145 files changed, 15645 insertions, 0 deletions

diff --git a/.gitattributes b/.gitattributes
new file mode 100644
index 0000000..6833f05
--- /dev/null
+++ b/.gitattributes
@@ -0,0 +1,3 @@
+* text=auto
+*.txt text
+*.md text
diff --git a/26366-0.txt b/26366-0.txt
new file mode 100644
index 0000000..db013fe
--- /dev/null
+++ b/26366-0.txt
@@ -0,0 +1,3661 @@
+The Project Gutenberg EBook of The Electric Bath, by George M. Schweig
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: The Electric Bath
+
+Author: George M. Schweig
+
+Release Date: August 20, 2008 [EBook #26366]
+
+Language: English
+
+Character set encoding: UTF-8
+
+*** START OF THIS PROJECT GUTENBERG EBOOK THE ELECTRIC BATH ***
+
+
+
+
+Produced by Bryan Ness, Markus Brenner and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+book was produced from scanned images of public domain
+material from the Google Print project.)
+
+
+
+
+
+
+                                  THE
+                             ELECTRIC BATH
+
+                       ITS MEDICAL USES, EFFECTS
+                             AND APPLIANCE
+
+
+                                  BY
+
+                        GEORGE M. SCHWEIG, M.D.
+
+   MEMBER OF THE NEW YORK COUNTY MEDICAL SOCIETY AND OF THE MEDICAL
+        JOURNAL ASSOCIATION OF THE CITY OF NEW YORK; ONE OF THE
+           PHYSICIANS TO THE NEW YORK LYING-IN ASYLUM, ETC.
+
+
+                               NEW YORK
+                          G. P. PUTNAM’S SONS
+                           182 FIFTH AVENUE
+                                 1877
+
+
+
+
+                              COPYRIGHT,
+                         G. P. PUTNAM’S SONS,
+                                 1876.
+
+
+
+
+                               PREFACE.
+
+
+In No 216 of “The Medical Record” (Dec. 15th, 1874) was published an
+article written by me, entitled “On some of the Uses of Galvanic and
+Faradic Baths.”
+
+The interest manifested in the subject, as evidenced by numerous letters
+of inquiry since received from physicians in almost all parts of the
+United States, and some in Europe, has induced me to write the present
+treatise, in which I have endeavored to present to the profession, as
+far as lies in my power, all that is necessary to a full comprehension
+of the electro-balneological treatment.
+
+When it is considered that in the employment of electric baths I have
+been to a great extent groping in the dark, that I have been deprived of
+the advantage of having the experience of others to guide me, it will
+not appear surprising that I should have met with many disappointments.
+My failures have been illustrative of the fact that the electric bath is
+no more a panacea for all ills than any other remedial agent.
+Applicable as it is to a great variety of pathological conditions, it
+meets with many where it is destined to have negative or at best
+imperfect results. Far from discouraging me, however, failures have
+served to inspire me with fresh ardor to seek for light, and to
+persevere in my efforts to establish on the basis of statistical truth,
+the therapeutic merits of the agent which I employed.
+
+In view of the imperfectness of the results thus far obtained, I should
+consider the present work premature, did I not find a justification for
+it in my desire to induce other and abler observers to investigate the
+subject, and place it on whatever footing it may merit.
+
+To say that I am fully conscious of the shortcomings of my work, would
+be but feebly to express my convictions in this respect. I beg the
+reader however to consider that the subject is not a hackneyed one, that
+mine has not been the work of the compiler who remodels the brain-work
+of others. It may be crude and rough, it may lack the gloss and polish
+that is the result of much handling, but I have at least the
+consciousness that it has the merits of originality and candor.
+
+              NEW YORK.
+  160 Second Avenue. November, 1876.
+
+
+
+
+                               CONTENTS.
+
+
+                              CHAPTER I.
+
+                            THE APPARATUS.
+
+                                                                  PAGE
+
+_a_)—The tub. _b_)—The electrodes and connections.
+_c_)—The water. _d_)—Chemicals. _e_)—The batteries.               7
+
+
+                              CHAPTER II.
+
+MODE OF ADMINISTRATION                                              19
+
+
+                             CHAPTER III.
+
+                        PHYSIOLOGICAL EFFECTS.
+
+Characteristic differences between the electric bath and
+other methods of electrization—Effects on sleep; on general
+sensation; on the change of matter; on the pulse and
+temperature; as a stimulant and tonic; on general nutrition;
+on the digestive apparatus; on the sexual apparatus—Sedative
+influence—Affects cranial nerves—Cutaneous sensation—Its
+freedom from pain—Muscular contractions—Effects on the mind       31
+
+
+                              CHAPTER IV.
+
+                 GENERAL THERAPEUTIC EFFECTS AND USES.
+
+The electric bath as a diagnostic; as an equalizer of the
+circulation; as a general counter-irritant; as a general
+invigorant and tonic—Its hypnotic and sedative influence—Its
+improvement of nutrition—As a prophylactic                         52
+
+
+                              CHAPTER V.
+
+               SPECIAL THERAPEUTICS AND CLINICAL RECORD.
+
+General directions—Special diseases—Acute rheumatism—Subacute
+rheumatism—Chronic rheumatism—Cases of rheumatism—Chorea,
+with cases—Hysterical affections, with cases—Neurasthenia,
+with cases—Agrypnia, with cases—Anæmia, with case—Paralyses
+and Pareses, with cases—Neuralgiæ, with cases—Articular
+effusions, with case—Impotency, with cases—Constipation, with
+cases—Hydrargyrosis, with case—Locomotor ataxia, with
+case—Cachexia, with case—Dyspepsia—Melancholia, with
+case—Inequalities of the circulation—Affections of the
+Sympathetic, with case—Miscellaneous conditions—Concluding
+remarks                                                             61
+
+
+
+
+                          THE ELECTRIC BATH.
+
+
+
+
+                              CHAPTER I.
+
+                            THE APPARATUS.
+
+
+To a proper comprehension of the succeeding chapters, it is necessary
+first of all to be familiar with the apparatus employed in carrying out
+electro-balneological treatment, and I therefore proceed to give a
+description of this.[1] It may conveniently be divided as follows, viz.
+
+    _a._ The tub;
+
+    _b._ The electrodes and connections;
+
+    _c._ The water;
+
+    _d._ Chemicals;
+
+    _e._ The batteries.
+
+(_a_) _The Tub._ This must be made of a non-conducting material. Of
+substances that will answer, I will mention: wood, porcelain, soapstone,
+vulcanized rubber, or glass. In choosing one of these materials, regard
+should be had to the facility of attaching the electrodes. In this
+respect wood deserves the preference over all the others mentioned.
+Where economy is to be studied, it has a further item in its favor.
+
+The tubs, which I have now in use for nearly three years are made of
+wood, and I find them to answer very well. It must not be forgotten,
+however, that a wooden tub requires to be well painted on the inside, in
+order to prevent its becoming water-soaked, because in that event it
+would become a conductor of electricity, and interfere to some extent,
+with the administration of the electric current in the bath.
+
+The shape and size of the tub may be the same as those of an ordinary
+bath tub. To suit individual cases however, its length may be made to
+vary. The only peculiarity in its construction is at the head. Here,
+instead of slanting, it is made square, and the slightly concave (from
+side to side) board against which the back of the bather is to rest, is
+fitted in afterwards. This is necessary, because it is very difficult to
+make a wooden tub with a slanting back water-tight. If the length of
+the tub from outside to outside is made to measure about five feet ten
+inches, the back-rest fitted in at a proper slant will bring the inside
+of the tub to about the right length for an average male adult. All
+around the upper edge of the tub runs a wooden coping, which must not be
+fastened down however until all the attachments for conducting the
+current are _in situ_. Along that portion of the top of the tub where
+required—and this will depend on the situation of the binding posts
+presently to be mentioned—and underneath the coping, runs a groove for
+the reception of the wires that are to connect the carbon electrodes on
+the inside of the tub with the binding posts on the outside. This groove
+is continued vertically along the inside of the back-rest and foot of
+the tub respectively, to communicate at either end with the bed for the
+reception of the carbon plates. These vertical grooves should at their
+lower end be a little over ¼ inch deep, in order to admit of the wires
+being introduced beneath the carbons.
+
+The face of the foot of the tub and that of the back-rest, should have
+in their centres (from side to side) and commencing at about five inches
+from the bottom of the tub, a bed for the reception of the carbons. The
+dimensions of these receptacles must of course correspond to those of
+the carbon plates to be employed as electrodes. Those which I use
+measure 12×8″ at the head, 8×6″ at the foot of the tub. They are ¼″
+thick. They are placed so as to have their long diameter correspond to
+the height of the tub. The bed which is to receive the carbon at the
+head of the tub must be deeper than ¼″ on account of the concavity of
+the back-rest.
+
+In order to adapt a tub to individuals of different lengths, it will be
+found advantageous to have two small vertical cleats on each side of the
+tub, near the foot and bottom, for the reception of a foot-board, which
+will practically shorten the tub and adapt it to persons of different
+lengths. This board may conveniently be six inches wide, and should have
+a number of perforations about an inch in diameter, for the transmission
+of the current to the feet. 1¼″ pine plank is the most suitable wood to
+use in the construction of the tub. This is preferable to any of the
+hard woods, because of the greater facility of fitting in the electrodes
+etc. It is also the most economical.
+
+(_b_) _The electrodes and connections._ These consist of two carbon
+plates, two brass binding posts, and insulated wires to connect the
+carbons with the binding posts, and these with the battery. The carbons
+are such as are ordinarily employed in the construction of galvanic
+batteries, and can, as well as the wire and binding posts, be procured
+from any house that deals in telegraph material. Their size is to some
+extent optional; the dimensions I have given above however answer very
+well.
+
+The inside of the tub having received one or preferably two coats of
+paint, the carbons are now fitted in the receptacles provided for them.
+The next step is the attaching of the binding posts. These should be of
+the kind known as “single” binding posts with “wood screws.” The most
+convenient location for them will be found on the coping covering the
+horizontal portion at the head of the tub. Here the coping, as it has to
+cover not only the upper edge of the head of the tub, but that of the
+back-rest also, is of necessity much wider than at any other portion,
+and thus affords most room for the binding posts.
+
+Having marked out then a site for the binding posts, say in the centre
+of the coping at the head of the tub—which should now be placed in
+position—and about two inches apart, the posts are laid aside to be put
+in place when the wires are all _in situ_, and the coping fastened down.
+
+In order to facilitate the description of the placing of the wires by
+means of which communication is to be established between the electrodes
+and the binding posts, I shall term the end of the wire that is to be
+attached to the electrodes the distal, that which is attached to the
+binding posts the proximal end. A gimlet hole sufficiently large to
+admit of the passage of one wire should be made half an inch outwards
+from the centre of the site of each binding post. The best wire to use
+is about No. 16 copper wire, coated with gutta percha or rubber. The
+site of the posts being as above suggested, it will be found that the
+wire which is to connect the head electrode with one post requires to be
+about 18 inches long, that which runs from the other post to the
+foot-electrode, between eight and nine feet. The distal ends of the
+wires should be stripped of their coating for a length of about three
+inches, the proximal ends for about two inches. The denuded portion of
+the distal ends should be rolled up in the form of a spiral coil; this
+will insure their constant impinging on the carbons more certainly than
+could be expected from a simple straight end of wire.
+
+The carbons having now been fitted in their beds, the distal end (coil)
+of the head wire is placed beneath the carbon, and the wire itself
+continued up along the vertical groove to either one of the gimlet
+holes. Through this, from within outward, the proximal end of the wire
+is now drawn and left for the present. The distal end of the second wire
+having now been placed beneath the carbon at the foot of the tub, this
+wire is continued up through the vertical groove, along the upper edge
+of the foot of the tub to the side nearest the binding post to which the
+wire is to be attached, along the groove on the upper edge of this side
+to the head of the tub, and thence to the respective gimlet hole, and
+through this, from within outward. The wires being now all in position,
+all the coping is next screwed or nailed down firmly, care being taken
+that the screws or nails used for this purpose do not injure any of the
+wires. The coping fastened down, the binding posts are now screwed down
+in the sites previously marked out for them. Before they are screwed
+_entirely_ down, the denuded portion of the proximal end of each wire is
+securely wound around the screw of the respective binding post, and the
+posts are then _firmly_ screwed down, holding the proximal ends of the
+wires in place. Connection is now established between the binding posts
+and the head and foot electrodes respectively. The vertical grooves are
+now to be filled in with putty and painted over, care being taken to
+keep the carbon free from paint. The last step towards completing the
+apparatus is to fasten the carbons in their beds. The simplest way of
+doing this is by stretching over each carbon a piece of muslin, folded
+double, and tacking this down around the edges. Zinc or galvanized iron
+tacks are best. Copper tacks should be avoided on account of their
+superior conductivity.
+
+In order to be able when required to localize the current in special
+portions of the body, it is well to be provided with what I have termed
+a “surface board.” This is a piece of black walnut, say 14 in. long by 5
+in. wide, ¾ thick, having in the centre a bed to accommodate a carbon
+plate, say 5 in. long by 2 in. wide, ¼ thick. From the centre of this
+bed a gimlet hole pierces the board. The denuded end of an insulated
+wire is drawn through this gimlet hole from without inward (toward the
+bed) and twisted in the form of a spiral to prevent its slipping back,
+as well as to insure its more certain connection with the carbon. The
+carbon is now placed in the bed, and kept there by a piece of muslin
+drawn over it and tacked down. The wire should be of sufficient length
+to reach the battery. I shall speak further on of the use to be made of
+the surface board.
+
+
+_c_) _The Water._ The quantity of water may be the same as that in an
+ordinary bath. In those cases alone where it is intended to localize the
+current by means of the surface board, and to concentrate it _very
+strongly_ in one spot, the water in the tub should be left low enough to
+leave the particular spot to be treated uncovered by this; the surface
+board can then be applied to this spot without the loss to the current
+of strength, through derived currents, inevitable in its application
+under water.
+
+The temperature of the water may range from 85° to 105° Fahrenheit. As a
+rule the comfort of the patient may be consulted in this respect. There
+are certain cases, however, where an especially high or low temperature
+is indicated, and where the extremes mentioned have to be touched.
+
+
+_d_) _Chemicals._ Where these are added to the water of the bath, it is
+for one of three purposes: viz. 1)—To exercise a direct therapeutic
+influence on the patient, either internally by being absorbed, or
+externally by their action on the skin; 2)—Through chemical affinity to
+aid in eliminating certain metallic substances from the body; or 3)—To
+further the absorption of morbid deposits. The various indications in
+these respects will be treated of in their proper places.
+
+
+_e_) _The Batteries._ In the choice of this, the most important part of
+the electro-balneological apparatus, the greatest circumspection is
+necessary. Inferior instruments and such as are liable to get out of
+order frequently, have time and again been the means of discouraging the
+beginner in electro-therapeutics, and causing him to abandon the study
+of an art, the pursuit of which would have well repaid him for all his
+labor. Fortunately our manufacturers here in New York turn out very good
+instruments, and if a physician purchases an inferior one, the fault is
+his own.
+
+Two different currents are required for the baths, viz. 1)—The
+galvanic, which may be employed either in the constant or interrupted
+(by means of a rheotome) form; and 2)—the faradic or induced current.
+Several manufacturers of this city turn out good and serviceable faradic
+instruments. Those which I have been in the habit of using for some
+years past are manufactured by the Galvano-Faradic Manufacturing
+Company, and they have given me unvarying satisfaction. By means of a
+recently introduced attachment to their batteries, termed the “fine
+adjustment,” a current of exquisite “fineness” (rapidity of
+interruption) is obtained, thus removing the only inferiority that has
+heretofore distinguished American from the best imported instruments.
+The instrument is very easy of management, and its liability to get out
+of order very small.
+
+As however the galvanic current is of vastly greater importance in a
+therapeutic respect, than the faradic, so also much greater care is
+required in the choice of a galvanic than a faradic battery. In making
+choice of a galvanic battery, we have to consider its relative quantity,
+intensity, constancy, permanency, economy of running expenses, and
+facility of management. We cannot be guided here by the same
+considerations that guide us in the choice of a battery for office use,
+where the _séances_ are usually brief and the elements taxed not nearly
+so much as in the administration of baths. It is not within the scope of
+this work to enter into a description of the various galvanic batteries
+that are in use. Neither do I believe that, in a therapeutic sense,
+there is much difference between the various batteries ordinarily found
+described in text-books on electro-therapeutics.
+
+Where the battery is to be stationary, a zinc-copper battery, such as
+the Hill battery for example, is preferable both on account of its
+constancy and the economy of running it. Of this there should be fully
+sixty cells, communicating with the bath through a current selector, by
+means of which the current from any desired number of cells can be
+obtained. The electro-susceptibility of different individuals varies to
+such an extent that this is absolutely necessary. Where a portable
+battery is desired, the Stöhrer zinc-carbon battery will be found the
+most useful.
+
+I have mentioned these two batteries simply because I have them in use,
+and they give me satisfaction. There are many others, however, that will
+answer equally well. On the whole, any battery possessing quantity and
+intensity in a medium degree will answer.
+
+
+    Footnotes:
+
+    [Footnote 1: A written description can never convey so true an
+    idea of anything, as an ocular inspection. I will therefore say
+    that it will afford me much pleasure to show any member of the
+    profession the apparatus I am about to describe, at my
+    residence.]
+
+
+
+
+                              CHAPTER II.
+
+                        MODE OF ADMINISTRATION.
+
+
+I shall describe under this head the _modus operandi_ of administering a
+routine galvanic or faradic bath. As it will become necessary to
+describe special modes of administration when speaking of the
+electro-balneological treatment of special diseases, the describing them
+now would only lead to tautologies that I am desirous of avoiding.
+
+Taking our cue from the indications to be met in each case, it becomes
+necessary, according to circumstances, to use either the galvanic
+current, the faradic, or both successively. As modifications of the
+application of the currents we have to consider 1) their intensity; 2)
+their direction, and 3) the duration of the application.
+
+The intensity of the galvanic current corresponds directly to the number
+of cells from which it is derived. It were vain however to attempt to
+express this in figures, because the electro-motive force of different
+batteries varies to so great an extent, that a number of cells of some
+batteries of low intensity yield a current so feeble as to be barely
+appreciable in the bath, while the same number of cells of a battery of
+high intensity, furnish a current that few persons can bear without
+pain. In thus comparing the Hill cell with the Stöhrer cell, I have
+found the ratio to be about as 1 to 2½, i.e., as intense a current can
+be derived from twenty-four Stöhrer as from sixty Hill cells—and this
+is rather below than above the mark. Were all batteries alike in this
+respect, however, still no particular number of cells could be given as
+furnishing a current of suitable average intensity for the galvanic
+bath, because of the excessively great variations in the degree of
+electro-sensibility of different persons. This is so marked that I have
+seen persons in the bath tub who could bear no more than six Hill cells,
+diffused as was the current from these through the water and over the
+entire body; while on the other hand I have met with male patients on
+whom a current from thirty-two Stöhrer cells made not the slightest
+impression, and where I was compelled to supplement the current by that
+from a ten-cell quantity battery (zinc carbon elements 6 in. long by 4½
+wide) in order to make them realize the presence of a current. These
+gentlemen had no cutaneous anæsthesia.
+
+In view of the facts just stated, I have found it impracticable, when
+giving directions for the administration of a galvanic bath, to indicate
+any certain number of cells to be used. I am in the habit of ordering
+the administration of a “mild,” a “medium” or a “strong” current, as may
+be required in the respective cases; and in every instance it is the
+electro-sensibility of the patient that determines the number of cells
+requisite to obtain the desired result as represented by one of these
+terms. The same applies also to the faradic current.
+
+To determine the direction of the current is sufficiently simple. Where
+a descending current is desired, the binding post which represents the
+electrode at the head of the tub must be connected to the positive pole
+of the battery, the other binding post to the negative pole; where an
+ascending current is desired, the reverse of this is done.
+
+The duration of the bath varies with different cases. The average is
+about twenty minutes, though the time may range from ten minutes to an
+hour and a half.
+
+Where it is desired to give the patient a galvanic shock, it is only
+necessary rapidly to reverse the current by means of the commutator. The
+simultaneous contraction of almost the ENTIRE muscular system that
+accompanies the reversal of a current of sufficient intensity in the
+bath, affords a striking illustration of the _general_ effects of the
+galvanic bath. In cases where paralyzed muscles have lost their faradic
+irritability, galvanic interruptions are almost indispensable to
+successful treatment.
+
+I have before (page 14) described a “surface board,” which I have
+devised for the purpose of localizing the current from one of the poles
+in any portion of the body where required. This proceeding should by no
+means be looked upon as a “local” method of electrization; on the
+contrary, it is just as much “general” as the ordinary electric bath.
+Whereas in local applications the current runs from one point of the
+body to another, in this case, supposing the spot where the surface
+board is applied to be the centre, and the rest of the body the
+periphery, a current runs between _every point_ of the periphery and the
+centre, its direction being centripetal when the surface board
+communicates with the negative, centrifugal when with the positive pole
+of the battery.
+
+The current is felt more or less intensely in proportion to the
+proximity to the body of the surface board. With the galvanic this is
+less noticeable than with the faradic current. When, for example, a
+faradic current of medium strength being employed, the surface board is
+held about six inches from the abdominal surface, little or no current
+is felt. Let the surface board be now gradually approximated to the
+abdomen, and the current will be felt more and more sensibly, until,
+when about an inch away from the skin, or touching this, its influence
+becomes so strong as to cause more or less energetic contractions of the
+abdominal muscles. Where the galvanic current is employed, the skin
+beneath the surface board will be found more or less reddened after a
+few minutes’ application; the burning sensation ordinarily accompanying
+galvanic applications will also be experienced more or less intensely,
+in proportion to the strength of the current employed.
+
+Where the current is to be concentrated in a manner still more energetic
+than that described, this can be effected by raising the objective part
+above the surface of the water, and then applying the surface board. In
+this way the _entire_ strength of the current is concentrated in one
+spot, whereas, when the surface board is applied under water, a large
+portion of current is absorbed by this.
+
+This appears to me the fittest place to say a few words in regard to the
+relative conductivity of the human body and water—the latter at the
+temperature ordinarily employed in baths, say from 90° to 95°
+Fahrenheit. BEARD and ROCKWELL, in their work on Medical and Surgical
+Electricity,[2] state that “the human body is a better conductor of
+electricity than water at the same temperature.” Certain phenomena
+connected with the administration of electric baths having forced upon
+me some doubts in this respect, I made very careful experiments, both
+with and without the aid of the galvanometer (Bradley’s Tangent), to
+satisfy these. Without wearying the reader with details, I will state
+that the result of my experiments leaves no room for doubt that water at
+the temperatures stated—and still more so at 98½°—is superior to the
+human body as a conductor of electricity. I do not mean to be understood
+that water is a better conductor than _every constituent_ of the human
+body; blood, for example, is a better conductor. But when I speak of the
+body in this connection, I take it as we find it practically, i.e., with
+the resistance of the skin, and especially the epidermis, superadded to
+internal resistances. I have no doubt that with a flayed individual it
+would be otherwise. I will add, that it will give me great pleasure to
+repeat these experiments, which are sufficiently simple, in the
+presence of any of my _confreres_ who feel an interest in the subject.
+
+Having thus cursorily considered the manner of using the electric
+current in the administration of a “routine” bath, and there being no
+remarks required concerning the water employed, in addition to what has
+been said in the previous chapter, a few words are in place on the
+subject of chemicals. As has been previously stated (page 13) these are
+added: _a_) to be absorbed, and thus act medicinally on the patient;
+_b_) to act on the skin; _c_) through chemical affinity to facilitate
+the elimination from the body of certain metallic substances, and _d_)
+to further the absorption of morbid deposits. Of the many drugs and
+medicines that no doubt may be made to answer these various purposes, I
+have had personal experience with but few, and of these I will mention
+the leading ones only. A requisite of all chemicals to be employed is
+their ready solubility in water. Of substances intended for
+absorption[3] I have used but three, viz: iron, iodine, and extract of
+malt. The first of these I have employed in anæmic and enfeebled
+conditions generally, but especially in chlorosis and chlorotic
+hysteria, with marked success. It has the advantage, when administered
+in this manner, not only of sparing the alimentary canal the frequently
+injurious task of becoming the medium of its assimilation, but, in
+addition to this, I believe that it can in this way be introduced into
+the blood much more rapidly and in larger quantities than when given by
+the mouth. The preparation which I have found, all things considered,
+the most eligible for this purpose, is the “tartrate of iron and
+ammonia.” This is very readily soluble, leaving no deposit, is
+assimilable, and not too expensive for the purpose. As, in my experience
+at least, it leaves nothing to wish for, I would consider it superfluous
+to discuss in this connection any of the other ferruginous preparations.
+
+Iodine I have employed with a view to its absorption in rheumatism and
+gout. I cannot speak favorably of it in this connection. I have not in a
+single instance found a bath charged with iodine, either in the form of
+the tincture or of iodide of potassium, followed by results in any way
+differing from those of the simple galvanic bath employed in the same
+cases.
+
+Extract of malt I have employed as a roborant, either alone or in
+conjunction with iron, in cases of debility and malnutrition, and found
+it of service.
+
+Where the absorption of substances is aimed at, the _galvanic_ current
+must be employed.
+
+Where we add substances to an electric bath with a view of producing
+some special action on the skin, we may be guided by the same principles
+that govern ordinary balneology. Thus to obtain counter-irritant
+effects, we may add mustard or common salt; to render the bath alkaline,
+bicarbonate of potassa or soda, etc., etc.
+
+An important object to be furthered by the addition to the galvanic bath
+of chemicals, is the elimination from the system of certain metallic
+substances. It will be found here that in practice we have to deal
+chiefly with two substances, viz: mercury and lead. That the elimination
+of these bodies by means of the galvanic bath is feasible, I shall
+endeavor to demonstrate further on. At present I have simply to consider
+the chemicals adapted for the purpose, and the manner of using them.
+
+To facilitate the extraction from the system of mercury, nitric-acid has
+been recommended by those who have heretofore instituted this treatment.
+While I cannot positively deny that this substance may aid in the
+elimination of the metal, I am compelled to state, after its trial in
+several cases, that I have obtained equally good results from the simple
+galvanic bath. In the light of my own limited experience, therefore, I
+cannot insist on the necessity of adding any chemical to a galvanic bath
+which is administered for the purpose of extracting mercury from the
+body.
+
+Where the elimination of lead is the object aimed at, I am, on the other
+hand, satisfied of the utility of adding certain chemicals to the water
+of the bath. Sulphuric acid has been suggested and used for this
+purpose. I can say nothing respecting its usefulness, as I have never
+tried it. Indeed, the results with iodide of potassium added to the bath
+have been so satisfactory, that I have had no occasion to try any other
+chemical, although almost any other of the preparations of iodine would
+probably answer equally well. The chemical affinity of iodine for lead
+affords a ready explanation of its usefulness in this respect. One ounce
+of iodide of potassium to each bath appears to me a suitable quantity.
+
+I have had no personal experience with any other cases of chronic
+metallic intoxication than those with lead and mercury.
+
+The absorption of morbid deposits (plastic exudations, etc.) can be
+materially furthered by adding to a galvanic bath some resolvent—above
+all, iodine.
+
+I have said above (page 26) that I had found no perceptible benefit from
+the addition of this substance to the galvanic bath in cases of
+rheumatism or gout. The contrary holds good however with respect to the
+frequent sequence of these diseases—articular deposits. When the acute,
+and to a great extent the subacute symptoms have subsided—and in
+chronic cases especially, and the disease has left effusions in various
+joints, iodine, which when employed in this manner, appears to have
+little or no influence on the pain accompanying these complaints, is a
+powerful adjuvant in promoting the absorption of the deposits. In
+chronic synovitis and all other articular affections accompanied by
+exudation, the same holds good.
+
+I have no doubt that future advances in this branch of science will
+develop the utility of numerous other drugs and chemicals as additions
+to the galvanic bath.—Before leaving this subject I must call attention
+to the influence which the addition to the bath of certain substances
+has on the conductivity of the water, resp. thus: the action of the
+current on the patient. I have found that when I caused salt or
+bicarbonate of soda to be added to the bath, the conductivity of the
+water became so much increased, so disproportionately greater than that
+of the body, as to render necessary the employment of very powerful
+currents in order to cause the patient to feel them.
+
+
+    Footnotes:
+
+    [Footnote 2: “Medical and Surgical Electricity.” New York. 1875.
+    Wm. Wood & Co. pp. 431 and 432.]
+
+    [Footnote 3: For some experiments concerning the cataphoric
+    effects of the galvanic current, see an article by MUNK,
+    entitled “Ueber die galvanische Einführung differenter
+    Flüssigkeiten in den unversehrten lebenden Organismus,” in the
+    Allgemeine Medicinsche Central-Zeitung, No. 16, 1875.]
+
+
+
+
+                             CHAPTER III.
+
+                        PHYSIOLOGICAL EFFECTS.
+
+
+In accordance with the plan of the present work, the remarks I shall
+offer under this head are by no means intended to comprise all that is
+known at the present day of the physiological effects of electricity in
+general. It was my purpose when I undertook to write these pages, to
+offer to the profession a book confined to one subject; not a
+compilation, but a volume made up almost if not wholly of original
+matter, chiefly, if not entirely the result of my own observations and
+experience. For the general physiological effects then of electricity as
+well as for the theories of its action, I refer those interested to the
+many excellent works on the subject that have appeared within the last
+few years. I will treat here only of the physiological effects peculiar
+to the electric bath.
+
+The daily observations that I have had the opportunity of making in this
+respect, extending as they do over a period of upwards of two years,
+have not been as fruitful of results as might be expected. This is due
+mainly to the circumstance that but a small percentage—and these took
+the baths merely as a refreshing tonic—of those whom I have had the
+opportunity of observing, were in a condition that might be called
+normal. By far the greater majority were suffering from some complaint,
+in most instances of a neurotic or rheumatic nature, the presence of
+which, while it afforded admirable opportunity for observing therapeutic
+results, modified more or less the physiological effects of the baths,
+and served to deprive them of a uniformity which might to a great extent
+justly be looked for in healthy organisms. If, therefore, what I now
+contribute to the physiology of the subject is but little, it will I
+trust be at least found of practical utility in its applicability to the
+therapeutics of the subject.
+
+Before entering into details, it is necessary in the first place to
+inquire in what respects electric baths differ from other methods of
+electrization—especially those recently introduced as “general”—that
+their physiological effects should merit individual consideration. They
+differ in two ways. One of these is self-evident. To the effects of
+electricity are superadded those of the warm bath. The effects of the
+warm bath _per se_ are too familiar to every physician to require
+comment. Its effects in combination with electricity, however, may not
+be so generally known; and I therefore feel justified in quoting here a
+passage that bears directly on the subject, from a recent German work by
+Dr. Hartmann[4] of Wiesbaden.
+
+    “The last question, whether mineral water acts also by contact
+    with the skin, leads us to one of its most important
+    effects—that through electricity.
+
+    “Although this question has not as yet been finally disposed of,
+    we have still advanced far toward its solution, through the
+    admirable researches of HEYMANN and KREBS. Both observers have
+    furnished proof that the contact of the water of the bath[5]
+    with the human body gives rise to electric currents, which
+    currents must be looked upon as being the excitors of the
+    nerve-currents, the body acting merely as a conductor. From
+    these experiments we conclude that no particular difference
+    obtains between artificial and transported waters on the one,
+    and natural waters on the other hand, the assertions of
+    SCOUTETTENS notwithstanding, who in regard to electricity
+    claimed to have found a difference between the artificial and
+    transported waters and the natural ones.
+
+    “We gather moreover from the experiments, that the electric
+    current generated through the contact of the body with the water
+    of the bath is modified chiefly by the gases, next by the
+    temperature of the water, and lastly only by its salts.
+
+    “The effects of the bath depend on the strength of the electric
+    current generated and on the condition of the peripheral endings
+    of the nerves; the effect may be stimulating or soothing. The
+    strength of the current is governed, as we have seen, by the
+    quantity of gases present, the temperature and the salts.
+    Ordinary lukewarm baths, indifferent baths containing a small
+    amount of gases, are less stimulating than mineral baths
+    containing a larger proportion of gases.
+
+    “With regard to the relative condition of the peripheral
+    nerve-ends, experiments on the motor nerves go to show that
+    swelling of the terminal ends of these nerves may diminish their
+    excitability to the point of its complete extinction, while it
+    becomes increased by their exsiccation. This fact as to the
+    motor nerves is adopted by HEYMANN likewise as applying to the
+    nerves of sensation. If, now, we presuppose absorption or even
+    imbibition on the part of the skin, a swelling of the nerve-ends
+    is comprehensible, as the imbibed fluid reaches them. But,
+    according to HEYMANN, the peripheral nerve-ends, i.e., the
+    terminal bulbs of KRAUSE, of the sensory nerves, and the tactile
+    corpuscles of MEISSNER, become even without this presupposition
+    sufficiently impregnated with water while in the bath, because
+    here all insensible perspiration must cease, and in a bath of a
+    temperature lower than blood-heat transpiration cannot take
+    place, so that all transudation to the skin being retained
+    during the bath, those termini are surrounded by moisture and
+    therefore swell up.
+
+    “From this the writer concludes with regard to the effects of
+    the baths, that all baths in which the electric current produced
+    by contact of the water with the body preponderates over the
+    swelling of the nerve-ends, have a stimulant effect, while
+    those baths where the swelling preponderates over the electric
+    current, act as a sedative.
+
+    “Taking a brief and comprehensive review therefore of the
+    effects of mineral water baths, we have those resulting from the
+    temperature, from the contents of carbonic acid and salts, and
+    lastly from the electric current generated in the bath water;
+    each effect however resolving itself into an excitation of the
+    peripheral nerve-ends, which leads in a reflex manner to an
+    enhancement of the change of matter.”
+
+From the foregoing quotation may be realized the importance which is
+attached to the electric current in the warm bath. And here let me ask
+the question: May not the remedial superiority, in many cases, of the
+mineral water bath over the ordinary warm bath be due mainly, if not
+solely, to the more abundant generation in the former of electricity? Or
+rather, is it not very likely that this is so? And if such is the case,
+it would appear evident that the mineral water bath, the electric
+properties of which, depending on the chemical changes going on between
+the gases and salts of the water on the one, and the cutaneous
+secretions and other constituents of the body on the other hand, are to
+a great extent beyond our control, must in turn be vastly inferior to a
+bath where the electric current is under our perfect control, and can be
+modified in intensity, direction and quantity to meet the individual
+requirements of every case. And such is the electric bath I am now
+describing.
+
+The second difference between the electric bath and all other methods of
+applying electricity is, that _the bath is the only method by means of
+which general electrization can be realized_. In making a distinction in
+this respect, it becomes necessary for me to advert more especially to a
+method first introduced to the profession in a systematized and
+scientific manner by Drs. BEARD and ROCKWELL,[6] and termed by them
+“General Faradization.” The undoubted good results that have been
+obtained from this method—for the details of which I refer the reader
+to the latest work of the authors[7]—have caused it to be extensively
+adopted by the medical profession, both here and in Europe. It is,
+however, not with its results that I have to do at present, but with its
+appellation and true nature. General faradization, so-called, consists
+of a series of local faradizations, administered during one and the same
+séance, until the current has alternately been made to impinge upon and
+traverse the entire or at least a large portion of the body. This
+cumulative procedure, it is true, approaches general electrization, as
+represented by the electric bath, more closely than any of the other
+local methods; yet it is not that which its name would imply, and I do
+not think it requires argument to make it apparent, that even this
+procedure differs vastly from the electric (whether galvanic or faradic)
+bath, where the current at one and the same time impinges directly on
+every peripheral nerve-end (excepting those of the head and face) and
+traverses every part of the body, obtaining—both as to reflex and
+direct effects—as a whole that which the method known as general
+faradization seeks to obtain by the cumulation of fractional portions.
+
+Having thus, I trust, established the individuality of the bath as an
+electric method, I will without further digression proceed to the
+consideration of its physiological effects.
+
+The physiological effects of the electric bath may be qualified on the
+one hand as either “immediate,” or “remote,” on the other as either
+“transient” or “permanent.” Strictly to classify these is impracticable,
+and I will therefore be influenced in the order of their enumeration
+principally by their importance in a therapeutic respect.
+
+One of the most pronounced as well as uniform, and at the same time
+most important, effects of the electric bath, is its property as an
+
+
+                               HYPNOTIC.
+
+This somniferous influence, which is to some extent exercised by local
+electrization, is here distinguished by its far greater constancy as
+well as by its greater degree of perfection. That this difference should
+exist, appears quite natural, when it is considered that the same
+topical influences which produce it in local electrizations, and which I
+shall presently endeavor to analyze, are here brought to bear on the
+entire system. The hypnotic effect is both immediate and remote, and
+more or less permanent. When there is an immediate inclination to sleep,
+which may make itself manifest during the bath or immediately after
+this, it is generally accompanied by a
+
+
+                      PLEASANT SENSE OF FATIGUE,
+
+which cannot be likened to weariness, but rather to what we feel after
+moderate exercise; it is only in some instances, where an individual
+takes his first bath, or where, for therapeutic reasons, a strong
+faradic current—accompanied by responsive muscular contractions—is
+employed, that this feeling is intensified sufficiently to become
+unpleasant, calling for rest and recuperation, and must here be looked
+upon as analogous to the effects of _severe_ exercise. It invariably
+disappears after a brief rest.
+
+Experience and good judgment will enable us moreover in almost all cases
+to avoid effects of this kind. The immediate inclination to sleep is
+much more decided as well as constant when the bath is taken late in the
+day, than when taken in the forenoon. When the latter is the case
+however, the individual will as a rule become sleepy during the
+afternoon, or else at an earlier hour than usual in the evening, and
+sleep more soundly during the night. This is the effect of one bath. A
+series of baths will however produce more or less marked and permanent
+improvement in the sleep of individuals, where this has been below the
+normal standard. And this is among the most invariable of the effects of
+the electric bath, whether galvanic or faradic.
+
+I have formed a theory as to the _rationale_ of this influence, which I
+will offer as its probable explanation. We all know that sleep is a
+process designed by nature for the recuperation of the system after a
+certain period of activity. In other words, when the various functions
+have been more or less exercised for their daily allotted time—say
+seventeen hours—the respective organs need that profound rest which we
+know as sleep. Now, it is pretty well conceded by physiologists, that
+electricity stimulates the secretory as well as excretory organs; that
+it furthers endosmosis and exosmosis—by its electrolytic influence in a
+physical, by its influence on the nervous system in a catalytic manner,
+in short, and by virtue of these properties, that it greatly
+
+
+                     ENHANCES THE CHANGE OF MATTER
+
+and incites the various organs to so great an activity as to cause them
+to perform in a comparatively brief space of time—say an hour, the work
+of several hours. The natural sequence is obvious: _The want of rest—of
+sleep, is felt at a correspondingly earlier period._ I offer this as a
+probable explanation of the immediate or almost immediate disposition to
+sleep. As to the permanent improvement in sleep, where this has been
+below the normal standard, it must always be due to the removal of some
+morbid condition, and thus belongs among therapeutic results, rather
+than physiological effects. It is true that in many instances of
+_agrypnia_ we are unable to discover any pathological condition that
+would account for this symptom; but the probability is that here there
+is a sluggishness of some one or more of the functions, mental or
+physical, too obscurely manifested to be discovered by our present means
+of diagnosis, yet reached and rectified by a mode of electrization that
+traverses and permeates _every_ portion of the body.
+
+If this explanation of the hypnotic effect of the electric bath be not
+the true one, it is at least—so far as I know—the first attempt at
+accounting for a phenomenon that has been noticed as a result of even
+local applications of electricity by many observers, and about the
+pretty uniform occurrence of which there can be no doubt.
+
+With respect to the effect on the
+
+
+                        TEMPERATURE AND PULSE,
+
+I have made a number of observations, of which I have recorded
+twenty-two, made on persons where both were at or nearly at the normal
+standard. With regard to the frequency of the pulse, the results were
+conflicting and by no means reliable. In the majority of cases there was
+an increase, immediately after the bath, ranging from four to eighteen
+beats per minute. In others there was no change whatever, and in a few
+there was an absolute diminution in frequency; this last I believe
+however to be a therapeutic rather than physiological effect,
+manifesting itself only where there is pneumogastric asthenia, and
+attributable directly to electric stimulation of this nerve. Thus in one
+instance, which occurred in the person of a physician of this city, who
+had an intermittent pulse, the result was as follows: Immediately before
+bath: pulse 70, two intermissions; at the expiration of 15 minutes,
+during which he was under the influence of a descending galvanic
+current: pulse 65, two intermissions; at the end of ten more minutes,
+during which he received the faradic current: pulse 65, no
+intermissions; ten minutes after leaving the bath: pulse 66, no
+intermissions. As a rule then, we may look for an immediate and more or
+less transient moderate increase in frequency of the pulse. As for any
+permanent increase or reduction of the pulse, there is none as a
+physiological effect. Where such an one does take place, it is by the
+removal of some morbid influence on the heart, and must be looked upon
+as a therapeutic result.
+
+With respect to the temperature, the results were somewhat more uniform.
+I have found that where this is either normal or slightly below, the
+immediate but transient effect is to raise it from 2 to 6 tenths of a
+degree (Fahrenheit)—in most instances 4 tenths. In a very few cases it
+remained unchanged, and in one case, where before the bath the
+temperature was 100, at the close of the bath it was 99-3/5. Of
+permanent modifications of the temperature, the same holds good that I
+have said of permanent changes in the pulse. It must not be forgotten
+that the temperature of the water is undoubtedly an important factor in
+modifying the temperature of the body. In almost all instances where my
+observations were made, the temperature of the water was below that of
+the body, being 95° or a little less. This, which has a tendency to
+lower the bodily temperature, is to some extent counterbalanced by the
+suppression of the insensible perspiration, so that modifications of
+temperature resulting from electric baths, the water of which is but few
+degrees below 98½°, may justly be attributed to the influence of the
+electric current. The importance of the electric bath as a
+
+
+                   PHYSIOLOGICAL STIMULANT AND TONIC
+
+cannot be overrated. I deem it superior in this respect to any other
+known agent. This effect manifests itself _immediately_ by a feeling of
+exhilaration and unwonted vigor, _remotely_ by an improvement—where
+there is a margin for such—in the performance of some or all of the
+physiological functions, as well as by a gradual but nevertheless marked
+_increase in weight_.
+
+Most striking among the tonic influences of the baths, are those that
+occur within the sphere of the digestive and sexual apparatuses. I will
+first consider the effects on
+
+
+                       THE DIGESTIVE APPARATUS,
+
+which may be subdivided into those on _a_) the appetite, _b_) digestion,
+absorption and assimilation, and _c_) alvine excretion. The improvement
+of the appetite under electro-balneological treatment is one of the most
+constant effects of this. While a series of baths will produce permanent
+results in this respect, an increase of the appetite, in some instances
+amounting to positive hunger, is a tolerably uniform and more or less
+immediate result of each separate bath. The permanent improvement of the
+appetite is relative. Not very appreciable where this is normal, it
+becomes most marked where the appetite has from some cause been
+impaired. The effect on the appetite is _definite_. The effects on
+absorption and assimilation are _presumptive_; but when we couple the
+absence of any corresponding difficulty in digesting the increased
+supply of food, with the increase before alluded to in the weight of the
+body, their assumption becomes fully justifiable. It is these combined
+influences that make the electric bath so valuable a remedy in almost
+all forms of dyspepsia.
+
+The influence on the alvine process is if anything even more marked than
+that on the assimilative process. Where the action of the bowels is
+normal, it is not modified permanently by the electric bath, although we
+often have, as an immediate consequence, a cathartic effect that
+manifests itself as a more or less watery evacuation, either a few hours
+after the bath or on the succeeding day. Where the fecal process however
+is sluggish, the improvement resulting from the baths is very striking.
+I shall recur more fully to this subject under the head of constipation.
+
+The effects on the various functions connected with digestion are due
+doubtless to the combined influences of stimulation of the secretions of
+the alimentary canal and stimulation of the muscular coats of the
+stomach and intestines, as well as permanent tonization of the
+_muscularis_. While the enhancement of the secretions is undoubtedly due
+chiefly to the electric stimulus to the secreto-motor nerves, and the
+increased activity of the muscular coats to a like influence transmitted
+to their motor nerves, I believe the permanent tonization and
+invigoration of the muscular fibres to be mainly attributable to the
+direct trophic influence of the current traversing the parts
+themselves; and I have no doubt that this direct influence has much to
+do with the stimulation of the secretions and _peristalsis_ also. At any
+rate, I have never obtained from galvanization of the nervous centres,
+which I have practiced in a great number of cases, the striking effects
+on the alimentary processes which are so uniform a result of the baths.
+
+The influence on the
+
+
+                           SEXUAL APPARATUS
+
+of the electric bath does not manifest itself in so striking a manner as
+in the case of the organs of digestion. It is true I have seen
+individuals whose sexual functions were normal, have _stysis_ in the
+bath, but the mere cutaneous irritation of the electric current is here
+sufficient to account for a phenomenon which, where sexual irritability
+is intact, will follow any other local irritations.
+
+If not as immediately perceptible, the stimulant and permanent tonic and
+invigorating influences on the sexual organs are not much less constant
+than the corresponding influences on digestion. Careful observation,
+however, of a considerable number of cases where the sexual function was
+more or less impaired, has convinced me that while there can be no
+doubt that _direct_ influence on the innervation, tone and nutrition of
+the respective parts as well as the stimulus which the electric current
+furnishes to the seminal secretion, bear a share in the improvement that
+takes place, permanent beneficial results must be looked upon as chiefly
+the expression of improved nutrition and tonization of the system at
+large. I do not mean to be understood as wishing to put in negation the
+beneficial results that the local influence of electricity is capable of
+sometimes accomplishing in the sexual sphere. These results, however,
+are not of a physiological, but rather of a purely therapeutic nature,
+and are obtained there only where local morbid conditions exist. Now, in
+the great majority of the cases that have come under my observation, the
+causes of deterioration of the sexual capacity, though frequently
+obscure and indefinable, were certainly not local, but to be sought for
+in the general—most probably the nervous—system. In none but perhaps
+the very mildest and recent cases have I ever seen _rapid_ results
+follow electrical treatment of any kind whatsoever. In support of my
+assertion however that in the majority of cases the sexual sphere can be
+influenced only through the system at large, I will state _first_, that
+I have seen cases where local electrical treatment had utterly failed
+to do the slightest good, respond favorably to the baths, and _second_,
+that where success was met with, it was only after persistent treatment,
+continued long enough to modify favorably the condition of the entire
+organism, and through this the objective sphere.
