secondary coil (preferably the negative, so called) over the muscle that is weakened or over its nerve-point, and the other in some indifferent position, using a current that is just strong enough to cause a fair contraction, and employing a slow interrupter, which breaks the current from one to four times a second. The application should be short, five to ten good contractions of each muscle being sufficient.
Buzzard102 has used this current with success in two cases of impaired writing-power, one of these depending upon a local paralysis. Zuradelli,103 Meyer,104 and Haupt105 have also seen good results by this method. Duchenne106 states that he has “not even seen one success obtained by those who have praised this method of treatment.” The majority of the later writers coincide with this last opinion as regards the spastic form at least.
102 “Two Cases of Impaired Writing-power,” Practitioner, Aug., 1872.
103 Quoted by Erb and Poore, loc. cit.
104 Ibid., loc. cit.
105 Der Schreibekrampf mit Rücksicht auf Path. u. Therap., Wiesbaden, 1860, review in Schmidt's Jahrbucher, Bd. cxv. 3, 136, 1862.
106 Loc. cit.