+
+The stimulant and tonic effects under consideration, although shared to
+some extent by other methods of electrization, are here far more
+comprehensive and pronounced, a fact which is not surprising, when we
+reflect that in the electric bath not only are all the organs
+_indirectly_ influenced through stimulation of the nervous centres, but
+each separate organ is at the same time _directly_ acted upon by the
+current.
+
+A direct sequence of the stimulant and tonic effects of the electric
+bath is its
+
+
+                          SEDATIVE INFLUENCE.
+
+This sedative effect, whereof the hypnotic effect already spoken of is
+the supreme manifestation, must not be associated for a moment with any
+idea of depression, for here we have none such. In addition to what I
+have already said in endeavoring to account for the hypnotic influence
+of the baths, I refer the reader for further information to the
+admirable and lucid remarks on this subject by BEARD and ROCKWELL.[8]
+
+The _galvanic_ bath shares with other galvanic applications made in the
+cranial and upper spinal region, the effect of producing the galvanic
+_taste_, as also the _flashes_ when the current is interrupted, showing
+that the
+
+
+                            CRANIAL NERVES
+
+come within the sphere of its influence.
+
+A further effect peculiar to the galvanic bath is a sense of
+
+
+                               ITCHING,
+
+felt chiefly in the lower extremities and about the neck, and
+proportioned to the intensity of the current. Rather pleasant when mild
+or medium currents are used, under the influence of strong currents it
+may become so intense as to create an irresistible desire on the part of
+the bather to scratch especially the legs.
+
+A negative effect of the galvanic bath, even where very intense currents
+are used, is the
+
+
+                      ABSOLUTE FREEDOM FROM PAIN
+
+throughout the entire process. I wish this to be understood of course
+as holding good only when currents within the ordinary limits of
+intensity are employed. The strongest that I have used, and on which I
+base my statement, was that from 48 Stöhrer or 60 Hill cells. As
+stronger currents are not required for therapeutic purposes, what I have
+asserted remains practically true as applied within these limits.
+
+This absence of pain, which cannot be claimed for correspondingly
+intense local applications, is to be attributed to the _diffusion_ of
+the current throughout the body and its surface, as well as through the
+water of the bath. The redness of the _entire_ back after a galvanic
+bath, is among the proofs of this diffusion.
+
+Freedom from pain is a characteristic likewise of the faradic bath,
+_properly administered_. When too strong a faradic current however is
+incautiously administered, the resulting muscular contractions are
+accompanied by an amount of local pain proportioned to the violence of
+the contractions. By keeping the faradic current within proper limits,
+all pain can be avoided.
+
+With respect to
+
+
+                        MUSCULAR CONTRACTIONS,
+
+the effects of the electric bath may be distinguished from those
+obtained by other modes of faradization by their comprehensiveness.
+Many groups of muscles may be made simultaneously to contract by this
+means. The practical bearing of this on the therapeutics of _pareses_
+and _paralyses_, renders it an important characteristic of the bath.
+
+The physiological effects on
+
+
+                               THE MIND
+
+of electric baths, is a natural result of the enhanced tone and vigor of
+the physical system, and keeps pace with this. Mental buoyancy and even
+exhilaration are among the most common sequences of electric baths.
+Although indirect, these results are none the less decided.
+
+It has been my aim in the foregoing remarks to give the reader, as
+concisely as possible and within the limits which I set for myself in
+the beginning of the present chapter, a summary of the more important
+physiological effects of electric baths. As the isolated results of
+observations made in a limited field by one unaided individual, I trust
+the shortcomings of this chapter will be viewed indulgently. If what I
+have said of the physiological effects of electric baths proves the
+means of stimulating to further investigation more competent observers
+than myself, my labor, whatever its imperfections, will not have been in
+vain.
+
+
+    Footnotes:
+
+    [Footnote 4: Dr. Franz Hartmann; “Der acute and chronische
+    Gelenkrheumatismus,” Erlangen, 1874; pp. 194 et seq.]
+
+    [Footnote 5: The Author here refers to mineral-water. Dr. S.]
+
+    [Footnote 6: The Medical Use of Electricity, with special
+    reference to general electrization as a tonic, etc. New York,
+    1867.]
+
+    [Footnote 7: Beard and Rockwell; Medical and Surgical
+    Electricity. N. Y. 1875.]
+
+    [Footnote 8: Op. cit. pp. 253. et seq.]
+
+
+
+
+                              CHAPTER IV.
+
+                 GENERAL THERAPEUTIC EFFECTS AND USES.
+
+
+The therapeutic uses of a remedy are based on what we know of its
+physiological effects. Many—or rather most—of the therapeutic effects
+of this as well as of most other remedies, correspond to certain
+physiological effects. Those therapeutic effects whereto we find none
+analogous among the physiological effects, are yet the results of the
+physiological tendencies of the remedy, and where these tendencies do
+not manifest themselves as results, it is because they find no field for
+action in the healthy organism. When they meet with the requisite
+pathological conditions, these tendencies make themselves manifest in
+the shape of definite results, commonly known as therapeutic effects.
+
+NOTHNAGEL, in his classical work,[9] recognizes this theory by excluding
+from his book the term “therapeutic effects” altogether. Where he finds
+it necessary to say anything of the physiological effects of a remedy,
+in addition to those “on man in health,” he speaks—still under the head
+of “physiological effects”—of those “on man when sick.” When, setting
+aside its empirical employment, we come then to inquire what it is that
+furnishes us with the true indications for the use of a remedy, analysis
+of the question leads us invariably back to its physiological effects.
+If I have failed nevertheless to include the few effects which I am
+about to touch on, under the head of “physiological effects,” I have
+done so simply in compliance with universal usage, and as a matter of
+convenience for reference.
+
+I will now, without further digression, proceed to the consideration of
+those effects of electric baths not yet enumerated.
+
+As a fitting precursor to the enumeration of the therapeutic properties
+of the remedy under consideration, it may be well to dwell for a moment
+on what is among its most prominent characteristics; I have reference to
+its great value as a
+
+
+                              DIAGNOSTIC.
+
+In explanation of this, I will state that in a very large number of
+cases of disease of an obscure nature, and where, to be candid, the
+electric bath was employed empirically, or, if you please, tentatively,
+it has served to point out the _locus morbi_. The number of cases in
+which I have made this observation, has been sufficiently large to
+establish beyond a doubt the fact, that as a rule the electric current
+makes itself more decidedly and often even painfully felt in any part
+where a morbid condition exists; whether this be of an inflammatory,
+neuralgic, rheumatic, traumatic, congestive or other nature, the result
+is the same. It appears to be somewhat analogous to the “tenderness on
+pressure” that we find present in many of these conditions. In
+_anæsthesiæ_ even the current makes itself conspicuous by the _absence_
+of its normal effects. The value of this will at once be recognized in
+connection with a method of electric application which at one and the
+same time acts on every portion of the body. Local electrization is
+accompanied by like phenomena, _when we happen to strike the right
+spot_. The superiority of the bath as a means of diagnosis is found in
+the circumstance that here we _must_ touch it.
+
+The great importance of this feature of the electric bath will at once
+be realized by every physician of much experience, for there can be none
+such who has not frequently met with subacute or chronic conditions the
+etiology of which was more or less obscure.
+
+One of the most important effects in its therapeutic application of the
+electric bath, is its superior excellency as an
+
+
+                     EQUALIZER OF THE CIRCULATION;
+
+so far as I know, it is more potent, constant and comprehensive in this
+respect than any other agent. Where an imperfect circulation of the
+blood is due to irremovable organic causes, the results obtained will of
+course be transient only. In all other cases, however, favorable
+results, more or less perfect according to the nature of the case, may
+be reliably looked for. Both currents act very well in this respect,
+though on the whole I look upon the galvanic as superior to the faradic
+current.
+
+As a theory of this effect of the currents I would offer the following,
+viz: That the galvanic current acts by stimulating the vasomotor centres
+and peripheral nerves, by giving tone to the mucular coats of blood
+vessels, and by counter-irritation. That the _faradic_ current
+stimulates the vasomotor centres little, if at all, does not influence
+the coats of vessels, except such as are close to the skin, but
+tonicizes these latter more effectually than the galvanic current; that
+it stimulates the peripheral nerves to some extent, though far inferior
+in this respect to the galvanic current; but that when employed of
+sufficient intensity it superadds to those mentioned a strictly
+mechanical action, which consists in forcing static blood from the
+capillary into the general circulation through the medium of muscular
+contractions.
+
+As a
+
+
+                       GENERAL COUNTER-IRRITANT
+
+the _galvanic_ bath has few if any superiors. The degree of
+counter-irritation can be very nicely determined by regulating the
+intensity of the current. The characteristic tingling sensation of the
+galvanic current is felt over the entire surface, corresponding in
+degree of course to the intensity of the current; while the redness of
+the skin, bearing a like relation to the intensity of the current, is
+observable more especially near the electrodes, being particularly
+conspicuous over the entire back. Concentrated local counter-irritation
+can be obtained by the use of the surface board.
+
+The counter-irritant effects of the galvanic bath, differ from those of
+ordinary counter-irritants in their freedom from pain, even the slight
+burning sensation accompanying strong currents ceasing with the
+application. The redness remains quite a while and the stimulus to the
+peripheral circulation causes the persistence for some time of a
+“glowing” sensation all over the body.
+
+In the chapter on physiological effects enough has been stated to make
+it apparent that as a
+
+
+                     GENERAL INVIGORANT AND TONIC
+
+the electric bath can have few if any superiors. In the healthy
+organism, however, the stimulant and tonic effects of the baths are much
+less marked than they are where the general condition is “below par.” In
+health there is little or no margin for improvement. The results
+obtained are _temporary_ stimulation, and a permanent invigoration which
+partakes more of artificial development than anything else. It is
+analogous to the development by gymnastic or other exercise of a
+previously healthy set of muscles. Where we meet with atonic conditions
+however, with debility, malnutrition, want of energy or general asthenia
+of an obscure nature, and amenable to electric influence, the tonic
+effects of the baths become striking and brilliant. I have observed
+cases where patients fairly bloomed up under their influence and
+acquired actually more physical strength and weighed more than before
+they became sick. When we consider how in such conditions as those
+mentioned, patients are made to swallow pills and mixtures for months or
+years, or, more appropriately, and if they can afford it, are sent
+abroad, we can realize the importance of an agent by means of which the
+desired end can be obtained more conveniently, certainly, economically
+and in a shorter time than by any other means. There is no rule without
+its exceptions, and I freely admit that in many instances where persons
+are, as the saying is, “run down,” a sojourn in some mountainous region
+or a course of sea-bathing, etc., would do them more good than anything
+else, electric baths included. The results obtained from these last are
+however sufficiently uniform to justify us in looking for very favorable
+results in every case.
+
+In the preceding chapter I have already dwelt on the
+
+
+                    HYPNOTIC AND SEDATIVE INFLUENCE
+
+of the baths. It is only necessary to state here that this influence
+manifests itself still more decidedly in corresponding morbid conditions
+than in health. The greater the degree of restlessness, irritability or
+wakefulness, the more strikingly does the soothing and hypnotic
+influence of the baths—appropriately administered, of course—become
+apparent.
+
+
+                       IMPROVEMENT OF NUTRITION,
+
+as manifested by rapid increase of weight, and which I have likewise
+touched upon in the preceding chapter, is a reliable, constant effect of
+electric baths. Where previous loss of weight is due to an incurable
+organic disease, it is, if at all obtained, of course much less in
+degree, as well as transient. When due, however, as is frequently the
+case, to causes that are amenable to electrical influence, the increase
+in weight is marked, and has a tendency to be permanent.
+
+It will be seen that the few therapeutic effects which I have here
+enumerated, are in reality nothing more than intensified physiological
+effects, there being about them nothing that might be termed specific.
+It may be asked in reply: why then did I devote any space to them at
+all? I will answer that I thought best to point out some general
+therapeutic USES for which electric baths may be made available, and the
+indications for which are furnished by so great a number of pathological
+conditions, that omitting special reference to them would have led to a
+great deal of tautology in the chapter on “special therapeutics.”
+
+Before leaving the subject of “general uses” of the baths, I will dwell
+for a moment on their admirable adaptability as a
+
+
+                             PROPHYLACTIC.
+
+Every physician is fully aware of the fact that disturbances of the
+circulation constitute one of the most frequent causes of disease. There
+are, indeed, comparatively few pathological conditions that do not bring
+with them congestion of some more or less important organ. A remedy then
+which more than any other has a tendency to equalize the circulation,
+and thus counteract a condition which as cause or effect, or both, is an
+almost universal concomitant of disease, and which in addition to this
+is so admirable and physiological a stimulant and tonic, can hardly be
+surpassed as a prophylactic by any other uncombined remedy.
+
+
+    Footnotes:
+
+    [Footnote 9: Dr. Hermann Nothnagel: Handbuch der
+    Arzneimittellehre. Berlin, 1870.]
+
+
+
+
+                              CHAPTER V.
+
+               SPECIAL THERAPEUTICS AND CLINICAL RECORD.
+
+
+I have thought it best for practical purposes, to accompany the
+consideration of the treatment of special diseases by the histories of
+illustrative cases, where I had such at command.
+
+Before entering on the subject proper, I wish to offer some general
+considerations that may influence and guide us in determining when,
+where and why to employ electric baths as a remedy.
+
+To realize thoroughly the indications in given cases for the employment
+of electric baths, we must first of all be more or less familiar with
+the effects and uses of the electric current as well as those of the
+ordinary warm bath. We must realize the fact that here we not only have
+these two forces united, but that the more important of the two, the
+electric current, here acts directly (locally) as well as indirectly
+(through the nervous centres) on every portion of the body—a
+circumstance of great importance in differentiating indications on the
+one hand for the baths, on the other for local electrization. In view
+of these circumstances we are fully justified in looking for results far
+more comprehensive than any that might be obtained singly from either of
+the two remedies that are here combined. There can be no doubt that in
+many cases the resisting power of a disease is sufficient to withstand
+two remedies brought singly and alternately to combat it, whereas the
+simultaneous combined action of these remedies may be fully adequate to
+overcome this resisting power.
+
+Approaching in its effects more closely to the electric bath than any
+other remedy, is the process known as “general faradization,” to which I
+have already alluded (p. 36). In choosing between this and the bath, I
+state it as my conviction that, while there may be a small proportion of
+cases in which general faradization, so-called, is preferable, in almost
+all the cases where both these remedies are applicable, the faradic bath
+deserves the preference—it is a _more complete_ faradization.
+
+We need never be afraid of ordering electric baths on the score of any
+imagined exertion or discomfort attaching to them. The most delicate,
+the aged and children alike, bear them with far more ease, comfort and
+impunity than any ordinary warm bath, or any but the mildest local
+electrization. The entire absence of shock or pain of any kind
+whatsoever, is always an agreeable surprise to those who, urged by their
+physicians, have with fear and trembling submitted themselves to a
+treatment, the mere name of which filled their minds with
+extravagant—and, it is useless to say, groundless—visions of painful
+shocks. Thanks to the tonic effects of the current, they are by the
+feeble and infirm borne much better than the ordinary warm bath. There
+is likewise much less liability to get cold after the electric bath. The
+stimulus which the current furnishes to the peripheral circulation is a
+powerful protection against cold, so that even in midwinter I see people
+daily take electric baths at an average temperature of 95°, and enjoy
+apparent immunity from colds.
+
+Having once determined on the use of the baths in a given case, we have
+to observe certain points in their application.
+
+In the first place, guided by what we know of the relative effects of
+galvanism and induced electricity, we must decide which of these two
+currents to use, and if both, in which order. We must determine on the
+direction and intensity of the currents, as well as on the duration of
+the baths.
+
+Next we must use our judgment as physicians, in deciding whether a
+given case promises to get well under electro-balneological treatment
+alone, or whether auxiliary treatment may not be required to bring it to
+a favorable issue.
+
+With respect to the frequency of the applications, I will say that while
+there are some cases where a bath twice a week is sufficient, and others
+where a bath every day is imperatively necessary, in far the greater
+majority of cases suitable for electro-balneological treatment, a bath
+every alternate day is _sufficient_, but a bath every day is
+_better_—it leads to more rapid as well as certain results.
+
+In most of the cases, a daily bath for a few days or a week, followed by
+one every other day for a time, and, when the cure is about completed, a
+bath twice a week, to _consolidate_ and _confirm_ the good results
+obtained, has done me the best service.
+
+I would dwell particularly on the necessity of _perseverance_ in this
+treatment. The majority of cases that have come under my observation in
+this connection, have been of a more or less chronic nature. In many of
+these, where medicinal and other treatment had been unavailingly gone
+through with for weeks, months and even years, I have found existing the
+most absurd expectations with regard to the effects of the baths. People
+who had made the tour of almost all the watering-places of Europe
+without obtaining the slightest benefit, have come to me imbued with the
+idea—whence derived I know not—that one or two baths should greatly
+improve, and two or three more cure them; and when these expectations
+were not realized, they would promptly discontinue treatment, fully
+satisfied that electric baths were no more capable of benefiting them
+than “all the other things.” I do not mean to be understood for a moment
+as intending to imply that ideas of this nature are shared by the
+profession; I mention them simply in order to show the necessity on the
+part of physicians to disabuse in this respect the minds of those
+patients whom they may send for electro-balneological treatment.
+
+In appropriate cases, the use of the bath should not be too long
+deferred. I have had frequent occasion to become cognizant of the fact,
+that cases have been sent by physicians to take the baths only after
+prolonged ineffectual treatment of another nature had been gone through
+with, and where negative or at best tardy results took the place of the
+brilliant results that might have been obtained, had the cases been sent
+earlier. I do not mention this in a fault-finding spirit; to do so would
+be unjust. The remedy under consideration has up to the present time
+been too little known, the indications for its employment—in the
+absence of statistics—on too uncertain a basis, to expect from any but
+specialists the early realization in any case of its appropriateness. I
+trust however that in the future, from being a “dernier ressort,” it
+will come to take its proper place among other remedies, to be
+administered “when it will do the most good.” When this comes to pass,
+the results obtained, satisfactory as they are even now, will become as
+brilliant and well-authenticated as those of every other remedy from
+which experience has taught us how to reap the greatest advantage.
+
+In the following “clinical record” I shall not omit to cite cases where
+the baths were unsuccessful, wherever it shall appear to me that the
+citation of such cases may be of assistance in arriving at a true
+estimation of the therapeutic value of the remedy.
+
+In giving the histories of cases, it will scarcely be necessary to enter
+very minutely into details; the demands of the present work will be
+fully met if sufficient is said of a case to illustrate the effects of
+the baths in the class of cases that it represents.
+
+Finally, I wish it understood that in a few of the conditions in which
+I shall advise the employment of the baths, I have had no personal
+experience in their use, but base my opinions on what I know of their
+effects, together with what is known of the results obtained in
+analogous conditions by local electrical methods.
+
+
+                           SPECIAL DISEASES.
+
+                              RHEUMATISM.
+
+Its great frequency, the pain and discomfort which it occasions, and its
+many, often dangerous _sequelæ_, added to its frequent obstinacy under
+the most varied treatment, render rheumatism one of the most formidable
+diseases that we have to encounter. The long list of remedies that have
+from time to time been employed in its treatment, bear witness by their
+very number to the little reliance that can be placed in any one of
+them. A remedy then which can be _relied on_ to exercise a favorable
+influence in all the forms of rheumatism—acute, subacute and
+chronic—as well as on most of its sequelæ, should of right become a
+welcome addition to our armamentarium in the treatment of this disease;
+and such is the electric bath. The treatment of the sequelæ I shall
+speak of under separate heads. The disease itself I will divide into
+three classes, viz: _a_) acute, _b_) subacute and _c_) chronic
+rheumatism.
+
+_a_) ACUTE RHEUMATISM.—A few years ago the use of electricity in acute
+inflammatory conditions was scouted by most of the profession, and had
+it not been for the quiet and patient labors of a few progressive
+spirits, we would at the present day be still deprived of the benefits
+which we reap from it in these conditions. Even to-day, the number of
+those who are satisfied of the utility of electricity in this respect is
+comparatively small. Only two years ago, I attended a gentleman who was
+suffering from a very severe attack of rheumatic gout. I had both a
+galvanic and a faradic battery at his house, which, in addition to
+appropriate medicinal treatment, I applied daily to the affected
+joints,—using mainly the faradic current. Being compelled at the time
+to go to the country, the case during my absence drifted into the hands
+of a gentleman, a professor at one of the medical colleges, of high
+standing in the profession and considered one of our leading medical
+men, who ridiculed and promptly discontinued the use of electricity in
+the case. He gave it as his opinion that it did more harm than good, and
+I have no doubt he did so conscientiously—however unprofessional his
+conduct may have been, in this as well as other respects. The
+contributions of others have since then vindicated my views in this
+respect. Among others, Dr. Drosdoff[10] of St. Petersburg has given a
+number of cases of acute articular rheumatism from the clinique of
+Professor Botkin, in which the faradic current was employed either alone
+or in conjunction with other treatment. From among the deductions which
+he makes from a series of careful experiments in this respect, I quote a
+few—such as bear directly on our subject, and to which I affix my own
+numbers.
+
+    1) “The sense of pain as the result of electric irritation is
+    considerably diminished, and sometimes entirely lost, in joints
+    attacked by acute articular rheumatism, so that the patient
+    experiences no pain, even when the distance between the coils
+    equals naught[11], and both closure and opening are accompanied
+    by the evolution of numerous sparks. At the same time the
+    slightest pressure of the affected parts gives rise to the most
+    intense pain.”
+
+    “The diminution of the electro-sensibility appears in the
+    majority of cases to be in inverse proportion to the severity of
+    the disease and the intensity of the pain produced by mechanical
+    irritation.”
+
+    2) “The enhanced tactile and thermic sensibility of the diseased
+    joints is diminished by a faradization lasting from 5 to 10
+    minutes.”
+
+    3) “From 5 to 10 minutes faradization causes a reduction of the
+    previously heightened temperature of the diseased joints to the
+    normal standard, or even below this.”
+
+    4) “The subjective rheumatic pains which are augmented by
+    pressure and motion, are diminished by faradization. This
+    diminution is sometimes so considerable, that the joint, which
+    prior to the faradization admitted of no movement, is able to
+    execute passive and active movements with tolerable facility.”
+
+    5) “The rheumatic pains as well as the temperature of the
+    affected joints remain diminished after the faradization for 3,
+    4 and even 5 hours; they then gradually return to the previous
+    height. At the same time the duration of the paroxysms of pain
+    becomes shortened, and the intensity of this diminished.”
+
+    6) “Although the rheumatic process takes a more rapid course
+    under the influence of faradization, and incommodes the patient
+    less, we have nevertheless made the observation in one case,
+    that the tendency to recurrence is not diminished. The attacks
+    however become more brief and milder.”
+
+    7) “From what has here been said it follows, that daily
+    faradizations, lasting 5-10 minutes, diminish the severity of
+    acute articular rheumatism, restore the perverted cutaneous
+    sensibility, and cause a reduction of the temperature of the
+    affected joints.”
+
+    8) “Several of those suffering from the pathological processes
+    mentioned, received no medication in addition to the
+    faradization, and yet made a tolerably rapid recovery.”
+
+I might adduce further testimony of the value of electricity in recent
+cases of rheumatism, were it necessary to do so. The results in my own
+cases however have long since satisfied me of the utility in this
+respect of faradic not only, but also of mild constant currents.
+Accepting this as matter of fact, let us next inquire where and why we
+are to give _general_ electrization—in other words, the electric
+bath—the preference over local applications.
+
+Where the manifestations of the disease are limited to a single joint,
+or at best a very few joints, or where we have to do with a case of
+muscular rheumatism—to one group of muscles, local electrization, as
+_symptomatic_ treatment, will answer. Where on the one hand however many
+joints, on the other the muscles of entire limbs, or even more, are
+involved, the advantages of a method by means of which we reach all the
+affected parts at once, thus effecting in, say ten minutes, that which
+where, for example, six joints are involved, would by the ordinary
+method require sixty minutes, are readily realized. There is, however,
+another reason why the baths are preferable in rheumatism to local
+applications. Rheumatism is a constitutional disease with local
+manifestations. The metastatic character of muscular rheumatism
+especially appears to indicate the greater importance of general as
+compared to local treatment. Pre-supposing, then, that electricity
+exercises the favorable influence on rheumatism which clinical results
+would appear to demonstrate, it follows that the electric bath, while it
+furnishes symptomatic (local) treatment equally well with local
+applications, does something more; it meets the _indicatio morbi_
+likewise. The warm bath no doubt contributes its due share in bringing
+about the favorable results obtained.—Where the disease then does not
+confine the patient to bed, the electric bath will be found a most
+valuable remedy.
+
+The following directions will be found to answer best in the great
+majority of cases: The temperature of the water should range from 90° to
+98° F; a mild constant current, descending, should be applied for ten
+minutes; this to be followed by a faradic current of as great an
+intensity as the patient can bear _without the slightest degree of
+discomfort_. In the application of the faradic current, the surface
+board (see p. 12) may advantageously be had recourse to for the purpose
+of more concentrated influence on affected parts, to each of which it
+may be applied for a few minutes; the entire faradization may last from
+ten to fifteen minutes. When coming from the bath, the patient should be
+received in a warm blanket, anything like a chill being carefully
+guarded against. In cases where the cutaneous secretion is of an
+abnormally acid character (which is often so marked as to become
+apparent through the sense of smell), bicarbonate of soda or potassa may
+be added to the bath. As appears from the foregoing, the entire duration
+of the bath is from twenty to twenty-five minutes. The baths should be
+taken daily until all urgent symptoms have disappeared; after this,
+every two or three days as required, until an entire cure is wrought.
+
+As the results of this or similar treatment, conjoined with the
+requisite medicinal or other measures, I may state:
+
+_a_) Considerable abridgment of the period of the disease;
+
+_b_) Sequelæ are less constant;
+
+_c_) The tendency to recurrence is very much diminished;
+
+_d_) A relapse, if it does occur, is comparatively mild.
+
+With regard to _b_ and _c_, let it be understood that I speak within the
+restrictions of a period of observation extending over two and a half
+years only.
+
+
+                       _b_) SUBACUTE RHEUMATISM.
+
+In the subacute variety, the electro-balneological treatment is similar
+to that in acute cases, with the difference however, that here not so
+much care is necessary with regard to the intensity of the currents.
+Muscular contractions, as induced by strong faradic currents, are to be
+dreaded in direct proportion to the acuteness of the inflammation,
+_resp._ the sensitiveness of the inflamed tissues.
+
+It will be understood, I hope, that the electro-balneological treatment
+as laid down above, though it applies to the majority, does not apply to
+all cases. Special complications may make it expedient in individual
+cases to modify the treatment more or less. The course to be pursued in
+these instances may however be safely left to the judgment of the
+attending physician.
+
+_c_) CHRONIC RHEUMATISM. In this affection the course to be pursued
+varies from that indicated in the acute and subacute varieties. We have
+here little or no constitutional disturbance, and need have no fear of
+doing any harm by strong currents. On the contrary, I have found that
+mild currents rarely do any good. By far the greater majority of the
+cases that have come under my observation were of the muscular type, the
+algic portion of the symptoms approaching those of neuralgia rather than
+subacute rheumatism. Of chronic articular rheumatism I have treated but
+very few cases. Although in some of the cases the treatment under
+consideration was attended with brilliant results, I freely admit that
+in some instances the results were imperfect, in others again entirely
+negative. This I found true more especially of cases that involved
+tendons. I must add, however, that in perhaps the greater majority of
+the unsuccessful cases the fault lay with the patients themselves, who,
+finding they were not benefited as rapidly as they had expected,
+discontinued treatment before this had had time to effect any thing.
+
+In accordance with a theory which I have formed in regard to the
+pathology of chronic rheumatism, and which I am not yet prepared to
+promulgate (nor is it necessary here), I have of late been in the habit
+of administering in this disease, baths calculated to stimulate as much
+as possible the circulation of the blood. The best manner of applying
+the baths to this end will be found further on, under “Inequalities of
+the Circulation.” In addition to this I cause the galvanic (anode) as
+well as strong faradic currents to be applied to the affected parts by
+means of the surface board. Where there is any thickening, effusion or
+other similar concomitant of the disease, iodine may be added, as
+hereinbefore directed.
+
+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.
+
+    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.”
+
+    When Mr. S. came to consult me, he had but lately returned from
+    Europe, whence, he stated, his physicians had sent him home to
+    die. His complexion was sallow, sickly; skin of face plentifully
+    wrinkled; features wearing the air of suffering and anxiety that
+    so frequently accompanies painful chronic conditions. He had for
+    some time past suffered from excessive cerebro-spinal
+    irritability, for the relief of which cantharidal collodion had
+    been employed in the cervico-spinal region (the same had also
+    been used in the hepatic region, to meet the diagnostic views of
+    some one of his medical attendants). He had a remittent chronic
+    intestinal catarrh, with—noticeably during the periods of
+    exacerbation—abundant discharge of a glairy mucus. The appetite
+    was very capricious—not to say poor, and he was obliged to be
+    exceedingly careful in his diet. He was not capable of any
+    continued mental application. The muscular system was weak and
+    flabby. All the vegetative functions were more or less impaired.
+
+    On June 3d, 1874, Mr. S., by my directions, took an electric
+    bath. He continued the baths daily for some weeks; then every
+    two or three days, all the time steadily improving. He had some
+    adjuvant medicinal treatment, probably similar to what he had
+    already had in Europe. He states, however, that his improvement
+    commenced with the first bath he took; and the baths certainly
+    constituted the main treatment throughout. He gained daily in
+    every respect. Mind and body were invigorated; his muscles
+    increased in size and hardness; color gradually returned to his
+    cheeks, etc. He continued the baths with more or less regularity
+    until the close of the year, taking in all sixty-one baths. He
+    was then in a better condition than he had been for many years.
+    Thinking a trip to Europe would benefit him, I advised him to go
+    there and remain a few months. He left early in January and
+    returned in the beginning of April, 1875. He had been very well
+    during his absence, until within a few weeks prior to his
+    departure from Europe, when he experienced a severe attack of
+    cerebro-spinal congestion, which caused him much suffering. On
+    his return he resumed the baths, and continued them throughout
+    the spring, continually gaining in strength and weight. At the
+    beginning of last summer he was practically well. He has
+    regained his normal weight (120 pounds). As a criterion of his
+    bodily vigor, I will simply state that I have seen him lift,
+    with ease, 350 pounds, which, for a person of his weight, is not
+    bad. His mental force is as good as it has ever been. The
+    digestive disturbances have disappeared; he can eat things which
+    for years he had been compelled to eschew. To use his own words:
+    “I am well.” In view of the fact that he had already received,
+    at the hands of competent men, all sorts of internal as well as
+    external treatment, I believe I am justified in attributing his
+    cure almost entirely if not solely to the baths.
+
+    CASE XI. Mr. * * *, aet. about 50, lawyer, of large, vigorous
+    frame, came to consult me January 4th, 1875. He complained of
+    symptoms that are the frequent results of prolonged mental
+    over-taxation. His intellect was as good as ever, but he lacked
+    his wonted mental endurance and power of application. His mind
+    was perfectly clear, but unable to work. It was a case of
+    “_limited_ cerebral exhaustion.” Physical nutrition was pretty
+    good; yet his color was not normal, being rather paler than it
+    had been and has since become again. His flesh was flabby. There
+    were vague neurotic disturbances, etc., etc. He had until
+    recently occupied a leading public position, and the onerous
+    duties that devolved on him in connection with this, evidently
+    stood in direct etiological relation to his trouble. I ordered
+    an electric bath every other day. This was complied with until
+    the end of February, when the patient had apparently entirely
+    recovered his health, mentally as well as physically. I saw him
+    not very long ago; he looked the picture of health, and told me
+    that he was and had been since I saw him, perfectly well in
+    every respect.
+
+    CASE XII. Mr. L., aet. 23, presented himself for treatment in
+    October, 1874. He had at various times made the attempt to study
+    some profession, but had never been able to concentrate his mind
+    sufficiently on any object to enable him to persevere in its
+    pursuit. He was fretful, irritable and vacillating; would desire
+    one thing to-day, another to-morrow; never long of the same
+    mind. Melancholia, digestive disturbances and hypochondriacal
+    phenomena accompanied this condition. No organic disease was
+    discoverable. On October 1st he took his first bath. Very
+    shortly after this he commenced the study of medicine. He
+    improved rapidly in every respect. During the month of October
+    he had six baths, which resulted in complete and permanent
+    relief of all the symptoms. He progressed satisfactorily in his
+    studies, and is at the present time taking his second course in
+    one of our city medical colleges.
+
+
+                               AGRYPNIA.
+
+                      (INSOMNIA; SLEEPLESSNESS).
+
+Although, as a rule, but the symptom of some definite pathological
+condition, agrypnia is of such frequent occurrence, and so detrimental
+to the general health, that it appears to me to merit special
+consideration. This holds good especially in this connection, because,
+even where electric baths fail to influence the disease giving rise to
+the insomnia, they almost invariably remove this, irrespective of its
+cause. Even where, the disease itself remaining uncured, the insomnia
+must return sooner or later, the sleep is very much improved while the
+baths are being had recourse to. We must of course endeavor in all cases
+to relieve the original disease, and, where the baths are not adapted to
+this purpose, resort to other and appropriate means. It will be found of
+no small service to us in the therapeutical management of every case, to
+be enabled to procure for the patient, without the aid of medicinal
+hypnotics, sufficient of sleep during treatment.
+
+    CASE XIII. Mr. A., from the _clientele_ of Dr. LEONARD WEBER,
+    was sent by Dr. W. to take electric baths. He suffered from
+    chronic spinal congestion. Among the most prominent and annoying
+    symptoms was _agrypnia_. It was for the relief of this symptom
+    chiefly that Dr. W. ordered him the baths. He began to improve
+    in this respect from the time he took his first bath, and
+    although the disease itself remained uncured, he enjoyed good
+    sound sleep while he was under treatment, his general health
+    improved, and he frequently spoke of the notable benefits that
+    he received from the baths. He continued them until his
+    departure for Europe, where, by direction of his physician, he
+    went last spring. I have not seen him since, but Dr. W. tells me
+    that he is doing well.
+
+    CASE XIV. Mr. D. was brought on Sept. 30th, 1874, by his
+    physician, Dr. HOGAN. He was in the incipient stage of _delirium
+    tremens_. Had not slept for some nights. Dr. H. had administered
+    successively opiates, chloral and bromides in full doses,
+    without effect. On the evening of above date the patient had a
+    bath, in which the descending galvanic current was used. As a
+    result, he slept well that night. The baths were repeated on the
+    two succeeding days, with like effect. As the disease developed
+    however it became necessary to send the patient to an asylum,
+    whence he returned cured in a short time. The effect of the
+    baths in this case, where full doses of the most powerful
+    hypnotics of the materia medica had failed, was remarkably
+    illustrative of their hypnotic power.
+
+
+                                ANÆMIA.
+
+As is well known to the profession, anæmia forms the basis of a great
+number of morbid conditions. Hysteria, general debility, emaciation,
+sterility, various nervous affections, phthisis, in short, a perversion
+of almost any of the various physiological functions may be the direct
+result of anæmia. On the other hand, anæmia may be only a symptom or
+sequel of some other morbid condition—but of such cases I do not now
+speak. I have to do here only with those cases where anæmia is the
+primary and etiological of a group of symptoms, and where therefore it
+is to this that the treatment must be mainly directed. Now let us see
+what this treatment is. Dr. FLINT[15] suggests the following therapeutic
+measures: “_first_, a nutritious alimentation, into which meat should
+enter largely; _second_, the use of tonics and stimulants to render the
+digestive functions more active; _third_, iron as a special remedy—the
+effect of which is often remarkable; and, _fourth_, a regimen calculated
+to increase the energy of the assimilative functions, consisting of
+exercise in the open air, recreation, etc.” This agrees mainly with the
+views of other writers. It may conveniently be condensed under two
+heads, instead of four, namely: _first_, to secure for the patient
+appropriate food and adopt the best means to insure its assimilation;
+_second_, the administration of iron. As to the ingestion of appropriate
+food, open air exercise, etc., patients are of course to receive the
+necessary directions. The remainder of the therapeutic indications, as
+given above, are admirably met by electric baths. As we have seen in a
+preceding chapter (p. 43 et seq.), they are a tonic and stimulant of the
+first order, and as nearly as possible a specific for the furtherance of
+the digestive and assimilative processes. When impregnated with iron,
+they constitute a treatment for anæmia which, in conjunction with the
+requisite diet and other hygienic measures, is inferior to no other. It
+will moreover be found very efficacious in counteracting secondary
+anæmia, and thus, by maintaining the general strength of the patient,
+often enable nature and appropriate treatment to cope successfully with
+the original disease.
+
+    CASE XV. Mrs. S., aet. 22, four years married. I was called to
+    see her on October 2d, 1874. She then had a spontaneous
+    miscarriage, the fifth since her marriage. She asked me whether
+    nothing could be done to enable her to carry a child to full
+    term, as both she and her husband were very desirous to have
+    offspring. In pursuance of my directions, she presented herself
+    at my office about ten days after I first saw her. On
+    examination I found no organic trouble, no uterine displacement,
+    nor any other local trouble to account for her premature
+    confinements. Involution had progressed normally. The only
+    deviation from the normal that I could discover about the uterus
+    was undue paleness of the cervical portion. Her appearance was
+    very decidedly anæmic; features pale, flabby; lips whitish blue;
+    physical energy much depressed. She had had but very slight loss
+    of blood on the occasion of her recent miscarriage; certainly
+    not enough to account for her anæmic appearance. Viewing her
+    case as one of idiopathic anæmia, I ordered her electric baths
+    strongly impregnated with iron. In addition to this, the regimen
+    usual in such cases, and also strychnia and phosphorus
+    internally. She took her first bath on Oct. 14th; then one bath
+    weekly until she had taken six baths, the last of which was
+    administered on the 24th of November. During all this time she
+    kept steadily improving. The anæmic appearance and symptoms
+    gradually receded, and, soon after she had taken her last bath,
+    I discharged her, as far as the anæmia was concerned—cured.
+    While she was under treatment she had, by my advice, refrained
+    entirely from sexual intercourse. Early in the spring of 1875
+    she called to tell that she was again pregnant, and in November,
+    1875, I delivered her of a healthy male child, at full term.
+
+
+                        PARALYSES AND PARESES.
+
+I include these under one head, because not only is their origin
+frequently identical, but, chiefly, because the therapeutic indications
+are almost always the same in both. Whatever the cause in any given
+case, whether cerebral, spinal or peripheral, organic or functional;
+whatever the treatment that may be indicated—and this should never be
+neglected—for the primary trouble, the direct electrical treatment of
+the paralysis, sub-paralysis or paresis, being purely _symptomatic_
+treatment, remains in the great majority of cases essentially the same.
+The objects to be aimed at are two, viz: _first_, a normal state of
+nutrition of the affected muscles; _second_, their normal contractility.
+In other words, we are to endeavor to prevent atrophy of the affected
+muscles, or, where this has already taken place to some extent, to
+restore their normal bulk; and, _second_, we must strive to restore the
+more or less impaired contractility of the paralytic or paretic muscles.
+Even where symptomatic treatment for these purposes is the _only_
+treatment employed in a case, we frequently meet to a great extent the
+_indicatio morbi_, by favorably influencing, either in a reflex or
+direct manner, the primary disease. This is true of _local_
+electrizations of the affected parts; it holds good much more strongly
+however of _electric baths_, because here, in addition to the reflex
+influence that we get from local applications, we have also the direct
+influence of the electric current on the spinal cord and posterior
+portion of the brain not only, but on the sympathetic system and all the
+important organs contained in the thoracic and abdominal cavities. The
+great importance of this is apparent, when we reflect that in very many
+if not most cases of disease of the nervous system, central or
+peripheral, electricity in an appropriate form is a useful therapeutic
+agent, and that moreover the great majority of functional paralytic
+disorders respond favorably to its influence. As for any harm being done
+by it in those rare cases where its use may be contra-indicated, I admit
+that such may accrue from the administration of electric baths without
+medical supervision; it is entirely obviated however where the baths are
+under the supervision of a physician, who does not, like a layman,
+indiscriminately admit to their use any and everybody who is willing to
+pay for their administration, but will carefully discriminate, and
+conscientiously exclude those cases in which general electrization might
+result injuriously. In such cases a tolerably accurate diagnosis is as
+a rule readily made, and will enable the physician to separate the
+suitable from the unsuitable cases.
+
+As to the mode of administration of the baths in cases of the class
+under consideration, the use of both currents is requisite; the galvanic
+as a nutrient, the faradic as an excito-motor agent. Where, as is
+sometimes the case, faradic irritability is extinct, or so slight as to
+be practically unavailable, the (slowly) interrupted galvanic current
+must take the place of the faradic, until faradic irritability has
+become re-established. As to the intensity, direction, etc., of the
+currents, each individual case has its own laws, which must be
+recognized by the supervising physician.
+
+    CASE XVI.—_Infantile paralysis._ Albert Pichl, aet. 22 months,
+    was sent me by Dr. LILIENTHAL, October 3d, 1874. Had complete
+    paralysis of right leg (of four weeks standing), with
+    considerable atrophy of the entire leg as well as the gluteal
+    region of the corresponding side. The temperature of the leg was
+    much lower than that of the healthy limb. _Faradic irritability
+    was entirely extinct._ The treatment was begun by galvanizations
+    of the lower (lumbar and sacral) portion of the spinal cord, and
+    the use of the interrupted galvanic current on the affected
+    muscles. This was at first done daily. The contractility of the
+    muscles gradually but slowly improved, but neither the atrophy
+    nor temperature of the limb appeared visibly affected by the
+    treatment. With a view to favorably influencing these
+    conditions, I ordered him galvanic baths. He had a bath every
+    alternate day. The result was favorable and rapid. The leg
+    became sensibly and permanently warmer after each bath, and
+    commenced steadily to increase in bulk. Faradic irritability
+    soon returned. The local applications were continued several
+    times a week for some time, and then gradually abandoned, the
+    baths being meantime continued regularly. The boy very soon
+    began to walk, and in December active treatment was
+    discontinued. At that time, faradic irritability having long
+    since become completely re-established, I caused the child’s
+    father to purchase a faradic battery to use at home. The limb
+    was eventually entirely restored in every respect, with the
+    exception of a slight abduction of the foot, for which I
+    referred the patient to Dr. GIBNEY. I saw the child recently; he
+    remains well.
+
+    CASE XVII.* _Sub-hemiplegia from cerebral hemorrhage._ Mrs. S.,
+    aet. 30, married, from the practice of Dr. KREHBIEL, was sent by
+    Dr. K. to take baths, July 3d, 1874. It was a routine case,
+    differing in no respect from what is ordinarily witnessed as a
+    sequence of cerebral hemorrhage. Six baths, taken at intervals
+    of two and three days, restored almost entirely the muscular
+    power of the affected side. The patient subsequently made a
+    complete recovery without further treatment.
+
+    CASE XVIII. _Paralysis from insolation._ Mr. P., proof-reader
+    aet. about 40, had suffered for some time from sub-paraplegia,
+    the result of insolation. He was sent to take baths in May,
+    1874, by his physician, Dr. SCHIRMER. Electro-balneological
+    treatment in this case met with no success.
+
+    CASE XIX. _Lead paralysis._ Mr. M., aet. about 35, painter, was
+    referred to me for treatment May 15th, 1874, by Dr. MOHN. The
+    extensors of one (I believe it was the right) arm were
+    paralyzed. The characteristic blue line about the gums was
+    clearly defined. I ordered an electric bath daily. The
+    descending galvanic current was used for twenty minutes each
+    bath. From half to one ounce of iodide of potassium was added to
+    each bath. The blue line became less distinct from day to day,
+    until, after eleven baths, it had entirely disappeared. The
+    object for which I had ordered the baths having now been
+    accomplished, I treated the affected muscles with the faradic
+    current. A short course of this treatment sufficed to remove the
+    paralysis from all but one finger (it was either the middle or
+    ring finger), the extensors of which had probably undergone
+    fatty degeneration.
+
+
+                              NEURALGIÆ.
+
+The great variety of causes that may give rise to neuralgia, precludes
+the possibility of any specific for this symptom. In discussing its
+electro-balneological treatment, I would observe _a primo_ that I
+cannot, in the light of my personal experience, agree with those who
+claim for electrical treatment good results in a _majority_ of
+cases.[16] On the other hand it cannot be denied that, either as a
+palliative or curative measure, electricity, employed in an appropriate
+form and manner, is of inestimable value in many cases, and frequently
+succeeds where all other remedies are of no avail. Where we know the
+cause of a neuralgia, it is of course comparatively easy for us to
+determine whether or not electricity promises to avail anything. But
+even where the nature of the cases appeared to indicate its use, the
+failures, in my hands at least, have outnumbered the successes. The
+brilliant results—sometimes almost instantaneous—that we obtain now
+and then, should not lead us into overlooking our failures. Undoubtedly
+the circumstance that most of the cases that have come under my
+observation were of a very obstinate nature, referred to me by other
+physicians after varied unsuccessful treatment, has much to do with the
+formation of my views as expressed above, and future experience may
+perhaps lead me to modify them.
+
+Speaking still from my own experience, I will state that the cases that
+have proven the most amenable to treatment were, _first_, those of
+rheumatic origin; _second_, hysterical neuralgiæ, and, _third_, cases
+where no assignable cause could be elicited. The most obstinate
+varieties were those of a malarial type (even when quinine in large
+doses or arsenic were employed in conjunction with galvanism) and those
+that depended on some form of chronic inflammation—_neuritis_,
+_periostitis_, etc. Of central neuralgiæ, I have had excellent results
+in the sympathetic variety and in the pains of posterior spinal
+sclerosis, while in the neuralgiæ of cerebral origin (diffuse cerebral
+sclerosis, tumors, etc.) I have never met with any appreciable success.
+
+Where, then, we are able accurately to diagnose a case, there cannot be
+much doubt as to the appropriateness or not of electrical treatment, and
+in cases whose origin is obscure, which may be considered practically
+functional and therefore treated more or less empirically, electricity
+holds out as much or more hope than any other remedy. Whether
+electricity should be employed locally or in the form of baths, must
+depend on the features presented by each individual case. In neuralgia
+of the fifth pair—excepting those reflex cases where the _point
+d’origine_ is to be sought for somewhere in the trunk or extremities,
+and those that depend on cerebral hyperæmia or anæmia, where the
+equalizing effects of the baths on the circulation are frequently of
+great benefit—these are generally useless. Of other neuralgiæ, I have
+found the baths less successful in those of the superior than in those
+of the inferior spinal nerves. Lumbo-abdominal neuralgia and sciatica
+have yielded much more readily than brachial or dorso-intercostal
+neuralgia, etc., etc.
+
+The mode of administering the baths in neuralgiæ does not possess enough
+of uniformity to render suggestion in this respect of any value. I will
+state however that, as a rule, the best results have been obtained from
+the descending galvanic current.
+
+In chronic cases the baths should be administered daily, and should not
+be discarded as unavailing until at least a dozen have been successively
+taken.
+
+    CASE XX. _Sciatica._ Mr. R., a middle aged man, mechanic, was
+    sent by Dr. ARCULARIUS Nov. 9th, 1874. Had post-rheumatic
+    sciatica of some six weeks’ standing. There were no remarkable
+    features about the case, which however was sufficiently severe
+    to disable him from pursuing his avocation. He took his first
+    bath on the date above-mentioned. Another bath was administered
+    next day, and three more every alternate day. He was then almost
+    well. On Nov. 25th he returned, there remaining still some
+    traces of the affection. Four more baths, the last of which was
+    administered on Dec. 4th, sufficed to complete the cure.
+
+    CASE XXI. _Sciatica._ Mr. G., aet. about 35, saddler, was sent
+    by Dr. WAECHTER, March 6th, 1875. Had suffered from sciatica
+    without discoverable cause for several years. For one year prior
+    to his visit had been unable to work, and was confined to bed a
+    great portion of the time. There was slight atrophy of the
+    affected limb. He had had considerable medical (including local
+    electrical) treatment, without avail. The baths were faithfully
+    and persistently tried in this case, effecting however but
+    slight improvement. Subsequent hypodermic injections, first of
+    strychnia, then of atropia and finally of chloroform, the latter
+    in doses ranging from 30 to 60 minims, gave him only temporary
+    relief. The patient was finally discharged uncured.
+
+    CASE XXII. _Lumbo-abdominal neuralgia._ Mr. W., aet. about 40,
+    was brought by Dr. MARVIN S. BUTTLES in June, 1875. He had been
+    in poor health for a number of years, and was then in a very
+    cachectic condition. There was considerable gluteal atrophy on
+    the affected side. At Dr. B.’s suggestion he took a course of
+    electric baths, with the happiest result. He improved steadily,
+    and on the occasion of a late inquiry after I had not seen him
+    for some months, Dr. B. told me that the patient had entirely
+    recovered. His general condition as well as the neuralgia had
+    been very favorably modified by the baths, and he is now in far
+    better health than he has been for many years.
+
+    CASE XXIII.—_Lumbo-abdominal neuralgia._ Mr. G., aet. 40, came
+    to consult me in October, 1875. He had suffered from neuralgic
+    pains, more particularly in the renal region of both sides, but
+    also in the neighboring parts, for only one week. The case being
+    so recent, I entertained a very favorable prognosis, which
+    subsequently was amply verified. A bath on the 12th of October
+    and one on the 16th sufficed to effect a complete cure.
+
+
+                         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.
+
+
+                              IMPOTENCY.
+
+The frequent obstinacy of this distressing condition under every variety
+of non-electrical treatment, is the cause of the frequency with which
+cases present themselves to the specialist. Unfortunately however but
+few of the referred cases are of recent origin. In almost all instances
+they have gone through a vast amount of medication and other treatment,
+and finally, either through their attending physicians or of their own
+accord, they come as a _dernier ressort_ to seek relief from electrical
+treatment. I have already (p. 47) spoken of the comparative merits in
+this disease of local and general electrization. A few years ago I was
+ignorant of the good effects of the baths in male impotency. I came to
+test and employ them here from two causes. In the first place, patients
+were sent me specially for electro-balneological treatment, ordered by
+their physicians; and, second, I began, when I became familiarized with
+the effects of the baths, to have recourse to them in cases where with
+local electrical and other treatment I had been unable to accomplish
+anything. My average results, without becoming uniformly successful,
+became so very much better, that after a brief but abundant experience
+with this treatment, I have come to consider it the most important we
+possess in this affection; one that will frequently succeed when
+everything else, including local electrization, has failed, and which,
+in cases where no incurable organic changes underlie the affection,
+will, if properly persisted in, either cure or improve to a great extent
+a large majority of the cases. I have even seen instances where, the
+sexual power having receded as the legitimate result of advancing age,
+it returned almost or quite perfectly and with seeming permanency under
+the influence of the baths. In the class of cases—and they are quite
+numerous—in which impotency (loss of the power of erection) occurs as a
+purely nervous symptom in comparatively young men; where its cause is
+sometimes purely imaginative, at others the result of early excesses,
+the baths are attended with the most gratifying average results. Where
+the cause is purely psychical, a very few baths are sometimes sufficient
+to dispel the morbid phenomena. Where masturbation or excessive venery
+are at the bottom of the trouble, there is always a probability of more
+or less organic change in the lower portion of the spinal cord, and
+frequently also a secondary enfeeblement of the digestive functions,
+which render requisite a long and steadily continued use of the baths.
+Patients whose sexual power was intact, who took the baths for other
+purposes, have time and again called my attention to their aphrodisiac
+effects.
+
+While here the _general_ electric influence is the main remedial agency,
+there is no reason why the possible—or, I should say, probable—good to
+be obtained from its _local_ influence should not be realized—the less
+so that it is so facile to obtain this in the bath, by means of the
+surface board. While individual cases will undoubtedly call for
+modifications, I have found the following plan to answer best in
+certainly more than half the cases that have come under my observation:
+The first five minutes of the bath may be occupied by a general galvanic
+current of medium intensity, _descending_ where the patient is of an
+irritable, _ascending_ where of a phlegmatic temperament. The pole
+connected with the foot electrode should now be detached, and the
+surface board substituted. The second five or ten minutes may be
+consumed by running a galvanic current between the head electrode and
+the surface board, the latter applied alternately to the penis, scrotum,
+perineum and, where thought best, also to the lumbo-sacral region.
+Where, as is usual, the impotency is accompanied by a certain degree of
+cutaneous anæsthesia of the penis, but especially where the seminal
+secretion is scanty, the board should be positive (ascending current);
+where however nocturnal spermatorrhœa, premature discharges (before
+coition is possible) or other irritable phenomena characterize a case,
+the surface board should be negative (descending current). The head of
+the patient should rest on a sponge thoroughly saturated with water, and
+communicating with the water of the bath, so as to include the
+cerebellum in the direct circuit. The last five or ten minutes of the
+bath should be devoted to passing the faradic current between the head
+electrode and the surface board, this last applied about the genitals,
+but chiefly about the perineum, the current to be of sufficient
+intensity to contract the perineal muscles. With anæmic patients iron
+should be added to the baths. These should be taken at first daily,
+later on every other day, then three times a week, and so on until it
+becomes apparent that all the good that can be obtained from them has
+been obtained—whether this be a perfect cure or only a certain degree
+of improvement. Where it is thought requisite, internal medication and
+various hygienic measures may be advantageously resorted to as
+adjuvants. While these will do no good when employed alone, they may
+serve to enhance the effects of the baths.
+
+In the following cases, I will include some where the impotency was not
+perfect, where the conditions were merely those of sexual debility. As
+there is here merely a difference in degree, it would be superfluous to
+separate the two conditions under distinct heads.
+
+    CASE XXV.* _Perfect impotency._—Mr. F., from the practice of
+    Dr. CARO, a robust gentleman, aet. thirty-six, full of muscular
+    vigor. Had had syphilis, the symptoms of which had disappeared
+    under Dr. C.’s treatment. For two years the power of erection as
+    well as sexual appetite had become extinct—if we except an
+    occasional imperfect spontaneous erection on waking up in the
+    morning, and even this was of rare occurrence. Ordinary
+    medication proving inadequate, Dr. C. sent patient to take
+    electric baths. From March 7th to July 16th, Mr. F. used the
+    baths, averaging about two weekly. He was then, and still
+    remains, perfectly restored.
+
+    CASE XXVI. _Perfect impotency._ A. E. K., aet. 23, commercial
+    traveler, applied to me for treatment in the spring of 1873. His
+    general health was very good. He had masturbated but little. Had
+    been in full possession of his sexual power until almost
+    twenty-two years of age, when he found that, without assignable
+    cause, he had lost the power of erection. His general condition
+    being, as far as discoverable, perfect in every respect, I
+    instituted a local electrical treatment. This was continued for
+    some time without avail. Strychnia was then administered with no
+    better result, and after some months’ treatment I told him that
+    I could do nothing for him. He remained without any treatment
+    whatever until the spring of 1874, when I advised him to try
+    electric baths. He took in all about half a dozen baths, which
+    resulted in his complete and thus far permanent restoration.
+
+    CASE XXVII. _Sexual debility._ Mr. W., aet. 32, married,
+    manufacturer, consulted me in February 1875. Had gradually for
+    about a year past lost sexual power. Was able to perform the
+    marital act at rare intervals only, and when he did, felt
+    exhausted the whole of the succeeding day. I ordered him
+    electric baths. He took the first on February 22d, 1875. Between
+    this date and March 22d, he took six baths. The sexual power had
+    then fully returned. I must not omit to state that during the
+    time he was under treatment he took, by my direction, gr. 1/25
+    phosphorus twice daily, which may have somewhat accelerated the
+    result.
+
+
+                             CONSTIPATION.
+
+Atony of the _muscularis_ of the intestine is admittedly the direct
+cause, in most instances, of constipation. It is the condition known as
+“torpor of the bowels.” It is ordinarily due to abnormal innervation of
+the parts. The inefficient innervation may be—and in females frequently
+is—reflex, or its cause may be sought for in the central nervous
+system. The condition of the voluntary abdominal muscles is likewise a
+factor in the alvine process. Sluggishness of the abdominal (portal)
+circulation is a not infrequent etiological concomitant of constipation,
+and, finally, the conditions grouped as “dyspepsia” may form the
+causative feature of a case. I have mentioned these different causes
+simply in order to account to some extent for the almost wonderful
+effects in this condition of electric baths. When we consider that in
+every one of the morbid conditions here enumerated, electricity is a
+very efficient remedy, and that for the resulting muscular atony it may
+be called a specific, it will not appear surprising that a mode of
+application which brings the electric influence to bear on both cause
+and effect—often on a combination of several of the causes enumerated,
+should be attended with such brilliant results. I have thus far met with
+no failure in the electro-balneological treatment of constipation.
+
+In the majority of cases the following method has proven the most
+efficient. The first ten minutes of the bath should be devoted to the
+administration of a galvanic current, as intense as can comfortably be
+borne by the patient. The one pole should be connected with the
+head-electrode, the other, by means of the surface board, applied
+alternately, to the epigastrium, chiefly, and to the hypogastric region.
+The current should a portion of the time be ascending, the rest
+descending. Occasionally the current should be rapidly reversed by means
+of the commutator, the intensity however having been previously reduced,
+in order to avoid too severe a shock; this will cause efficient
+contractions of the abdominal _parietes_, and probably also of the
+intestinal _muscularis_. The second ten minutes of the bath should be
+devoted to faradization, employed in the same manner as the previous
+galvanization, only that here the direction of the current is
+immaterial, and no reversals are requisite. The current should be of
+sufficient intensity to produce energetic but not painful contractions
+of the abdominal parietes.
+
+    CASE XXVIII. Mrs. * *, aet. 55, in average health, without
+    however being robust, had suffered from constipation for about
+    thirty years. She had had every possible medicinal treatment,
+    with no avail. Nothing had ever ameliorated her condition.
+    Without the aid of a cathartic, her bowels moved but once every
+    week or ten days. She was of course compelled frequently to
+    resort to laxatives. In the fall of 1873 I ordered her electric
+    baths. She was not very energetic in anything, and this lack of
+    energy caused her to take the baths less frequently than I
+    desired her to. Had she taken them regularly, she would probably
+    have been restored in as many weeks as it took months to effect
+    her restoration. As it was, she took some thirty baths in the
+    course of about fifteen months. For nearly a year past she has
+    had a passage every day with the utmost regularity. No adjuvant
+    treatment was employed in this case.
+
+    CASE XXIX.* Emil Miller, a bright child two years of age, was
+    brought for treatment July 7th, 1874. He had suffered from
+    obstinate constipation almost from his birth. Had been under the
+    care of several physicians, but had never received any benefit
+    from treatment. Even with the aid of powerful cathartics, given
+    in doses suitable for an adult rather than a child, defecation
+    took place only once every three or four days, and was so
+    exceedingly painful as to elicit cries of pain from the child.
+    The feces were always hard and lumpy, and of an abnormally light
+    color. A digital examination per rectum revealed considerable
+    flaccidity. My diagnosis was _paresis of the muscularis of the
+    intestine_. I ordered faradic baths. On July 12th the first bath
+    was administered, and I must confess that the result was a
+    perfect surprise to me. True, I had expected a cure to take
+    place; but I had looked for gradual improvement, and was not
+    prepared for a result such as was here obtained. _From the time
+    the first bath was taken, defecation took place regularly once a
+    day, without pain; the feces became perfectly normal both as to
+    color and consistency, and the boy continues to the present day
+    to defecate regularly and in every respect normally._ To insure
+    permanency, the baths were continued, at first twice, then once
+    a week. They have now been discontinued for upwards of a year,
+    there being no occasion for their further use. No other
+    therapeutic measures, internal or external, were resorted to in
+    this case, nor was any change made in the diet of the child.
+
+
+                            HYDRARGYROSIS.
+
+The etiology of this condition requires no comment. I will simply relate
+a case illustrative of the eliminative effects of galvanic baths.
+
+    CASE XXX.* _Mercurial Stomatitis._ Mr. S., about 35 years of
+    age, came to me for treatment in the fall of 1872. He then had
+    indurated chancre, two buboes and syphilitic sore throat. He had
+    had the chancre for six weeks before applying to me, but had
+    been, he said, ashamed to consult a physician. Before medication
+    had had time to make any impression on the disease, roseola
+    appeared. The syphilis was very obstinate in this patient,
+    compelling me to keep him under the influence of mercury for a
+    long time. In October 1873, the patient presented himself with a
+    very aggravated mercurial stomatitis. The customary remedies,
+    internal as well as external, made little or no impression on
+    the affection. On November 11th, I discontinued all other
+    treatment, and ordered a course of galvanic baths. He took his
+    first bath on the same day. This was repeated every alternate
+    day until six baths had been taken, when all symptoms of the
+    disease had disappeared. He has had no mercurial trouble since
+    then. The descending galvanic current from a zinc-carbon battery
+    was used throughout.
+
+
+                           LOCOMOTOR ATAXIA.
+
+Were it not for the remarkable results obtained in the following case, I
+should not have felt justified in devoting any space to an allusion to
+this formidable disease. I insert the case as it was published in No.
+216 of the “Medical Record.” I have to add that the patient, some six
+months ago, suffered a relapse, which however is not nearly as
+aggravated as his former condition, nor are the symptoms so
+pathognomonic. I had a letter from him about a week previous to my
+writing this, in which he states that he intends soon to come to the
+city for the purpose of taking another course of treatment. Even if the
+treatment however has not had the effect of curing the disease—and this
+I do not claim for it, it has been of sufficient importance if it has
+resulted in arresting for a time its progress, giving the patient
+temporary comfort, and prolonging life. Further trial may possibly have
+better results—in more recent cases—with respect to permanency.
+
+    CASE XXXI.* Mr. W., aet. 48, came to consult me January 12th,
+    1874. He had then felt the symptoms of locomotor ataxia for
+    about six years. Had been unable for several years to walk
+    without the aid of a cane. When walking he dragged his right
+    leg along in a semicircle, and was able to accomplish very short
+    distances only. There were almost complete anæsthesia and great
+    paresis of the bladder. The same conditions were observable in
+    regard to the bowels. Anæsthesia of both lower extremities
+    existed, complete in every respect in the right leg, almost so
+    in the left. Dyspepsia and general debility and emaciation
+    accompanied the disease. Treatment was begun on January 15th. I
+    prescribed phosphorus and cod-liver oil, and passed a strong
+    galvanic current through the spine for probably ten minutes.
+    January 16th, a galvanic bath was administered. Towards the
+    close of the bath (which occupied twenty minutes), patient
+    thought he felt some sensation in his legs. The baths were taken
+    every two or three days, alternating with strong galvanizations
+    of the spine. While taking his second bath, patient remarked
+    that “his right leg felt warm for the first time in six years.”
+    The treatment as described was continued for about six weeks,
+    during the latter part of which the local applications were
+    gradually diminished in frequency, the baths being continued
+    regularly. Medication was discontinued about this time. About
+    the middle of March. Mr. W. was enabled to resume his occupation
+    (paymaster’s assistant on the Erie Railway). His improvement had
+    been rapid and steady. All the symptoms gradually disappeared,
+    and in the beginning of April the patient was, with the
+    exception of some feebleness, consequent on his protracted
+    illness, as well as ever. He continues so to the present
+    day.[17] He still takes two or three baths a month, but has had
+    no other treatment since May (1874). He walks freely without a
+    cane, and talks jocosely of running footraces. All functions are
+    performed normally.
+
+    Although in this case the baths were not employed exclusively,
+    yet they predominated in the treatment; and if the judgment of
+    the patient, a very intelligent gentleman, is to be relied on, a
+    large share of the success is due to the baths.
+
+
+                               CACHEXIÆ.
+
+After what has been said in a preceding chapter of the tonic effects of
+electric baths, it would scarcely appear necessary to introduce the
+subject of cachexiæ. If I do so nevertheless, it is only to be afforded
+the opportunity of relating the following case, which possesses
+sufficient interest to render its introduction here desirable. The first
+portion of it has already been published (Med. Record, No 216), but to
+this I have to add what occurred subsequently.
+
+    CASE XXXII.* _Mercurio-syphilitic Cachexia._—Mr. L., aet. 27,
+    had primary syphilis about four years ago. Subsequently had
+    inveterate constitutional symptoms, for which he was under
+    medical treatment both here and in Europe. When he had sojourned
+    in the latter country some time, he was pronounced cured by his
+    physicians. He married, and returned to this country in the fall
+    of 1872. A few weeks after his return he fell into a gradual
+    decline, which confined him to the house—and part of the time
+    to bed—for eight months, during the latter portion of which he
+    had discontinued all medical treatment. It was with difficulty
+    that, assisted by his wife, he managed to reach my office. I
+    found him terribly enfeebled; greatly emaciated; sallow
+    complexion. He was much annoyed by rheumatic pains, which I
+    considered specific. His condition was so exceedingly low, that
+    I decided to postpone all medication until he should be
+    stronger. I ordered galvano-faradic baths, i.e. the galvanic
+    current in the bath as an eliminative, the faradic as a tonic.
+    The first bath was taken on November 20th, 1873. For one month
+    he took the baths, and nothing else. He was then so much
+    stronger, that I felt justified in instituting a mild specific
+    course of treatment, the baths being continued as theretofore.
+    At the end of two months the patient was nearly as strong as
+    ever, was able to resume his occupation, and had gained
+    twenty-seven pounds in weight.
+
+    Thus far this case was published as above stated. For the sake
+    of the interest attaching to it, I will now proceed to give its
+    further history. Mr. L. remained to all appearances well until
+    July, 1874, when he commenced to suffer from headache and
+    constipation. On the 23d of August following, while I was absent
+    from the city, he presented himself to the gentleman who
+    attended to my practice during my absence, with paralysis of the
+    external rectus muscle of the left eye. He also consulted a
+    specialist, who pronounced the paralysis rheumatic. When I
+    returned from the country he presented himself for treatment. I
+    commenced a series of daily electric applications to the
+    affected muscle, which failed to respond to the faradic current,
+    but contracted very readily when the slowly interrupted galvanic
+    current was employed. As I had strong suspicions that syphilis
+    was at the bottom of the trouble, I also administered iodide of
+    potassium in gradually increasing doses—not however until
+    electrization and strychnia employed for some weeks had failed
+    to do any good. The administration of the iodide met with no
+    better success. The patient’s general health gradually declined.
+    On October 22d, he complained of numbness in the left leg, which
+    gradually increased, the leg at the same time becoming paretic,
+    so that the patient required the aid of a cane for ordinary
+    locomotion. His condition now became rapidly worse. His
+    movements became ataxic. Anæsthesia of the bladder, paresis of
+    this and the intestine, with obstinate constipation, loss of
+    appetite, emaciation, etc., rapidly supervened. I suspected the
+    development of _gummata_ on the meninges of the brain and cord,
+    and advised him to use the inunction cure, and to remain at home
+    until he should be well. This, on account of the business losses
+    which it involved, he was very much averse to doing. He
+    consequently proposed a consultation with an eminent physician,
+    which was had. This gentleman pronounced the case one of spinal
+    (either multiple or posterior) sclerosis, and discarded the
+    syphilitic theory. A consultation two days subsequently with
+    another physician had a like result. In deference to the opinion
+    of these gentlemen, I treated the patient in accordance with
+    their diagnosis. This was in the second week of November. The
+    patient became rapidly worse. He soon ceased to walk—he tumbled
+    about. After six days’ treatment, considering his life in
+    imminent danger, I reiterated my advice to institute the
+    inunction cure, and the patient then acquiesced. Nov. 24th I
+    ordered a drachm of Unguent Hydrarg. to be used every evening; I
+    could not however prevail on the patient to remain at home
+    during the treatment. He continued to grow worse. Nov. 26th he
+    had complete retention from vesical paralysis, and sent for me
+    at night to relieve him. Thenceforth until he got nearly well he
+    was obliged to use the catheter regularly. A few days after
+    this, fortunately for himself, he fell down as he was leaving a
+    horse car, and sprained his ankle. I say _fortunately_, for this
+    accident _compelled_ him to remain at home. From this time he
+    began to improve. December 2d I substituted for the ointment a
+    twenty per cent solution of the oleate of mercury, of which he
+    used a drachm morning and evening. The improvement from this day
+    was exceedingly rapid. On the 4th of December he had regained
+    control of the bladder. The constipation, which had been very
+    obstinate, also began to yield. From this date he used the
+    oleate only once daily, and discontinued it entirely on the
+    14th. On the 10th he had already resumed his avocation, and the
+    same month absolutely danced at a ball. He took iodide of
+    potassium for a time after his mercurial course. He has since
+    been and is now in perfect health.
+
+
+                              DYSPEPSIA.
+
+The remedies for this disease are unfortunately so numerous, there is so
+much temptation to try another where one remedy has failed, that it is
+seldom or never that an uncomplicated case of dyspepsia applies for
+electrical treatment. As a rule, the disease that furnishes cause for
+referring a case to the specialist, is some nervous trouble secondary to
+the dyspepsia.
+
+In regard to the influence of electric baths on dyspeptic conditions,
+whether complicated or not, I can however speak unqualifiedly in their
+favor. I know of no one other remedy that can at all approach them in
+this respect. Whatever the secondary or other troubles of patients, any
+co-existing dyspepsia was in every instance either cured or greatly
+ameliorated. The improvement usually begins at once—after the first or
+second bath, and continues steadily. As I have not had occasion to treat
+by means of electric baths any uncomplicated cases of dyspepsia, I can
+adduce none. I may safely claim however for the baths a reliability and
+bespeak for them a confidence that I might claim or bespeak for no other
+remedy or plan of treatment whatsoever—assertions which would appear
+rash and venturesome, had I not at my command abundant clinical evidence
+to warrant my making them.
+
+
+                             MELANCHOLIA.
+
+A case of melancholia, highly illustrative of the effects in this
+condition of electric baths, came under my notice very recently. It may
+serve as a guide in the treatment of this and kindred conditions.
+
+    CASE XXXIII. Mr. F., aet. 22, single, butcher, consulted me Oct.
+    21st, 1875, for melancholia and loss of memory, from which he
+    had suffered for upwards of a year. He had frequently
+    entertained the idea of suicide. A thorough examination revealed
+    no trouble of any of the viscera. All functions appeared normal.
+    He had never masturbated. There were no collateral symptoms to
+    furnish any evidence of organic cerebral trouble. I prescribed
+    phosphorus and strychnia, and galvanized the brain twice a week.
+    Two weeks of this treatment had completely negative results. I
+    then ordered electric baths. Four baths resulted in a complete
+    cure.
+
+
+                   INEQUALITIES OF THE CIRCULATION.
+
+As a very fruitful source of morbid conditions of almost every nature,
+abnormities of the circulation of the blood are well worthy our
+attention. As is the case with dyspepsia, so here likewise patients
+seldom present themselves for treatment unless some definite secondary
+pathological condition has supervened. We find these patients
+complaining of cold hands and feet, irregular and disturbed sleep,
+occasional local congestions, with vague, usually slight pains here and
+there, etc., etc. Where organic cardiac disease is at the bottom of the
+trouble, we cannot of course expect much permanent improvement. Although
+even here considerable relief is often afforded while the baths are
+being used, their discontinuance will in all probability be soon
+followed by a return of the former condition. Where, however, cases are
+not complicated by organic disease, where we have a “sluggishness” of
+the circulation, due either to vasomotor inertia or atony of the
+muscular coats of vessels, the electric bath will be found reliably
+efficient. I have already (p. 55) alluded to this subject, and explained
+the probable “mode of action” here of the baths. I will now offer some
+suggestions as to the best method of administering them with a view to
+equalizing the circulation.
+
+We must here seek to stimulate the vasomotor system, both central and
+peripheral; to give tone to the coats of vessels, both by direct and
+indirect electric influence; through counter-irritation to relieve
+internal congestions, by causing an afflux of blood to the skin. These
+objects are best attained by means of the galvanic current, which should
+be employed of sufficient intensity to produce a rubefacient effect. The
+faradic current acts in the same direction, but far less energetically,
+if we except the vessels near the surface, the muscular coats of which
+are probably more efficiently tonicised by this than by the constant
+current. The faradic current however is applicable here in another way,
+and for a very important object. I refer to the _mechanical_
+counter-action of a sluggish circulation, through the agency of
+prolonged muscular contraction. This mechanical effect is not of course
+peculiar to the faradic current; it is shared by gymnastic and other
+exercises; but obtained in any other way whatsoever (with the exception,
+perhaps, of _massage_, which is however much more troublesome as well
+as inferior, and moreover not always admissible) it involves, in order
+to produce perfect results, a considerable amount of bodily exertion,
+often beyond the physical power of persons who are in ill health, and
+bringing with it the risk of positive injury, through over-exertion,
+which with the _passive_ contractions obtained by means of the faradic
+current, is entirely obviated. By administering the _general_ faradic
+current in the bath, of sufficient intensity to _maintain_ muscular
+contraction as long as the circuit remains closed, any stagnant blood in
+the lower extremities will be efficiently forced into the general
+circulation. After from three to five minutes of this faradization, the
+surface board may be successively applied for a minute or two each to
+the arms, abdomen, pectoral and dorsal muscles. I believe the _best_
+results can be obtained by first going through the faradic process, then
+subjecting the patient to general galvanization, as above indicated, and
+concluding by another but brief faradization.
+
+
+                    AFFECTIONS OF THE SYMPATHETIC.
+
+Last, but not least, I have some remarks to offer on the treatment by
+the electric bath of certain affections of the sympathetic nerve. While
+I do not in any such cases accord to the baths the rank of an exclusive
+remedy or even a specific, their importance as an adjuvant is sufficient
+to entitle them to special consideration in this connection. In those
+neuroses of the sympathetic where electricity (galvanism) is indicated,
+the _greatest_ benefit can be obtained from local applications. On the
+other hand the baths, employed in addition to local applications, will
+be found a very important factor in the treatment, possessing, as they
+do, two advantages, viz: _first_, by their means, the electric influence
+is brought to bear—in a much less concentrated form it is true—on the
+entire sympathetic system, from the _ganglion impar_ to the _ganglion
+cervicale supremum_, and, by derived currents, on the cephalic ganglia
+also, at one and the same time; _second_, the rest of the body
+participates in the general nutrient and tonic effects of the bath
+equally with the sympathetic, the latter thus receiving a reflex benefit
+which local applications fail to furnish. There are, moreover, cases
+where hyperæsthetic conditions of the nerve do not admit of local
+applications, and where yet electricity is urgently called for. Thus I
+have at present under treatment a lad sixteen years of age, in whom both
+supreme cervical sympathetic ganglia as well as the ganglion impar were
+until recently so susceptible that the mere adjustment of the
+electrodes caused him great pain, while on the other hand he bore the
+baths exceedingly well. In such cases, electric baths, suitably
+administered, frequently constitute in conjunction with proper
+medication, the most useful treatment.
+
+As to the mode of administration in sympathetic neuroses of the baths,
+the most direct manner in which to influence the diseased nerve, is by
+connecting one pole of a _galvanic_ battery (I consider the faradic
+current next to useless here) to the head electrode, the other to the
+surface board, the latter applied portion of the time to the epigastrium
+(solar plexus), the balance to the coccyx (_ganglion impar_). This will
+include in the direct circuit the main portion of the sympathetic, the
+position in the tub of the bather bringing the cilio-spinal centre very
+close to the head-electrode. The direction of the current must be
+determined by the individual features presented by each case, as also
+the duration of the bath.
+
+    CASE XXXIV. Mr. S., aet. 31, merchant, was referred to me April
+    3d 1874, by Dr. KREHBIEL. In January, 1874, Mr. S., until then
+    in the enjoyment of good health, woke up one morning to find, as
+    he expressed it, “everything dark before his eyes.” He groped
+    his way to the window, in order to open the blinds. When at the
+    window, he felt as though about to fall out—probably vertigo.
+    He soon returned to an apparently normal condition, and went
+    about his business as usual. A week after, he had a much more
+    serious attack, which he describes as follows: “I had been
+    playing whist during the evening (several hours), when suddenly,
+    without premonition, I felt as though a champagne cork popped
+    against the top of my head, inside. Accompanying this was an
+    indefinable sensation about the heart as though the blood all
+    rushed thence down to the feet. I did not lose consciousness;
+    did not fall. I trembled all over, and a great fear came over
+    me. Felt very weak all night; my pulse was very slow.” About two
+    months subsequently, patient was referred to me, as above
+    stated. He then had an uneasy look; an indefinable continual
+    sense of fear; was excessively nervous in the forepart of the
+    day; had brief attacks of tremor—usually every alternate
+    morning, but not typical as to time of occurrence. The history
+    exhibited neither syphilis, malaria nor intemperance. Had never
+    had headache. Sleep good; appetite likewise. The most
+    pathognomonic symptom, however, related to his pulse. This was
+    abnormally slow, ranging from 44 to 54 (the latter only when
+    standing or after walking) per minute. It was full and regular.
+    There was no organic heart trouble. In the absence of any other
+    symptom whatsoever pointing to irritation of the pneumogastric
+    or spinal accessory, I was justified in excluding this as the
+    possible cause of the cardiac infrequency. On the other hand,
+    the pathogenetic manifestations appeared all to point to
+    “asthenia of the sympathetic”—at any rate the portion of this
+    whence the cardiac nerves take their origin, and I formed my
+    diagnosis accordingly. In the beginning, the treatment consisted
+    of bilateral ascending (from cilio-spinal centre to both mastoid
+    fossæ) galvanizations of the sympathetic, and galvanic baths
+    (head electrode negative, surface board positive, to
+    epigastrium) on alternate days. Improvement in every respect was
+    steady, though not rapid. At the end of three weeks, I
+    supplemented this treatment by the administration of ergotin and
+    nux vomica. At the expiration of two more weeks, the patient
+    being nearly recovered, I discontinued these medicaments,
+    substituting the valerianates of zinc and iron, and steadily
+    maintaining meanwhile the electrical treatment as above
+    indicated. After a short time recovery appeared complete, and
+    patient was discharged from treatment. He returned however a few
+    months subsequently, complaining of “faint spells” in the
+    mornings, accompanied with excessive nervousness, and a renewed
+    though moderate cardiac infrequency. Electrical treatment,
+    similar to that above described, soon restored him. One or two
+    more slight relapses occurred during the next six months. For
+    over a year past however Mr. S. has been in the enjoyment of
+    perfect and undisturbed health. His normal pulse ranges from 72
+    to 80.
+
+Whoever is familiar with the physiological effects of electric baths,
+will readily concede their great utility in a variety of conditions that
+I have not thus far specially alluded to. Of such I would mention
+ASTHENIÆ, ATONIC AND DEBILITATED CONDITIONS GENERALLY, including the
+state of CONVALESCENCE FROM ACUTE DISEASES and the DECLINE OF ADVANCING
+AGE; many cases of CHRONIC HEADACHE; some INCLASSIFIABLE CONDITIONS OF
+MARASMUS and MALNUTRITION, etc., etc. In all such cases, when purely
+functional and uncomplicated by incurable organic disease, good results
+may be confidently looked for.
+
+       *       *       *       *       *
+
+With these remarks I conclude my subject. Whichever the errors that a
+too limited experience may have engendered—and I doubt not there are
+many, I cannot on reviewing my work accuse myself of lack of candor nor
+yet of undue enthusiasm. I have cited but a small proportion of the
+successful cases whereof I possess records; still I believe that I have
+adduced amply sufficient clinical proof of the great value as a remedial
+agent of electric baths, and of the desirability of their more general
+adoption. I would more especially call attention to the
+inappropriateness of deferring their employment until almost all other
+remedies have been exhausted; and when I reflect that pretty much all
+those cases that had been referred to me by other physicians had already
+had the doubtful benefit of almost every other conceivable treatment,
+while many of those who came of their own accord, had in addition made
+the rounds of all the quacks, and exhausted nearly all the nostrums that
+are to be found advertised in the columns of our daily papers, the
+wonder seems that the results obtained were as good as they have been. I
+sincerely trust that in the future physicians will avail themselves
+more frequently than heretofore of a remedy that is certainly capable of
+accomplishing much good; and I hope that in addition to myself there
+will be found others, more competent, to devote themselves to the study
+of the subject. To these, and perhaps to myself at a future time, I
+relegate the task of correcting my errors and promulgating hitherto
+undiscovered truths.
+
+
+    Footnotes:
+
+    [Footnote 10: Centralblatt für die medicinischen Wissenschaften,
+    No. 17, 1875.]
+
+    [Footnote 11: The apparatus used in these experiments was that
+    of Du Bois-Reymond, with a Grove’s element.]
+
+    [Footnote 12: Since writing the above, this case has had an
+    entirely favorable termination.]
+
+    [Footnote 13: The cases distinguished by an asterisk were
+    published in No. 216 of the “Medical Record.”]
+
+    [Footnote 14: Wherever I use the word “general” as descriptive
+    of an electric current used in the bath, it is not as a
+    characteristic, but merely to distinguish it from the instances
+    where the surface board is employed.]
+
+    [Footnote 15: Austin Flint, M.D. A Treatise on the Principles
+    and Practice of Medicine. Philadelphia, 1873. 4th ed. pp. 63 and
+    64.]
+
+    [Footnote 16: See Beard and Rockwell, op. cit., 2d ed. p. 472.]
+
+    [Footnote 17: This was written a year ago. See remarks preceding
+    the case.]
+
+
+
+
+                                INDEX.
+
+
+                            A.
+                                                  PAGE
+    Agrypnia                                        92
+    Anæmia                                          93
+    Apparatus for baths                              7
+    Articular effusions                            105
+
+
+                            B.
+
+    Bath-tub                                         8
+    Batteries                                       16
+
+
+                            C.
+
+    Cachexiæ                                       118
+    Chemicals in baths                              15
+    Chorea                                          80
+    Circulation, effects on                         55
+         "       inequalities of                   123
+    Clinical Record                                 61
+    Conductivity of water, etc.                     13
+    Constipation                                   112
+    Counter-irritant effects                        56
+
+
+                            D.
+
+    Debility, general                          129-130
+    Diagnostic uses                                 53
+    Digestive apparatus, effects on                 44
+    Dyspepsia                                      121
+
+
+                            E.
+
+    Electric Bath compared with other
+      electrical methods                            32
+    Electrodes                                      10
+
+
+                            G.
+
+    General Therapeutics                            52
+
+
+                            H.
+
+    Hydrargyrosis                                  115
+    Hypnotic effects                             38-58
+    Hysterical affections                           82
+
+
+                            I.
+
+    Impotency                                      106
+    Insomnia                                        92
+    Invigorant properties                           57
+
+
+                            L.
+
+    Locomotor Ataxia                               116
+
+
+                            M.
+
+    Melancholia                                    122
+    Mind, effects on                                51
+    Miscellaneous disorders                    129-130
+    Mode of administration                          19
+    Muscular contractions                           50
+
+
+                            N.
+
+    Nervous Exhaustion                              84
+    Neuralgiæ                                      100
+    Neurasthenia                                    84
+    Nutrition, effects on                           59
+
+
+                            P.
+
+    Paralyses                                       96
+    Pareses                                         96
+    Physiological effects                           31
+    Prophylactic influence                          60
+    Pulse, effects on                               41
+
+
+                            R.
+
+    Rheumatism                                      67
+        "      acute                                68
+        "      chronic                              74
+        "      subacute                             73
+        "      cases of                             77
+
+
+                            S.
+
+    Sedative effects                             48-58
+    Sexual apparatus, effects on                    46
+    Sexual debility                                106
+    Sleep, effects on                               38
+    Special therapeutics                            61
+    Stimulant effects                               43
+    Surface board                                   14
+    Sympathetic, affections of                     126
+
+
+                            T.
+
+    Temperature, effects on                         41
+    Tonic properties                             43-57
+
+
+
+[Transcriber’s Notes: The table below lists all corrections applied to
+the original text.
+
+p. 029: [normalized] the sub-acute symptoms -> subacute
+p. 056: GENERAL COUNTER IRRITANT -> COUNTER-IRRITANT
+p. 056: [normalized] the use of the surface-board -> surface board
+p. 059: does ... became apparent -> become apparent
+p. 067: [normalized] acute, sub-acute and chronic -> subacute
+p. 073: [normalized] bi-carbonate of soda or potassa -> bicarbonate
+p. 107: ordered by their physicians: -> physicians; ]
+
+
+
+
+
+End of the Project Gutenberg EBook of The Electric Bath, by George M. Schweig
+
+*** END OF THIS PROJECT GUTENBERG EBOOK THE ELECTRIC BATH ***
+
+***** This file should be named 26366-0.txt or 26366-0.zip *****
+This and all associated files of various formats will be found in:
+        https://www.gutenberg.org/2/6/3/6/26366/
+
+Produced by Bryan Ness, Markus Brenner and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+book was produced from scanned images of public domain
+material from the Google Print project.)
+
+
+Updated editions will replace the previous one--the old editions
+will be renamed.
+
+Creating the works from public domain print editions means that no
+one owns a United States copyright in these works, so the Foundation
+(and you!) can copy and distribute it in the United States without
+permission and without paying copyright royalties.  Special rules,
+set forth in the General Terms of Use part of this license, apply to
+copying and distributing Project Gutenberg-tm electronic works to
+protect the PROJECT GUTENBERG-tm concept and trademark.  Project
+Gutenberg is a registered trademark, and may not be used if you
+charge for the eBooks, unless you receive specific permission.  If you
+do not charge anything for copies of this eBook, complying with the
+rules is very easy.  You may use this eBook for nearly any purpose
+such as creation of derivative works, reports, performances and
+research.  They may be modified and printed and given away--you may do
+practically ANYTHING with public domain eBooks.  Redistribution is
+subject to the trademark license, especially commercial
+redistribution.
+
+
+
+*** START: FULL LICENSE ***
+
+THE FULL PROJECT GUTENBERG LICENSE
+PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK
+
+To protect the Project Gutenberg-tm mission of promoting the free
+distribution of electronic works, by using or distributing this work
+(or any other work associated in any way with the phrase "Project
+Gutenberg"), you agree to comply with all the terms of the Full Project
+Gutenberg-tm License (available with this file or online at
+https://gutenberg.org/license).
+
+
+Section 1.  General Terms of Use and Redistributing Project Gutenberg-tm
+electronic works
+
+1.A.  By reading or using any part of this Project Gutenberg-tm
+electronic work, you indicate that you have read, understand, agree to
+and accept all the terms of this license and intellectual property
+(trademark/copyright) agreement.  If you do not agree to abide by all
+the terms of this agreement, you must cease using and return or destroy
+all copies of Project Gutenberg-tm electronic works in your possession.
+If you paid a fee for obtaining a copy of or access to a Project
+Gutenberg-tm electronic work and you do not agree to be bound by the
+terms of this agreement, you may obtain a refund from the person or
+entity to whom you paid the fee as set forth in paragraph 1.E.8.
+
+1.B.  "Project Gutenberg" is a registered trademark.  It may only be
+used on or associated in any way with an electronic work by people who
+agree to be bound by the terms of this agreement.  There are a few
+things that you can do with most Project Gutenberg-tm electronic works
+even without complying with the full terms of this agreement.  See
+paragraph 1.C below.  There are a lot of things you can do with Project
+Gutenberg-tm electronic works if you follow the terms of this agreement
+and help preserve free future access to Project Gutenberg-tm electronic
+works.  See paragraph 1.E below.
+
+1.C.  The Project Gutenberg Literary Archive Foundation ("the Foundation"
+or PGLAF), owns a compilation copyright in the collection of Project
+Gutenberg-tm electronic works.  Nearly all the individual works in the
+collection are in the public domain in the United States.  If an
+individual work is in the public domain in the United States and you are
+located in the United States, we do not claim a right to prevent you from
+copying, distributing, performing, displaying or creating derivative
+works based on the work as long as all references to Project Gutenberg
+are removed.  Of course, we hope that you will support the Project
+Gutenberg-tm mission of promoting free access to electronic works by
+freely sharing Project Gutenberg-tm works in compliance with the terms of
+this agreement for keeping the Project Gutenberg-tm name associated with
+the work.  You can easily comply with the terms of this agreement by
+keeping this work in the same format with its attached full Project
+Gutenberg-tm License when you share it without charge with others.
+
+1.D.  The copyright laws of the place where you are located also govern
+what you can do with this work.  Copyright laws in most countries are in
+a constant state of change.  If you are outside the United States, check
+the laws of your country in addition to the terms of this agreement
+before downloading, copying, displaying, performing, distributing or
+creating derivative works based on this work or any other Project
+Gutenberg-tm work.  The Foundation makes no representations concerning
+the copyright status of any work in any country outside the United
+States.
+
+1.E.  Unless you have removed all references to Project Gutenberg:
+
+1.E.1.  The following sentence, with active links to, or other immediate
+access to, the full Project Gutenberg-tm License must appear prominently
+whenever any copy of a Project Gutenberg-tm work (any work on which the
+phrase "Project Gutenberg" appears, or with which the phrase "Project
+Gutenberg" is associated) is accessed, displayed, performed, viewed,
+copied or distributed:
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+1.E.2.  If an individual Project Gutenberg-tm electronic work is derived
+from the public domain (does not contain a notice indicating that it is
+posted with permission of the copyright holder), the work can be copied
+and distributed to anyone in the United States without paying any fees
+or charges.  If you are redistributing or providing access to a work
+with the phrase "Project Gutenberg" associated with or appearing on the
+work, you must comply either with the requirements of paragraphs 1.E.1
+through 1.E.7 or obtain permission for the use of the work and the
+Project Gutenberg-tm trademark as set forth in paragraphs 1.E.8 or
+1.E.9.
+
+1.E.3.  If an individual Project Gutenberg-tm electronic work is posted
+with the permission of the copyright holder, your use and distribution
+must comply with both paragraphs 1.E.1 through 1.E.7 and any additional
+terms imposed by the copyright holder.  Additional terms will be linked
+to the Project Gutenberg-tm License for all works posted with the
+permission of the copyright holder found at the beginning of this work.
+
+1.E.4.  Do not unlink or detach or remove the full Project Gutenberg-tm
+License terms from this work, or any files containing a part of this
+work or any other work associated with Project Gutenberg-tm.
+
+1.E.5.  Do not copy, display, perform, distribute or redistribute this
+electronic work, or any part of this electronic work, without
+prominently displaying the sentence set forth in paragraph 1.E.1 with
+active links or immediate access to the full terms of the Project
+Gutenberg-tm License.
+
+1.E.6.  You may convert to and distribute this work in any binary,
+compressed, marked up, nonproprietary or proprietary form, including any
+word processing or hypertext form.  However, if you provide access to or
+distribute copies of a Project Gutenberg-tm work in a format other than
+"Plain Vanilla ASCII" or other format used in the official version
+posted on the official Project Gutenberg-tm web site (www.gutenberg.org),
+you must, at no additional cost, fee or expense to the user, provide a
+copy, a means of exporting a copy, or a means of obtaining a copy upon
+request, of the work in its original "Plain Vanilla ASCII" or other
+form.  Any alternate format must include the full Project Gutenberg-tm
+License as specified in paragraph 1.E.1.
+
+1.E.7.  Do not charge a fee for access to, viewing, displaying,
+performing, copying or distributing any Project Gutenberg-tm works
+unless you comply with paragraph 1.E.8 or 1.E.9.
+
+1.E.8.  You may charge a reasonable fee for copies of or providing
+access to or distributing Project Gutenberg-tm electronic works provided
+that
+
+- You pay a royalty fee of 20% of the gross profits you derive from
+     the use of Project Gutenberg-tm works calculated using the method
+     you already use to calculate your applicable taxes.  The fee is
+     owed to the owner of the Project Gutenberg-tm trademark, but he
+     has agreed to donate royalties under this paragraph to the
+     Project Gutenberg Literary Archive Foundation.  Royalty payments
+     must be paid within 60 days following each date on which you
+     prepare (or are legally required to prepare) your periodic tax
+     returns.  Royalty payments should be clearly marked as such and
+     sent to the Project Gutenberg Literary Archive Foundation at the
+     address specified in Section 4, "Information about donations to
+     the Project Gutenberg Literary Archive Foundation."
+
+- You provide a full refund of any money paid by a user who notifies
+     you in writing (or by e-mail) within 30 days of receipt that s/he
+     does not agree to the terms of the full Project Gutenberg-tm
+     License.  You must require such a user to return or
+     destroy all copies of the works possessed in a physical medium
+     and discontinue all use of and all access to other copies of
+     Project Gutenberg-tm works.
+
+- You provide, in accordance with paragraph 1.F.3, a full refund of any
+     money paid for a work or a replacement copy, if a defect in the
+     electronic work is discovered and reported to you within 90 days
+     of receipt of the work.
+
+- You comply with all other terms of this agreement for free
+     distribution of Project Gutenberg-tm works.
+
+1.E.9.  If you wish to charge a fee or distribute a Project Gutenberg-tm
+electronic work or group of works on different terms than are set
+forth in this agreement, you must obtain permission in writing from
+both the Project Gutenberg Literary Archive Foundation and Michael
+Hart, the owner of the Project Gutenberg-tm trademark.  Contact the
+Foundation as set forth in Section 3 below.
+
+1.F.
+
+1.F.1.  Project Gutenberg volunteers and employees expend considerable
+effort to identify, do copyright research on, transcribe and proofread
+public domain works in creating the Project Gutenberg-tm
+collection.  Despite these efforts, Project Gutenberg-tm electronic
+works, and the medium on which they may be stored, may contain
+"Defects," such as, but not limited to, incomplete, inaccurate or
+corrupt data, transcription errors, a copyright or other intellectual
+property infringement, a defective or damaged disk or other medium, a
+computer virus, or computer codes that damage or cannot be read by
+your equipment.
+
+1.F.2.  LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the "Right
+of Replacement or Refund" described in paragraph 1.F.3, the Project
+Gutenberg Literary Archive Foundation, the owner of the Project
+Gutenberg-tm trademark, and any other party distributing a Project
+Gutenberg-tm electronic work under this agreement, disclaim all
+liability to you for damages, costs and expenses, including legal
+fees.  YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
+LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
+PROVIDED IN PARAGRAPH F3.  YOU AGREE THAT THE FOUNDATION, THE
+TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
+LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
+INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
+DAMAGE.
+
+1.F.3.  LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
+defect in this electronic work within 90 days of receiving it, you can
+receive a refund of the money (if any) you paid for it by sending a
+written explanation to the person you received the work from.  If you
+received the work on a physical medium, you must return the medium with
+your written explanation.  The person or entity that provided you with
+the defective work may elect to provide a replacement copy in lieu of a
+refund.  If you received the work electronically, the person or entity
+providing it to you may choose to give you a second opportunity to
+receive the work electronically in lieu of a refund.  If the second copy
+is also defective, you may demand a refund in writing without further
+opportunities to fix the problem.
+
+1.F.4.  Except for the limited right of replacement or refund set forth
+in paragraph 1.F.3, this work is provided to you 'AS-IS' WITH NO OTHER
+WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO
+WARRANTIES OF MERCHANTIBILITY OR FITNESS FOR ANY PURPOSE.
+
+1.F.5.  Some states do not allow disclaimers of certain implied
+warranties or the exclusion or limitation of certain types of damages.
+If any disclaimer or limitation set forth in this agreement violates the
+law of the state applicable to this agreement, the agreement shall be
+interpreted to make the maximum disclaimer or limitation permitted by
+the applicable state law.  The invalidity or unenforceability of any
+provision of this agreement shall not void the remaining provisions.
+
+1.F.6.  INDEMNITY - You agree to indemnify and hold the Foundation, the
+trademark owner, any agent or employee of the Foundation, anyone
+providing copies of Project Gutenberg-tm electronic works in accordance
+with this agreement, and any volunteers associated with the production,
+promotion and distribution of Project Gutenberg-tm electronic works,
+harmless from all liability, costs and expenses, including legal fees,
+that arise directly or indirectly from any of the following which you do
+or cause to occur: (a) distribution of this or any Project Gutenberg-tm
+work, (b) alteration, modification, or additions or deletions to any
+Project Gutenberg-tm work, and (c) any Defect you cause.
+
+
+Section  2.  Information about the Mission of Project Gutenberg-tm
+
+Project Gutenberg-tm is synonymous with the free distribution of
+electronic works in formats readable by the widest variety of computers
+including obsolete, old, middle-aged and new computers.  It exists
+because of the efforts of hundreds of volunteers and donations from
+people in all walks of life.
+
+Volunteers and financial support to provide volunteers with the
+assistance they need, is critical to reaching Project Gutenberg-tm's
+goals and ensuring that the Project Gutenberg-tm collection will
+remain freely available for generations to come.  In 2001, the Project
+Gutenberg Literary Archive Foundation was created to provide a secure
+and permanent future for Project Gutenberg-tm and future generations.
+To learn more about the Project Gutenberg Literary Archive Foundation
+and how your efforts and donations can help, see Sections 3 and 4
+and the Foundation web page at https://www.pglaf.org.
+
+
+Section 3.  Information about the Project Gutenberg Literary Archive
+Foundation
+
+The Project Gutenberg Literary Archive Foundation is a non profit
+501(c)(3) educational corporation organized under the laws of the
+state of Mississippi and granted tax exempt status by the Internal
+Revenue Service.  The Foundation's EIN or federal tax identification
+number is 64-6221541.  Its 501(c)(3) letter is posted at
+https://pglaf.org/fundraising.  Contributions to the Project Gutenberg
+Literary Archive Foundation are tax deductible to the full extent
+permitted by U.S. federal laws and your state's laws.
+
+The Foundation's principal office is located at 4557 Melan Dr. S.
+Fairbanks, AK, 99712., but its volunteers and employees are scattered
+throughout numerous locations.  Its business office is located at
+809 North 1500 West, Salt Lake City, UT 84116, (801) 596-1887, email
+business@pglaf.org.  Email contact links and up to date contact
+information can be found at the Foundation's web site and official
+page at https://pglaf.org
+
+For additional contact information:
+     Dr. Gregory B. Newby
+     Chief Executive and Director
+     gbnewby@pglaf.org
+
+
+Section 4.  Information about Donations to the Project Gutenberg
+Literary Archive Foundation
+
+Project Gutenberg-tm depends upon and cannot survive without wide
+spread public support and donations to carry out its mission of
+increasing the number of public domain and licensed works that can be
+freely distributed in machine readable form accessible by the widest
+array of equipment including outdated equipment.  Many small donations
+($1 to $5,000) are particularly important to maintaining tax exempt
+status with the IRS.
+
+The Foundation is committed to complying with the laws regulating
+charities and charitable donations in all 50 states of the United
+States.  Compliance requirements are not uniform and it takes a
+considerable effort, much paperwork and many fees to meet and keep up
+with these requirements.  We do not solicit donations in locations
+where we have not received written confirmation of compliance.  To
+SEND DONATIONS or determine the status of compliance for any
+particular state visit https://pglaf.org
+
+While we cannot and do not solicit contributions from states where we
+have not met the solicitation requirements, we know of no prohibition
+against accepting unsolicited donations from donors in such states who
+approach us with offers to donate.
+
+International donations are gratefully accepted, but we cannot make
+any statements concerning tax treatment of donations received from
+outside the United States.  U.S. laws alone swamp our small staff.
+
+Please check the Project Gutenberg Web pages for current donation
+methods and addresses.  Donations are accepted in a number of other
+ways including including checks, online payments and credit card
+donations.  To donate, please visit: https://pglaf.org/donate
+
+
+Section 5.  General Information About Project Gutenberg-tm electronic
+works.
+
+Professor Michael S. Hart was the originator of the Project Gutenberg-tm
+concept of a library of electronic works that could be freely shared
+with anyone.  For thirty years, he produced and distributed Project
+Gutenberg-tm eBooks with only a loose network of volunteer support.
+
+
+Project Gutenberg-tm eBooks are often created from several printed
+editions, all of which are confirmed as Public Domain in the U.S.
+unless a copyright notice is included.  Thus, we do not necessarily
+keep eBooks in compliance with any particular paper edition.
+
+
+Most people start at our Web site which has the main PG search facility:
+
+     https://www.gutenberg.org
+
+This Web site includes information about Project Gutenberg-tm,
+including how to make donations to the Project Gutenberg Literary
+Archive Foundation, how to help produce our new eBooks, and how to
+subscribe to our email newsletter to hear about new eBooks.
diff --git a/26366-0.zip b/26366-0.zip
new file mode 100644
index 0000000..b9a5ca9
--- /dev/null
+++ b/26366-0.zip
diff --git a/26366-8.txt b/26366-8.txt
new file mode 100644
index 0000000..5b42193
--- /dev/null
+++ b/26366-8.txt
@@ -0,0 +1,3661 @@
+The Project Gutenberg EBook of The Electric Bath, by George M. Schweig
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: The Electric Bath
+
+Author: George M. Schweig
+
+Release Date: August 20, 2008 [EBook #26366]
+
+Language: English
+
+Character set encoding: ISO-8859-1
+
+*** START OF THIS PROJECT GUTENBERG EBOOK THE ELECTRIC BATH ***
+
+
+
+
+Produced by Bryan Ness, Markus Brenner and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+book was produced from scanned images of public domain
+material from the Google Print project.)
+
+
+
+
+
+
+                                  THE
+                             ELECTRIC BATH
+
+                       ITS MEDICAL USES, EFFECTS
+                             AND APPLIANCE
+
+
+                                  BY
+
+                        GEORGE M. SCHWEIG, M.D.
+
+   MEMBER OF THE NEW YORK COUNTY MEDICAL SOCIETY AND OF THE MEDICAL
+        JOURNAL ASSOCIATION OF THE CITY OF NEW YORK; ONE OF THE
+           PHYSICIANS TO THE NEW YORK LYING-IN ASYLUM, ETC.
+
+
+                               NEW YORK
+                          G.�P. PUTNAM'S SONS
+                           182 FIFTH AVENUE
+                                 1877
+
+
+
+
+                              COPYRIGHT,
+                         G.�P. PUTNAM'S SONS,
+                                 1876.
+
+
+
+
+                               PREFACE.
+
+
+In No 216 of "The Medical Record" (Dec. 15th, 1874) was published an
+article written by me, entitled "On some of the Uses of Galvanic and
+Faradic Baths."
+
+The interest manifested in the subject, as evidenced by numerous letters
+of inquiry since received from physicians in almost all parts of the
+United States, and some in Europe, has induced me to write the present
+treatise, in which I have endeavored to present to the profession, as
+far as lies in my power, all that is necessary to a full comprehension
+of the electro-balneological treatment.
+
+When it is considered that in the employment of electric baths I have
+been to a great extent groping in the dark, that I have been deprived of
+the advantage of having the experience of others to guide me, it will
+not appear surprising that I should have met with many disappointments.
+My failures have been illustrative of the fact that the electric bath is
+no more a panacea for all ills than any other remedial agent.
+Applicable as it is to a great variety of pathological conditions, it
+meets with many where it is destined to have negative or at best
+imperfect results. Far from discouraging me, however, failures have
+served to inspire me with fresh ardor to seek for light, and to
+persevere in my efforts to establish on the basis of statistical truth,
+the therapeutic merits of the agent which I employed.
+
+In view of the imperfectness of the results thus far obtained, I should
+consider the present work premature, did I not find a justification for
+it in my desire to induce other and abler observers to investigate the
+subject, and place it on whatever footing it may merit.
+
+To say that I am fully conscious of the shortcomings of my work, would
+be but feebly to express my convictions in this respect. I beg the
+reader however to consider that the subject is not a hackneyed one, that
+mine has not been the work of the compiler who remodels the brain-work
+of others. It may be crude and rough, it may lack the gloss and polish
+that is the result of much handling, but I have at least the
+consciousness that it has the merits of originality and candor.
+
+              NEW YORK.
+  160 Second Avenue. November, 1876.
+
+
+
+
+                               CONTENTS.
+
+
+                              CHAPTER I.
+
+                            THE APPARATUS.
+
+                                                                  PAGE
+
+_a_)--The tub. _b_)--The electrodes and connections.
+_c_)--The water. _d_)--Chemicals. _e_)--The batteries.               7
+
+
+                              CHAPTER II.
+
+MODE OF ADMINISTRATION                                              19
+
+
+                             CHAPTER III.
+
+                        PHYSIOLOGICAL EFFECTS.
+
+Characteristic differences between the electric bath and
+other methods of electrization--Effects on sleep; on general
+sensation; on the change of matter; on the pulse and
+temperature; as a stimulant and tonic; on general nutrition;
+on the digestive apparatus; on the sexual apparatus--Sedative
+influence--Affects cranial nerves--Cutaneous sensation--Its
+freedom from pain--Muscular contractions--Effects on the mind       31
+
+
+                              CHAPTER IV.
+
+                 GENERAL THERAPEUTIC EFFECTS AND USES.
+
+The electric bath as a diagnostic; as an equalizer of the
+circulation; as a general counter-irritant; as a general
+invigorant and tonic--Its hypnotic and sedative influence--Its
+improvement of nutrition--As a prophylactic                         52
+
+
+                              CHAPTER V.
+
+               SPECIAL THERAPEUTICS AND CLINICAL RECORD.
+
+General directions--Special diseases--Acute rheumatism--Subacute
+rheumatism--Chronic rheumatism--Cases of rheumatism--Chorea,
+with cases--Hysterical affections, with cases--Neurasthenia,
+with cases--Agrypnia, with cases--An�mia, with case--Paralyses
+and Pareses, with cases--Neuralgi�, with cases--Articular
+effusions, with case--Impotency, with cases--Constipation, with
+cases--Hydrargyrosis, with case--Locomotor ataxia, with
+case--Cachexia, with case--Dyspepsia--Melancholia, with
+case--Inequalities of the circulation--Affections of the
+Sympathetic, with case--Miscellaneous conditions--Concluding
+remarks                                                             61
+
+
+
+
+                          THE ELECTRIC BATH.
+
+
+
+
+                              CHAPTER I.
+
+                            THE APPARATUS.
+
+
+To a proper comprehension of the succeeding chapters, it is necessary
+first of all to be familiar with the apparatus employed in carrying out
+electro-balneological treatment, and I therefore proceed to give a
+description of this.[1] It may conveniently be divided as follows, viz.
+
+    _a._ The tub;
+
+    _b._ The electrodes and connections;
+
+    _c._ The water;
+
+    _d._ Chemicals;
+
+    _e._ The batteries.
+
+(_a_) _The Tub._ This must be made of a non-conducting material. Of
+substances that will answer, I will mention: wood, porcelain, soapstone,
+vulcanized rubber, or glass. In choosing one of these materials, regard
+should be had to the facility of attaching the electrodes. In this
+respect wood deserves the preference over all the others mentioned.
+Where economy is to be studied, it has a further item in its favor.
+
+The tubs, which I have now in use for nearly three years are made of
+wood, and I find them to answer very well. It must not be forgotten,
+however, that a wooden tub requires to be well painted on the inside, in
+order to prevent its becoming water-soaked, because in that event it
+would become a conductor of electricity, and interfere to some extent,
+with the administration of the electric current in the bath.
+
+The shape and size of the tub may be the same as those of an ordinary
+bath tub. To suit individual cases however, its length may be made to
+vary. The only peculiarity in its construction is at the head. Here,
+instead of slanting, it is made square, and the slightly concave (from
+side to side) board against which the back of the bather is to rest, is
+fitted in afterwards. This is necessary, because it is very difficult to
+make a wooden tub with a slanting back water-tight. If the length of
+the tub from outside to outside is made to measure about five feet ten
+inches, the back-rest fitted in at a proper slant will bring the inside
+of the tub to about the right length for an average male adult. All
+around the upper edge of the tub runs a wooden coping, which must not be
+fastened down however until all the attachments for conducting the
+current are _in situ_. Along that portion of the top of the tub where
+required--and this will depend on the situation of the binding posts
+presently to be mentioned--and underneath the coping, runs a groove for
+the reception of the wires that are to connect the carbon electrodes on
+the inside of the tub with the binding posts on the outside. This groove
+is continued vertically along the inside of the back-rest and foot of
+the tub respectively, to communicate at either end with the bed for the
+reception of the carbon plates. These vertical grooves should at their
+lower end be a little over � inch deep, in order to admit of the wires
+being introduced beneath the carbons.
+
+The face of the foot of the tub and that of the back-rest, should have
+in their centres (from side to side) and commencing at about five inches
+from the bottom of the tub, a bed for the reception of the carbons. The
+dimensions of these receptacles must of course correspond to those of
+the carbon plates to be employed as electrodes. Those which I use
+measure 12�8" at the head, 8�6" at the foot of the tub. They are �"
+thick. They are placed so as to have their long diameter correspond to
+the height of the tub. The bed which is to receive the carbon at the
+head of the tub must be deeper than �" on account of the concavity of
+the back-rest.
+
+In order to adapt a tub to individuals of different lengths, it will be
+found advantageous to have two small vertical cleats on each side of the
+tub, near the foot and bottom, for the reception of a foot-board, which
+will practically shorten the tub and adapt it to persons of different
+lengths. This board may conveniently be six inches wide, and should have
+a number of perforations about an inch in diameter, for the transmission
+of the current to the feet. 1�" pine plank is the most suitable wood to
+use in the construction of the tub. This is preferable to any of the
+hard woods, because of the greater facility of fitting in the electrodes
+etc. It is also the most economical.
+
+(_b_) _The electrodes and connections._ These consist of two carbon
+plates, two brass binding posts, and insulated wires to connect the
+carbons with the binding posts, and these with the battery. The carbons
+are such as are ordinarily employed in the construction of galvanic
+batteries, and can, as well as the wire and binding posts, be procured
+from any house that deals in telegraph material. Their size is to some
+extent optional; the dimensions I have given above however answer very
+well.
+
+The inside of the tub having received one or preferably two coats of
+paint, the carbons are now fitted in the receptacles provided for them.
+The next step is the attaching of the binding posts. These should be of
+the kind known as "single" binding posts with "wood screws." The most
+convenient location for them will be found on the coping covering the
+horizontal portion at the head of the tub. Here the coping, as it has to
+cover not only the upper edge of the head of the tub, but that of the
+back-rest also, is of necessity much wider than at any other portion,
+and thus affords most room for the binding posts.
+
+Having marked out then a site for the binding posts, say in the centre
+of the coping at the head of the tub--which should now be placed in
+position--and about two inches apart, the posts are laid aside to be put
+in place when the wires are all _in situ_, and the coping fastened down.
+
+In order to facilitate the description of the placing of the wires by
+means of which communication is to be established between the electrodes
+and the binding posts, I shall term the end of the wire that is to be
+attached to the electrodes the distal, that which is attached to the
+binding posts the proximal end. A gimlet hole sufficiently large to
+admit of the passage of one wire should be made half an inch outwards
+from the centre of the site of each binding post. The best wire to use
+is about No. 16 copper wire, coated with gutta percha or rubber. The
+site of the posts being as above suggested, it will be found that the
+wire which is to connect the head electrode with one post requires to be
+about 18 inches long, that which runs from the other post to the
+foot-electrode, between eight and nine feet. The distal ends of the
+wires should be stripped of their coating for a length of about three
+inches, the proximal ends for about two inches. The denuded portion of
+the distal ends should be rolled up in the form of a spiral coil; this
+will insure their constant impinging on the carbons more certainly than
+could be expected from a simple straight end of wire.
+
+The carbons having now been fitted in their beds, the distal end (coil)
+of the head wire is placed beneath the carbon, and the wire itself
+continued up along the vertical groove to either one of the gimlet
+holes. Through this, from within outward, the proximal end of the wire
+is now drawn and left for the present. The distal end of the second wire
+having now been placed beneath the carbon at the foot of the tub, this
+wire is continued up through the vertical groove, along the upper edge
+of the foot of the tub to the side nearest the binding post to which the
+wire is to be attached, along the groove on the upper edge of this side
+to the head of the tub, and thence to the respective gimlet hole, and
+through this, from within outward. The wires being now all in position,
+all the coping is next screwed or nailed down firmly, care being taken
+that the screws or nails used for this purpose do not injure any of the
+wires. The coping fastened down, the binding posts are now screwed down
+in the sites previously marked out for them. Before they are screwed
+_entirely_ down, the denuded portion of the proximal end of each wire is
+securely wound around the screw of the respective binding post, and the
+posts are then _firmly_ screwed down, holding the proximal ends of the
+wires in place. Connection is now established between the binding posts
+and the head and foot electrodes respectively. The vertical grooves are
+now to be filled in with putty and painted over, care being taken to
+keep the carbon free from paint. The last step towards completing the
+apparatus is to fasten the carbons in their beds. The simplest way of
+doing this is by stretching over each carbon a piece of muslin, folded
+double, and tacking this down around the edges. Zinc or galvanized iron
+tacks are best. Copper tacks should be avoided on account of their
+superior conductivity.
+
+In order to be able when required to localize the current in special
+portions of the body, it is well to be provided with what I have termed
+a "surface board." This is a piece of black walnut, say 14 in. long by 5
+in. wide, � thick, having in the centre a bed to accommodate a carbon
+plate, say 5 in. long by 2 in. wide, � thick. From the centre of this
+bed a gimlet hole pierces the board. The denuded end of an insulated
+wire is drawn through this gimlet hole from without inward (toward the
+bed) and twisted in the form of a spiral to prevent its slipping back,
+as well as to insure its more certain connection with the carbon. The
+carbon is now placed in the bed, and kept there by a piece of muslin
+drawn over it and tacked down. The wire should be of sufficient length
+to reach the battery. I shall speak further on of the use to be made of
+the surface board.
+
+
+_c_) _The Water._ The quantity of water may be the same as that in an
+ordinary bath. In those cases alone where it is intended to localize the
+current by means of the surface board, and to concentrate it _very
+strongly_ in one spot, the water in the tub should be left low enough to
+leave the particular spot to be treated uncovered by this; the surface
+board can then be applied to this spot without the loss to the current
+of strength, through derived currents, inevitable in its application
+under water.
+
+The temperature of the water may range from 85� to 105� Fahrenheit. As a
+rule the comfort of the patient may be consulted in this respect. There
+are certain cases, however, where an especially high or low temperature
+is indicated, and where the extremes mentioned have to be touched.
+
+
+_d_) _Chemicals._ Where these are added to the water of the bath, it is
+for one of three purposes: viz. 1)--To exercise a direct therapeutic
+influence on the patient, either internally by being absorbed, or
+externally by their action on the skin; 2)--Through chemical affinity to
+aid in eliminating certain metallic substances from the body; or 3)--To
+further the absorption of morbid deposits. The various indications in
+these respects will be treated of in their proper places.
+
+
+_e_) _The Batteries._ In the choice of this, the most important part of
+the electro-balneological apparatus, the greatest circumspection is
+necessary. Inferior instruments and such as are liable to get out of
+order frequently, have time and again been the means of discouraging the
+beginner in electro-therapeutics, and causing him to abandon the study
+of an art, the pursuit of which would have well repaid him for all his
+labor. Fortunately our manufacturers here in New York turn out very good
+instruments, and if a physician purchases an inferior one, the fault is
+his own.
+
+Two different currents are required for the baths, viz. 1)--The
+galvanic, which may be employed either in the constant or interrupted
+(by means of a rheotome) form; and 2)--the faradic or induced current.
+Several manufacturers of this city turn out good and serviceable faradic
+instruments. Those which I have been in the habit of using for some
+years past are manufactured by the Galvano-Faradic Manufacturing
+Company, and they have given me unvarying satisfaction. By means of a
+recently introduced attachment to their batteries, termed the "fine
+adjustment," a current of exquisite "fineness" (rapidity of
+interruption) is obtained, thus removing the only inferiority that has
+heretofore distinguished American from the best imported instruments.
+The instrument is very easy of management, and its liability to get out
+of order very small.
+
+As however the galvanic current is of vastly greater importance in a
+therapeutic respect, than the faradic, so also much greater care is
+required in the choice of a galvanic than a faradic battery. In making
+choice of a galvanic battery, we have to consider its relative quantity,
+intensity, constancy, permanency, economy of running expenses, and
+facility of management. We cannot be guided here by the same
+considerations that guide us in the choice of a battery for office use,
+where the _s�ances_ are usually brief and the elements taxed not nearly
+so much as in the administration of baths. It is not within the scope of
+this work to enter into a description of the various galvanic batteries
+that are in use. Neither do I believe that, in a therapeutic sense,
+there is much difference between the various batteries ordinarily found
+described in text-books on electro-therapeutics.
+
+Where the battery is to be stationary, a zinc-copper battery, such as
+the Hill battery for example, is preferable both on account of its
+constancy and the economy of running it. Of this there should be fully
+sixty cells, communicating with the bath through a current selector, by
+means of which the current from any desired number of cells can be
+obtained. The electro-susceptibility of different individuals varies to
+such an extent that this is absolutely necessary. Where a portable
+battery is desired, the St�hrer zinc-carbon battery will be found the
+most useful.
+
+I have mentioned these two batteries simply because I have them in use,
+and they give me satisfaction. There are many others, however, that will
+answer equally well. On the whole, any battery possessing quantity and
+intensity in a medium degree will answer.
+
+
+    Footnotes:
+
+    [Footnote 1: A written description can never convey so true an
+    idea of anything, as an ocular inspection. I will therefore say
+    that it will afford me much pleasure to show any member of the
+    profession the apparatus I am about to describe, at my
+    residence.]
+
+
+
+
+                              CHAPTER II.
+
+                        MODE OF ADMINISTRATION.
+
+
+I shall describe under this head the _modus operandi_ of administering a
+routine galvanic or faradic bath. As it will become necessary to
+describe special modes of administration when speaking of the
+electro-balneological treatment of special diseases, the describing them
+now would only lead to tautologies that I am desirous of avoiding.
+
+Taking our cue from the indications to be met in each case, it becomes
+necessary, according to circumstances, to use either the galvanic
+current, the faradic, or both successively. As modifications of the
+application of the currents we have to consider 1) their intensity; 2)
+their direction, and 3) the duration of the application.
+
+The intensity of the galvanic current corresponds directly to the number
+of cells from which it is derived. It were vain however to attempt to
+express this in figures, because the electro-motive force of different
+batteries varies to so great an extent, that a number of cells of some
+batteries of low intensity yield a current so feeble as to be barely
+appreciable in the bath, while the same number of cells of a battery of
+high intensity, furnish a current that few persons can bear without
+pain. In thus comparing the Hill cell with the St�hrer cell, I have
+found the ratio to be about as 1 to 2�, i.e., as intense a current can
+be derived from twenty-four St�hrer as from sixty Hill cells--and this
+is rather below than above the mark. Were all batteries alike in this
+respect, however, still no particular number of cells could be given as
+furnishing a current of suitable average intensity for the galvanic
+bath, because of the excessively great variations in the degree of
+electro-sensibility of different persons. This is so marked that I have
+seen persons in the bath tub who could bear no more than six Hill cells,
+diffused as was the current from these through the water and over the
+entire body; while on the other hand I have met with male patients on
+whom a current from thirty-two St�hrer cells made not the slightest
+impression, and where I was compelled to supplement the current by that
+from a ten-cell quantity battery (zinc carbon elements 6 in. long by 4�
+wide) in order to make them realize the presence of a current. These
+gentlemen had no cutaneous an�sthesia.
+
+In view of the facts just stated, I have found it impracticable, when
+giving directions for the administration of a galvanic bath, to indicate
+any certain number of cells to be used. I am in the habit of ordering
+the administration of a "mild," a "medium" or a "strong" current, as may
+be required in the respective cases; and in every instance it is the
+electro-sensibility of the patient that determines the number of cells
+requisite to obtain the desired result as represented by one of these
+terms. The same applies also to the faradic current.
+
+To determine the direction of the current is sufficiently simple. Where
+a descending current is desired, the binding post which represents the
+electrode at the head of the tub must be connected to the positive pole
+of the battery, the other binding post to the negative pole; where an
+ascending current is desired, the reverse of this is done.
+
+The duration of the bath varies with different cases. The average is
+about twenty minutes, though the time may range from ten minutes to an
+hour and a half.
+
+Where it is desired to give the patient a galvanic shock, it is only
+necessary rapidly to reverse the current by means of the commutator. The
+simultaneous contraction of almost the ENTIRE muscular system that
+accompanies the reversal of a current of sufficient intensity in the
+bath, affords a striking illustration of the _general_ effects of the
+galvanic bath. In cases where paralyzed muscles have lost their faradic
+irritability, galvanic interruptions are almost indispensable to
+successful treatment.
+
+I have before (page 14) described a "surface board," which I have
+devised for the purpose of localizing the current from one of the poles
+in any portion of the body where required. This proceeding should by no
+means be looked upon as a "local" method of electrization; on the
+contrary, it is just as much "general" as the ordinary electric bath.
+Whereas in local applications the current runs from one point of the
+body to another, in this case, supposing the spot where the surface
+board is applied to be the centre, and the rest of the body the
+periphery, a current runs between _every point_ of the periphery and the
+centre, its direction being centripetal when the surface board
+communicates with the negative, centrifugal when with the positive pole
+of the battery.
+
+The current is felt more or less intensely in proportion to the
+proximity to the body of the surface board. With the galvanic this is
+less noticeable than with the faradic current. When, for example, a
+faradic current of medium strength being employed, the surface board is
+held about six inches from the abdominal surface, little or no current
+is felt. Let the surface board be now gradually approximated to the
+abdomen, and the current will be felt more and more sensibly, until,
+when about an inch away from the skin, or touching this, its influence
+becomes so strong as to cause more or less energetic contractions of the
+abdominal muscles. Where the galvanic current is employed, the skin
+beneath the surface board will be found more or less reddened after a
+few minutes' application; the burning sensation ordinarily accompanying
+galvanic applications will also be experienced more or less intensely,
+in proportion to the strength of the current employed.
+
+Where the current is to be concentrated in a manner still more energetic
+than that described, this can be effected by raising the objective part
+above the surface of the water, and then applying the surface board. In
+this way the _entire_ strength of the current is concentrated in one
+spot, whereas, when the surface board is applied under water, a large
+portion of current is absorbed by this.
+
+This appears to me the fittest place to say a few words in regard to the
+relative conductivity of the human body and water--the latter at the
+temperature ordinarily employed in baths, say from 90� to 95�
+Fahrenheit. BEARD and ROCKWELL, in their work on Medical and Surgical
+Electricity,[2] state that "the human body is a better conductor of
+electricity than water at the same temperature." Certain phenomena
+connected with the administration of electric baths having forced upon
+me some doubts in this respect, I made very careful experiments, both
+with and without the aid of the galvanometer (Bradley's Tangent), to
+satisfy these. Without wearying the reader with details, I will state
+that the result of my experiments leaves no room for doubt that water at
+the temperatures stated--and still more so at 98��--is superior to the
+human body as a conductor of electricity. I do not mean to be understood
+that water is a better conductor than _every constituent_ of the human
+body; blood, for example, is a better conductor. But when I speak of the
+body in this connection, I take it as we find it practically, i.e., with
+the resistance of the skin, and especially the epidermis, superadded to
+internal resistances. I have no doubt that with a flayed individual it
+would be otherwise. I will add, that it will give me great pleasure to
+repeat these experiments, which are sufficiently simple, in the
+presence of any of my _confreres_ who feel an interest in the subject.
+
+Having thus cursorily considered the manner of using the electric
+current in the administration of a "routine" bath, and there being no
+remarks required concerning the water employed, in addition to what has
+been said in the previous chapter, a few words are in place on the
+subject of chemicals. As has been previously stated (page 13) these are
+added: _a_) to be absorbed, and thus act medicinally on the patient;
+_b_) to act on the skin; _c_) through chemical affinity to facilitate
+the elimination from the body of certain metallic substances, and _d_)
+to further the absorption of morbid deposits. Of the many drugs and
+medicines that no doubt may be made to answer these various purposes, I
+have had personal experience with but few, and of these I will mention
+the leading ones only. A requisite of all chemicals to be employed is
+their ready solubility in water. Of substances intended for
+absorption[3] I have used but three, viz: iron, iodine, and extract of
+malt. The first of these I have employed in an�mic and enfeebled
+conditions generally, but especially in chlorosis and chlorotic
+hysteria, with marked success. It has the advantage, when administered
+in this manner, not only of sparing the alimentary canal the frequently
+injurious task of becoming the medium of its assimilation, but, in
+addition to this, I believe that it can in this way be introduced into
+the blood much more rapidly and in larger quantities than when given by
+the mouth. The preparation which I have found, all things considered,
+the most eligible for this purpose, is the "tartrate of iron and
+ammonia." This is very readily soluble, leaving no deposit, is
+assimilable, and not too expensive for the purpose. As, in my experience
+at least, it leaves nothing to wish for, I would consider it superfluous
+to discuss in this connection any of the other ferruginous preparations.
+
+Iodine I have employed with a view to its absorption in rheumatism and
+gout. I cannot speak favorably of it in this connection. I have not in a
+single instance found a bath charged with iodine, either in the form of
+the tincture or of iodide of potassium, followed by results in any way
+differing from those of the simple galvanic bath employed in the same
+cases.
+
+Extract of malt I have employed as a roborant, either alone or in
+conjunction with iron, in cases of debility and malnutrition, and found
+it of service.
+
+Where the absorption of substances is aimed at, the _galvanic_ current
+must be employed.
+
+Where we add substances to an electric bath with a view of producing
+some special action on the skin, we may be guided by the same principles
+that govern ordinary balneology. Thus to obtain counter-irritant
+effects, we may add mustard or common salt; to render the bath alkaline,
+bicarbonate of potassa or soda, etc., etc.
+
+An important object to be furthered by the addition to the galvanic bath
+of chemicals, is the elimination from the system of certain metallic
+substances. It will be found here that in practice we have to deal
+chiefly with two substances, viz: mercury and lead. That the elimination
+of these bodies by means of the galvanic bath is feasible, I shall
+endeavor to demonstrate further on. At present I have simply to consider
+the chemicals adapted for the purpose, and the manner of using them.
+
+To facilitate the extraction from the system of mercury, nitric-acid has
+been recommended by those who have heretofore instituted this treatment.
+While I cannot positively deny that this substance may aid in the
+elimination of the metal, I am compelled to state, after its trial in
+several cases, that I have obtained equally good results from the simple
+galvanic bath. In the light of my own limited experience, therefore, I
+cannot insist on the necessity of adding any chemical to a galvanic bath
+which is administered for the purpose of extracting mercury from the
+body.
+
+Where the elimination of lead is the object aimed at, I am, on the other
+hand, satisfied of the utility of adding certain chemicals to the water
+of the bath. Sulphuric acid has been suggested and used for this
+purpose. I can say nothing respecting its usefulness, as I have never
+tried it. Indeed, the results with iodide of potassium added to the bath
+have been so satisfactory, that I have had no occasion to try any other
+chemical, although almost any other of the preparations of iodine would
+probably answer equally well. The chemical affinity of iodine for lead
+affords a ready explanation of its usefulness in this respect. One ounce
+of iodide of potassium to each bath appears to me a suitable quantity.
+
+I have had no personal experience with any other cases of chronic
+metallic intoxication than those with lead and mercury.
+
+The absorption of morbid deposits (plastic exudations, etc.) can be
+materially furthered by adding to a galvanic bath some resolvent--above
+all, iodine.
+
+I have said above (page 26) that I had found no perceptible benefit from
+the addition of this substance to the galvanic bath in cases of
+rheumatism or gout. The contrary holds good however with respect to the
+frequent sequence of these diseases--articular deposits. When the acute,
+and to a great extent the subacute symptoms have subsided--and in
+chronic cases especially, and the disease has left effusions in various
+joints, iodine, which when employed in this manner, appears to have
+little or no influence on the pain accompanying these complaints, is a
+powerful adjuvant in promoting the absorption of the deposits. In
+chronic synovitis and all other articular affections accompanied by
+exudation, the same holds good.
+
+I have no doubt that future advances in this branch of science will
+develop the utility of numerous other drugs and chemicals as additions
+to the galvanic bath.--Before leaving this subject I must call attention
+to the influence which the addition to the bath of certain substances
+has on the conductivity of the water, resp. thus: the action of the
+current on the patient. I have found that when I caused salt or
+bicarbonate of soda to be added to the bath, the conductivity of the
+water became so much increased, so disproportionately greater than that
+of the body, as to render necessary the employment of very powerful
+currents in order to cause the patient to feel them.
+
+
+    Footnotes:
+
+    [Footnote 2: "Medical and Surgical Electricity." New York. 1875.
+    Wm. Wood & Co. pp. 431 and 432.]
+
+    [Footnote 3: For some experiments concerning the cataphoric
+    effects of the galvanic current, see an article by MUNK,
+    entitled "Ueber die galvanische Einf�hrung differenter
+    Fl�ssigkeiten in den unversehrten lebenden Organismus," in the
+    Allgemeine Medicinsche Central-Zeitung, No. 16, 1875.]
+
+
+
+
+                             CHAPTER III.
+
+                        PHYSIOLOGICAL EFFECTS.
+
+
+In accordance with the plan of the present work, the remarks I shall
+offer under this head are by no means intended to comprise all that is
+known at the present day of the physiological effects of electricity in
+general. It was my purpose when I undertook to write these pages, to
+offer to the profession a book confined to one subject; not a
+compilation, but a volume made up almost if not wholly of original
+matter, chiefly, if not entirely the result of my own observations and
+experience. For the general physiological effects then of electricity as
+well as for the theories of its action, I refer those interested to the
+many excellent works on the subject that have appeared within the last
+few years. I will treat here only of the physiological effects peculiar
+to the electric bath.
+
+The daily observations that I have had the opportunity of making in this
+respect, extending as they do over a period of upwards of two years,
+have not been as fruitful of results as might be expected. This is due
+mainly to the circumstance that but a small percentage--and these took
+the baths merely as a refreshing tonic--of those whom I have had the
+opportunity of observing, were in a condition that might be called
+normal. By far the greater majority were suffering from some complaint,
+in most instances of a neurotic or rheumatic nature, the presence of
+which, while it afforded admirable opportunity for observing therapeutic
+results, modified more or less the physiological effects of the baths,
+and served to deprive them of a uniformity which might to a great extent
+justly be looked for in healthy organisms. If, therefore, what I now
+contribute to the physiology of the subject is but little, it will I
+trust be at least found of practical utility in its applicability to the
+therapeutics of the subject.
+
+Before entering into details, it is necessary in the first place to
+inquire in what respects electric baths differ from other methods of
+electrization--especially those recently introduced as "general"--that
+their physiological effects should merit individual consideration. They
+differ in two ways. One of these is self-evident. To the effects of
+electricity are superadded those of the warm bath. The effects of the
+warm bath _per se_ are too familiar to every physician to require
+comment. Its effects in combination with electricity, however, may not
+be so generally known; and I therefore feel justified in quoting here a
+passage that bears directly on the subject, from a recent German work by
+Dr. Hartmann[4] of Wiesbaden.
+
+    "The last question, whether mineral water acts also by contact
+    with the skin, leads us to one of its most important
+    effects--that through electricity.
+
+    "Although this question has not as yet been finally disposed of,
+    we have still advanced far toward its solution, through the
+    admirable researches of HEYMANN and KREBS. Both observers have
+    furnished proof that the contact of the water of the bath[5]
+    with the human body gives rise to electric currents, which
+    currents must be looked upon as being the excitors of the
+    nerve-currents, the body acting merely as a conductor. From
+    these experiments we conclude that no particular difference
+    obtains between artificial and transported waters on the one,
+    and natural waters on the other hand, the assertions of
+    SCOUTETTENS notwithstanding, who in regard to electricity
+    claimed to have found a difference between the artificial and
+    transported waters and the natural ones.
+
+    "We gather moreover from the experiments, that the electric
+    current generated through the contact of the body with the water
+    of the bath is modified chiefly by the gases, next by the
+    temperature of the water, and lastly only by its salts.
+
+    "The effects of the bath depend on the strength of the electric
+    current generated and on the condition of the peripheral endings
+    of the nerves; the effect may be stimulating or soothing. The
+    strength of the current is governed, as we have seen, by the
+    quantity of gases present, the temperature and the salts.
+    Ordinary lukewarm baths, indifferent baths containing a small
+    amount of gases, are less stimulating than mineral baths
+    containing a larger proportion of gases.
+
+    "With regard to the relative condition of the peripheral
+    nerve-ends, experiments on the motor nerves go to show that
+    swelling of the terminal ends of these nerves may diminish their
+    excitability to the point of its complete extinction, while it
+    becomes increased by their exsiccation. This fact as to the
+    motor nerves is adopted by HEYMANN likewise as applying to the
+    nerves of sensation. If, now, we presuppose absorption or even
+    imbibition on the part of the skin, a swelling of the nerve-ends
+    is comprehensible, as the imbibed fluid reaches them. But,
+    according to HEYMANN, the peripheral nerve-ends, i.e., the
+    terminal bulbs of KRAUSE, of the sensory nerves, and the tactile
+    corpuscles of MEISSNER, become even without this presupposition
+    sufficiently impregnated with water while in the bath, because
+    here all insensible perspiration must cease, and in a bath of a
+    temperature lower than blood-heat transpiration cannot take
+    place, so that all transudation to the skin being retained
+    during the bath, those termini are surrounded by moisture and
+    therefore swell up.
+
+    "From this the writer concludes with regard to the effects of
+    the baths, that all baths in which the electric current produced
+    by contact of the water with the body preponderates over the
+    swelling of the nerve-ends, have a stimulant effect, while
+    those baths where the swelling preponderates over the electric
+    current, act as a sedative.
+
+    "Taking a brief and comprehensive review therefore of the
+    effects of mineral water baths, we have those resulting from the
+    temperature, from the contents of carbonic acid and salts, and
+    lastly from the electric current generated in the bath water;
+    each effect however resolving itself into an excitation of the
+    peripheral nerve-ends, which leads in a reflex manner to an
+    enhancement of the change of matter."
+
+From the foregoing quotation may be realized the importance which is
+attached to the electric current in the warm bath. And here let me ask
+the question: May not the remedial superiority, in many cases, of the
+mineral water bath over the ordinary warm bath be due mainly, if not
+solely, to the more abundant generation in the former of electricity? Or
+rather, is it not very likely that this is so? And if such is the case,
+it would appear evident that the mineral water bath, the electric
+properties of which, depending on the chemical changes going on between
+the gases and salts of the water on the one, and the cutaneous
+secretions and other constituents of the body on the other hand, are to
+a great extent beyond our control, must in turn be vastly inferior to a
+bath where the electric current is under our perfect control, and can be
+modified in intensity, direction and quantity to meet the individual
+requirements of every case. And such is the electric bath I am now
+describing.
+
+The second difference between the electric bath and all other methods of
+applying electricity is, that _the bath is the only method by means of
+which general electrization can be realized_. In making a distinction in
+this respect, it becomes necessary for me to advert more especially to a
+method first introduced to the profession in a systematized and
+scientific manner by Drs. BEARD and ROCKWELL,[6] and termed by them
+"General Faradization." The undoubted good results that have been
+obtained from this method--for the details of which I refer the reader
+to the latest work of the authors[7]--have caused it to be extensively
+adopted by the medical profession, both here and in Europe. It is,
+however, not with its results that I have to do at present, but with its
+appellation and true nature. General faradization, so-called, consists
+of a series of local faradizations, administered during one and the same
+s�ance, until the current has alternately been made to impinge upon and
+traverse the entire or at least a large portion of the body. This
+cumulative procedure, it is true, approaches general electrization, as
+represented by the electric bath, more closely than any of the other
+local methods; yet it is not that which its name would imply, and I do
+not think it requires argument to make it apparent, that even this
+procedure differs vastly from the electric (whether galvanic or faradic)
+bath, where the current at one and the same time impinges directly on
+every peripheral nerve-end (excepting those of the head and face) and
+traverses every part of the body, obtaining--both as to reflex and
+direct effects--as a whole that which the method known as general
+faradization seeks to obtain by the cumulation of fractional portions.
+
+Having thus, I trust, established the individuality of the bath as an
+electric method, I will without further digression proceed to the
+consideration of its physiological effects.
+
+The physiological effects of the electric bath may be qualified on the
+one hand as either "immediate," or "remote," on the other as either
+"transient" or "permanent." Strictly to classify these is impracticable,
+and I will therefore be influenced in the order of their enumeration
+principally by their importance in a therapeutic respect.
+
+One of the most pronounced as well as uniform, and at the same time
+most important, effects of the electric bath, is its property as an
+
+
+                               HYPNOTIC.
+
+This somniferous influence, which is to some extent exercised by local
+electrization, is here distinguished by its far greater constancy as
+well as by its greater degree of perfection. That this difference should
+exist, appears quite natural, when it is considered that the same
+topical influences which produce it in local electrizations, and which I
+shall presently endeavor to analyze, are here brought to bear on the
+entire system. The hypnotic effect is both immediate and remote, and
+more or less permanent. When there is an immediate inclination to sleep,
+which may make itself manifest during the bath or immediately after
+this, it is generally accompanied by a
+
+
+                      PLEASANT SENSE OF FATIGUE,
+
+which cannot be likened to weariness, but rather to what we feel after
+moderate exercise; it is only in some instances, where an individual
+takes his first bath, or where, for therapeutic reasons, a strong
+faradic current--accompanied by responsive muscular contractions--is
+employed, that this feeling is intensified sufficiently to become
+unpleasant, calling for rest and recuperation, and must here be looked
+upon as analogous to the effects of _severe_ exercise. It invariably
+disappears after a brief rest.
+
+Experience and good judgment will enable us moreover in almost all cases
+to avoid effects of this kind. The immediate inclination to sleep is
+much more decided as well as constant when the bath is taken late in the
+day, than when taken in the forenoon. When the latter is the case
+however, the individual will as a rule become sleepy during the
+afternoon, or else at an earlier hour than usual in the evening, and
+sleep more soundly during the night. This is the effect of one bath. A
+series of baths will however produce more or less marked and permanent
+improvement in the sleep of individuals, where this has been below the
+normal standard. And this is among the most invariable of the effects of
+the electric bath, whether galvanic or faradic.
+
+I have formed a theory as to the _rationale_ of this influence, which I
+will offer as its probable explanation. We all know that sleep is a
+process designed by nature for the recuperation of the system after a
+certain period of activity. In other words, when the various functions
+have been more or less exercised for their daily allotted time--say
+seventeen hours--the respective organs need that profound rest which we
+know as sleep. Now, it is pretty well conceded by physiologists, that
+electricity stimulates the secretory as well as excretory organs; that
+it furthers endosmosis and exosmosis--by its electrolytic influence in a
+physical, by its influence on the nervous system in a catalytic manner,
+in short, and by virtue of these properties, that it greatly
+
+
+                     ENHANCES THE CHANGE OF MATTER
+
+and incites the various organs to so great an activity as to cause them
+to perform in a comparatively brief space of time--say an hour, the work
+of several hours. The natural sequence is obvious: _The want of rest--of
+sleep, is felt at a correspondingly earlier period._ I offer this as a
+probable explanation of the immediate or almost immediate disposition to
+sleep. As to the permanent improvement in sleep, where this has been
+below the normal standard, it must always be due to the removal of some
+morbid condition, and thus belongs among therapeutic results, rather
+than physiological effects. It is true that in many instances of
+_agrypnia_ we are unable to discover any pathological condition that
+would account for this symptom; but the probability is that here there
+is a sluggishness of some one or more of the functions, mental or
+physical, too obscurely manifested to be discovered by our present means
+of diagnosis, yet reached and rectified by a mode of electrization that
+traverses and permeates _every_ portion of the body.
+
+If this explanation of the hypnotic effect of the electric bath be not
+the true one, it is at least--so far as I know--the first attempt at
+accounting for a phenomenon that has been noticed as a result of even
+local applications of electricity by many observers, and about the
+pretty uniform occurrence of which there can be no doubt.
+
+With respect to the effect on the
+
+
+                        TEMPERATURE AND PULSE,
+
+I have made a number of observations, of which I have recorded
+twenty-two, made on persons where both were at or nearly at the normal
+standard. With regard to the frequency of the pulse, the results were
+conflicting and by no means reliable. In the majority of cases there was
+an increase, immediately after the bath, ranging from four to eighteen
+beats per minute. In others there was no change whatever, and in a few
+there was an absolute diminution in frequency; this last I believe
+however to be a therapeutic rather than physiological effect,
+manifesting itself only where there is pneumogastric asthenia, and
+attributable directly to electric stimulation of this nerve. Thus in one
+instance, which occurred in the person of a physician of this city, who
+had an intermittent pulse, the result was as follows: Immediately before
+bath: pulse 70, two intermissions; at the expiration of 15 minutes,
+during which he was under the influence of a descending galvanic
+current: pulse 65, two intermissions; at the end of ten more minutes,
+during which he received the faradic current: pulse 65, no
+intermissions; ten minutes after leaving the bath: pulse 66, no
+intermissions. As a rule then, we may look for an immediate and more or
+less transient moderate increase in frequency of the pulse. As for any
+permanent increase or reduction of the pulse, there is none as a
+physiological effect. Where such an one does take place, it is by the
+removal of some morbid influence on the heart, and must be looked upon
+as a therapeutic result.
+
+With respect to the temperature, the results were somewhat more uniform.
+I have found that where this is either normal or slightly below, the
+immediate but transient effect is to raise it from 2 to 6 tenths of a
+degree (Fahrenheit)--in most instances 4 tenths. In a very few cases it
+remained unchanged, and in one case, where before the bath the
+temperature was 100, at the close of the bath it was 99-3/5. Of
+permanent modifications of the temperature, the same holds good that I
+have said of permanent changes in the pulse. It must not be forgotten
+that the temperature of the water is undoubtedly an important factor in
+modifying the temperature of the body. In almost all instances where my
+observations were made, the temperature of the water was below that of
+the body, being 95� or a little less. This, which has a tendency to
+lower the bodily temperature, is to some extent counterbalanced by the
+suppression of the insensible perspiration, so that modifications of
+temperature resulting from electric baths, the water of which is but few
+degrees below 98��, may justly be attributed to the influence of the
+electric current. The importance of the electric bath as a
+
+
+                   PHYSIOLOGICAL STIMULANT AND TONIC
+
+cannot be overrated. I deem it superior in this respect to any other
+known agent. This effect manifests itself _immediately_ by a feeling of
+exhilaration and unwonted vigor, _remotely_ by an improvement--where
+there is a margin for such--in the performance of some or all of the
+physiological functions, as well as by a gradual but nevertheless marked
+_increase in weight_.
+
+Most striking among the tonic influences of the baths, are those that
+occur within the sphere of the digestive and sexual apparatuses. I will
+first consider the effects on
+
+
+                       THE DIGESTIVE APPARATUS,
+
+which may be subdivided into those on _a_) the appetite, _b_) digestion,
+absorption and assimilation, and _c_) alvine excretion. The improvement
+of the appetite under electro-balneological treatment is one of the most
+constant effects of this. While a series of baths will produce permanent
+results in this respect, an increase of the appetite, in some instances
+amounting to positive hunger, is a tolerably uniform and more or less
+immediate result of each separate bath. The permanent improvement of the
+appetite is relative. Not very appreciable where this is normal, it
+becomes most marked where the appetite has from some cause been
+impaired. The effect on the appetite is _definite_. The effects on
+absorption and assimilation are _presumptive_; but when we couple the
+absence of any corresponding difficulty in digesting the increased
+supply of food, with the increase before alluded to in the weight of the
+body, their assumption becomes fully justifiable. It is these combined
+influences that make the electric bath so valuable a remedy in almost
+all forms of dyspepsia.
+
+The influence on the alvine process is if anything even more marked than
+that on the assimilative process. Where the action of the bowels is
+normal, it is not modified permanently by the electric bath, although we
+often have, as an immediate consequence, a cathartic effect that
+manifests itself as a more or less watery evacuation, either a few hours
+after the bath or on the succeeding day. Where the fecal process however
+is sluggish, the improvement resulting from the baths is very striking.
+I shall recur more fully to this subject under the head of constipation.
+
+The effects on the various functions connected with digestion are due
+doubtless to the combined influences of stimulation of the secretions of
+the alimentary canal and stimulation of the muscular coats of the
+stomach and intestines, as well as permanent tonization of the
+_muscularis_. While the enhancement of the secretions is undoubtedly due
+chiefly to the electric stimulus to the secreto-motor nerves, and the
+increased activity of the muscular coats to a like influence transmitted
+to their motor nerves, I believe the permanent tonization and
+invigoration of the muscular fibres to be mainly attributable to the
+direct trophic influence of the current traversing the parts
+themselves; and I have no doubt that this direct influence has much to
+do with the stimulation of the secretions and _peristalsis_ also. At any
+rate, I have never obtained from galvanization of the nervous centres,
+which I have practiced in a great number of cases, the striking effects
+on the alimentary processes which are so uniform a result of the baths.
+
+The influence on the
+
+
+                           SEXUAL APPARATUS
+
+of the electric bath does not manifest itself in so striking a manner as
+in the case of the organs of digestion. It is true I have seen
+individuals whose sexual functions were normal, have _stysis_ in the
+bath, but the mere cutaneous irritation of the electric current is here
+sufficient to account for a phenomenon which, where sexual irritability
+is intact, will follow any other local irritations.
+
+If not as immediately perceptible, the stimulant and permanent tonic and
+invigorating influences on the sexual organs are not much less constant
+than the corresponding influences on digestion. Careful observation,
+however, of a considerable number of cases where the sexual function was
+more or less impaired, has convinced me that while there can be no
+doubt that _direct_ influence on the innervation, tone and nutrition of
+the respective parts as well as the stimulus which the electric current
+furnishes to the seminal secretion, bear a share in the improvement that
+takes place, permanent beneficial results must be looked upon as chiefly
+the expression of improved nutrition and tonization of the system at
+large. I do not mean to be understood as wishing to put in negation the
+beneficial results that the local influence of electricity is capable of
+sometimes accomplishing in the sexual sphere. These results, however,
+are not of a physiological, but rather of a purely therapeutic nature,
+and are obtained there only where local morbid conditions exist. Now, in
+the great majority of the cases that have come under my observation, the
+causes of deterioration of the sexual capacity, though frequently
+obscure and indefinable, were certainly not local, but to be sought for
+in the general--most probably the nervous--system. In none but perhaps
+the very mildest and recent cases have I ever seen _rapid_ results
+follow electrical treatment of any kind whatsoever. In support of my
+assertion however that in the majority of cases the sexual sphere can be
+influenced only through the system at large, I will state _first_, that
+I have seen cases where local electrical treatment had utterly failed
+to do the slightest good, respond favorably to the baths, and _second_,
+that where success was met with, it was only after persistent treatment,
+continued long enough to modify favorably the condition of the entire
+organism, and through this the objective sphere.
+
+The stimulant and tonic effects under consideration, although shared to
+some extent by other methods of electrization, are here far more
+comprehensive and pronounced, a fact which is not surprising, when we
+reflect that in the electric bath not only are all the organs
+_indirectly_ influenced through stimulation of the nervous centres, but
+each separate organ is at the same time _directly_ acted upon by the
+current.
+
+A direct sequence of the stimulant and tonic effects of the electric
+bath is its
+
+
+                          SEDATIVE INFLUENCE.
+
+This sedative effect, whereof the hypnotic effect already spoken of is
+the supreme manifestation, must not be associated for a moment with any
+idea of depression, for here we have none such. In addition to what I
+have already said in endeavoring to account for the hypnotic influence
+of the baths, I refer the reader for further information to the
+admirable and lucid remarks on this subject by BEARD and ROCKWELL.[8]
+
+The _galvanic_ bath shares with other galvanic applications made in the
+cranial and upper spinal region, the effect of producing the galvanic
+_taste_, as also the _flashes_ when the current is interrupted, showing
+that the
+
+
+                            CRANIAL NERVES
+
+come within the sphere of its influence.
+
+A further effect peculiar to the galvanic bath is a sense of
+
+
+                               ITCHING,
+
+felt chiefly in the lower extremities and about the neck, and
+proportioned to the intensity of the current. Rather pleasant when mild
+or medium currents are used, under the influence of strong currents it
+may become so intense as to create an irresistible desire on the part of
+the bather to scratch especially the legs.
+
+A negative effect of the galvanic bath, even where very intense currents
+are used, is the
+
+
+                      ABSOLUTE FREEDOM FROM PAIN
+
+throughout the entire process. I wish this to be understood of course
+as holding good only when currents within the ordinary limits of
+intensity are employed. The strongest that I have used, and on which I
+base my statement, was that from 48 St�hrer or 60 Hill cells. As
+stronger currents are not required for therapeutic purposes, what I have
+asserted remains practically true as applied within these limits.
+
+This absence of pain, which cannot be claimed for correspondingly
+intense local applications, is to be attributed to the _diffusion_ of
+the current throughout the body and its surface, as well as through the
+water of the bath. The redness of the _entire_ back after a galvanic
+bath, is among the proofs of this diffusion.
+
+Freedom from pain is a characteristic likewise of the faradic bath,
+_properly administered_. When too strong a faradic current however is
+incautiously administered, the resulting muscular contractions are
+accompanied by an amount of local pain proportioned to the violence of
+the contractions. By keeping the faradic current within proper limits,
+all pain can be avoided.
+
+With respect to
+
+
+                        MUSCULAR CONTRACTIONS,
+
+the effects of the electric bath may be distinguished from those
+obtained by other modes of faradization by their comprehensiveness.
+Many groups of muscles may be made simultaneously to contract by this
+means. The practical bearing of this on the therapeutics of _pareses_
+and _paralyses_, renders it an important characteristic of the bath.
+
+The physiological effects on
+
+
+                               THE MIND
+
+of electric baths, is a natural result of the enhanced tone and vigor of
+the physical system, and keeps pace with this. Mental buoyancy and even
+exhilaration are among the most common sequences of electric baths.
+Although indirect, these results are none the less decided.
+
+It has been my aim in the foregoing remarks to give the reader, as
+concisely as possible and within the limits which I set for myself in
+the beginning of the present chapter, a summary of the more important
+physiological effects of electric baths. As the isolated results of
+observations made in a limited field by one unaided individual, I trust
+the shortcomings of this chapter will be viewed indulgently. If what I
+have said of the physiological effects of electric baths proves the
+means of stimulating to further investigation more competent observers
+than myself, my labor, whatever its imperfections, will not have been in
+vain.
+
+
+    Footnotes:
+
+    [Footnote 4: Dr. Franz Hartmann; "Der acute and chronische
+    Gelenkrheumatismus," Erlangen, 1874; pp. 194 et seq.]
+
+    [Footnote 5: The Author here refers to mineral-water. Dr.�S.]
+
+    [Footnote 6: The Medical Use of Electricity, with special
+    reference to general electrization as a tonic, etc. New York,
+    1867.]
+
+    [Footnote 7: Beard and Rockwell; Medical and Surgical
+    Electricity. N.�Y. 1875.]
+
+    [Footnote 8: Op. cit. pp. 253. et seq.]
+
+
+
+
+                              CHAPTER IV.
+
+                 GENERAL THERAPEUTIC EFFECTS AND USES.
+
+
+The therapeutic uses of a remedy are based on what we know of its
+physiological effects. Many--or rather most--of the therapeutic effects
+of this as well as of most other remedies, correspond to certain
+physiological effects. Those therapeutic effects whereto we find none
+analogous among the physiological effects, are yet the results of the
+physiological tendencies of the remedy, and where these tendencies do
+not manifest themselves as results, it is because they find no field for
+action in the healthy organism. When they meet with the requisite
+pathological conditions, these tendencies make themselves manifest in
+the shape of definite results, commonly known as therapeutic effects.
+
+NOTHNAGEL, in his classical work,[9] recognizes this theory by excluding
+from his book the term "therapeutic effects" altogether. Where he finds
+it necessary to say anything of the physiological effects of a remedy,
+in addition to those "on man in health," he speaks--still under the head
+of "physiological effects"--of those "on man when sick." When, setting
+aside its empirical employment, we come then to inquire what it is that
+furnishes us with the true indications for the use of a remedy, analysis
+of the question leads us invariably back to its physiological effects.
+If I have failed nevertheless to include the few effects which I am
+about to touch on, under the head of "physiological effects," I have
+done so simply in compliance with universal usage, and as a matter of
+convenience for reference.
+
+I will now, without further digression, proceed to the consideration of
+those effects of electric baths not yet enumerated.
+
+As a fitting precursor to the enumeration of the therapeutic properties
+of the remedy under consideration, it may be well to dwell for a moment
+on what is among its most prominent characteristics; I have reference to
+its great value as a
+
+
+                              DIAGNOSTIC.
+
+In explanation of this, I will state that in a very large number of
+cases of disease of an obscure nature, and where, to be candid, the
+electric bath was employed empirically, or, if you please, tentatively,
+it has served to point out the _locus morbi_. The number of cases in
+which I have made this observation, has been sufficiently large to
+establish beyond a doubt the fact, that as a rule the electric current
+makes itself more decidedly and often even painfully felt in any part
+where a morbid condition exists; whether this be of an inflammatory,
+neuralgic, rheumatic, traumatic, congestive or other nature, the result
+is the same. It appears to be somewhat analogous to the "tenderness on
+pressure" that we find present in many of these conditions. In
+_an�sthesi�_ even the current makes itself conspicuous by the _absence_
+of its normal effects. The value of this will at once be recognized in
+connection with a method of electric application which at one and the
+same time acts on every portion of the body. Local electrization is
+accompanied by like phenomena, _when we happen to strike the right
+spot_. The superiority of the bath as a means of diagnosis is found in
+the circumstance that here we _must_ touch it.
+
+The great importance of this feature of the electric bath will at once
+be realized by every physician of much experience, for there can be none
+such who has not frequently met with subacute or chronic conditions the
+etiology of which was more or less obscure.
+
+One of the most important effects in its therapeutic application of the
+electric bath, is its superior excellency as an
+
+
+                     EQUALIZER OF THE CIRCULATION;
+
+so far as I know, it is more potent, constant and comprehensive in this
+respect than any other agent. Where an imperfect circulation of the
+blood is due to irremovable organic causes, the results obtained will of
+course be transient only. In all other cases, however, favorable
+results, more or less perfect according to the nature of the case, may
+be reliably looked for. Both currents act very well in this respect,
+though on the whole I look upon the galvanic as superior to the faradic
+current.
+
+As a theory of this effect of the currents I would offer the following,
+viz: That the galvanic current acts by stimulating the vasomotor centres
+and peripheral nerves, by giving tone to the mucular coats of blood
+vessels, and by counter-irritation. That the _faradic_ current
+stimulates the vasomotor centres little, if at all, does not influence
+the coats of vessels, except such as are close to the skin, but
+tonicizes these latter more effectually than the galvanic current; that
+it stimulates the peripheral nerves to some extent, though far inferior
+in this respect to the galvanic current; but that when employed of
+sufficient intensity it superadds to those mentioned a strictly
+mechanical action, which consists in forcing static blood from the
+capillary into the general circulation through the medium of muscular
+contractions.
+
+As a
+
+
+                       GENERAL COUNTER-IRRITANT
+
+the _galvanic_ bath has few if any superiors. The degree of
+counter-irritation can be very nicely determined by regulating the
+intensity of the current. The characteristic tingling sensation of the
+galvanic current is felt over the entire surface, corresponding in
+degree of course to the intensity of the current; while the redness of
+the skin, bearing a like relation to the intensity of the current, is
+observable more especially near the electrodes, being particularly
+conspicuous over the entire back. Concentrated local counter-irritation
+can be obtained by the use of the surface board.
+
+The counter-irritant effects of the galvanic bath, differ from those of
+ordinary counter-irritants in their freedom from pain, even the slight
+burning sensation accompanying strong currents ceasing with the
+application. The redness remains quite a while and the stimulus to the
+peripheral circulation causes the persistence for some time of a
+"glowing" sensation all over the body.
+
+In the chapter on physiological effects enough has been stated to make
+it apparent that as a
+
+
+                     GENERAL INVIGORANT AND TONIC
+
+the electric bath can have few if any superiors. In the healthy
+organism, however, the stimulant and tonic effects of the baths are much
+less marked than they are where the general condition is "below par." In
+health there is little or no margin for improvement. The results
+obtained are _temporary_ stimulation, and a permanent invigoration which
+partakes more of artificial development than anything else. It is
+analogous to the development by gymnastic or other exercise of a
+previously healthy set of muscles. Where we meet with atonic conditions
+however, with debility, malnutrition, want of energy or general asthenia
+of an obscure nature, and amenable to electric influence, the tonic
+effects of the baths become striking and brilliant. I have observed
+cases where patients fairly bloomed up under their influence and
+acquired actually more physical strength and weighed more than before
+they became sick. When we consider how in such conditions as those
+mentioned, patients are made to swallow pills and mixtures for months or
+years, or, more appropriately, and if they can afford it, are sent
+abroad, we can realize the importance of an agent by means of which the
+desired end can be obtained more conveniently, certainly, economically
+and in a shorter time than by any other means. There is no rule without
+its exceptions, and I freely admit that in many instances where persons
+are, as the saying is, "run down," a sojourn in some mountainous region
+or a course of sea-bathing, etc., would do them more good than anything
+else, electric baths included. The results obtained from these last are
+however sufficiently uniform to justify us in looking for very favorable
+results in every case.
+
+In the preceding chapter I have already dwelt on the
+
+
+                    HYPNOTIC AND SEDATIVE INFLUENCE
+
+of the baths. It is only necessary to state here that this influence
+manifests itself still more decidedly in corresponding morbid conditions
+than in health. The greater the degree of restlessness, irritability or
+wakefulness, the more strikingly does the soothing and hypnotic
+influence of the baths--appropriately administered, of course--become
+apparent.
+
+
+                       IMPROVEMENT OF NUTRITION,
+
+as manifested by rapid increase of weight, and which I have likewise
+touched upon in the preceding chapter, is a reliable, constant effect of
+electric baths. Where previous loss of weight is due to an incurable
+organic disease, it is, if at all obtained, of course much less in
+degree, as well as transient. When due, however, as is frequently the
+case, to causes that are amenable to electrical influence, the increase
+in weight is marked, and has a tendency to be permanent.
+
+It will be seen that the few therapeutic effects which I have here
+enumerated, are in reality nothing more than intensified physiological
+effects, there being about them nothing that might be termed specific.
+It may be asked in reply: why then did I devote any space to them at
+all? I will answer that I thought best to point out some general
+therapeutic USES for which electric baths may be made available, and the
+indications for which are furnished by so great a number of pathological
+conditions, that omitting special reference to them would have led to a
+great deal of tautology in the chapter on "special therapeutics."
+
+Before leaving the subject of "general uses" of the baths, I will dwell
+for a moment on their admirable adaptability as a
+
+
+                             PROPHYLACTIC.
+
+Every physician is fully aware of the fact that disturbances of the
+circulation constitute one of the most frequent causes of disease. There
+are, indeed, comparatively few pathological conditions that do not bring
+with them congestion of some more or less important organ. A remedy then
+which more than any other has a tendency to equalize the circulation,
+and thus counteract a condition which as cause or effect, or both, is an
+almost universal concomitant of disease, and which in addition to this
+is so admirable and physiological a stimulant and tonic, can hardly be
+surpassed as a prophylactic by any other uncombined remedy.
+
+
+    Footnotes:
+
+    [Footnote 9: Dr. Hermann Nothnagel: Handbuch der
+    Arzneimittellehre. Berlin, 1870.]
+
+
+
+
+                              CHAPTER V.
+
+               SPECIAL THERAPEUTICS AND CLINICAL RECORD.
+
+
+I have thought it best for practical purposes, to accompany the
+consideration of the treatment of special diseases by the histories of
+illustrative cases, where I had such at command.
+
+Before entering on the subject proper, I wish to offer some general
+considerations that may influence and guide us in determining when,
+where and why to employ electric baths as a remedy.
+
+To realize thoroughly the indications in given cases for the employment
+of electric baths, we must first of all be more or less familiar with
+the effects and uses of the electric current as well as those of the
+ordinary warm bath. We must realize the fact that here we not only have
+these two forces united, but that the more important of the two, the
+electric current, here acts directly (locally) as well as indirectly
+(through the nervous centres) on every portion of the body--a
+circumstance of great importance in differentiating indications on the
+one hand for the baths, on the other for local electrization. In view
+of these circumstances we are fully justified in looking for results far
+more comprehensive than any that might be obtained singly from either of
+the two remedies that are here combined. There can be no doubt that in
+many cases the resisting power of a disease is sufficient to withstand
+two remedies brought singly and alternately to combat it, whereas the
+simultaneous combined action of these remedies may be fully adequate to
+overcome this resisting power.
+
+Approaching in its effects more closely to the electric bath than any
+other remedy, is the process known as "general faradization," to which I
+have already alluded (p. 36). In choosing between this and the bath, I
+state it as my conviction that, while there may be a small proportion of
+cases in which general faradization, so-called, is preferable, in almost
+all the cases where both these remedies are applicable, the faradic bath
+deserves the preference--it is a _more complete_ faradization.
+
+We need never be afraid of ordering electric baths on the score of any
+imagined exertion or discomfort attaching to them. The most delicate,
+the aged and children alike, bear them with far more ease, comfort and
+impunity than any ordinary warm bath, or any but the mildest local
+electrization. The entire absence of shock or pain of any kind
+whatsoever, is always an agreeable surprise to those who, urged by their
+physicians, have with fear and trembling submitted themselves to a
+treatment, the mere name of which filled their minds with
+extravagant--and, it is useless to say, groundless--visions of painful
+shocks. Thanks to the tonic effects of the current, they are by the
+feeble and infirm borne much better than the ordinary warm bath. There
+is likewise much less liability to get cold after the electric bath. The
+stimulus which the current furnishes to the peripheral circulation is a
+powerful protection against cold, so that even in midwinter I see people
+daily take electric baths at an average temperature of 95�, and enjoy
+apparent immunity from colds.
+
+Having once determined on the use of the baths in a given case, we have
+to observe certain points in their application.
+
+In the first place, guided by what we know of the relative effects of
+galvanism and induced electricity, we must decide which of these two
+currents to use, and if both, in which order. We must determine on the
+direction and intensity of the currents, as well as on the duration of
+the baths.
+
+Next we must use our judgment as physicians, in deciding whether a
+given case promises to get well under electro-balneological treatment
+alone, or whether auxiliary treatment may not be required to bring it to
+a favorable issue.
+
+With respect to the frequency of the applications, I will say that while
+there are some cases where a bath twice a week is sufficient, and others
+where a bath every day is imperatively necessary, in far the greater
+majority of cases suitable for electro-balneological treatment, a bath
+every alternate day is _sufficient_, but a bath every day is
+_better_--it leads to more rapid as well as certain results.
+
+In most of the cases, a daily bath for a few days or a week, followed by
+one every other day for a time, and, when the cure is about completed, a
+bath twice a week, to _consolidate_ and _confirm_ the good results
+obtained, has done me the best service.
+
+I would dwell particularly on the necessity of _perseverance_ in this
+treatment. The majority of cases that have come under my observation in
+this connection, have been of a more or less chronic nature. In many of
+these, where medicinal and other treatment had been unavailingly gone
+through with for weeks, months and even years, I have found existing the
+most absurd expectations with regard to the effects of the baths. People
+who had made the tour of almost all the watering-places of Europe
+without obtaining the slightest benefit, have come to me imbued with the
+idea--whence derived I know not--that one or two baths should greatly
+improve, and two or three more cure them; and when these expectations
+were not realized, they would promptly discontinue treatment, fully
+satisfied that electric baths were no more capable of benefiting them
+than "all the other things." I do not mean to be understood for a moment
+as intending to imply that ideas of this nature are shared by the
+profession; I mention them simply in order to show the necessity on the
+part of physicians to disabuse in this respect the minds of those
+patients whom they may send for electro-balneological treatment.
+
+In appropriate cases, the use of the bath should not be too long
+deferred. I have had frequent occasion to become cognizant of the fact,
+that cases have been sent by physicians to take the baths only after
+prolonged ineffectual treatment of another nature had been gone through
+with, and where negative or at best tardy results took the place of the
+brilliant results that might have been obtained, had the cases been sent
+earlier. I do not mention this in a fault-finding spirit; to do so would
+be unjust. The remedy under consideration has up to the present time
+been too little known, the indications for its employment--in the
+absence of statistics--on too uncertain a basis, to expect from any but
+specialists the early realization in any case of its appropriateness. I
+trust however that in the future, from being a "dernier ressort," it
+will come to take its proper place among other remedies, to be
+administered "when it will do the most good." When this comes to pass,
+the results obtained, satisfactory as they are even now, will become as
+brilliant and well-authenticated as those of every other remedy from
+which experience has taught us how to reap the greatest advantage.
+
+In the following "clinical record" I shall not omit to cite cases where
+the baths were unsuccessful, wherever it shall appear to me that the
+citation of such cases may be of assistance in arriving at a true
+estimation of the therapeutic value of the remedy.
+
+In giving the histories of cases, it will scarcely be necessary to enter
+very minutely into details; the demands of the present work will be
+fully met if sufficient is said of a case to illustrate the effects of
+the baths in the class of cases that it represents.
+
+Finally, I wish it understood that in a few of the conditions in which
+I shall advise the employment of the baths, I have had no personal
+experience in their use, but base my opinions on what I know of their
+effects, together with what is known of the results obtained in
+analogous conditions by local electrical methods.
+
+
+                           SPECIAL DISEASES.
+
+                              RHEUMATISM.
+
+Its great frequency, the pain and discomfort which it occasions, and its
+many, often dangerous _sequel�_, added to its frequent obstinacy under
+the most varied treatment, render rheumatism one of the most formidable
+diseases that we have to encounter. The long list of remedies that have
+from time to time been employed in its treatment, bear witness by their
+very number to the little reliance that can be placed in any one of
+them. A remedy then which can be _relied on_ to exercise a favorable
+influence in all the forms of rheumatism--acute, subacute and
+chronic--as well as on most of its sequel�, should of right become a
+welcome addition to our armamentarium in the treatment of this disease;
+and such is the electric bath. The treatment of the sequel� I shall
+speak of under separate heads. The disease itself I will divide into
+three classes, viz: _a_) acute, _b_) subacute and _c_) chronic
+rheumatism.
+
+_a_) ACUTE RHEUMATISM.--A few years ago the use of electricity in acute
+inflammatory conditions was scouted by most of the profession, and had
+it not been for the quiet and patient labors of a few progressive
+spirits, we would at the present day be still deprived of the benefits
+which we reap from it in these conditions. Even to-day, the number of
+those who are satisfied of the utility of electricity in this respect is
+comparatively small. Only two years ago, I attended a gentleman who was
+suffering from a very severe attack of rheumatic gout. I had both a
+galvanic and a faradic battery at his house, which, in addition to
+appropriate medicinal treatment, I applied daily to the affected
+joints,--using mainly the faradic current. Being compelled at the time
+to go to the country, the case during my absence drifted into the hands
+of a gentleman, a professor at one of the medical colleges, of high
+standing in the profession and considered one of our leading medical
+men, who ridiculed and promptly discontinued the use of electricity in
+the case. He gave it as his opinion that it did more harm than good, and
+I have no doubt he did so conscientiously--however unprofessional his
+conduct may have been, in this as well as other respects. The
+contributions of others have since then vindicated my views in this
+respect. Among others, Dr. Drosdoff[10] of St. Petersburg has given a
+number of cases of acute articular rheumatism from the clinique of
+Professor Botkin, in which the faradic current was employed either alone
+or in conjunction with other treatment. From among the deductions which
+he makes from a series of careful experiments in this respect, I quote a
+few--such as bear directly on our subject, and to which I affix my own
+numbers.
+
+    1) "The sense of pain as the result of electric irritation is
+    considerably diminished, and sometimes entirely lost, in joints
+    attacked by acute articular rheumatism, so that the patient
+    experiences no pain, even when the distance between the coils
+    equals naught[11], and both closure and opening are accompanied
+    by the evolution of numerous sparks. At the same time the
+    slightest pressure of the affected parts gives rise to the most
+    intense pain."
+
+    "The diminution of the electro-sensibility appears in the
+    majority of cases to be in inverse proportion to the severity of
+    the disease and the intensity of the pain produced by mechanical
+    irritation."
+
+    2) "The enhanced tactile and thermic sensibility of the diseased
+    joints is diminished by a faradization lasting from 5 to 10
+    minutes."
+
+    3) "From 5 to 10 minutes faradization causes a reduction of the
+    previously heightened temperature of the diseased joints to the
+    normal standard, or even below this."
+
+    4) "The subjective rheumatic pains which are augmented by
+    pressure and motion, are diminished by faradization. This
+    diminution is sometimes so considerable, that the joint, which
+    prior to the faradization admitted of no movement, is able to
+    execute passive and active movements with tolerable facility."
+
+    5) "The rheumatic pains as well as the temperature of the
+    affected joints remain diminished after the faradization for 3,
+    4 and even 5 hours; they then gradually return to the previous
+    height. At the same time the duration of the paroxysms of pain
+    becomes shortened, and the intensity of this diminished."
+
+    6) "Although the rheumatic process takes a more rapid course
+    under the influence of faradization, and incommodes the patient
+    less, we have nevertheless made the observation in one case,
+    that the tendency to recurrence is not diminished. The attacks
+    however become more brief and milder."
+
+    7) "From what has here been said it follows, that daily
+    faradizations, lasting 5-10 minutes, diminish the severity of
+    acute articular rheumatism, restore the perverted cutaneous
+    sensibility, and cause a reduction of the temperature of the
+    affected joints."
+
+    8) "Several of those suffering from the pathological processes
+    mentioned, received no medication in addition to the
+    faradization, and yet made a tolerably rapid recovery."
+
+I might adduce further testimony of the value of electricity in recent
+cases of rheumatism, were it necessary to do so. The results in my own
+cases however have long since satisfied me of the utility in this
+respect of faradic not only, but also of mild constant currents.
+Accepting this as matter of fact, let us next inquire where and why we
+are to give _general_ electrization--in other words, the electric
+bath--the preference over local applications.
+
+Where the manifestations of the disease are limited to a single joint,
+or at best a very few joints, or where we have to do with a case of
+muscular rheumatism--to one group of muscles, local electrization, as
+_symptomatic_ treatment, will answer. Where on the one hand however many
+joints, on the other the muscles of entire limbs, or even more, are
+involved, the advantages of a method by means of which we reach all the
+affected parts at once, thus effecting in, say ten minutes, that which
+where, for example, six joints are involved, would by the ordinary
+method require sixty minutes, are readily realized. There is, however,
+another reason why the baths are preferable in rheumatism to local
+applications. Rheumatism is a constitutional disease with local
+manifestations. The metastatic character of muscular rheumatism
+especially appears to indicate the greater importance of general as
+compared to local treatment. Pre-supposing, then, that electricity
+exercises the favorable influence on rheumatism which clinical results
+would appear to demonstrate, it follows that the electric bath, while it
+furnishes symptomatic (local) treatment equally well with local
+applications, does something more; it meets the _indicatio morbi_
+likewise. The warm bath no doubt contributes its due share in bringing
+about the favorable results obtained.--Where the disease then does not
+confine the patient to bed, the electric bath will be found a most
+valuable remedy.
+
+The following directions will be found to answer best in the great
+majority of cases: The temperature of the water should range from 90� to
+98��F; a mild constant current, descending, should be applied for ten
+minutes; this to be followed by a faradic current of as great an
+intensity as the patient can bear _without the slightest degree of
+discomfort_. In the application of the faradic current, the surface
+board (see p. 12) may advantageously be had recourse to for the purpose
+of more concentrated influence on affected parts, to each of which it
+may be applied for a few minutes; the entire faradization may last from
+ten to fifteen minutes. When coming from the bath, the patient should be
+received in a warm blanket, anything like a chill being carefully
+guarded against. In cases where the cutaneous secretion is of an
+abnormally acid character (which is often so marked as to become
+apparent through the sense of smell), bicarbonate of soda or potassa may
+be added to the bath. As appears from the foregoing, the entire duration
+of the bath is from twenty to twenty-five minutes. The baths should be
+taken daily until all urgent symptoms have disappeared; after this,
+every two or three days as required, until an entire cure is wrought.
+
+As the results of this or similar treatment, conjoined with the
+requisite medicinal or other measures, I may state:
+
+_a_) Considerable abridgment of the period of the disease;
+
+_b_) Sequel� are less constant;
+
+_c_) The tendency to recurrence is very much diminished;
+
+_d_) A relapse, if it does occur, is comparatively mild.
+
+With regard to _b_ and _c_, let it be understood that I speak within the
+restrictions of a period of observation extending over two and a half
+years only.
+
+
+                       _b_) SUBACUTE RHEUMATISM.
+
+In the subacute variety, the electro-balneological treatment is similar
+to that in acute cases, with the difference however, that here not so
+much care is necessary with regard to the intensity of the currents.
+Muscular contractions, as induced by strong faradic currents, are to be
+dreaded in direct proportion to the acuteness of the inflammation,
+_resp._ the sensitiveness of the inflamed tissues.
+
+It will be understood, I hope, that the electro-balneological treatment
+as laid down above, though it applies to the majority, does not apply to
+all cases. Special complications may make it expedient in individual
+cases to modify the treatment more or less. The course to be pursued in
+these instances may however be safely left to the judgment of the
+attending physician.
+
+_c_) CHRONIC RHEUMATISM. In this affection the course to be pursued
+varies from that indicated in the acute and subacute varieties. We have
+here little or no constitutional disturbance, and need have no fear of
+doing any harm by strong currents. On the contrary, I have found that
+mild currents rarely do any good. By far the greater majority of the
+cases that have come under my observation were of the muscular type, the
+algic portion of the symptoms approaching those of neuralgia rather than
+subacute rheumatism. Of chronic articular rheumatism I have treated but
+very few cases. Although in some of the cases the treatment under
+consideration was attended with brilliant results, I freely admit that
+in some instances the results were imperfect, in others again entirely
+negative. This I found true more especially of cases that involved
+tendons. I must add, however, that in perhaps the greater majority of
+the unsuccessful cases the fault lay with the patients themselves, who,
+finding they were not benefited as rapidly as they had expected,
+discontinued treatment before this had had time to effect any thing.
+
+In accordance with a theory which I have formed in regard to the
+pathology of chronic rheumatism, and which I am not yet prepared to
+promulgate (nor is it necessary here), I have of late been in the habit
+of administering in this disease, baths calculated to stimulate as much
+as possible the circulation of the blood. The best manner of applying
+the baths to this end will be found further on, under "Inequalities of
+the Circulation." In addition to this I cause the galvanic (anode) as
+well as strong faradic currents to be applied to the affected parts by
+means of the surface board. Where there is any thickening, effusion or
+other similar concomitant of the disease, iodine may be added, as
+hereinbefore directed.
+
+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 diarrhoea. 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
+an�mic 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.
+
+    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."
+
+    When Mr.�S. came to consult me, he had but lately returned from
+    Europe, whence, he stated, his physicians had sent him home to
+    die. His complexion was sallow, sickly; skin of face plentifully
+    wrinkled; features wearing the air of suffering and anxiety that
+    so frequently accompanies painful chronic conditions. He had for
+    some time past suffered from excessive cerebro-spinal
+    irritability, for the relief of which cantharidal collodion had
+    been employed in the cervico-spinal region (the same had also
+    been used in the hepatic region, to meet the diagnostic views of
+    some one of his medical attendants). He had a remittent chronic
+    intestinal catarrh, with--noticeably during the periods of
+    exacerbation--abundant discharge of a glairy mucus. The appetite
+    was very capricious--not to say poor, and he was obliged to be
+    exceedingly careful in his diet. He was not capable of any
+    continued mental application. The muscular system was weak and
+    flabby. All the vegetative functions were more or less impaired.
+
+    On June 3d, 1874, Mr.�S., by my directions, took an electric
+    bath. He continued the baths daily for some weeks; then every
+    two or three days, all the time steadily improving. He had some
+    adjuvant medicinal treatment, probably similar to what he had
+    already had in Europe. He states, however, that his improvement
+    commenced with the first bath he took; and the baths certainly
+    constituted the main treatment throughout. He gained daily in
+    every respect. Mind and body were invigorated; his muscles
+    increased in size and hardness; color gradually returned to his
+    cheeks, etc. He continued the baths with more or less regularity
+    until the close of the year, taking in all sixty-one baths. He
+    was then in a better condition than he had been for many years.
+    Thinking a trip to Europe would benefit him, I advised him to go
+    there and remain a few months. He left early in January and
+    returned in the beginning of April, 1875. He had been very well
+    during his absence, until within a few weeks prior to his
+    departure from Europe, when he experienced a severe attack of
+    cerebro-spinal congestion, which caused him much suffering. On
+    his return he resumed the baths, and continued them throughout
+    the spring, continually gaining in strength and weight. At the
+    beginning of last summer he was practically well. He has
+    regained his normal weight (120 pounds). As a criterion of his
+    bodily vigor, I will simply state that I have seen him lift,
+    with ease, 350 pounds, which, for a person of his weight, is not
+    bad. His mental force is as good as it has ever been. The
+    digestive disturbances have disappeared; he can eat things which
+    for years he had been compelled to eschew. To use his own words:
+    "I am well." In view of the fact that he had already received,
+    at the hands of competent men, all sorts of internal as well as
+    external treatment, I believe I am justified in attributing his
+    cure almost entirely if not solely to the baths.
+
+    CASE XI. Mr. *�*�*, aet. about 50, lawyer, of large, vigorous
+    frame, came to consult me January 4th, 1875. He complained of
+    symptoms that are the frequent results of prolonged mental
+    over-taxation. His intellect was as good as ever, but he lacked
+    his wonted mental endurance and power of application. His mind
+    was perfectly clear, but unable to work. It was a case of
+    "_limited_ cerebral exhaustion." Physical nutrition was pretty
+    good; yet his color was not normal, being rather paler than it
+    had been and has since become again. His flesh was flabby. There
+    were vague neurotic disturbances, etc., etc. He had until
+    recently occupied a leading public position, and the onerous
+    duties that devolved on him in connection with this, evidently
+    stood in direct etiological relation to his trouble. I ordered
+    an electric bath every other day. This was complied with until
+    the end of February, when the patient had apparently entirely
+    recovered his health, mentally as well as physically. I saw him
+    not very long ago; he looked the picture of health, and told me
+    that he was and had been since I saw him, perfectly well in
+    every respect.
+
+    CASE XII. Mr.�L., aet. 23, presented himself for treatment in
+    October, 1874. He had at various times made the attempt to study
+    some profession, but had never been able to concentrate his mind
+    sufficiently on any object to enable him to persevere in its
+    pursuit. He was fretful, irritable and vacillating; would desire
+    one thing to-day, another to-morrow; never long of the same
+    mind. Melancholia, digestive disturbances and hypochondriacal
+    phenomena accompanied this condition. No organic disease was
+    discoverable. On October 1st he took his first bath. Very
+    shortly after this he commenced the study of medicine. He
+    improved rapidly in every respect. During the month of October
+    he had six baths, which resulted in complete and permanent
+    relief of all the symptoms. He progressed satisfactorily in his
+    studies, and is at the present time taking his second course in
+    one of our city medical colleges.
+
+
+                               AGRYPNIA.
+
+                      (INSOMNIA; SLEEPLESSNESS).
+
+Although, as a rule, but the symptom of some definite pathological
+condition, agrypnia is of such frequent occurrence, and so detrimental
+to the general health, that it appears to me to merit special
+consideration. This holds good especially in this connection, because,
+even where electric baths fail to influence the disease giving rise to
+the insomnia, they almost invariably remove this, irrespective of its
+cause. Even where, the disease itself remaining uncured, the insomnia
+must return sooner or later, the sleep is very much improved while the
+baths are being had recourse to. We must of course endeavor in all cases
+to relieve the original disease, and, where the baths are not adapted to
+this purpose, resort to other and appropriate means. It will be found of
+no small service to us in the therapeutical management of every case, to
+be enabled to procure for the patient, without the aid of medicinal
+hypnotics, sufficient of sleep during treatment.
+
+    CASE XIII. Mr.�A., from the _clientele_ of Dr. LEONARD WEBER,
+    was sent by Dr.�W. to take electric baths. He suffered from
+    chronic spinal congestion. Among the most prominent and annoying
+    symptoms was _agrypnia_. It was for the relief of this symptom
+    chiefly that Dr.�W. ordered him the baths. He began to improve
+    in this respect from the time he took his first bath, and
+    although the disease itself remained uncured, he enjoyed good
+    sound sleep while he was under treatment, his general health
+    improved, and he frequently spoke of the notable benefits that
+    he received from the baths. He continued them until his
+    departure for Europe, where, by direction of his physician, he
+    went last spring. I have not seen him since, but Dr.�W. tells me
+    that he is doing well.
+
+    CASE XIV. Mr.�D. was brought on Sept. 30th, 1874, by his
+    physician, Dr. HOGAN. He was in the incipient stage of _delirium
+    tremens_. Had not slept for some nights. Dr.�H. had administered
+    successively opiates, chloral and bromides in full doses,
+    without effect. On the evening of above date the patient had a
+    bath, in which the descending galvanic current was used. As a
+    result, he slept well that night. The baths were repeated on the
+    two succeeding days, with like effect. As the disease developed
+    however it became necessary to send the patient to an asylum,
+    whence he returned cured in a short time. The effect of the
+    baths in this case, where full doses of the most powerful
+    hypnotics of the materia medica had failed, was remarkably
+    illustrative of their hypnotic power.
+
+
+                                AN�MIA.
+
+As is well known to the profession, an�mia forms the basis of a great
+number of morbid conditions. Hysteria, general debility, emaciation,
+sterility, various nervous affections, phthisis, in short, a perversion
+of almost any of the various physiological functions may be the direct
+result of an�mia. On the other hand, an�mia may be only a symptom or
+sequel of some other morbid condition--but of such cases I do not now
+speak. I have to do here only with those cases where an�mia is the
+primary and etiological of a group of symptoms, and where therefore it
+is to this that the treatment must be mainly directed. Now let us see
+what this treatment is. Dr. FLINT[15] suggests the following therapeutic
+measures: "_first_, a nutritious alimentation, into which meat should
+enter largely; _second_, the use of tonics and stimulants to render the
+digestive functions more active; _third_, iron as a special remedy--the
+effect of which is often remarkable; and, _fourth_, a regimen calculated
+to increase the energy of the assimilative functions, consisting of
+exercise in the open air, recreation, etc." This agrees mainly with the
+views of other writers. It may conveniently be condensed under two
+heads, instead of four, namely: _first_, to secure for the patient
+appropriate food and adopt the best means to insure its assimilation;
+_second_, the administration of iron. As to the ingestion of appropriate
+food, open air exercise, etc., patients are of course to receive the
+necessary directions. The remainder of the therapeutic indications, as
+given above, are admirably met by electric baths. As we have seen in a
+preceding chapter (p. 43 et seq.), they are a tonic and stimulant of the
+first order, and as nearly as possible a specific for the furtherance of
+the digestive and assimilative processes. When impregnated with iron,
+they constitute a treatment for an�mia which, in conjunction with the
+requisite diet and other hygienic measures, is inferior to no other. It
+will moreover be found very efficacious in counteracting secondary
+an�mia, and thus, by maintaining the general strength of the patient,
+often enable nature and appropriate treatment to cope successfully with
+the original disease.
+
+    CASE XV. Mrs.�S., aet. 22, four years married. I was called to
+    see her on October 2d, 1874. She then had a spontaneous
+    miscarriage, the fifth since her marriage. She asked me whether
+    nothing could be done to enable her to carry a child to full
+    term, as both she and her husband were very desirous to have
+    offspring. In pursuance of my directions, she presented herself
+    at my office about ten days after I first saw her. On
+    examination I found no organic trouble, no uterine displacement,
+    nor any other local trouble to account for her premature
+    confinements. Involution had progressed normally. The only
+    deviation from the normal that I could discover about the uterus
+    was undue paleness of the cervical portion. Her appearance was
+    very decidedly an�mic; features pale, flabby; lips whitish blue;
+    physical energy much depressed. She had had but very slight loss
+    of blood on the occasion of her recent miscarriage; certainly
+    not enough to account for her an�mic appearance. Viewing her
+    case as one of idiopathic an�mia, I ordered her electric baths
+    strongly impregnated with iron. In addition to this, the regimen
+    usual in such cases, and also strychnia and phosphorus
+    internally. She took her first bath on Oct. 14th; then one bath
+    weekly until she had taken six baths, the last of which was
+    administered on the 24th of November. During all this time she
+    kept steadily improving. The an�mic appearance and symptoms
+    gradually receded, and, soon after she had taken her last bath,
+    I discharged her, as far as the an�mia was concerned--cured.
+    While she was under treatment she had, by my advice, refrained
+    entirely from sexual intercourse. Early in the spring of 1875
+    she called to tell that she was again pregnant, and in November,
+    1875, I delivered her of a healthy male child, at full term.
+
+
+                        PARALYSES AND PARESES.
+
+I include these under one head, because not only is their origin
+frequently identical, but, chiefly, because the therapeutic indications
+are almost always the same in both. Whatever the cause in any given
+case, whether cerebral, spinal or peripheral, organic or functional;
+whatever the treatment that may be indicated--and this should never be
+neglected--for the primary trouble, the direct electrical treatment of
+the paralysis, sub-paralysis or paresis, being purely _symptomatic_
+treatment, remains in the great majority of cases essentially the same.
+The objects to be aimed at are two, viz: _first_, a normal state of
+nutrition of the affected muscles; _second_, their normal contractility.
+In other words, we are to endeavor to prevent atrophy of the affected
+muscles, or, where this has already taken place to some extent, to
+restore their normal bulk; and, _second_, we must strive to restore the
+more or less impaired contractility of the paralytic or paretic muscles.
+Even where symptomatic treatment for these purposes is the _only_
+treatment employed in a case, we frequently meet to a great extent the
+_indicatio morbi_, by favorably influencing, either in a reflex or
+direct manner, the primary disease. This is true of _local_
+electrizations of the affected parts; it holds good much more strongly
+however of _electric baths_, because here, in addition to the reflex
+influence that we get from local applications, we have also the direct
+influence of the electric current on the spinal cord and posterior
+portion of the brain not only, but on the sympathetic system and all the
+important organs contained in the thoracic and abdominal cavities. The
+great importance of this is apparent, when we reflect that in very many
+if not most cases of disease of the nervous system, central or
+peripheral, electricity in an appropriate form is a useful therapeutic
+agent, and that moreover the great majority of functional paralytic
+disorders respond favorably to its influence. As for any harm being done
+by it in those rare cases where its use may be contra-indicated, I admit
+that such may accrue from the administration of electric baths without
+medical supervision; it is entirely obviated however where the baths are
+under the supervision of a physician, who does not, like a layman,
+indiscriminately admit to their use any and everybody who is willing to
+pay for their administration, but will carefully discriminate, and
+conscientiously exclude those cases in which general electrization might
+result injuriously. In such cases a tolerably accurate diagnosis is as
+a rule readily made, and will enable the physician to separate the
+suitable from the unsuitable cases.
+
+As to the mode of administration of the baths in cases of the class
+under consideration, the use of both currents is requisite; the galvanic
+as a nutrient, the faradic as an excito-motor agent. Where, as is
+sometimes the case, faradic irritability is extinct, or so slight as to
+be practically unavailable, the (slowly) interrupted galvanic current
+must take the place of the faradic, until faradic irritability has
+become re-established. As to the intensity, direction, etc., of the
+currents, each individual case has its own laws, which must be
+recognized by the supervising physician.
+
+    CASE XVI.--_Infantile paralysis._ Albert Pichl, aet. 22 months,
+    was sent me by Dr. LILIENTHAL, October 3d, 1874. Had complete
+    paralysis of right leg (of four weeks standing), with
+    considerable atrophy of the entire leg as well as the gluteal
+    region of the corresponding side. The temperature of the leg was
+    much lower than that of the healthy limb. _Faradic irritability
+    was entirely extinct._ The treatment was begun by galvanizations
+    of the lower (lumbar and sacral) portion of the spinal cord, and
+    the use of the interrupted galvanic current on the affected
+    muscles. This was at first done daily. The contractility of the
+    muscles gradually but slowly improved, but neither the atrophy
+    nor temperature of the limb appeared visibly affected by the
+    treatment. With a view to favorably influencing these
+    conditions, I ordered him galvanic baths. He had a bath every
+    alternate day. The result was favorable and rapid. The leg
+    became sensibly and permanently warmer after each bath, and
+    commenced steadily to increase in bulk. Faradic irritability
+    soon returned. The local applications were continued several
+    times a week for some time, and then gradually abandoned, the
+    baths being meantime continued regularly. The boy very soon
+    began to walk, and in December active treatment was
+    discontinued. At that time, faradic irritability having long
+    since become completely re-established, I caused the child's
+    father to purchase a faradic battery to use at home. The limb
+    was eventually entirely restored in every respect, with the
+    exception of a slight abduction of the foot, for which I
+    referred the patient to Dr. GIBNEY. I saw the child recently; he
+    remains well.
+
+    CASE XVII.* _Sub-hemiplegia from cerebral hemorrhage._ Mrs.�S.,
+    aet. 30, married, from the practice of Dr. KREHBIEL, was sent by
+    Dr.�K. to take baths, July 3d, 1874. It was a routine case,
+    differing in no respect from what is ordinarily witnessed as a
+    sequence of cerebral hemorrhage. Six baths, taken at intervals
+    of two and three days, restored almost entirely the muscular
+    power of the affected side. The patient subsequently made a
+    complete recovery without further treatment.
+
+    CASE XVIII. _Paralysis from insolation._ Mr.�P., proof-reader
+    aet. about 40, had suffered for some time from sub-paraplegia,
+    the result of insolation. He was sent to take baths in May,
+    1874, by his physician, Dr. SCHIRMER. Electro-balneological
+    treatment in this case met with no success.
+
+    CASE XIX. _Lead paralysis._ Mr.�M., aet. about 35, painter, was
+    referred to me for treatment May 15th, 1874, by Dr. MOHN. The
+    extensors of one (I believe it was the right) arm were
+    paralyzed. The characteristic blue line about the gums was
+    clearly defined. I ordered an electric bath daily. The
+    descending galvanic current was used for twenty minutes each
+    bath. From half to one ounce of iodide of potassium was added to
+    each bath. The blue line became less distinct from day to day,
+    until, after eleven baths, it had entirely disappeared. The
+    object for which I had ordered the baths having now been
+    accomplished, I treated the affected muscles with the faradic
+    current. A short course of this treatment sufficed to remove the
+    paralysis from all but one finger (it was either the middle or
+    ring finger), the extensors of which had probably undergone
+    fatty degeneration.
+
+
+                              NEURALGI�.
+
+The great variety of causes that may give rise to neuralgia, precludes
+the possibility of any specific for this symptom. In discussing its
+electro-balneological treatment, I would observe _a primo_ that I
+cannot, in the light of my personal experience, agree with those who
+claim for electrical treatment good results in a _majority_ of
+cases.[16] On the other hand it cannot be denied that, either as a
+palliative or curative measure, electricity, employed in an appropriate
+form and manner, is of inestimable value in many cases, and frequently
+succeeds where all other remedies are of no avail. Where we know the
+cause of a neuralgia, it is of course comparatively easy for us to
+determine whether or not electricity promises to avail anything. But
+even where the nature of the cases appeared to indicate its use, the
+failures, in my hands at least, have outnumbered the successes. The
+brilliant results--sometimes almost instantaneous--that we obtain now
+and then, should not lead us into overlooking our failures. Undoubtedly
+the circumstance that most of the cases that have come under my
+observation were of a very obstinate nature, referred to me by other
+physicians after varied unsuccessful treatment, has much to do with the
+formation of my views as expressed above, and future experience may
+perhaps lead me to modify them.
+
+Speaking still from my own experience, I will state that the cases that
+have proven the most amenable to treatment were, _first_, those of
+rheumatic origin; _second_, hysterical neuralgi�, and, _third_, cases
+where no assignable cause could be elicited. The most obstinate
+varieties were those of a malarial type (even when quinine in large
+doses or arsenic were employed in conjunction with galvanism) and those
+that depended on some form of chronic inflammation--_neuritis_,
+_periostitis_, etc. Of central neuralgi�, I have had excellent results
+in the sympathetic variety and in the pains of posterior spinal
+sclerosis, while in the neuralgi� of cerebral origin (diffuse cerebral
+sclerosis, tumors, etc.) I have never met with any appreciable success.
+
+Where, then, we are able accurately to diagnose a case, there cannot be
+much doubt as to the appropriateness or not of electrical treatment, and
+in cases whose origin is obscure, which may be considered practically
+functional and therefore treated more or less empirically, electricity
+holds out as much or more hope than any other remedy. Whether
+electricity should be employed locally or in the form of baths, must
+depend on the features presented by each individual case. In neuralgia
+of the fifth pair--excepting those reflex cases where the _point
+d'origine_ is to be sought for somewhere in the trunk or extremities,
+and those that depend on cerebral hyper�mia or an�mia, where the
+equalizing effects of the baths on the circulation are frequently of
+great benefit--these are generally useless. Of other neuralgi�, I have
+found the baths less successful in those of the superior than in those
+of the inferior spinal nerves. Lumbo-abdominal neuralgia and sciatica
+have yielded much more readily than brachial or dorso-intercostal
+neuralgia, etc., etc.
+
+The mode of administering the baths in neuralgi� does not possess enough
+of uniformity to render suggestion in this respect of any value. I will
+state however that, as a rule, the best results have been obtained from
+the descending galvanic current.
+
+In chronic cases the baths should be administered daily, and should not
+be discarded as unavailing until at least a dozen have been successively
+taken.
+
+    CASE XX. _Sciatica._ Mr.�R., a middle aged man, mechanic, was
+    sent by Dr. ARCULARIUS Nov. 9th, 1874. Had post-rheumatic
+    sciatica of some six weeks' standing. There were no remarkable
+    features about the case, which however was sufficiently severe
+    to disable him from pursuing his avocation. He took his first
+    bath on the date above-mentioned. Another bath was administered
+    next day, and three more every alternate day. He was then almost
+    well. On Nov. 25th he returned, there remaining still some
+    traces of the affection. Four more baths, the last of which was
+    administered on Dec. 4th, sufficed to complete the cure.
+
+    CASE XXI. _Sciatica._ Mr.�G., aet. about 35, saddler, was sent
+    by Dr. WAECHTER, March 6th, 1875. Had suffered from sciatica
+    without discoverable cause for several years. For one year prior
+    to his visit had been unable to work, and was confined to bed a
+    great portion of the time. There was slight atrophy of the
+    affected limb. He had had considerable medical (including local
+    electrical) treatment, without avail. The baths were faithfully
+    and persistently tried in this case, effecting however but
+    slight improvement. Subsequent hypodermic injections, first of
+    strychnia, then of atropia and finally of chloroform, the latter
+    in doses ranging from 30 to 60 minims, gave him only temporary
+    relief. The patient was finally discharged uncured.
+
+    CASE XXII. _Lumbo-abdominal neuralgia._ Mr.�W., aet. about 40,
+    was brought by Dr. MARVIN S. BUTTLES in June, 1875. He had been
+    in poor health for a number of years, and was then in a very
+    cachectic condition. There was considerable gluteal atrophy on
+    the affected side. At Dr.�B.'s suggestion he took a course of
+    electric baths, with the happiest result. He improved steadily,
+    and on the occasion of a late inquiry after I had not seen him
+    for some months, Dr.�B. told me that the patient had entirely
+    recovered. His general condition as well as the neuralgia had
+    been very favorably modified by the baths, and he is now in far
+    better health than he has been for many years.
+
+    CASE XXIII.--_Lumbo-abdominal neuralgia._ Mr.�G., aet. 40, came
+    to consult me in October, 1875. He had suffered from neuralgic
+    pains, more particularly in the renal region of both sides, but
+    also in the neighboring parts, for only one week. The case being
+    so recent, I entertained a very favorable prognosis, which
+    subsequently was amply verified. A bath on the 12th of October
+    and one on the 16th sufficed to effect a complete cure.
+
+
+                         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.
+
+
+                              IMPOTENCY.
+
+The frequent obstinacy of this distressing condition under every variety
+of non-electrical treatment, is the cause of the frequency with which
+cases present themselves to the specialist. Unfortunately however but
+few of the referred cases are of recent origin. In almost all instances
+they have gone through a vast amount of medication and other treatment,
+and finally, either through their attending physicians or of their own
+accord, they come as a _dernier ressort_ to seek relief from electrical
+treatment. I have already (p. 47) spoken of the comparative merits in
+this disease of local and general electrization. A few years ago I was
+ignorant of the good effects of the baths in male impotency. I came to
+test and employ them here from two causes. In the first place, patients
+were sent me specially for electro-balneological treatment, ordered by
+their physicians; and, second, I began, when I became familiarized with
+the effects of the baths, to have recourse to them in cases where with
+local electrical and other treatment I had been unable to accomplish
+anything. My average results, without becoming uniformly successful,
+became so very much better, that after a brief but abundant experience
+with this treatment, I have come to consider it the most important we
+possess in this affection; one that will frequently succeed when
+everything else, including local electrization, has failed, and which,
+in cases where no incurable organic changes underlie the affection,
+will, if properly persisted in, either cure or improve to a great extent
+a large majority of the cases. I have even seen instances where, the
+sexual power having receded as the legitimate result of advancing age,
+it returned almost or quite perfectly and with seeming permanency under
+the influence of the baths. In the class of cases--and they are quite
+numerous--in which impotency (loss of the power of erection) occurs as a
+purely nervous symptom in comparatively young men; where its cause is
+sometimes purely imaginative, at others the result of early excesses,
+the baths are attended with the most gratifying average results. Where
+the cause is purely psychical, a very few baths are sometimes sufficient
+to dispel the morbid phenomena. Where masturbation or excessive venery
+are at the bottom of the trouble, there is always a probability of more
+or less organic change in the lower portion of the spinal cord, and
+frequently also a secondary enfeeblement of the digestive functions,
+which render requisite a long and steadily continued use of the baths.
+Patients whose sexual power was intact, who took the baths for other
+purposes, have time and again called my attention to their aphrodisiac
+effects.
+
+While here the _general_ electric influence is the main remedial agency,
+there is no reason why the possible--or, I should say, probable--good to
+be obtained from its _local_ influence should not be realized--the less
+so that it is so facile to obtain this in the bath, by means of the
+surface board. While individual cases will undoubtedly call for
+modifications, I have found the following plan to answer best in
+certainly more than half the cases that have come under my observation:
+The first five minutes of the bath may be occupied by a general galvanic
+current of medium intensity, _descending_ where the patient is of an
+irritable, _ascending_ where of a phlegmatic temperament. The pole
+connected with the foot electrode should now be detached, and the
+surface board substituted. The second five or ten minutes may be
+consumed by running a galvanic current between the head electrode and
+the surface board, the latter applied alternately to the penis, scrotum,
+perineum and, where thought best, also to the lumbo-sacral region.
+Where, as is usual, the impotency is accompanied by a certain degree of
+cutaneous an�sthesia of the penis, but especially where the seminal
+secretion is scanty, the board should be positive (ascending current);
+where however nocturnal spermatorrhoea, premature discharges (before
+coition is possible) or other irritable phenomena characterize a case,
+the surface board should be negative (descending current). The head of
+the patient should rest on a sponge thoroughly saturated with water, and
+communicating with the water of the bath, so as to include the
+cerebellum in the direct circuit. The last five or ten minutes of the
+bath should be devoted to passing the faradic current between the head
+electrode and the surface board, this last applied about the genitals,
+but chiefly about the perineum, the current to be of sufficient
+intensity to contract the perineal muscles. With an�mic patients iron
+should be added to the baths. These should be taken at first daily,
+later on every other day, then three times a week, and so on until it
+becomes apparent that all the good that can be obtained from them has
+been obtained--whether this be a perfect cure or only a certain degree
+of improvement. Where it is thought requisite, internal medication and
+various hygienic measures may be advantageously resorted to as
+adjuvants. While these will do no good when employed alone, they may
+serve to enhance the effects of the baths.
+
+In the following cases, I will include some where the impotency was not
+perfect, where the conditions were merely those of sexual debility. As
+there is here merely a difference in degree, it would be superfluous to
+separate the two conditions under distinct heads.
+
+    CASE XXV.* _Perfect impotency._--Mr.�F., from the practice of
+    Dr. CARO, a robust gentleman, aet. thirty-six, full of muscular
+    vigor. Had had syphilis, the symptoms of which had disappeared
+    under Dr.�C.'s treatment. For two years the power of erection as
+    well as sexual appetite had become extinct--if we except an
+    occasional imperfect spontaneous erection on waking up in the
+    morning, and even this was of rare occurrence. Ordinary
+    medication proving inadequate, Dr.�C. sent patient to take
+    electric baths. From March 7th to July 16th, Mr.�F. used the
+    baths, averaging about two weekly. He was then, and still
+    remains, perfectly restored.
+
+    CASE XXVI. _Perfect impotency._ A.�E.�K., aet. 23, commercial
+    traveler, applied to me for treatment in the spring of 1873. His
+    general health was very good. He had masturbated but little. Had
+    been in full possession of his sexual power until almost
+    twenty-two years of age, when he found that, without assignable
+    cause, he had lost the power of erection. His general condition
+    being, as far as discoverable, perfect in every respect, I
+    instituted a local electrical treatment. This was continued for
+    some time without avail. Strychnia was then administered with no
+    better result, and after some months' treatment I told him that
+    I could do nothing for him. He remained without any treatment
+    whatever until the spring of 1874, when I advised him to try
+    electric baths. He took in all about half a dozen baths, which
+    resulted in his complete and thus far permanent restoration.
+
+    CASE XXVII. _Sexual debility._ Mr.�W., aet. 32, married,
+    manufacturer, consulted me in February 1875. Had gradually for
+    about a year past lost sexual power. Was able to perform the
+    marital act at rare intervals only, and when he did, felt
+    exhausted the whole of the succeeding day. I ordered him
+    electric baths. He took the first on February 22d, 1875. Between
+    this date and March 22d, he took six baths. The sexual power had
+    then fully returned. I must not omit to state that during the
+    time he was under treatment he took, by my direction, gr. 1/25
+    phosphorus twice daily, which may have somewhat accelerated the
+    result.
+
+
+                             CONSTIPATION.
+
+Atony of the _muscularis_ of the intestine is admittedly the direct
+cause, in most instances, of constipation. It is the condition known as
+"torpor of the bowels." It is ordinarily due to abnormal innervation of
+the parts. The inefficient innervation may be--and in females frequently
+is--reflex, or its cause may be sought for in the central nervous
+system. The condition of the voluntary abdominal muscles is likewise a
+factor in the alvine process. Sluggishness of the abdominal (portal)
+circulation is a not infrequent etiological concomitant of constipation,
+and, finally, the conditions grouped as "dyspepsia" may form the
+causative feature of a case. I have mentioned these different causes
+simply in order to account to some extent for the almost wonderful
+effects in this condition of electric baths. When we consider that in
+every one of the morbid conditions here enumerated, electricity is a
+very efficient remedy, and that for the resulting muscular atony it may
+be called a specific, it will not appear surprising that a mode of
+application which brings the electric influence to bear on both cause
+and effect--often on a combination of several of the causes enumerated,
+should be attended with such brilliant results. I have thus far met with
+no failure in the electro-balneological treatment of constipation.
+
+In the majority of cases the following method has proven the most
+efficient. The first ten minutes of the bath should be devoted to the
+administration of a galvanic current, as intense as can comfortably be
+borne by the patient. The one pole should be connected with the
+head-electrode, the other, by means of the surface board, applied
+alternately, to the epigastrium, chiefly, and to the hypogastric region.
+The current should a portion of the time be ascending, the rest
+descending. Occasionally the current should be rapidly reversed by means
+of the commutator, the intensity however having been previously reduced,
+in order to avoid too severe a shock; this will cause efficient
+contractions of the abdominal _parietes_, and probably also of the
+intestinal _muscularis_. The second ten minutes of the bath should be
+devoted to faradization, employed in the same manner as the previous
+galvanization, only that here the direction of the current is
+immaterial, and no reversals are requisite. The current should be of
+sufficient intensity to produce energetic but not painful contractions
+of the abdominal parietes.
+
+    CASE XXVIII. Mrs. *�*, aet. 55, in average health, without
+    however being robust, had suffered from constipation for about
+    thirty years. She had had every possible medicinal treatment,
+    with no avail. Nothing had ever ameliorated her condition.
+    Without the aid of a cathartic, her bowels moved but once every
+    week or ten days. She was of course compelled frequently to
+    resort to laxatives. In the fall of 1873 I ordered her electric
+    baths. She was not very energetic in anything, and this lack of
+    energy caused her to take the baths less frequently than I
+    desired her to. Had she taken them regularly, she would probably
+    have been restored in as many weeks as it took months to effect
+    her restoration. As it was, she took some thirty baths in the
+    course of about fifteen months. For nearly a year past she has
+    had a passage every day with the utmost regularity. No adjuvant
+    treatment was employed in this case.
+
+    CASE XXIX.* Emil Miller, a bright child two years of age, was
+    brought for treatment July 7th, 1874. He had suffered from
+    obstinate constipation almost from his birth. Had been under the
+    care of several physicians, but had never received any benefit
+    from treatment. Even with the aid of powerful cathartics, given
+    in doses suitable for an adult rather than a child, defecation
+    took place only once every three or four days, and was so
+    exceedingly painful as to elicit cries of pain from the child.
+    The feces were always hard and lumpy, and of an abnormally light
+    color. A digital examination per rectum revealed considerable
+    flaccidity. My diagnosis was _paresis of the muscularis of the
+    intestine_. I ordered faradic baths. On July 12th the first bath
+    was administered, and I must confess that the result was a
+    perfect surprise to me. True, I had expected a cure to take
+    place; but I had looked for gradual improvement, and was not
+    prepared for a result such as was here obtained. _From the time
+    the first bath was taken, defecation took place regularly once a
+    day, without pain; the feces became perfectly normal both as to
+    color and consistency, and the boy continues to the present day
+    to defecate regularly and in every respect normally._ To insure
+    permanency, the baths were continued, at first twice, then once
+    a week. They have now been discontinued for upwards of a year,
+    there being no occasion for their further use. No other
+    therapeutic measures, internal or external, were resorted to in
+    this case, nor was any change made in the diet of the child.
+
+
+                            HYDRARGYROSIS.
+
+The etiology of this condition requires no comment. I will simply relate
+a case illustrative of the eliminative effects of galvanic baths.
+
+    CASE XXX.* _Mercurial Stomatitis._ Mr.�S., about 35 years of
+    age, came to me for treatment in the fall of 1872. He then had
+    indurated chancre, two buboes and syphilitic sore throat. He had
+    had the chancre for six weeks before applying to me, but had
+    been, he said, ashamed to consult a physician. Before medication
+    had had time to make any impression on the disease, roseola
+    appeared. The syphilis was very obstinate in this patient,
+    compelling me to keep him under the influence of mercury for a
+    long time. In October 1873, the patient presented himself with a
+    very aggravated mercurial stomatitis. The customary remedies,
+    internal as well as external, made little or no impression on
+    the affection. On November 11th, I discontinued all other
+    treatment, and ordered a course of galvanic baths. He took his
+    first bath on the same day. This was repeated every alternate
+    day until six baths had been taken, when all symptoms of the
+    disease had disappeared. He has had no mercurial trouble since
+    then. The descending galvanic current from a zinc-carbon battery
+    was used throughout.
+
+
+                           LOCOMOTOR ATAXIA.
+
+Were it not for the remarkable results obtained in the following case, I
+should not have felt justified in devoting any space to an allusion to
+this formidable disease. I insert the case as it was published in No.
+216 of the "Medical Record." I have to add that the patient, some six
+months ago, suffered a relapse, which however is not nearly as
+aggravated as his former condition, nor are the symptoms so
+pathognomonic. I had a letter from him about a week previous to my
+writing this, in which he states that he intends soon to come to the
+city for the purpose of taking another course of treatment. Even if the
+treatment however has not had the effect of curing the disease--and this
+I do not claim for it, it has been of sufficient importance if it has
+resulted in arresting for a time its progress, giving the patient
+temporary comfort, and prolonging life. Further trial may possibly have
+better results--in more recent cases--with respect to permanency.
+
+    CASE XXXI.* Mr.�W., aet. 48, came to consult me January 12th,
+    1874. He had then felt the symptoms of locomotor ataxia for
+    about six years. Had been unable for several years to walk
+    without the aid of a cane. When walking he dragged his right
+    leg along in a semicircle, and was able to accomplish very short
+    distances only. There were almost complete an�sthesia and great
+    paresis of the bladder. The same conditions were observable in
+    regard to the bowels. An�sthesia of both lower extremities
+    existed, complete in every respect in the right leg, almost so
+    in the left. Dyspepsia and general debility and emaciation
+    accompanied the disease. Treatment was begun on January 15th. I
+    prescribed phosphorus and cod-liver oil, and passed a strong
+    galvanic current through the spine for probably ten minutes.
+    January 16th, a galvanic bath was administered. Towards the
+    close of the bath (which occupied twenty minutes), patient
+    thought he felt some sensation in his legs. The baths were taken
+    every two or three days, alternating with strong galvanizations
+    of the spine. While taking his second bath, patient remarked
+    that "his right leg felt warm for the first time in six years."
+    The treatment as described was continued for about six weeks,
+    during the latter part of which the local applications were
+    gradually diminished in frequency, the baths being continued
+    regularly. Medication was discontinued about this time. About
+    the middle of March. Mr.�W. was enabled to resume his occupation
+    (paymaster's assistant on the Erie Railway). His improvement had
+    been rapid and steady. All the symptoms gradually disappeared,
+    and in the beginning of April the patient was, with the
+    exception of some feebleness, consequent on his protracted
+    illness, as well as ever. He continues so to the present
+    day.[17] He still takes two or three baths a month, but has had
+    no other treatment since May (1874). He walks freely without a
+    cane, and talks jocosely of running footraces. All functions are
+    performed normally.
+
+    Although in this case the baths were not employed exclusively,
+    yet they predominated in the treatment; and if the judgment of
+    the patient, a very intelligent gentleman, is to be relied on, a
+    large share of the success is due to the baths.
+
+
+                               CACHEXI�.
+
+After what has been said in a preceding chapter of the tonic effects of
+electric baths, it would scarcely appear necessary to introduce the
+subject of cachexi�. If I do so nevertheless, it is only to be afforded
+the opportunity of relating the following case, which possesses
+sufficient interest to render its introduction here desirable. The first
+portion of it has already been published (Med. Record, No 216), but to
+this I have to add what occurred subsequently.
+
+    CASE XXXII.* _Mercurio-syphilitic Cachexia._--Mr.�L., aet. 27,
+    had primary syphilis about four years ago. Subsequently had
+    inveterate constitutional symptoms, for which he was under
+    medical treatment both here and in Europe. When he had sojourned
+    in the latter country some time, he was pronounced cured by his
+    physicians. He married, and returned to this country in the fall
+    of 1872. A few weeks after his return he fell into a gradual
+    decline, which confined him to the house--and part of the time
+    to bed--for eight months, during the latter portion of which he
+    had discontinued all medical treatment. It was with difficulty
+    that, assisted by his wife, he managed to reach my office. I
+    found him terribly enfeebled; greatly emaciated; sallow
+    complexion. He was much annoyed by rheumatic pains, which I
+    considered specific. His condition was so exceedingly low, that
+    I decided to postpone all medication until he should be
+    stronger. I ordered galvano-faradic baths, i.e. the galvanic
+    current in the bath as an eliminative, the faradic as a tonic.
+    The first bath was taken on November 20th, 1873. For one month
+    he took the baths, and nothing else. He was then so much
+    stronger, that I felt justified in instituting a mild specific
+    course of treatment, the baths being continued as theretofore.
+    At the end of two months the patient was nearly as strong as
+    ever, was able to resume his occupation, and had gained
+    twenty-seven pounds in weight.
+
+    Thus far this case was published as above stated. For the sake
+    of the interest attaching to it, I will now proceed to give its
+    further history. Mr.�L. remained to all appearances well until
+    July, 1874, when he commenced to suffer from headache and
+    constipation. On the 23d of August following, while I was absent
+    from the city, he presented himself to the gentleman who
+    attended to my practice during my absence, with paralysis of the
+    external rectus muscle of the left eye. He also consulted a
+    specialist, who pronounced the paralysis rheumatic. When I
+    returned from the country he presented himself for treatment. I
+    commenced a series of daily electric applications to the
+    affected muscle, which failed to respond to the faradic current,
+    but contracted very readily when the slowly interrupted galvanic
+    current was employed. As I had strong suspicions that syphilis
+    was at the bottom of the trouble, I also administered iodide of
+    potassium in gradually increasing doses--not however until
+    electrization and strychnia employed for some weeks had failed
+    to do any good. The administration of the iodide met with no
+    better success. The patient's general health gradually declined.
+    On October 22d, he complained of numbness in the left leg, which
+    gradually increased, the leg at the same time becoming paretic,
+    so that the patient required the aid of a cane for ordinary
+    locomotion. His condition now became rapidly worse. His
+    movements became ataxic. An�sthesia of the bladder, paresis of
+    this and the intestine, with obstinate constipation, loss of
+    appetite, emaciation, etc., rapidly supervened. I suspected the
+    development of _gummata_ on the meninges of the brain and cord,
+    and advised him to use the inunction cure, and to remain at home
+    until he should be well. This, on account of the business losses
+    which it involved, he was very much averse to doing. He
+    consequently proposed a consultation with an eminent physician,
+    which was had. This gentleman pronounced the case one of spinal
+    (either multiple or posterior) sclerosis, and discarded the
+    syphilitic theory. A consultation two days subsequently with
+    another physician had a like result. In deference to the opinion
+    of these gentlemen, I treated the patient in accordance with
+    their diagnosis. This was in the second week of November. The
+    patient became rapidly worse. He soon ceased to walk--he tumbled
+    about. After six days' treatment, considering his life in
+    imminent danger, I reiterated my advice to institute the
+    inunction cure, and the patient then acquiesced. Nov. 24th I
+    ordered a drachm of Unguent Hydrarg. to be used every evening; I
+    could not however prevail on the patient to remain at home
+    during the treatment. He continued to grow worse. Nov. 26th he
+    had complete retention from vesical paralysis, and sent for me
+    at night to relieve him. Thenceforth until he got nearly well he
+    was obliged to use the catheter regularly. A few days after
+    this, fortunately for himself, he fell down as he was leaving a
+    horse car, and sprained his ankle. I say _fortunately_, for this
+    accident _compelled_ him to remain at home. From this time he
+    began to improve. December 2d I substituted for the ointment a
+    twenty per cent solution of the oleate of mercury, of which he
+    used a drachm morning and evening. The improvement from this day
+    was exceedingly rapid. On the 4th of December he had regained
+    control of the bladder. The constipation, which had been very
+    obstinate, also began to yield. From this date he used the
+    oleate only once daily, and discontinued it entirely on the
+    14th. On the 10th he had already resumed his avocation, and the
+    same month absolutely danced at a ball. He took iodide of
+    potassium for a time after his mercurial course. He has since
+    been and is now in perfect health.
+
+
+                              DYSPEPSIA.
+
+The remedies for this disease are unfortunately so numerous, there is so
+much temptation to try another where one remedy has failed, that it is
+seldom or never that an uncomplicated case of dyspepsia applies for
+electrical treatment. As a rule, the disease that furnishes cause for
+referring a case to the specialist, is some nervous trouble secondary to
+the dyspepsia.
+
+In regard to the influence of electric baths on dyspeptic conditions,
+whether complicated or not, I can however speak unqualifiedly in their
+favor. I know of no one other remedy that can at all approach them in
+this respect. Whatever the secondary or other troubles of patients, any
+co-existing dyspepsia was in every instance either cured or greatly
+ameliorated. The improvement usually begins at once--after the first or
+second bath, and continues steadily. As I have not had occasion to treat
+by means of electric baths any uncomplicated cases of dyspepsia, I can
+adduce none. I may safely claim however for the baths a reliability and
+bespeak for them a confidence that I might claim or bespeak for no other
+remedy or plan of treatment whatsoever--assertions which would appear
+rash and venturesome, had I not at my command abundant clinical evidence
+to warrant my making them.
+
+
+                             MELANCHOLIA.
+
+A case of melancholia, highly illustrative of the effects in this
+condition of electric baths, came under my notice very recently. It may
+serve as a guide in the treatment of this and kindred conditions.
+
+    CASE XXXIII. Mr.�F., aet. 22, single, butcher, consulted me Oct.
+    21st, 1875, for melancholia and loss of memory, from which he
+    had suffered for upwards of a year. He had frequently
+    entertained the idea of suicide. A thorough examination revealed
+    no trouble of any of the viscera. All functions appeared normal.
+    He had never masturbated. There were no collateral symptoms to
+    furnish any evidence of organic cerebral trouble. I prescribed
+    phosphorus and strychnia, and galvanized the brain twice a week.
+    Two weeks of this treatment had completely negative results. I
+    then ordered electric baths. Four baths resulted in a complete
+    cure.
+
+
+                   INEQUALITIES OF THE CIRCULATION.
+
+As a very fruitful source of morbid conditions of almost every nature,
+abnormities of the circulation of the blood are well worthy our
+attention. As is the case with dyspepsia, so here likewise patients
+seldom present themselves for treatment unless some definite secondary
+pathological condition has supervened. We find these patients
+complaining of cold hands and feet, irregular and disturbed sleep,
+occasional local congestions, with vague, usually slight pains here and
+there, etc., etc. Where organic cardiac disease is at the bottom of the
+trouble, we cannot of course expect much permanent improvement. Although
+even here considerable relief is often afforded while the baths are
+being used, their discontinuance will in all probability be soon
+followed by a return of the former condition. Where, however, cases are
+not complicated by organic disease, where we have a "sluggishness" of
+the circulation, due either to vasomotor inertia or atony of the
+muscular coats of vessels, the electric bath will be found reliably
+efficient. I have already (p. 55) alluded to this subject, and explained
+the probable "mode of action" here of the baths. I will now offer some
+suggestions as to the best method of administering them with a view to
+equalizing the circulation.
+
+We must here seek to stimulate the vasomotor system, both central and
+peripheral; to give tone to the coats of vessels, both by direct and
+indirect electric influence; through counter-irritation to relieve
+internal congestions, by causing an afflux of blood to the skin. These
+objects are best attained by means of the galvanic current, which should
+be employed of sufficient intensity to produce a rubefacient effect. The
+faradic current acts in the same direction, but far less energetically,
+if we except the vessels near the surface, the muscular coats of which
+are probably more efficiently tonicised by this than by the constant
+current. The faradic current however is applicable here in another way,
+and for a very important object. I refer to the _mechanical_
+counter-action of a sluggish circulation, through the agency of
+prolonged muscular contraction. This mechanical effect is not of course
+peculiar to the faradic current; it is shared by gymnastic and other
+exercises; but obtained in any other way whatsoever (with the exception,
+perhaps, of _massage_, which is however much more troublesome as well
+as inferior, and moreover not always admissible) it involves, in order
+to produce perfect results, a considerable amount of bodily exertion,
+often beyond the physical power of persons who are in ill health, and
+bringing with it the risk of positive injury, through over-exertion,
+which with the _passive_ contractions obtained by means of the faradic
+current, is entirely obviated. By administering the _general_ faradic
+current in the bath, of sufficient intensity to _maintain_ muscular
+contraction as long as the circuit remains closed, any stagnant blood in
+the lower extremities will be efficiently forced into the general
+circulation. After from three to five minutes of this faradization, the
+surface board may be successively applied for a minute or two each to
+the arms, abdomen, pectoral and dorsal muscles. I believe the _best_
+results can be obtained by first going through the faradic process, then
+subjecting the patient to general galvanization, as above indicated, and
+concluding by another but brief faradization.
+
+
+                    AFFECTIONS OF THE SYMPATHETIC.
+
+Last, but not least, I have some remarks to offer on the treatment by
+the electric bath of certain affections of the sympathetic nerve. While
+I do not in any such cases accord to the baths the rank of an exclusive
+remedy or even a specific, their importance as an adjuvant is sufficient
+to entitle them to special consideration in this connection. In those
+neuroses of the sympathetic where electricity (galvanism) is indicated,
+the _greatest_ benefit can be obtained from local applications. On the
+other hand the baths, employed in addition to local applications, will
+be found a very important factor in the treatment, possessing, as they
+do, two advantages, viz: _first_, by their means, the electric influence
+is brought to bear--in a much less concentrated form it is true--on the
+entire sympathetic system, from the _ganglion impar_ to the _ganglion
+cervicale supremum_, and, by derived currents, on the cephalic ganglia
+also, at one and the same time; _second_, the rest of the body
+participates in the general nutrient and tonic effects of the bath
+equally with the sympathetic, the latter thus receiving a reflex benefit
+which local applications fail to furnish. There are, moreover, cases
+where hyper�sthetic conditions of the nerve do not admit of local
+applications, and where yet electricity is urgently called for. Thus I
+have at present under treatment a lad sixteen years of age, in whom both
+supreme cervical sympathetic ganglia as well as the ganglion impar were
+until recently so susceptible that the mere adjustment of the
+electrodes caused him great pain, while on the other hand he bore the
+baths exceedingly well. In such cases, electric baths, suitably
+administered, frequently constitute in conjunction with proper
+medication, the most useful treatment.
+
+As to the mode of administration in sympathetic neuroses of the baths,
+the most direct manner in which to influence the diseased nerve, is by
+connecting one pole of a _galvanic_ battery (I consider the faradic
+current next to useless here) to the head electrode, the other to the
+surface board, the latter applied portion of the time to the epigastrium
+(solar plexus), the balance to the coccyx (_ganglion impar_). This will
+include in the direct circuit the main portion of the sympathetic, the
+position in the tub of the bather bringing the cilio-spinal centre very
+close to the head-electrode. The direction of the current must be
+determined by the individual features presented by each case, as also
+the duration of the bath.
+
+    CASE XXXIV. Mr.�S., aet. 31, merchant, was referred to me April
+    3d 1874, by Dr. KREHBIEL. In January, 1874, Mr.�S., until then
+    in the enjoyment of good health, woke up one morning to find, as
+    he expressed it, "everything dark before his eyes." He groped
+    his way to the window, in order to open the blinds. When at the
+    window, he felt as though about to fall out--probably vertigo.
+    He soon returned to an apparently normal condition, and went
+    about his business as usual. A week after, he had a much more
+    serious attack, which he describes as follows: "I had been
+    playing whist during the evening (several hours), when suddenly,
+    without premonition, I felt as though a champagne cork popped
+    against the top of my head, inside. Accompanying this was an
+    indefinable sensation about the heart as though the blood all
+    rushed thence down to the feet. I did not lose consciousness;
+    did not fall. I trembled all over, and a great fear came over
+    me. Felt very weak all night; my pulse was very slow." About two
+    months subsequently, patient was referred to me, as above
+    stated. He then had an uneasy look; an indefinable continual
+    sense of fear; was excessively nervous in the forepart of the
+    day; had brief attacks of tremor--usually every alternate
+    morning, but not typical as to time of occurrence. The history
+    exhibited neither syphilis, malaria nor intemperance. Had never
+    had headache. Sleep good; appetite likewise. The most
+    pathognomonic symptom, however, related to his pulse. This was
+    abnormally slow, ranging from 44 to 54 (the latter only when
+    standing or after walking) per minute. It was full and regular.
+    There was no organic heart trouble. In the absence of any other
+    symptom whatsoever pointing to irritation of the pneumogastric
+    or spinal accessory, I was justified in excluding this as the
+    possible cause of the cardiac infrequency. On the other hand,
+    the pathogenetic manifestations appeared all to point to
+    "asthenia of the sympathetic"--at any rate the portion of this
+    whence the cardiac nerves take their origin, and I formed my
+    diagnosis accordingly. In the beginning, the treatment consisted
+    of bilateral ascending (from cilio-spinal centre to both mastoid
+    foss�) galvanizations of the sympathetic, and galvanic baths
+    (head electrode negative, surface board positive, to
+    epigastrium) on alternate days. Improvement in every respect was
+    steady, though not rapid. At the end of three weeks, I
+    supplemented this treatment by the administration of ergotin and
+    nux vomica. At the expiration of two more weeks, the patient
+    being nearly recovered, I discontinued these medicaments,
+    substituting the valerianates of zinc and iron, and steadily
+    maintaining meanwhile the electrical treatment as above
+    indicated. After a short time recovery appeared complete, and
+    patient was discharged from treatment. He returned however a few
+    months subsequently, complaining of "faint spells" in the
+    mornings, accompanied with excessive nervousness, and a renewed
+    though moderate cardiac infrequency. Electrical treatment,
+    similar to that above described, soon restored him. One or two
+    more slight relapses occurred during the next six months. For
+    over a year past however Mr.�S. has been in the enjoyment of
+    perfect and undisturbed health. His normal pulse ranges from 72
+    to 80.
+
+Whoever is familiar with the physiological effects of electric baths,
+will readily concede their great utility in a variety of conditions that
+I have not thus far specially alluded to. Of such I would mention
+ASTHENI�, ATONIC AND DEBILITATED CONDITIONS GENERALLY, including the
+state of CONVALESCENCE FROM ACUTE DISEASES and the DECLINE OF ADVANCING
+AGE; many cases of CHRONIC HEADACHE; some INCLASSIFIABLE CONDITIONS OF
+MARASMUS and MALNUTRITION, etc., etc. In all such cases, when purely
+functional and uncomplicated by incurable organic disease, good results
+may be confidently looked for.
+
+       *       *       *       *       *
+
+With these remarks I conclude my subject. Whichever the errors that a
+too limited experience may have engendered--and I doubt not there are
+many, I cannot on reviewing my work accuse myself of lack of candor nor
+yet of undue enthusiasm. I have cited but a small proportion of the
+successful cases whereof I possess records; still I believe that I have
+adduced amply sufficient clinical proof of the great value as a remedial
+agent of electric baths, and of the desirability of their more general
+adoption. I would more especially call attention to the
+inappropriateness of deferring their employment until almost all other
+remedies have been exhausted; and when I reflect that pretty much all
+those cases that had been referred to me by other physicians had already
+had the doubtful benefit of almost every other conceivable treatment,
+while many of those who came of their own accord, had in addition made
+the rounds of all the quacks, and exhausted nearly all the nostrums that
+are to be found advertised in the columns of our daily papers, the
+wonder seems that the results obtained were as good as they have been. I
+sincerely trust that in the future physicians will avail themselves
+more frequently than heretofore of a remedy that is certainly capable of
+accomplishing much good; and I hope that in addition to myself there
+will be found others, more competent, to devote themselves to the study
+of the subject. To these, and perhaps to myself at a future time, I
+relegate the task of correcting my errors and promulgating hitherto
+undiscovered truths.
+
+
+    Footnotes:
+
+    [Footnote 10: Centralblatt f�r die medicinischen Wissenschaften,
+    No.�17, 1875.]
+
+    [Footnote 11: The apparatus used in these experiments was that
+    of Du Bois-Reymond, with a Grove's element.]
+
+    [Footnote 12: Since writing the above, this case has had an
+    entirely favorable termination.]
+
+    [Footnote 13: The cases distinguished by an asterisk were
+    published in No. 216 of the "Medical Record."]
+
+    [Footnote 14: Wherever I use the word "general" as descriptive
+    of an electric current used in the bath, it is not as a
+    characteristic, but merely to distinguish it from the instances
+    where the surface board is employed.]
+
+    [Footnote 15: Austin Flint, M.D. A Treatise on the Principles
+    and Practice of Medicine. Philadelphia, 1873. 4th ed. pp. 63 and
+    64.]
+
+    [Footnote 16: See Beard and Rockwell, op. cit., 2d ed. p. 472.]
+
+    [Footnote 17: This was written a year ago. See remarks preceding
+    the case.]
+
+
+
+
+                                INDEX.
+
+
+                            A.
+                                                  PAGE
+    Agrypnia                                        92
+    An�mia                                          93
+    Apparatus for baths                              7
+    Articular effusions                            105
+
+
+                            B.
+
+    Bath-tub                                         8
+    Batteries                                       16
+
+
+                            C.
+
+    Cachexi�                                       118
+    Chemicals in baths                              15
+    Chorea                                          80
+    Circulation, effects on                         55
+         "       inequalities of                   123
+    Clinical Record                                 61
+    Conductivity of water, etc.                     13
+    Constipation                                   112
+    Counter-irritant effects                        56
+
+
+                            D.
+
+    Debility, general                          129-130
+    Diagnostic uses                                 53
+    Digestive apparatus, effects on                 44
+    Dyspepsia                                      121
+
+
+                            E.
+
+    Electric Bath compared with other
+      electrical methods                            32
+    Electrodes                                      10
+
+
+                            G.
+
+    General Therapeutics                            52
+
+
+                            H.
+
+    Hydrargyrosis                                  115
+    Hypnotic effects                             38-58
+    Hysterical affections                           82
+
+
+                            I.
+
+    Impotency                                      106
+    Insomnia                                        92
+    Invigorant properties                           57
+
+
+                            L.
+
+    Locomotor Ataxia                               116
+
+
+                            M.
+
+    Melancholia                                    122
+    Mind, effects on                                51
+    Miscellaneous disorders                    129-130
+    Mode of administration                          19
+    Muscular contractions                           50
+
+
+                            N.
+
+    Nervous Exhaustion                              84
+    Neuralgi�                                      100
+    Neurasthenia                                    84
+    Nutrition, effects on                           59
+
+
+                            P.
+
+    Paralyses                                       96
+    Pareses                                         96
+    Physiological effects                           31
+    Prophylactic influence                          60
+    Pulse, effects on                               41
+
+
+                            R.
+
+    Rheumatism                                      67
+        "      acute                                68
+        "      chronic                              74
+        "      subacute                             73
+        "      cases of                             77
+
+
+                            S.
+
+    Sedative effects                             48-58
+    Sexual apparatus, effects on                    46
+    Sexual debility                                106
+    Sleep, effects on                               38
+    Special therapeutics                            61
+    Stimulant effects                               43
+    Surface board                                   14
+    Sympathetic, affections of                     126
+
+
+                            T.
+
+    Temperature, effects on                         41
+    Tonic properties                             43-57
+
+
+
+[Transcriber's Notes: The table below lists all corrections applied to
+the original text.
+
+p. 029: [normalized] the sub-acute symptoms -> subacute
+p. 056: GENERAL COUNTER IRRITANT -> COUNTER-IRRITANT
+p. 056: [normalized] the use of the surface-board -> surface board
+p. 059: does ... became apparent -> become apparent
+p. 067: [normalized] acute, sub-acute and chronic -> subacute
+p. 073: [normalized] bi-carbonate of soda or potassa -> bicarbonate
+p. 107: ordered by their physicians: -> physicians; ]
+
+
+
+
+
+End of the Project Gutenberg EBook of The Electric Bath, by George M. Schweig
+
+*** END OF THIS PROJECT GUTENBERG EBOOK THE ELECTRIC BATH ***
+
+***** This file should be named 26366-8.txt or 26366-8.zip *****
+This and all associated files of various formats will be found in:
+        https://www.gutenberg.org/2/6/3/6/26366/
+
+Produced by Bryan Ness, Markus Brenner and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+book was produced from scanned images of public domain
+material from the Google Print project.)
+
+
+Updated editions will replace the previous one--the old editions
+will be renamed.
+
+Creating the works from public domain print editions means that no
+one owns a United States copyright in these works, so the Foundation
+(and you!) can copy and distribute it in the United States without
+permission and without paying copyright royalties.  Special rules,
+set forth in the General Terms of Use part of this license, apply to
+copying and distributing Project Gutenberg-tm electronic works to
+protect the PROJECT GUTENBERG-tm concept and trademark.  Project
+Gutenberg is a registered trademark, and may not be used if you
+charge for the eBooks, unless you receive specific permission.  If you
+do not charge anything for copies of this eBook, complying with the
+rules is very easy.  You may use this eBook for nearly any purpose
+such as creation of derivative works, reports, performances and
+research.  They may be modified and printed and given away--you may do
+practically ANYTHING with public domain eBooks.  Redistribution is
+subject to the trademark license, especially commercial
+redistribution.
+
+
+
+*** START: FULL LICENSE ***
+
+THE FULL PROJECT GUTENBERG LICENSE
+PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK
+
+To protect the Project Gutenberg-tm mission of promoting the free
+distribution of electronic works, by using or distributing this work
+(or any other work associated in any way with the phrase "Project
+Gutenberg"), you agree to comply with all the terms of the Full Project
+Gutenberg-tm License (available with this file or online at
+https://gutenberg.org/license).
+
+
+Section 1.  General Terms of Use and Redistributing Project Gutenberg-tm
+electronic works
+
+1.A.  By reading or using any part of this Project Gutenberg-tm
+electronic work, you indicate that you have read, understand, agree to
+and accept all the terms of this license and intellectual property
+(trademark/copyright) agreement.  If you do not agree to abide by all
+the terms of this agreement, you must cease using and return or destroy
+all copies of Project Gutenberg-tm electronic works in your possession.
+If you paid a fee for obtaining a copy of or access to a Project
+Gutenberg-tm electronic work and you do not agree to be bound by the
+terms of this agreement, you may obtain a refund from the person or
+entity to whom you paid the fee as set forth in paragraph 1.E.8.
+
+1.B.  "Project Gutenberg" is a registered trademark.  It may only be
+used on or associated in any way with an electronic work by people who
+agree to be bound by the terms of this agreement.  There are a few
+things that you can do with most Project Gutenberg-tm electronic works
+even without complying with the full terms of this agreement.  See
+paragraph 1.C below.  There are a lot of things you can do with Project
+Gutenberg-tm electronic works if you follow the terms of this agreement
+and help preserve free future access to Project Gutenberg-tm electronic
+works.  See paragraph 1.E below.
+
+1.C.  The Project Gutenberg Literary Archive Foundation ("the Foundation"
+or PGLAF), owns a compilation copyright in the collection of Project
+Gutenberg-tm electronic works.  Nearly all the individual works in the
+collection are in the public domain in the United States.  If an
+individual work is in the public domain in the United States and you are
+located in the United States, we do not claim a right to prevent you from
+copying, distributing, performing, displaying or creating derivative
+works based on the work as long as all references to Project Gutenberg
+are removed.  Of course, we hope that you will support the Project
+Gutenberg-tm mission of promoting free access to electronic works by
+freely sharing Project Gutenberg-tm works in compliance with the terms of
+this agreement for keeping the Project Gutenberg-tm name associated with
+the work.  You can easily comply with the terms of this agreement by
+keeping this work in the same format with its attached full Project
+Gutenberg-tm License when you share it without charge with others.
+
+1.D.  The copyright laws of the place where you are located also govern
+what you can do with this work.  Copyright laws in most countries are in
+a constant state of change.  If you are outside the United States, check
+the laws of your country in addition to the terms of this agreement
+before downloading, copying, displaying, performing, distributing or
+creating derivative works based on this work or any other Project
+Gutenberg-tm work.  The Foundation makes no representations concerning
+the copyright status of any work in any country outside the United
+States.
+
+1.E.  Unless you have removed all references to Project Gutenberg:
+
+1.E.1.  The following sentence, with active links to, or other immediate
+access to, the full Project Gutenberg-tm License must appear prominently
+whenever any copy of a Project Gutenberg-tm work (any work on which the
+phrase "Project Gutenberg" appears, or with which the phrase "Project
+Gutenberg" is associated) is accessed, displayed, performed, viewed,
+copied or distributed:
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+1.E.2.  If an individual Project Gutenberg-tm electronic work is derived
+from the public domain (does not contain a notice indicating that it is
+posted with permission of the copyright holder), the work can be copied
+and distributed to anyone in the United States without paying any fees
+or charges.  If you are redistributing or providing access to a work
+with the phrase "Project Gutenberg" associated with or appearing on the
+work, you must comply either with the requirements of paragraphs 1.E.1
+through 1.E.7 or obtain permission for the use of the work and the
+Project Gutenberg-tm trademark as set forth in paragraphs 1.E.8 or
+1.E.9.
+
+1.E.3.  If an individual Project Gutenberg-tm electronic work is posted
+with the permission of the copyright holder, your use and distribution
+must comply with both paragraphs 1.E.1 through 1.E.7 and any additional
+terms imposed by the copyright holder.  Additional terms will be linked
+to the Project Gutenberg-tm License for all works posted with the
+permission of the copyright holder found at the beginning of this work.
+
+1.E.4.  Do not unlink or detach or remove the full Project Gutenberg-tm
+License terms from this work, or any files containing a part of this
+work or any other work associated with Project Gutenberg-tm.
+
+1.E.5.  Do not copy, display, perform, distribute or redistribute this
+electronic work, or any part of this electronic work, without
+prominently displaying the sentence set forth in paragraph 1.E.1 with
+active links or immediate access to the full terms of the Project
+Gutenberg-tm License.
+
+1.E.6.  You may convert to and distribute this work in any binary,
+compressed, marked up, nonproprietary or proprietary form, including any
+word processing or hypertext form.  However, if you provide access to or
+distribute copies of a Project Gutenberg-tm work in a format other than
+"Plain Vanilla ASCII" or other format used in the official version
+posted on the official Project Gutenberg-tm web site (www.gutenberg.org),
+you must, at no additional cost, fee or expense to the user, provide a
+copy, a means of exporting a copy, or a means of obtaining a copy upon
+request, of the work in its original "Plain Vanilla ASCII" or other
+form.  Any alternate format must include the full Project Gutenberg-tm
+License as specified in paragraph 1.E.1.
+
+1.E.7.  Do not charge a fee for access to, viewing, displaying,
+performing, copying or distributing any Project Gutenberg-tm works
+unless you comply with paragraph 1.E.8 or 1.E.9.
+
+1.E.8.  You may charge a reasonable fee for copies of or providing
+access to or distributing Project Gutenberg-tm electronic works provided
+that
+
+- You pay a royalty fee of 20% of the gross profits you derive from
+     the use of Project Gutenberg-tm works calculated using the method
+     you already use to calculate your applicable taxes.  The fee is
+     owed to the owner of the Project Gutenberg-tm trademark, but he
+     has agreed to donate royalties under this paragraph to the
+     Project Gutenberg Literary Archive Foundation.  Royalty payments
+     must be paid within 60 days following each date on which you
+     prepare (or are legally required to prepare) your periodic tax
+     returns.  Royalty payments should be clearly marked as such and
+     sent to the Project Gutenberg Literary Archive Foundation at the
+     address specified in Section 4, "Information about donations to
+     the Project Gutenberg Literary Archive Foundation."
+
+- You provide a full refund of any money paid by a user who notifies
+     you in writing (or by e-mail) within 30 days of receipt that s/he
+     does not agree to the terms of the full Project Gutenberg-tm
+     License.  You must require such a user to return or
+     destroy all copies of the works possessed in a physical medium
+     and discontinue all use of and all access to other copies of
+     Project Gutenberg-tm works.
+
+- You provide, in accordance with paragraph 1.F.3, a full refund of any
+     money paid for a work or a replacement copy, if a defect in the
+     electronic work is discovered and reported to you within 90 days
+     of receipt of the work.
+
+- You comply with all other terms of this agreement for free
+     distribution of Project Gutenberg-tm works.
+
+1.E.9.  If you wish to charge a fee or distribute a Project Gutenberg-tm
+electronic work or group of works on different terms than are set
+forth in this agreement, you must obtain permission in writing from
+both the Project Gutenberg Literary Archive Foundation and Michael
+Hart, the owner of the Project Gutenberg-tm trademark.  Contact the
+Foundation as set forth in Section 3 below.
+
+1.F.
+
+1.F.1.  Project Gutenberg volunteers and employees expend considerable
+effort to identify, do copyright research on, transcribe and proofread
+public domain works in creating the Project Gutenberg-tm
+collection.  Despite these efforts, Project Gutenberg-tm electronic
+works, and the medium on which they may be stored, may contain
+"Defects," such as, but not limited to, incomplete, inaccurate or
+corrupt data, transcription errors, a copyright or other intellectual
+property infringement, a defective or damaged disk or other medium, a
+computer virus, or computer codes that damage or cannot be read by
+your equipment.
+
+1.F.2.  LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the "Right
+of Replacement or Refund" described in paragraph 1.F.3, the Project
+Gutenberg Literary Archive Foundation, the owner of the Project
+Gutenberg-tm trademark, and any other party distributing a Project
+Gutenberg-tm electronic work under this agreement, disclaim all
+liability to you for damages, costs and expenses, including legal
+fees.  YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
+LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
+PROVIDED IN PARAGRAPH F3.  YOU AGREE THAT THE FOUNDATION, THE
+TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
+LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
+INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
+DAMAGE.
+
+1.F.3.  LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
+defect in this electronic work within 90 days of receiving it, you can
+receive a refund of the money (if any) you paid for it by sending a
+written explanation to the person you received the work from.  If you
+received the work on a physical medium, you must return the medium with
+your written explanation.  The person or entity that provided you with
+the defective work may elect to provide a replacement copy in lieu of a
+refund.  If you received the work electronically, the person or entity
+providing it to you may choose to give you a second opportunity to
+receive the work electronically in lieu of a refund.  If the second copy
+is also defective, you may demand a refund in writing without further
+opportunities to fix the problem.
+
+1.F.4.  Except for the limited right of replacement or refund set forth
+in paragraph 1.F.3, this work is provided to you 'AS-IS' WITH NO OTHER
+WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO
+WARRANTIES OF MERCHANTIBILITY OR FITNESS FOR ANY PURPOSE.
+
+1.F.5.  Some states do not allow disclaimers of certain implied
+warranties or the exclusion or limitation of certain types of damages.
+If any disclaimer or limitation set forth in this agreement violates the
+law of the state applicable to this agreement, the agreement shall be
+interpreted to make the maximum disclaimer or limitation permitted by
+the applicable state law.  The invalidity or unenforceability of any
+provision of this agreement shall not void the remaining provisions.
+
+1.F.6.  INDEMNITY - You agree to indemnify and hold the Foundation, the
+trademark owner, any agent or employee of the Foundation, anyone
+providing copies of Project Gutenberg-tm electronic works in accordance
+with this agreement, and any volunteers associated with the production,
+promotion and distribution of Project Gutenberg-tm electronic works,
+harmless from all liability, costs and expenses, including legal fees,
+that arise directly or indirectly from any of the following which you do
+or cause to occur: (a) distribution of this or any Project Gutenberg-tm
+work, (b) alteration, modification, or additions or deletions to any
+Project Gutenberg-tm work, and (c) any Defect you cause.
+
+
+Section  2.  Information about the Mission of Project Gutenberg-tm
+
+Project Gutenberg-tm is synonymous with the free distribution of
+electronic works in formats readable by the widest variety of computers
+including obsolete, old, middle-aged and new computers.  It exists
+because of the efforts of hundreds of volunteers and donations from
+people in all walks of life.
+
+Volunteers and financial support to provide volunteers with the
+assistance they need, is critical to reaching Project Gutenberg-tm's
+goals and ensuring that the Project Gutenberg-tm collection will
+remain freely available for generations to come.  In 2001, the Project
+Gutenberg Literary Archive Foundation was created to provide a secure
+and permanent future for Project Gutenberg-tm and future generations.
+To learn more about the Project Gutenberg Literary Archive Foundation
+and how your efforts and donations can help, see Sections 3 and 4
+and the Foundation web page at https://www.pglaf.org.
+
+
+Section 3.  Information about the Project Gutenberg Literary Archive
+Foundation
+
+The Project Gutenberg Literary Archive Foundation is a non profit
+501(c)(3) educational corporation organized under the laws of the
+state of Mississippi and granted tax exempt status by the Internal
+Revenue Service.  The Foundation's EIN or federal tax identification
+number is 64-6221541.  Its 501(c)(3) letter is posted at
+https://pglaf.org/fundraising.  Contributions to the Project Gutenberg
+Literary Archive Foundation are tax deductible to the full extent
+permitted by U.S. federal laws and your state's laws.
+
+The Foundation's principal office is located at 4557 Melan Dr. S.
+Fairbanks, AK, 99712., but its volunteers and employees are scattered
+throughout numerous locations.  Its business office is located at
+809 North 1500 West, Salt Lake City, UT 84116, (801) 596-1887, email
+business@pglaf.org.  Email contact links and up to date contact
+information can be found at the Foundation's web site and official
+page at https://pglaf.org
+
+For additional contact information:
+     Dr. Gregory B. Newby
+     Chief Executive and Director
+     gbnewby@pglaf.org
+
+
+Section 4.  Information about Donations to the Project Gutenberg
+Literary Archive Foundation
+
+Project Gutenberg-tm depends upon and cannot survive without wide
+spread public support and donations to carry out its mission of
+increasing the number of public domain and licensed works that can be
+freely distributed in machine readable form accessible by the widest
+array of equipment including outdated equipment.  Many small donations
+($1 to $5,000) are particularly important to maintaining tax exempt
+status with the IRS.
+
+The Foundation is committed to complying with the laws regulating
+charities and charitable donations in all 50 states of the United
+States.  Compliance requirements are not uniform and it takes a
+considerable effort, much paperwork and many fees to meet and keep up
+with these requirements.  We do not solicit donations in locations
+where we have not received written confirmation of compliance.  To
+SEND DONATIONS or determine the status of compliance for any
+particular state visit https://pglaf.org
+
+While we cannot and do not solicit contributions from states where we
+have not met the solicitation requirements, we know of no prohibition
+against accepting unsolicited donations from donors in such states who
+approach us with offers to donate.
+
+International donations are gratefully accepted, but we cannot make
+any statements concerning tax treatment of donations received from
+outside the United States.  U.S. laws alone swamp our small staff.
+
+Please check the Project Gutenberg Web pages for current donation
+methods and addresses.  Donations are accepted in a number of other
+ways including including checks, online payments and credit card
+donations.  To donate, please visit: https://pglaf.org/donate
+
+
+Section 5.  General Information About Project Gutenberg-tm electronic
+works.
+
+Professor Michael S. Hart was the originator of the Project Gutenberg-tm
+concept of a library of electronic works that could be freely shared
+with anyone.  For thirty years, he produced and distributed Project
+Gutenberg-tm eBooks with only a loose network of volunteer support.
+
+
+Project Gutenberg-tm eBooks are often created from several printed
+editions, all of which are confirmed as Public Domain in the U.S.
+unless a copyright notice is included.  Thus, we do not necessarily
+keep eBooks in compliance with any particular paper edition.
+
+
+Most people start at our Web site which has the main PG search facility:
+
+     https://www.gutenberg.org
+
+This Web site includes information about Project Gutenberg-tm,
+including how to make donations to the Project Gutenberg Literary
+Archive Foundation, how to help produce our new eBooks, and how to
+subscribe to our email newsletter to hear about new eBooks.
diff --git a/26366-8.zip b/26366-8.zip
new file mode 100644
index 0000000..212019d
--- /dev/null
+++ b/26366-8.zip
diff --git a/26366-h.zip b/26366-h.zip
new file mode 100644
index 0000000..e7c82af
--- /dev/null
+++ b/26366-h.zip
diff --git a/26366-h/26366-h.htm b/26366-h/26366-h.htm
new file mode 100644
index 0000000..b420abb
--- /dev/null
+++ b/26366-h/26366-h.htm
@@ -0,0 +1,4644 @@
+<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN"
+    "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
+
+<html xmlns="http://www.w3.org/1999/xhtml" lang="en" xml:lang="en">
+  <head>
+    <meta http-equiv="Content-Type" content="text/html;charset=iso-8859-1" />
+    <title>
+      The Project Gutenberg eBook of The Electric Bath, by George M. Schweig, M.D.
+    </title>
+    <style type="text/css">
+/*<![CDATA[  XML blockout */
+<!--
+    body {
+        margin-left: 10%;
+        margin-right: 10%;
+        }
+    p { margin-top: .75em;
+        text-align: justify;
+        margin-bottom: .75em;
+        text-indent: 1em;
+        }
+    h1,h2,h3,h4,h5,h6 {
+        text-align: center; /* all headings centered */
+        clear: both;
+        margin-top: 0em;
+        margin-bottom: 0em;
+        font-weight: normal;
+        }
+
+    h1 {
+        font-size: xx-large;
+        line-height: 180%;
+        margin-top: 1em;
+        margin-bottom: 0em;
+        letter-spacing: 0.3ex;
+        padding-left: 0.3ex;
+        }
+    h2 {
+        font-size: large;
+        margin-top: 1.5em;
+        margin-bottom: 0.75em;
+        }
+    h2.preface, h2.contents {
+        margin-top: 4em;
+        margin-bottom: 1.5em;
+        }
+    h2.index {
+        margin-top: 4em;
+        margin-bottom: 1.5em;
+        letter-spacing: 0.75ex;
+        padding-left: 0.75ex;
+        }
+    h3 {
+        font-size: 90%;
+        line-height: 150%;
+        margin-top: 1.5em;
+        margin-bottom: 0.75em;
+        }
+    h3.special {
+        font-size: large;
+        margin-top: 2em;
+        margin-bottom: 1em;
+        }
+
+    em.gesperrt {
+        letter-spacing: 0.35ex;
+        padding-left: 0.35ex;
+        font-style: normal;
+        }
+
+    hr {
+        margin-left: auto;
+        margin-right: auto;
+        margin-top: 0em;
+        margin-bottom: 0em;
+        clear: both;
+        height: 1px;
+        border: 0;
+        background-color: black;
+        color: black;
+        }
+
+    p.continued {
+        text-indent: 0em;
+        }
+    p.subtitle {
+        margin-top: 1.5em;
+        margin-bottom: 1em;
+        font-size: large;
+        line-height: 160%;
+        text-align: center;
+        text-indent: 0em;
+        }
+    p.by {
+        margin-top: 3em;
+        margin-bottom: 0em;
+        font-size: small;
+        text-align: center;
+        text-indent: 0em;
+        }
+    p.author {
+        margin-top: 0.5em;
+        margin-bottom: 0em;
+        font-size: large;
+        line-height: 140%;
+        text-align: center;
+        text-indent: 0em;
+        }
+    p.details {
+        margin-top: 0.7em;
+        margin-bottom: 0em;
+        font-size: small;
+        line-height: 160%;
+        text-align: center;
+        text-indent: 0em;
+        }
+    p.publisher {
+        margin-top: 0em;
+        margin-bottom: 0em;
+        font-size: medium;
+        line-height: 125%;
+        text-align: center;
+        text-indent: 0em;
+        }
+    p.copyright {
+        margin-top: 5em;
+        margin-bottom: 5em;
+        font-size: smaller;
+        line-height: 175%;
+        text-align: center;
+        text-indent: 0em;
+        }
+    p.signature {
+        margin-top: 1em;
+        margin-bottom: 2em;
+        margin-left: 1em;
+        font-size: small;
+        text-indent: 5em;
+        }
+    p.maintitle {
+        margin-top: 3em;
+        margin-bottom: 1.25em;
+        font-size: x-large;
+        letter-spacing: 0.2ex;
+        padding-left: 0.2ex;
+        text-align: center;
+        text-indent: 0em;
+        }
+    p.subheader {
+        margin-top: 1em;
+        margin-bottom: 0.5em;
+        font-size: 90%;
+        text-align: center;
+        text-indent: 0em;
+        }
+    p.tbsection {
+        margin-top: 2em;
+        }
+    p.newsection {
+        margin-top: 1em;
+        text-indent: 0em;
+        }
+
+    span.dropcap {
+        float: left;
+        padding-top: 2px;
+        padding-left: 0px;
+        padding-right: 2px;
+        font-size: 280%;
+        line-height: 80%;
+        overflow: visible;
+        }
+    span.uppercase {
+        text-transform: uppercase;
+        }
+
+    table {
+        margin-left: auto;
+        margin-right: auto;
+        }
+    table.toc {
+        font-size: medium;
+        width: 90%;
+        margin-top: 1em;
+        margin-bottom: 1em;
+        }
+    table.toc td {
+        padding-top: 0.75em;
+        }
+    table.toc td.chapter {
+        padding-top: 1.5em;
+        text-align: center;
+        line-height: 200%;
+        }
+    table.toc td.chapter span.title {
+        font-variant: small-caps;
+        font-size: 90%;
+        }
+
+    table.toc td.content {
+        font-size: 90%;
+        padding-left: 2.5em;
+        text-indent: -2em;
+        text-align: justify;
+        }
+    table.toc td.onpage {
+        font-size: 90%;
+        padding-left: 2em;
+        vertical-align: bottom;
+        text-align: right;
+        }
+    table.toc th.onpage {
+        font-size: 80%;
+        font-weight: normal;
+        padding-top: 0em;
+        text-align: right;
+        }
+
+    table.index th {
+        padding-top: 1.5em;
+        padding-bottom: 0.5em;
+        font-weight: normal;
+        font-size: medium;
+        }
+    table.index td.onpage {
+        font-size: 90%;
+        padding-left: 2em;
+        text-align: right;
+        }
+
+    div.note {
+        margin: 4em 10% 0 10%;
+        padding: 1em;
+        border: 1px dashed black;
+        color: inherit;
+        background-color: #F0F8FF;
+        font-size: smaller;
+        }
+    div.note p {
+        margin-top: 0em;
+        text-indent: 0em;
+        }
+
+    ul {
+        list-style: none;
+        margin-left: 0em;
+        margin-bottom: 0em;
+        padding-left: 1.5em;
+        text-indent: -1.5em;
+        }
+
+    .pagenum  { /* uncomment the next line for invisible page numbers */
+        /*  visibility: hidden;  */
+        position: absolute;
+        right: 1%;
+        font-size: x-small;
+        font-weight: normal;
+        font-style: normal;
+        text-align: right;
+        text-indent: 0em;
+        letter-spacing: normal;
+        padding-left: 0em;
+        color: gray;
+        background-color: inherit;
+        }
+
+    a:link {
+        text-decoration: none;
+        color: rgb(10%,30%,60%);
+        background-color: inherit;
+        }
+    a:visited {
+        text-decoration: none;
+        color: rgb(10%,30%,60%);
+        background-color: inherit;
+        }
+    a:hover {
+        text-decoration: underline;
+        }
+    a:active {
+        text-decoration: underline;
+        }
+
+    .blockquot {
+        margin-top: 1.5em;
+        margin-left: 5%;
+        margin-right: 5%;
+        font-size: 90%;
+        }
+
+    .above, .below { font-size: 65%;}
+    .above { vertical-align: 0.7ex; }
+    .below { vertical-align: -0.3ex; }
+
+    .smcap { font-variant: small-caps; }
+
+    .footnotes {
+        border: dotted 1px;
+        padding-bottom: 1em;
+        margin-top: 2em;
+        }
+    .footnote {
+        margin-left: 10%;
+        margin-right: 10%;
+        font-size: smaller;
+        }
+    .footnote .label {
+        position: absolute;
+        right: 84%;
+        text-align: right;
+        }
+    .fnanchor {
+        vertical-align: baseline;
+        font-size: 80%;
+        position: relative;
+        top: -.4em;
+        }
+    p.footnotetitle {
+        text-align: center;
+        clear: both;
+        font-size: medium;
+        font-style: italic;
+        font-weight: normal;
+        }
+    div.footnotes div.footnote p {
+        text-indent: 0em;
+        }
+
+    // -->
+    /* XML end  ]]>*/
+    </style>
+  </head>
+<body>
+
+
+<pre>
+
+The Project Gutenberg EBook of The Electric Bath, by George M. Schweig
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: The Electric Bath
+
+Author: George M. Schweig
+
+Release Date: August 20, 2008 [EBook #26366]
+
+Language: English
+
+Character set encoding: ISO-8859-1
+
+*** START OF THIS PROJECT GUTENBERG EBOOK THE ELECTRIC BATH ***
+
+
+
+
+Produced by Bryan Ness, Markus Brenner and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+book was produced from scanned images of public domain
+material from the Google Print project.)
+
+
+
+
+
+
+</pre>
+
+<p><span class="pagenum"><a name="Page_1" id="Page_1">[1]</a></span></p>
+<h1><span style="font-size: medium">THE</span><br />
+ELECTRIC BATH</h1>
+
+<p class="subtitle">ITS MEDICAL USES, EFFECTS<br />
+AND APPLIANCE</p>
+
+
+<p class="by">BY</p>
+
+<p class="author">GEORGE M. SCHWEIG, M.D.</p>
+
+<p class="details">MEMBER OF THE NEW YORK COUNTY MEDICAL SOCIETY AND OF THE MEDICAL<br />
+JOURNAL ASSOCIATION OF THE CITY OF NEW YORK; ONE OF THE<br />
+PHYSICIANS TO THE NEW YORK LYING-IN ASYLUM, ETC.</p>
+
+<hr style="margin-top: 50px; margin-bottom: 50px; width: 10em;" />
+
+<p class="publisher"><span style="letter-spacing: 0.3ex; font-size: 90%">NEW YORK<br />
+G.&nbsp;P. PUTNAM&#8217;S SONS</span><br />
+<small>182 FIFTH AVENUE<br />
+1877</small></p>
+
+
+<p class="copyright">
+<span class="pagenum"><a name="Page_2" id="Page_2">[2]</a></span>
+<span class="smcap">Copyright</span>,<br />
+G.&nbsp;P. <em class="gesperrt">PUTNAM&#8217;S SONS</em>,<br />
+1876.<br />
+</p>
+
+
+
+<p><span class="pagenum"><a name="Page_3" id="Page_3">[3]</a></span></p>
+<h2 class="preface"><a name="PREFACE" id="PREFACE"></a><em class="gesperrt">PREFACE</em>.</h2>
+
+<hr style="width: 4em;" />
+
+
+<p class="newsection"><span class="uppercase"><span class="dropcap">I</span>n</span> No 216 of &#8220;The Medical Record&#8221; (Dec. 15th,
+1874) was published an article written by me,
+entitled &#8220;On some of the Uses of Galvanic and Faradic
+Baths.&#8221;</p>
+
+<p>The interest manifested in the subject, as evidenced
+by numerous letters of inquiry since received
+from physicians in almost all parts of the United
+States, and some in Europe, has induced me to
+write the present treatise, in which I have endeavored
+to present to the profession, as far as lies in my
+power, all that is necessary to a full comprehension
+of the electro-balneological treatment.</p>
+
+<p>When it is considered that in the employment
+of electric baths I have been to a great extent groping
+in the dark, that I have been deprived of the
+advantage of having the experience of others to
+guide me, it will not appear surprising that I should
+have met with many disappointments. My failures
+have been illustrative of the fact that the electric
+bath is no more a panacea for all ills than any
+<span class="pagenum"><a name="Page_4" id="Page_4">[4]</a></span>other remedial agent. Applicable as it is to a great
+variety of pathological conditions, it meets with
+many where it is destined to have negative or at
+best imperfect results. Far from discouraging me,
+however, failures have served to inspire me with
+fresh ardor to seek for light, and to persevere in my
+efforts to establish on the basis of statistical truth, the
+therapeutic merits of the agent which I employed.</p>
+
+<p>In view of the imperfectness of the results thus
+far obtained, I should consider the present work
+premature, did I not find a justification for it in my
+desire to induce other and abler observers to investigate
+the subject, and place it on whatever footing
+it may merit.</p>
+
+<p>To say that I am fully conscious of the shortcomings
+of my work, would be but feebly to express
+my convictions in this respect. I beg the reader
+however to consider that the subject is not a hackneyed
+one, that mine has not been the work of the
+compiler who remodels the brain-work of others.
+It may be crude and rough, it may lack the gloss
+and polish that is the result of much handling, but
+I have at least the consciousness that it has the
+merits of originality and candor.</p>
+
+<p class="signature">
+<span class="smcap">New York.</span><br />
+160 Second Avenue. November, 1876.<br />
+</p>
+
+<h2 class="contents"><span class="pagenum"><a name="Page_5" id="Page_5">[5]</a></span>
+<em class="gesperrt">CONTENTS.</em></h2>
+
+<hr style="width: 4em;" />
+
+<table class="toc">
+
+<tr><td class="chapter" colspan="2"><a href="#CHAPTER_I">CHAPTER I.</a><br />
+<span class="title">The Apparatus.</span></td></tr>
+
+<tr><th></th><th class="onpage">PAGE</th></tr>
+
+<tr><td class="content"><i>a</i>)&mdash;The tub. <i>b</i>)&mdash;The electrodes and connections. <i>c</i>)&mdash;The
+water. <i>d</i>)&mdash;Chemicals. <i>e</i>)&mdash;The batteries.</td><td class="onpage"><a href="#Page_7">7</a></td></tr>
+
+
+<tr><td class="chapter" colspan="2"><a href="#CHAPTER_II">CHAPTER II.</a></td></tr>
+
+<tr><td class="content"><span class="smcap">Mode of Administration</span></td><td class="onpage"><a href="#Page_19">19</a></td></tr>
+
+
+<tr><td class="chapter" colspan="2"><a href="#CHAPTER_III">CHAPTER III.</a><br />
+<span class="title">Physiological Effects.</span></td></tr>
+
+<tr><td class="content">Characteristic differences between the electric bath and
+other methods of electrization&mdash;Effects on sleep; on
+general sensation; on the change of matter; on the
+pulse and temperature; as a stimulant and tonic; on
+general nutrition; on the digestive apparatus; on the
+sexual apparatus&mdash;Sedative influence&mdash;Affects cranial
+nerves&mdash;Cutaneous sensation&mdash;Its freedom from pain&mdash;Muscular
+contractions&mdash;Effects on the mind</td><td class="onpage"><a href="#Page_31">31</a></td></tr>
+
+
+<tr><td class="chapter" colspan="2"><span class="pagenum"><a name="Page_6" id="Page_6">[6]</a></span><a href="#CHAPTER_IV">CHAPTER IV.</a><br />
+<span class="title">General Therapeutic Effects and Uses.</span></td></tr>
+
+<tr><td class="content">The electric bath as a diagnostic; as an equalizer of the
+circulation; as a general counter-irritant; as a general
+invigorant and tonic&mdash;Its hypnotic and sedative influence&mdash;Its
+improvement of nutrition&mdash;As a prophylactic</td><td class="onpage"><a href="#Page_52">52</a></td></tr>
+
+
+<tr><td class="chapter" colspan="2"><a href="#CHAPTER_V">CHAPTER V.</a><br />
+<span class="title">Special Therapeutics and Clinical Record.</span></td></tr>
+
+<tr><td class="content">General directions&mdash;Special diseases&mdash;Acute rheumatism&mdash;Subacute
+rheumatism&mdash;Chronic rheumatism&mdash;Cases
+of rheumatism&mdash;Chorea, with cases&mdash;Hysterical affections,
+with cases&mdash;Neurasthenia, with cases&mdash;Agrypnia,
+with cases&mdash;An&aelig;mia, with case&mdash;Paralyses and
+Pareses, with cases&mdash;Neuralgi&aelig;, with cases&mdash;Articular
+effusions, with case&mdash;Impotency, with cases&mdash;Constipation,
+with cases&mdash;Hydrargyrosis, with case&mdash;Locomotor
+ataxia, with case&mdash;Cachexia, with case&mdash;Dyspepsia&mdash;Melancholia,
+with case&mdash;Inequalities of the circulation&mdash;Affections
+of the Sympathetic, with case&mdash;Miscellaneous
+conditions&mdash;Concluding remarks</td><td class="onpage"><a href="#Page_61">61</a></td></tr>
+</table>
+
+
+
+<p class="maintitle"><span class="pagenum"><a name="Page_7" id="Page_7">[7]</a></span>THE ELECTRIC BATH.</p>
+
+<hr style="width: 8em;" />
+
+<h2><a name="CHAPTER_I" id="CHAPTER_I"></a>CHAPTER I.</h2>
+
+<p class="subheader">THE APPARATUS.</p>
+
+
+<p class="newsection"><span class="uppercase"><span class="dropcap">T</span>o</span> a proper comprehension of the succeeding
+chapters, it is necessary first of all to be familiar
+with the apparatus employed in carrying out
+electro-balneological treatment, and I therefore proceed
+to give a description of this.<a name="FNanchor_1_1" id="FNanchor_1_1"></a><a href="#Footnote_1_1" class="fnanchor">[1]</a> It may conveniently
+be divided as follows, viz.</p>
+
+<ul style="padding-left: 4em;">
+<li><i>a.</i> The tub;</li>
+<li><i>b.</i> The electrodes and connections;</li>
+<li><i>c.</i> The water;</li>
+<li><i>d.</i> Chemicals;</li>
+<li><i>e.</i> The batteries.</li>
+</ul>
+
+<p><span class="pagenum"><a name="Page_8" id="Page_8">[8]</a></span>(<i>a</i>) <i>The Tub.</i> This must be made of a non-conducting
+material. Of substances that will answer, I
+will mention: wood, porcelain, soapstone, vulcanized
+rubber, or glass. In choosing one of these materials,
+regard should be had to the facility of attaching
+the electrodes. In this respect wood deserves the
+preference over all the others mentioned. Where
+economy is to be studied, it has a further item in its
+favor.</p>
+
+<p>The tubs, which I have now in use for nearly three
+years are made of wood, and I find them to answer
+very well. It must not be forgotten, however, that a
+wooden tub requires to be well painted on the inside,
+in order to prevent its becoming water-soaked, because
+in that event it would become a conductor of
+electricity, and interfere to some extent, with the administration
+of the electric current in the bath.</p>
+
+<p>The shape and size of the tub may be the same
+as those of an ordinary bath tub. To suit individual
+cases however, its length may be made to vary. The
+only peculiarity in its construction is at the head.
+Here, instead of slanting, it is made square, and the
+slightly concave (from side to side) board against
+which the back of the bather is to rest, is fitted in
+afterwards. This is necessary, because it is very
+difficult to make a wooden tub with a slanting back
+<span class="pagenum"><a name="Page_9" id="Page_9">[9]</a></span>water-tight. If the length of the tub from outside
+to outside is made to measure about five feet ten
+inches, the back-rest fitted in at a proper slant will
+bring the inside of the tub to about the right length
+for an average male adult. All around the upper
+edge of the tub runs a wooden coping, which must
+not be fastened down however until all the attachments
+for conducting the current are <i>in situ</i>. Along
+that portion of the top of the tub where required&mdash;and
+this will depend on the situation of the binding
+posts presently to be mentioned&mdash;and underneath
+the coping, runs a groove for the reception of the
+wires that are to connect the carbon electrodes on
+the inside of the tub with the binding posts on the
+outside. This groove is continued vertically along
+the inside of the back-rest and foot of the tub respectively,
+to communicate at either end with the bed
+for the reception of the carbon plates. These vertical
+grooves should at their lower end be a little over
+&frac14; inch deep, in order to admit of the wires being introduced
+beneath the carbons.</p>
+
+<p>The face of the foot of the tub and that of the
+back-rest, should have in their centres (from side to
+side) and commencing at about five inches from the
+bottom of the tub, a bed for the reception of the
+carbons. The dimensions of these receptacles must
+<span class="pagenum"><a name="Page_10" id="Page_10">[10]</a></span>of course correspond to those of the carbon plates
+to be employed as electrodes. Those which I use
+measure 12&times;8&#8243; at the head, 8&times;6&#8243; at the foot of the
+tub. They are &frac14;&#8243; thick. They are placed so as to
+have their long diameter correspond to the height
+of the tub. The bed which is to receive the carbon
+at the head of the tub must be deeper than &frac14;&#8243; on account
+of the concavity of the back-rest.</p>
+
+<p>In order to adapt a tub to individuals of different
+lengths, it will be found advantageous to have
+two small vertical cleats on each side of the tub,
+near the foot and bottom, for the reception of a foot-board,
+which will practically shorten the tub and
+adapt it to persons of different lengths. This board
+may conveniently be six inches wide, and should
+have a number of perforations about an inch in diameter,
+for the transmission of the current to the
+feet. 1&frac14;&#8243; pine plank is the most suitable wood to
+use in the construction of the tub. This is preferable
+to any of the hard woods, because of the
+greater facility of fitting in the electrodes etc. It
+is also the most economical.</p>
+
+<p>(<i>b</i>) <i>The electrodes and connections.</i> These consist
+of two carbon plates, two brass binding posts, and
+insulated wires to connect the carbons with the
+binding posts, and these with the battery. The
+<span class="pagenum"><a name="Page_11" id="Page_11">[11]</a></span>carbons are such as are ordinarily employed in
+the construction of galvanic batteries, and can, as
+well as the wire and binding posts, be procured
+from any house that deals in telegraph material.
+Their size is to some extent optional; the dimensions
+I have given above however answer very well.</p>
+
+<p>The inside of the tub having received one or
+preferably two coats of paint, the carbons are now
+fitted in the receptacles provided for them. The
+next step is the attaching of the binding posts.
+These should be of the kind known as &#8220;single&#8221;
+binding posts with &#8220;wood screws.&#8221; The most
+convenient location for them will be found on the
+coping covering the horizontal portion at the head
+of the tub. Here the coping, as it has to cover
+not only the upper edge of the head of the tub, but
+that of the back-rest also, is of necessity much wider
+than at any other portion, and thus affords most
+room for the binding posts.</p>
+
+<p>Having marked out then a site for the binding
+posts, say in the centre of the coping at the head
+of the tub&mdash;which should now be placed in position&mdash;and
+about two inches apart, the posts are laid
+aside to be put in place when the wires are all <i>in
+situ</i>, and the coping fastened down.</p>
+
+<p>In order to facilitate the description of the placing
+<span class="pagenum"><a name="Page_12" id="Page_12">[12]</a></span>of the wires by means of which communication
+is to be established between the electrodes and the
+binding posts, I shall term the end of the wire that
+is to be attached to the electrodes the distal, that
+which is attached to the binding posts the proximal
+end. A gimlet hole sufficiently large to admit of
+the passage of one wire should be made half an inch
+outwards from the centre of the site of each binding
+post. The best wire to use is about No. 16 copper
+wire, coated with gutta percha or rubber. The site
+of the posts being as above suggested, it will be
+found that the wire which is to connect the head
+electrode with one post requires to be about 18
+inches long, that which runs from the other post to
+the foot-electrode, between eight and nine feet.
+The distal ends of the wires should be stripped of
+their coating for a length of about three inches, the
+proximal ends for about two inches. The denuded
+portion of the distal ends should be rolled up in the
+form of a spiral coil; this will insure their constant
+impinging on the carbons more certainly than
+could be expected from a simple straight end of
+wire.</p>
+
+<p>The carbons having now been fitted in their beds,
+the distal end (coil) of the head wire is placed beneath
+the carbon, and the wire itself continued up along
+<span class="pagenum"><a name="Page_13" id="Page_13">[13]</a></span>the vertical groove to either one of the gimlet holes.
+Through this, from within outward, the proximal
+end of the wire is now drawn and left for the present.
+The distal end of the second wire having now
+been placed beneath the carbon at the foot of the
+tub, this wire is continued up through the vertical
+groove, along the upper edge of the foot of the tub
+to the side nearest the binding post to which the
+wire is to be attached, along the groove on the upper
+edge of this side to the head of the tub, and thence
+to the respective gimlet hole, and through this, from
+within outward. The wires being now all in position,
+all the coping is next screwed or nailed down
+firmly, care being taken that the screws or nails used
+for this purpose do not injure any of the wires. The
+coping fastened down, the binding posts are now
+screwed down in the sites previously marked out for
+them. Before they are screwed <i>entirely</i> down, the
+denuded portion of the proximal end of each wire is
+securely wound around the screw of the respective
+binding post, and the posts are then <i>firmly</i> screwed
+down, holding the proximal ends of the wires in
+place. Connection is now established between the
+binding posts and the head and foot electrodes respectively.
+The vertical grooves are now to be filled
+in with putty and painted over, care being taken to
+<span class="pagenum"><a name="Page_14" id="Page_14">[14]</a></span>keep the carbon free from paint. The last step towards
+completing the apparatus is to fasten the carbons
+in their beds. The simplest way of doing this
+is by stretching over each carbon a piece of muslin,
+folded double, and tacking this down around the
+edges. Zinc or galvanized iron tacks are best. Copper
+tacks should be avoided on account of their superior
+conductivity.</p>
+
+<p>In order to be able when required to localize the
+current in special portions of the body, it is well to be
+provided with what I have termed a &#8220;surface board.&#8221;
+This is a piece of black walnut, say 14 in. long by 5
+in. wide, &frac34; thick, having in the centre a bed to accommodate
+a carbon plate, say 5 in. long by 2 in.
+wide, &frac14; thick. From the centre of this bed a gimlet
+hole pierces the board. The denuded end of an insulated
+wire is drawn through this gimlet hole from
+without inward (toward the bed) and twisted in the
+form of a spiral to prevent its slipping back, as well
+as to insure its more certain connection with the carbon.
+The carbon is now placed in the bed, and kept
+there by a piece of muslin drawn over it and tacked
+down. The wire should be of sufficient length to
+reach the battery. I shall speak further on of the
+use to be made of the surface board.</p>
+
+
+<p><i>c</i>) <i>The Water.</i> The quantity of water may be
+<span class="pagenum"><a name="Page_15" id="Page_15">[15]</a></span>the same as that in an ordinary bath. In those
+cases alone where it is intended to localize the current
+by means of the surface board, and to concentrate
+it <i>very strongly</i> in one spot, the water in the
+tub should be left low enough to leave the particular
+spot to be treated uncovered by this; the surface
+board can then be applied to this spot without
+the loss to the current of strength, through derived
+currents, inevitable in its application under water.</p>
+
+<p>The temperature of the water may range from
+85&deg; to 105&deg; Fahrenheit. As a rule the comfort of
+the patient may be consulted in this respect. There
+are certain cases, however, where an especially high or
+low temperature is indicated, and where the extremes
+mentioned have to be touched.</p>
+
+
+<p><i>d</i>) <i>Chemicals.</i> Where these are added to the
+water of the bath, it is for one of three purposes:
+viz. 1)&mdash;To exercise a direct therapeutic influence on
+the patient, either internally by being absorbed, or
+externally by their action on the skin; 2)&mdash;Through
+chemical affinity to aid in eliminating certain metallic
+substances from the body; or 3)&mdash;To further
+the absorption of morbid deposits. The various indications
+in these respects will be treated of in their
+proper places.</p>
+
+
+<p><i>e</i>) <i>The Batteries.</i> In the choice of this, the
+<span class="pagenum"><a name="Page_16" id="Page_16">[16]</a></span>most important part of the electro-balneological apparatus,
+the greatest circumspection is necessary.
+Inferior instruments and such as are liable to get
+out of order frequently, have time and again been
+the means of discouraging the beginner in electro-therapeutics,
+and causing him to abandon the study
+of an art, the pursuit of which would have well repaid
+him for all his labor. Fortunately our manufacturers
+here in New York turn out very good instruments,
+and if a physician purchases an inferior
+one, the fault is his own.</p>
+
+<p>Two different currents are required for the
+baths, viz. 1)&mdash;The galvanic, which may be employed
+either in the constant or interrupted (by means
+of a rheotome) form; and 2)&mdash;the faradic or induced
+current. Several manufacturers of this city
+turn out good and serviceable faradic instruments.
+Those which I have been in the habit of using for
+some years past are manufactured by the Galvano-Faradic
+Manufacturing Company, and they have
+given me unvarying satisfaction. By means of a
+recently introduced attachment to their batteries,
+termed the &#8220;fine adjustment,&#8221; a current of exquisite
+&#8220;fineness&#8221; (rapidity of interruption) is obtained,
+thus removing the only inferiority that has heretofore
+distinguished American from the best imported
+<span class="pagenum"><a name="Page_17" id="Page_17">[17]</a></span>instruments. The instrument is very easy of management,
+and its liability to get out of order very
+small.</p>
+
+<p>As however the galvanic current is of vastly
+greater importance in a therapeutic respect, than
+the faradic, so also much greater care is required in
+the choice of a galvanic than a faradic battery. In
+making choice of a galvanic battery, we have to consider
+its relative quantity, intensity, constancy, permanency,
+economy of running expenses, and facility
+of management. We cannot be guided here by the
+same considerations that guide us in the choice of
+a battery for office use, where the <i>s&eacute;ances</i> are usually
+brief and the elements taxed not nearly so much
+as in the administration of baths. It is not within
+the scope of this work to enter into a description
+of the various galvanic batteries that are in use.
+Neither do I believe that, in a therapeutic sense,
+there is much difference between the various batteries
+ordinarily found described in text-books on electro-therapeutics.</p>
+
+<p>Where the battery is to be stationary, a zinc-copper
+battery, such as the Hill battery for example, is
+preferable both on account of its constancy and the
+economy of running it. Of this there should be fully
+sixty cells, communicating with the bath through a
+<span class="pagenum"><a name="Page_18" id="Page_18">[18]</a></span>current selector, by means of which the current from
+any desired number of cells can be obtained. The
+electro-susceptibility of different individuals varies
+to such an extent that this is absolutely necessary.
+Where a portable battery is desired, the St&ouml;hrer zinc-carbon
+battery will be found the most useful.</p>
+
+<p>I have mentioned these two batteries simply because
+I have them in use, and they give me satisfaction.
+There are many others, however, that will
+answer equally well. On the whole, any battery possessing
+quantity and intensity in a medium degree
+will answer.</p>
+
+<div class="footnotes"><p class="footnotetitle">Footnotes:</p>
+
+<div class="footnote"><p><a name="Footnote_1_1" id="Footnote_1_1"></a><a href="#FNanchor_1_1"><span class="label">[1]</span></a> A written description can never convey so true an idea of
+anything, as an ocular inspection. I will therefore say that it
+will afford me much pleasure to show any member of the profession
+the apparatus I am about to describe, at my residence.</p></div>
+</div>
+
+
+
+
+<h2><span class="pagenum"><a name="Page_19" id="Page_19">[19]</a></span><a name="CHAPTER_II" id="CHAPTER_II"></a>CHAPTER II.</h2>
+
+<p class="subheader">MODE OF ADMINISTRATION.</p>
+
+
+<p class="newsection"><span class="uppercase"><span class="dropcap">I</span> shall</span> describe under this head the <i>modus
+operandi</i> of administering a routine galvanic or
+faradic bath. As it will become necessary to describe
+special modes of administration when speaking of
+the electro-balneological treatment of special diseases,
+the describing them now would only lead to
+tautologies that I am desirous of avoiding.</p>
+
+<p>Taking our cue from the indications to be met in
+each case, it becomes necessary, according to circumstances,
+to use either the galvanic current, the faradic,
+or both successively. As modifications of the
+application of the currents we have to consider 1)
+their intensity; 2) their direction, and 3) the duration
+of the application.</p>
+
+<p>The intensity of the galvanic current corresponds
+directly to the number of cells from which it is derived.
+It were vain however to attempt to express
+this in figures, because the electro-motive force of
+different batteries varies to so great an extent, that a
+<span class="pagenum"><a name="Page_20" id="Page_20">[20]</a></span>number of cells of some batteries of low intensity
+yield a current so feeble as to be barely appreciable
+in the bath, while the same number of cells of a battery
+of high intensity, furnish a current that few
+persons can bear without pain. In thus comparing
+the Hill cell with the St&ouml;hrer cell, I have found the
+ratio to be about as 1 to 2&frac12;, i.e., as intense a current
+can be derived from twenty-four St&ouml;hrer as from
+sixty Hill cells&mdash;and this is rather below than above
+the mark. Were all batteries alike in this respect,
+however, still no particular number of cells could be
+given as furnishing a current of suitable average intensity
+for the galvanic bath, because of the excessively
+great variations in the degree of electro-sensibility
+of different persons. This is so marked that
+I have seen persons in the bath tub who could bear
+no more than six Hill cells, diffused as was the current
+from these through the water and over the
+entire body; while on the other hand I have met
+with male patients on whom a current from thirty-two
+St&ouml;hrer cells made not the slightest impression,
+and where I was compelled to supplement the current
+by that from a ten-cell quantity battery (zinc carbon
+elements 6 in. long by 4&frac12; wide) in order to make
+them realize the presence of a current. These gentlemen
+had no cutaneous an&aelig;sthesia.</p>
+
+<p><span class="pagenum"><a name="Page_21" id="Page_21">[21]</a></span>In view of the facts just stated, I have found it
+impracticable, when giving directions for the administration
+of a galvanic bath, to indicate any certain
+number of cells to be used. I am in the habit of
+ordering the administration of a &#8220;mild,&#8221; a &#8220;medium&#8221;
+or a &#8220;strong&#8221; current, as may be required in
+the respective cases; and in every instance it is the
+electro-sensibility of the patient that determines the
+number of cells requisite to obtain the desired result
+as represented by one of these terms. The same
+applies also to the faradic current.</p>
+
+<p>To determine the direction of the current is sufficiently
+simple. Where a descending current is
+desired, the binding post which represents the electrode
+at the head of the tub must be connected to
+the positive pole of the battery, the other binding
+post to the negative pole; where an ascending current
+is desired, the reverse of this is done.</p>
+
+<p>The duration of the bath varies with different
+cases. The average is about twenty minutes,
+though the time may range from ten minutes to an
+hour and a half.</p>
+
+<p>Where it is desired to give the patient a galvanic
+shock, it is only necessary rapidly to reverse the
+current by means of the commutator. The simultaneous
+contraction of almost the <small>ENTIRE</small> muscular
+<span class="pagenum"><a name="Page_22" id="Page_22">[22]</a></span>system that accompanies the reversal of a current of
+sufficient intensity in the bath, affords a striking
+illustration of the <i>general</i> effects of the galvanic bath.
+In cases where paralyzed muscles have lost their
+faradic irritability, galvanic interruptions are almost
+indispensable to successful treatment.</p>
+
+<p>I have before (<a href="#Page_14">page&nbsp;14</a>) described a &#8220;surface
+board,&#8221; which I have devised for the purpose of localizing
+the current from one of the poles in any
+portion of the body where required. This proceeding
+should by no means be looked upon as a &#8220;local&#8221;
+method of electrization; on the contrary, it is just
+as much &#8220;general&#8221; as the ordinary electric bath.
+Whereas in local applications the current runs from
+one point of the body to another, in this case, supposing
+the spot where the surface board is applied to
+be the centre, and the rest of the body the periphery,
+a current runs between <i>every point</i> of the periphery
+and the centre, its direction being centripetal
+when the surface board communicates with the
+negative, centrifugal when with the positive pole
+of the battery.</p>
+
+<p>The current is felt more or less intensely in proportion
+to the proximity to the body of the surface
+board. With the galvanic this is less noticeable than
+with the faradic current. When, for example, a faradic
+<span class="pagenum"><a name="Page_23" id="Page_23">[23]</a></span>current of medium strength being employed, the
+surface board is held about six inches from the abdominal
+surface, little or no current is felt. Let the
+surface board be now gradually approximated to the
+abdomen, and the current will be felt more and more
+sensibly, until, when about an inch away from the
+skin, or touching this, its influence becomes so strong
+as to cause more or less energetic contractions of the
+abdominal muscles. Where the galvanic current is
+employed, the skin beneath the surface board will be
+found more or less reddened after a few minutes&#8217; application;
+the burning sensation ordinarily accompanying
+galvanic applications will also be experienced
+more or less intensely, in proportion to the strength
+of the current employed.</p>
+
+<p>Where the current is to be concentrated in a
+manner still more energetic than that described, this
+can be effected by raising the objective part above
+the surface of the water, and then applying the surface
+board. In this way the <i>entire</i> strength of the
+current is concentrated in one spot, whereas, when
+the surface board is applied under water, a large portion
+of current is absorbed by this.</p>
+
+<p>This appears to me the fittest place to say a few
+words in regard to the relative conductivity of the
+human body and water&mdash;the latter at the temperature
+<span class="pagenum"><a name="Page_24" id="Page_24">[24]</a></span>ordinarily employed in baths, say from 90&deg; to
+95&deg; Fahrenheit. <span class="smcap">Beard</span> and <span class="smcap">Rockwell</span>, in their
+work on Medical and Surgical Electricity,<a name="FNanchor_2_2" id="FNanchor_2_2"></a><a href="#Footnote_2_2" class="fnanchor">[2]</a> state that
+&#8220;the human body is a better conductor of electricity
+than water at the same temperature.&#8221; Certain
+phenomena connected with the administration of
+electric baths having forced upon me some doubts
+in this respect, I made very careful experiments,
+both with and without the aid of the galvanometer
+(Bradley&#8217;s Tangent), to satisfy these. Without
+wearying the reader with details, I will state that the
+result of my experiments leaves no room for doubt
+that water at the temperatures stated&mdash;and still
+more so at 98&frac12;&deg;&mdash;is superior to the human body as a
+conductor of electricity. I do not mean to be understood
+that water is a better conductor than <i>every constituent</i>
+of the human body; blood, for example, is a
+better conductor. But when I speak of the body in
+this connection, I take it as we find it practically, i.e.,
+with the resistance of the skin, and especially the
+epidermis, superadded to internal resistances. I
+have no doubt that with a flayed individual it would
+be otherwise. I will add, that it will give me great
+pleasure to repeat these experiments, which are
+<span class="pagenum"><a name="Page_25" id="Page_25">[25]</a></span>sufficiently simple, in the presence of any of my <i>confreres</i>
+who feel an interest in the subject.</p>
+
+<p>Having thus cursorily considered the manner of
+using the electric current in the administration of a
+&#8220;routine&#8221; bath, and there being no remarks required
+concerning the water employed, in addition
+to what has been said in the previous chapter, a few
+words are in place on the subject of chemicals. As
+has been previously stated (<a href="#Page_13">page&nbsp;13</a>) these are
+added: <i>a</i>) to be absorbed, and thus act medicinally
+on the patient; <i>b</i>) to act on the skin; <i>c</i>) through
+chemical affinity to facilitate the elimination from
+the body of certain metallic substances, and <i>d</i>) to
+further the absorption of morbid deposits. Of the
+many drugs and medicines that no doubt may be
+made to answer these various purposes, I have had
+personal experience with but few, and of these I will
+mention the leading ones only. A requisite of all
+chemicals to be employed is their ready solubility
+in water. Of substances intended for absorption<a name="FNanchor_3_3" id="FNanchor_3_3"></a><a href="#Footnote_3_3" class="fnanchor">[3]</a>
+I have used but three, viz: iron, iodine, and extract
+of malt. The first of these I have employed
+<span class="pagenum"><a name="Page_26" id="Page_26">[26]</a></span>in an&aelig;mic and enfeebled conditions generally, but
+especially in chlorosis and chlorotic hysteria, with
+marked success. It has the advantage, when administered
+in this manner, not only of sparing the
+alimentary canal the frequently injurious task of
+becoming the medium of its assimilation, but, in addition
+to this, I believe that it can in this way be
+introduced into the blood much more rapidly and in
+larger quantities than when given by the mouth.
+The preparation which I have found, all things considered,
+the most eligible for this purpose, is the
+&#8220;tartrate of iron and ammonia.&#8221; This is very readily
+soluble, leaving no deposit, is assimilable, and
+not too expensive for the purpose. As, in my experience
+at least, it leaves nothing to wish for, I
+would consider it superfluous to discuss in this connection
+any of the other ferruginous preparations.</p>
+
+<p>Iodine I have employed with a view to its absorption
+in rheumatism and gout. I cannot speak
+favorably of it in this connection. I have not in a
+single instance found a bath charged with iodine,
+either in the form of the tincture or of iodide of
+potassium, followed by results in any way differing
+from those of the simple galvanic bath employed in
+the same cases.</p>
+
+<p>Extract of malt I have employed as a roborant,
+<span class="pagenum"><a name="Page_27" id="Page_27">[27]</a></span>either alone or in conjunction with iron, in cases of
+debility and malnutrition, and found it of service.</p>
+
+<p>Where the absorption of substances is aimed at,
+the <i>galvanic</i> current must be employed.</p>
+
+<p>Where we add substances to an electric bath with
+a view of producing some special action on the skin,
+we may be guided by the same principles that govern
+ordinary balneology. Thus to obtain counter-irritant
+effects, we may add mustard or common salt;
+to render the bath alkaline, bicarbonate of potassa
+or soda, etc., etc.</p>
+
+<p>An important object to be furthered by the addition
+to the galvanic bath of chemicals, is the elimination
+from the system of certain metallic substances.
+It will be found here that in practice we have to deal
+chiefly with two substances, viz: mercury and lead.
+That the elimination of these bodies by means of the
+galvanic bath is feasible, I shall endeavor to demonstrate
+further on. At present I have simply to consider
+the chemicals adapted for the purpose, and the
+manner of using them.</p>
+
+<p>To facilitate the extraction from the system of
+mercury, nitric-acid has been recommended by those
+who have heretofore instituted this treatment.
+While I cannot positively deny that this substance
+may aid in the elimination of the metal, I am compelled
+<span class="pagenum"><a name="Page_28" id="Page_28">[28]</a></span>to state, after its trial in several cases, that I
+have obtained equally good results from the simple
+galvanic bath. In the light of my own limited experience,
+therefore, I cannot insist on the necessity of
+adding any chemical to a galvanic bath which is administered
+for the purpose of extracting mercury
+from the body.</p>
+
+<p>Where the elimination of lead is the object aimed
+at, I am, on the other hand, satisfied of the utility
+of adding certain chemicals to the water of the bath.
+Sulphuric acid has been suggested and used for this
+purpose. I can say nothing respecting its usefulness, as
+I have never tried it. Indeed, the results with iodide
+of potassium added to the bath have been so satisfactory,
+that I have had no occasion to try any other
+chemical, although almost any other of the preparations
+of iodine would probably answer equally well.
+The chemical affinity of iodine for lead affords a ready
+explanation of its usefulness in this respect. One
+ounce of iodide of potassium to each bath appears to
+me a suitable quantity.</p>
+
+<p>I have had no personal experience with any
+other cases of chronic metallic intoxication than
+those with lead and mercury.</p>
+
+<p>The absorption of morbid deposits (plastic exudations,
+etc.) can be materially furthered by adding
+<span class="pagenum"><a name="Page_29" id="Page_29">[29]</a></span>to a galvanic bath some resolvent&mdash;above all,
+iodine.</p>
+
+<p>I have said above (<a href="#Page_26">page&nbsp;26</a>) that I had found no
+perceptible benefit from the addition of this substance
+to the galvanic bath in cases of rheumatism
+or gout. The contrary holds good however with
+respect to the frequent sequence of these diseases&mdash;articular
+deposits. When the acute, and to a great
+extent the subacute symptoms have subsided&mdash;and
+in chronic cases especially, and the disease has left
+effusions in various joints, iodine, which when employed
+in this manner, appears to have little or no
+influence on the pain accompanying these complaints,
+is a powerful adjuvant in promoting the absorption
+of the deposits. In chronic synovitis and
+all other articular affections accompanied by exudation,
+the same holds good.</p>
+
+<p>I have no doubt that future advances in this
+branch of science will develop the utility of numerous
+other drugs and chemicals as additions to the
+galvanic bath.&mdash;Before leaving this subject I must
+call attention to the influence which the addition to
+the bath of certain substances has on the conductivity
+of the water, resp. thus: the action of the current
+on the patient. I have found that when I
+caused salt or bicarbonate of soda to be added to
+<span class="pagenum"><a name="Page_30" id="Page_30">[30]</a></span>the bath, the conductivity of the water became so
+much increased, so disproportionately greater than
+that of the body, as to render necessary the employment
+of very powerful currents in order to cause the
+patient to feel them.</p>
+
+<div class="footnotes"><p class="footnotetitle">Footnotes:</p>
+
+<div class="footnote"><p><a name="Footnote_2_2" id="Footnote_2_2"></a><a href="#FNanchor_2_2"><span class="label">[2]</span></a> &#8220;Medical and Surgical Electricity.&#8221; New York. 1875.
+Wm. Wood &amp; Co. pp.&nbsp;431 and 432.</p></div>
+
+<div class="footnote"><p><a name="Footnote_3_3" id="Footnote_3_3"></a><a href="#FNanchor_3_3"><span class="label">[3]</span></a> For some experiments concerning the cataphoric effects
+of the galvanic current, see an article by <span class="smcap">Munk</span>, entitled &#8220;Ueber
+die galvanische Einf&uuml;hrung differenter Fl&uuml;ssigkeiten in den unversehrten
+lebenden Organismus,&#8221; in the Allgemeine Medicinsche
+Central-Zeitung, No. 16, 1875.</p></div>
+</div>
+
+
+
+
+<h2><span class="pagenum"><a name="Page_31" id="Page_31">[31]</a></span><a name="CHAPTER_III" id="CHAPTER_III"></a>CHAPTER III.</h2>
+
+<p class="subheader">PHYSIOLOGICAL EFFECTS.</p>
+
+
+<p class="newsection"><span class="uppercase"><span class="dropcap">I</span>n</span> accordance with the plan of the present work,
+the remarks I shall offer under this head are by
+no means intended to comprise all that is known at
+the present day of the physiological effects of electricity
+in general. It was my purpose when I undertook
+to write these pages, to offer to the profession
+a book confined to one subject; not a compilation,
+but a volume made up almost if not wholly of original
+matter, chiefly, if not entirely the result of my
+own observations and experience. For the general
+physiological effects then of electricity as well as for
+the theories of its action, I refer those interested to
+the many excellent works on the subject that have
+appeared within the last few years. I will treat here
+only of the physiological effects peculiar to the electric
+bath.</p>
+
+<p>The daily observations that I have had the opportunity
+of making in this respect, extending as
+they do over a period of upwards of two years, have
+<span class="pagenum"><a name="Page_32" id="Page_32">[32]</a></span>not been as fruitful of results as might be expected.
+This is due mainly to the circumstance that
+but a small percentage&mdash;and these took the baths
+merely as a refreshing tonic&mdash;of those whom I have
+had the opportunity of observing, were in a condition
+that might be called normal. By far the greater
+majority were suffering from some complaint, in most
+instances of a neurotic or rheumatic nature, the presence
+of which, while it afforded admirable opportunity
+for observing therapeutic results, modified more or
+less the physiological effects of the baths, and served to
+deprive them of a uniformity which might to a great
+extent justly be looked for in healthy organisms. If,
+therefore, what I now contribute to the physiology
+of the subject is but little, it will I trust be at least
+found of practical utility in its applicability to the
+therapeutics of the subject.</p>
+
+<p>Before entering into details, it is necessary in the
+first place to inquire in what respects electric baths
+differ from other methods of electrization&mdash;especially
+those recently introduced as &#8220;general&#8221;&mdash;that their
+physiological effects should merit individual consideration.
+They differ in two ways. One of these is
+self-evident. To the effects of electricity are superadded
+those of the warm bath. The effects of the
+warm bath <i>per se</i> are too familiar to every physician
+<span class="pagenum"><a name="Page_33" id="Page_33">[33]</a></span>to require comment. Its effects in combination with
+electricity, however, may not be so generally known;
+and I therefore feel justified in quoting here a passage
+that bears directly on the subject, from a recent German
+work by Dr. Hartmann<a name="FNanchor_4_4" id="FNanchor_4_4"></a><a href="#Footnote_4_4" class="fnanchor">[4]</a> of Wiesbaden.</p>
+
+<div class="blockquot"><p>&#8220;The last question, whether mineral water acts also by contact
+with the skin, leads us to one of its most important effects&mdash;that
+through electricity.</p>
+
+<p>&#8220;Although this question has not as yet been finally disposed
+of, we have still advanced far toward its solution, through the
+admirable researches of <span class="smcap">Heymann</span> and <span class="smcap">Krebs</span>. Both observers
+have furnished proof that the contact of the water of the bath<a name="FNanchor_5_5" id="FNanchor_5_5"></a><a href="#Footnote_5_5" class="fnanchor">[5]</a>
+with the human body gives rise to electric currents, which currents
+must be looked upon as being the excitors of the nerve-currents,
+the body acting merely as a conductor. From these
+experiments we conclude that no particular difference obtains
+between artificial and transported waters on the one, and natural
+waters on the other hand, the assertions of <span class="smcap">Scoutettens</span> notwithstanding,
+who in regard to electricity claimed to have found
+a difference between the artificial and transported waters and
+the natural ones.</p>
+
+<p>&#8220;We gather moreover from the experiments, that the electric
+current generated through the contact of the body with the
+water of the bath is modified chiefly by the gases, next by the
+temperature of the water, and lastly only by its salts.</p>
+
+<p><span class="pagenum"><a name="Page_34" id="Page_34">[34]</a></span>&#8220;The effects of the bath depend on the strength of the electric
+current generated and on the condition of the peripheral
+endings of the nerves; the effect may be stimulating or soothing.
+The strength of the current is governed, as we have seen,
+by the quantity of gases present, the temperature and the salts.
+Ordinary lukewarm baths, indifferent baths containing a small
+amount of gases, are less stimulating than mineral baths containing
+a larger proportion of gases.</p>
+
+<p>&#8220;With regard to the relative condition of the peripheral nerve-ends,
+experiments on the motor nerves go to show that swelling
+of the terminal ends of these nerves may diminish their excitability
+to the point of its complete extinction, while it becomes
+increased by their exsiccation. This fact as to the motor nerves
+is adopted by <span class="smcap">Heymann</span> likewise as applying to the nerves of
+sensation. If, now, we presuppose absorption or even imbibition
+on the part of the skin, a swelling of the nerve-ends is comprehensible,
+as the imbibed fluid reaches them. But, according to
+<span class="smcap">Heymann</span>, the peripheral nerve-ends, i.e., the terminal bulbs of
+<span class="smcap">Krause</span>, of the sensory nerves, and the tactile corpuscles of
+<span class="smcap">Meissner</span>, become even without this presupposition sufficiently
+impregnated with water while in the bath, because here all insensible
+perspiration must cease, and in a bath of a temperature
+lower than blood-heat transpiration cannot take place, so
+that all transudation to the skin being retained during the
+bath, those termini are surrounded by moisture and therefore
+swell up.</p>
+
+<p>&#8220;From this the writer concludes with regard to the effects
+of the baths, that all baths in which the electric current produced
+by contact of the water with the body preponderates
+over the swelling of the nerve-ends, have a stimulant effect,
+<span class="pagenum"><a name="Page_35" id="Page_35">[35]</a></span>while those baths where the swelling preponderates over the
+electric current, act as a sedative.</p>
+
+<p>&#8220;Taking a brief and comprehensive review therefore of the
+effects of mineral water baths, we have those resulting from
+the temperature, from the contents of carbonic acid and salts,
+and lastly from the electric current generated in the bath water;
+each effect however resolving itself into an excitation of the
+peripheral nerve-ends, which leads in a reflex manner to an enhancement
+of the change of matter.&#8221;</p></div>
+
+<p>From the foregoing quotation may be realized
+the importance which is attached to the electric current
+in the warm bath. And here let me ask the
+question: May not the remedial superiority, in
+many cases, of the mineral water bath over the ordinary
+warm bath be due mainly, if not solely, to
+the more abundant generation in the former of electricity?
+Or rather, is it not very likely that this is
+so? And if such is the case, it would appear evident
+that the mineral water bath, the electric properties
+of which, depending on the chemical changes
+going on between the gases and salts of the water
+on the one, and the cutaneous secretions and other
+constituents of the body on the other hand, are to a
+great extent beyond our control, must in turn be
+vastly inferior to a bath where the electric current is
+under our perfect control, and can be modified in
+intensity, direction and quantity to meet the individual
+<span class="pagenum"><a name="Page_36" id="Page_36">[36]</a></span>requirements of every case. And such is
+the electric bath I am now describing.</p>
+
+<p>The second difference between the electric bath
+and all other methods of applying electricity is, that
+<i>the bath is the only method by means of which general
+electrization can be realized</i>. In making a distinction
+in this respect, it becomes necessary for me to
+advert more especially to a method first introduced
+to the profession in a systematized and scientific
+manner by Drs. <span class="smcap">Beard</span> and <span class="smcap">Rockwell</span>,<a name="FNanchor_6_6" id="FNanchor_6_6"></a><a href="#Footnote_6_6" class="fnanchor">[6]</a> and
+termed by them &#8220;General Faradization.&#8221; The undoubted
+good results that have been obtained from
+this method&mdash;for the details of which I refer the
+reader to the latest work of the authors<a name="FNanchor_7_7" id="FNanchor_7_7"></a><a href="#Footnote_7_7" class="fnanchor">[7]</a>&mdash;have
+caused it to be extensively adopted by the medical
+profession, both here and in Europe. It is, however,
+not with its results that I have to do at present, but
+with its appellation and true nature. General faradization,
+so-called, consists of a series of local faradizations,
+administered during one and the same
+s&eacute;ance, until the current has alternately been made
+to impinge upon and traverse the entire or at least
+<span class="pagenum"><a name="Page_37" id="Page_37">[37]</a></span>a large portion of the body. This cumulative procedure,
+it is true, approaches general electrization,
+as represented by the electric bath, more closely
+than any of the other local methods; yet it is not
+that which its name would imply, and I do not
+think it requires argument to make it apparent, that
+even this procedure differs vastly from the electric
+(whether galvanic or faradic) bath, where the current
+at one and the same time impinges directly on
+every peripheral nerve-end (excepting those of the
+head and face) and traverses every part of the body,
+obtaining&mdash;both as to reflex and direct effects&mdash;as
+a whole that which the method known as general
+faradization seeks to obtain by the cumulation of
+fractional portions.</p>
+
+<p>Having thus, I trust, established the individuality
+of the bath as an electric method, I will without further
+digression proceed to the consideration of its
+physiological effects.</p>
+
+<p>The physiological effects of the electric bath may
+be qualified on the one hand as either &#8220;immediate,&#8221;
+or &#8220;remote,&#8221; on the other as either &#8220;transient&#8221; or
+&#8220;permanent.&#8221; Strictly to classify these is impracticable,
+and I will therefore be influenced in the order
+of their enumeration principally by their importance
+in a therapeutic respect.</p>
+
+<p><span class="pagenum"><a name="Page_38" id="Page_38">[38]</a></span>One of the most pronounced as well as uniform,
+and at the same time most important, effects of the
+electric bath, is its property as an</p>
+
+
+<h3>HYPNOTIC.</h3>
+
+<p>This somniferous influence, which is to some extent
+exercised by local electrization, is here distinguished
+by its far greater constancy as well as by its
+greater degree of perfection. That this difference
+should exist, appears quite natural, when it is considered
+that the same topical influences which produce
+it in local electrizations, and which I shall presently
+endeavor to analyze, are here brought to bear
+on the entire system. The hypnotic effect is both
+immediate and remote, and more or less permanent.
+When there is an immediate inclination to sleep,
+which may make itself manifest during the bath or
+immediately after this, it is generally accompanied
+by a</p>
+
+
+<h3>PLEASANT SENSE OF FATIGUE,</h3>
+
+<p class="continued">which cannot be likened to weariness, but rather to
+what we feel after moderate exercise; it is only in
+some instances, where an individual takes his first
+bath, or where, for therapeutic reasons, a strong
+faradic current&mdash;accompanied by responsive muscular
+contractions&mdash;is employed, that this feeling is intensified
+<span class="pagenum"><a name="Page_39" id="Page_39">[39]</a></span>sufficiently to become unpleasant, calling for
+rest and recuperation, and must here be looked upon
+as analogous to the effects of <i>severe</i> exercise. It invariably
+disappears after a brief rest.</p>
+
+<p>Experience and good judgment will enable us
+moreover in almost all cases to avoid effects of this
+kind. The immediate inclination to sleep is much
+more decided as well as constant when the bath is
+taken late in the day, than when taken in the forenoon.
+When the latter is the case however, the individual
+will as a rule become sleepy during the afternoon,
+or else at an earlier hour than usual in the evening,
+and sleep more soundly during the night. This is
+the effect of one bath. A series of baths will however
+produce more or less marked and permanent
+improvement in the sleep of individuals, where this
+has been below the normal standard. And this is
+among the most invariable of the effects of the electric
+bath, whether galvanic or faradic.</p>
+
+<p>I have formed a theory as to the <i>rationale</i> of this
+influence, which I will offer as its probable explanation.
+We all know that sleep is a process designed
+by nature for the recuperation of the system after a
+certain period of activity. In other words, when the
+various functions have been more or less exercised
+for their daily allotted time&mdash;say seventeen hours&mdash;the
+<span class="pagenum"><a name="Page_40" id="Page_40">[40]</a></span>respective organs need that profound rest which
+we know as sleep. Now, it is pretty well conceded
+by physiologists, that electricity stimulates the secretory
+as well as excretory organs; that it furthers
+endosmosis and exosmosis&mdash;by its electrolytic influence
+in a physical, by its influence on the nervous
+system in a catalytic manner, in short, and by virtue
+of these properties, that it greatly</p>
+
+
+<h3>ENHANCES THE CHANGE OF MATTER</h3>
+
+<p class="continued">and incites the various organs to so great an activity
+as to cause them to perform in a comparatively brief
+space of time&mdash;say an hour, the work of several
+hours. The natural sequence is obvious: <i>The want
+of rest&mdash;of sleep, is felt at a correspondingly earlier
+period.</i> I offer this as a probable explanation of the
+immediate or almost immediate disposition to sleep.
+As to the permanent improvement in sleep, where
+this has been below the normal standard, it must
+always be due to the removal of some morbid condition,
+and thus belongs among therapeutic results,
+rather than physiological effects. It is true that in
+many instances of <i>agrypnia</i> we are unable to discover
+any pathological condition that would account for
+this symptom; but the probability is that here there
+is a sluggishness of some one or more of the functions,
+<span class="pagenum"><a name="Page_41" id="Page_41">[41]</a></span>mental or physical, too obscurely manifested to
+be discovered by our present means of diagnosis, yet
+reached and rectified by a mode of electrization that
+traverses and permeates <i>every</i> portion of the body.</p>
+
+<p>If this explanation of the hypnotic effect of the
+electric bath be not the true one, it is at least&mdash;so
+far as I know&mdash;the first attempt at accounting for a
+phenomenon that has been noticed as a result of
+even local applications of electricity by many observers,
+and about the pretty uniform occurrence of
+which there can be no doubt.</p>
+
+<p>With respect to the effect on the</p>
+
+
+<h3>TEMPERATURE AND PULSE,</h3>
+
+<p class="continued">I have made a number of observations, of which I
+have recorded twenty-two, made on persons where
+both were at or nearly at the normal standard.
+With regard to the frequency of the pulse, the results
+were conflicting and by no means reliable. In the
+majority of cases there was an increase, immediately
+after the bath, ranging from four to eighteen beats
+per minute. In others there was no change whatever,
+and in a few there was an absolute diminution in
+frequency; this last I believe however to be a therapeutic
+rather than physiological effect, manifesting
+itself only where there is pneumogastric asthenia,
+<span class="pagenum"><a name="Page_42" id="Page_42">[42]</a></span>and attributable directly to electric stimulation of
+this nerve. Thus in one instance, which occurred in
+the person of a physician of this city, who had an
+intermittent pulse, the result was as follows: Immediately
+before bath: pulse 70, two intermissions;
+at the expiration of 15 minutes, during which he
+was under the influence of a descending galvanic
+current: pulse 65, two intermissions; at the end of
+ten more minutes, during which he received the
+faradic current: pulse 65, no intermissions; ten
+minutes after leaving the bath: pulse 66, no intermissions.
+As a rule then, we may look for an immediate
+and more or less transient moderate increase
+in frequency of the pulse. As for any permanent
+increase or reduction of the pulse, there is none as a
+physiological effect. Where such an one does take
+place, it is by the removal of some morbid influence
+on the heart, and must be looked upon as a therapeutic
+result.</p>
+
+<p>With respect to the temperature, the results were
+somewhat more uniform. I have found that where
+this is either normal or slightly below, the immediate
+but transient effect is to raise it from 2 to 6
+tenths of a degree (Fahrenheit)&mdash;in most instances
+4 tenths. In a very few cases it remained unchanged,
+and in one case, where before the bath
+<span class="pagenum"><a name="Page_43" id="Page_43">[43]</a></span>the temperature was 100, at the close of the bath it
+was 99&#8535;. Of permanent modifications of the temperature,
+the same holds good that I have said of
+permanent changes in the pulse. It must not be
+forgotten that the temperature of the water is undoubtedly
+an important factor in modifying the temperature
+of the body. In almost all instances where
+my observations were made, the temperature of the
+water was below that of the body, being 95&deg; or a
+little less. This, which has a tendency to lower the
+bodily temperature, is to some extent counterbalanced
+by the suppression of the insensible perspiration,
+so that modifications of temperature resulting
+from electric baths, the water of which is but
+few degrees below 98&frac12;&deg;, may justly be attributed to
+the influence of the electric current. The importance
+of the electric bath as a</p>
+
+
+<h3>PHYSIOLOGICAL STIMULANT AND TONIC</h3>
+
+<p class="continued">cannot be overrated. I deem it superior in this respect
+to any other known agent. This effect manifests
+itself <i>immediately</i> by a feeling of exhilaration and
+unwonted vigor, <i>remotely</i> by an improvement&mdash;where
+there is a margin for such&mdash;in the performance of
+some or all of the physiological functions, as well as by
+a gradual but nevertheless marked <i>increase in weight</i>.</p>
+
+<p><span class="pagenum"><a name="Page_44" id="Page_44">[44]</a></span>Most striking among the tonic influences of the
+baths, are those that occur within the sphere of the
+digestive and sexual apparatuses. I will first consider
+the effects on</p>
+
+
+<h3>THE DIGESTIVE APPARATUS,</h3>
+
+<p class="continued">which may be subdivided into those on <i>a</i>) the appetite,
+<i>b</i>) digestion, absorption and assimilation, and <i>c</i>)
+alvine excretion. The improvement of the appetite
+under electro-balneological treatment is one of the
+most constant effects of this. While a series of baths
+will produce permanent results in this respect, an increase
+of the appetite, in some instances amounting
+to positive hunger, is a tolerably uniform and more
+or less immediate result of each separate bath. The
+permanent improvement of the appetite is relative.
+Not very appreciable where this is normal, it becomes
+most marked where the appetite has from some
+cause been impaired. The effect on the appetite is
+<i>definite</i>. The effects on absorption and assimilation
+are <i>presumptive</i>; but when we couple the absence of
+any corresponding difficulty in digesting the increased
+supply of food, with the increase before
+alluded to in the weight of the body, their assumption
+becomes fully justifiable. It is these combined
+<span class="pagenum"><a name="Page_45" id="Page_45">[45]</a></span>influences that make the electric bath so valuable a
+remedy in almost all forms of dyspepsia.</p>
+
+<p>The influence on the alvine process is if anything
+even more marked than that on the assimilative process.
+Where the action of the bowels is normal, it
+is not modified permanently by the electric bath,
+although we often have, as an immediate consequence,
+a cathartic effect that manifests itself as a
+more or less watery evacuation, either a few hours
+after the bath or on the succeeding day. Where the
+fecal process however is sluggish, the improvement
+resulting from the baths is very striking. I shall
+recur more fully to this subject under the head of
+constipation.</p>
+
+<p>The effects on the various functions connected
+with digestion are due doubtless to the combined
+influences of stimulation of the secretions of the
+alimentary canal and stimulation of the muscular coats
+of the stomach and intestines, as well as permanent
+tonization of the <i>muscularis</i>. While the enhancement
+of the secretions is undoubtedly due chiefly to
+the electric stimulus to the secreto-motor nerves,
+and the increased activity of the muscular coats to a
+like influence transmitted to their motor nerves, I
+believe the permanent tonization and invigoration of
+the muscular fibres to be mainly attributable to the
+<span class="pagenum"><a name="Page_46" id="Page_46">[46]</a></span>direct trophic influence of the current traversing the
+parts themselves; and I have no doubt that this direct
+influence has much to do with the stimulation of
+the secretions and <i>peristalsis</i> also. At any rate, I
+have never obtained from galvanization of the nervous
+centres, which I have practiced in a great number
+of cases, the striking effects on the alimentary
+processes which are so uniform a result of the baths.</p>
+
+<p>The influence on the</p>
+
+
+<h3>SEXUAL APPARATUS</h3>
+
+<p class="continued">of the electric bath does not manifest itself in so
+striking a manner as in the case of the organs of
+digestion. It is true I have seen individuals whose
+sexual functions were normal, have <i>stysis</i> in the
+bath, but the mere cutaneous irritation of the electric
+current is here sufficient to account for a phenomenon
+which, where sexual irritability is intact,
+will follow any other local irritations.</p>
+
+<p>If not as immediately perceptible, the stimulant
+and permanent tonic and invigorating influences on
+the sexual organs are not much less constant than
+the corresponding influences on digestion. Careful
+observation, however, of a considerable number of
+cases where the sexual function was more or less
+impaired, has convinced me that while there can be
+<span class="pagenum"><a name="Page_47" id="Page_47">[47]</a></span>no doubt that <i>direct</i> influence on the innervation,
+tone and nutrition of the respective parts as well as
+the stimulus which the electric current furnishes to
+the seminal secretion, bear a share in the improvement
+that takes place, permanent beneficial results
+must be looked upon as chiefly the expression of improved
+nutrition and tonization of the system at
+large. I do not mean to be understood as wishing
+to put in negation the beneficial results that the local
+influence of electricity is capable of sometimes accomplishing
+in the sexual sphere. These results,
+however, are not of a physiological, but rather of a
+purely therapeutic nature, and are obtained there
+only where local morbid conditions exist. Now, in
+the great majority of the cases that have come under
+my observation, the causes of deterioration of the
+sexual capacity, though frequently obscure and indefinable,
+were certainly not local, but to be sought for
+in the general&mdash;most probably the nervous&mdash;system.
+In none but perhaps the very mildest and recent
+cases have I ever seen <i>rapid</i> results follow electrical
+treatment of any kind whatsoever. In support of
+my assertion however that in the majority of cases
+the sexual sphere can be influenced only through
+the system at large, I will state <i>first</i>, that I have seen
+cases where local electrical treatment had utterly
+<span class="pagenum"><a name="Page_48" id="Page_48">[48]</a></span>failed to do the slightest good, respond favorably to
+the baths, and <i>second</i>, that where success was met
+with, it was only after persistent treatment, continued
+long enough to modify favorably the condition
+of the entire organism, and through this the objective
+sphere.</p>
+
+<p>The stimulant and tonic effects under consideration,
+although shared to some extent by other
+methods of electrization, are here far more comprehensive
+and pronounced, a fact which is not surprising,
+when we reflect that in the electric bath not
+only are all the organs <i>indirectly</i> influenced through
+stimulation of the nervous centres, but each separate
+organ is at the same time <i>directly</i> acted upon
+by the current.</p>
+
+<p>A direct sequence of the stimulant and tonic
+effects of the electric bath is its</p>
+
+
+<h3>SEDATIVE INFLUENCE.</h3>
+
+<p>This sedative effect, whereof the hypnotic effect
+already spoken of is the supreme manifestation,
+must not be associated for a moment with any idea
+of depression, for here we have none such. In addition
+to what I have already said in endeavoring to
+account for the hypnotic influence of the baths, I
+refer the reader for further information to the admirable
+<span class="pagenum"><a name="Page_49" id="Page_49">[49]</a></span>and lucid remarks on this subject by <span class="smcap">Beard</span>
+and <span class="smcap">Rockwell</span>.<a name="FNanchor_8_8" id="FNanchor_8_8"></a><a href="#Footnote_8_8" class="fnanchor">[8]</a></p>
+
+<p>The <i>galvanic</i> bath shares with other galvanic applications
+made in the cranial and upper spinal region,
+the effect of producing the galvanic <i>taste</i>, as
+also the <i>flashes</i> when the current is interrupted,
+showing that the</p>
+
+
+<h3>CRANIAL NERVES</h3>
+
+<p class="continued">come within the sphere of its influence.</p>
+
+<p>A further effect peculiar to the galvanic bath is
+a sense of</p>
+
+
+<h3>ITCHING,</h3>
+
+<p class="continued">felt chiefly in the lower extremities and about the
+neck, and proportioned to the intensity of the
+current. Rather pleasant when mild or medium
+currents are used, under the influence of strong
+currents it may become so intense as to create an irresistible
+desire on the part of the bather to scratch
+especially the legs.</p>
+
+<p>A negative effect of the galvanic bath, even
+where very intense currents are used, is the</p>
+
+
+<h3>ABSOLUTE FREEDOM FROM PAIN</h3>
+
+<p class="continued">throughout the entire process. I wish this to be
+<span class="pagenum"><a name="Page_50" id="Page_50">[50]</a></span>understood of course as holding good only when
+currents within the ordinary limits of intensity are
+employed. The strongest that I have used, and on
+which I base my statement, was that from 48 St&ouml;hrer
+or 60 Hill cells. As stronger currents are not required
+for therapeutic purposes, what I have asserted
+remains practically true as applied within these limits.</p>
+
+<p>This absence of pain, which cannot be claimed
+for correspondingly intense local applications, is to
+be attributed to the <i>diffusion</i> of the current throughout
+the body and its surface, as well as through the
+water of the bath. The redness of the <i>entire</i> back after
+a galvanic bath, is among the proofs of this diffusion.</p>
+
+<p>Freedom from pain is a characteristic likewise of
+the faradic bath, <i>properly administered</i>. When too
+strong a faradic current however is incautiously administered,
+the resulting muscular contractions are
+accompanied by an amount of local pain proportioned
+to the violence of the contractions. By keeping
+the faradic current within proper limits, all pain
+can be avoided.</p>
+
+<p>With respect to</p>
+
+
+<h3>MUSCULAR CONTRACTIONS,</h3>
+
+<p class="continued">the effects of the electric bath may be distinguished
+from those obtained by other modes of faradization
+<span class="pagenum"><a name="Page_51" id="Page_51">[51]</a></span>by their comprehensiveness. Many groups of muscles
+may be made simultaneously to contract by this
+means. The practical bearing of this on the therapeutics
+of <i>pareses</i> and <i>paralyses</i>, renders it an important
+characteristic of the bath.</p>
+
+<p>The physiological effects on</p>
+
+
+<h3>THE MIND</h3>
+
+<p class="continued">of electric baths, is a natural result of the enhanced
+tone and vigor of the physical system, and keeps
+pace with this. Mental buoyancy and even exhilaration
+are among the most common sequences of
+electric baths. Although indirect, these results are
+none the less decided.</p>
+
+<p>It has been my aim in the foregoing remarks to
+give the reader, as concisely as possible and within
+the limits which I set for myself in the beginning of
+the present chapter, a summary of the more important
+physiological effects of electric baths. As the
+isolated results of observations made in a limited
+field by one unaided individual, I trust the shortcomings
+of this chapter will be viewed indulgently.
+If what I have said of the physiological effects of
+electric baths proves the means of stimulating to
+further investigation more competent observers than
+myself, my labor, whatever its imperfections, will
+not have been in vain.</p>
+
+<div class="footnotes"><p class="footnotetitle">Footnotes:</p>
+
+<div class="footnote"><p><a name="Footnote_4_4" id="Footnote_4_4"></a><a href="#FNanchor_4_4"><span class="label">[4]</span></a> Dr. Franz Hartmann; &#8220;Der acute and chronische Gelenkrheumatismus,&#8221;
+Erlangen, 1874; pp.&nbsp;194 et seq.</p></div>
+
+<div class="footnote"><p><a name="Footnote_5_5" id="Footnote_5_5"></a><a href="#FNanchor_5_5"><span class="label">[5]</span></a> The Author here refers to mineral-water. Dr.&nbsp;S.</p></div>
+
+<div class="footnote"><p><a name="Footnote_6_6" id="Footnote_6_6"></a><a href="#FNanchor_6_6"><span class="label">[6]</span></a> The Medical Use of Electricity, with special reference to
+general electrization as a tonic, etc. New York, 1867.</p></div>
+
+<div class="footnote"><p><a name="Footnote_7_7" id="Footnote_7_7"></a><a href="#FNanchor_7_7"><span class="label">[7]</span></a> Beard and Rockwell; Medical and Surgical Electricity.
+N.&nbsp;Y. 1875.</p></div>
+
+<div class="footnote"><p><a name="Footnote_8_8" id="Footnote_8_8"></a><a href="#FNanchor_8_8"><span class="label">[8]</span></a> Op. cit. pp.&nbsp;253. et seq.</p></div>
+</div>
+
+
+
+
+<h2><span class="pagenum"><a name="Page_52" id="Page_52">[52]</a></span><a name="CHAPTER_IV" id="CHAPTER_IV"></a>CHAPTER IV.</h2>
+
+<p class="subheader">GENERAL THERAPEUTIC EFFECTS AND USES.</p>
+
+
+<p class="newsection"><span class="uppercase"><span class="dropcap">T</span>he</span> therapeutic uses of a remedy are based on
+what we know of its physiological effects.
+Many&mdash;or rather most&mdash;of the therapeutic effects of
+this as well as of most other remedies, correspond
+to certain physiological effects. Those therapeutic
+effects whereto we find none analogous among the
+physiological effects, are yet the results of the physiological
+tendencies of the remedy, and where these
+tendencies do not manifest themselves as results, it
+is because they find no field for action in the healthy
+organism. When they meet with the requisite
+pathological conditions, these tendencies make themselves
+manifest in the shape of definite results, commonly
+known as therapeutic effects.</p>
+
+<p><span class="smcap">Nothnagel</span>, in his classical work,<a name="FNanchor_9_9" id="FNanchor_9_9"></a><a href="#Footnote_9_9" class="fnanchor">[9]</a> recognizes this
+theory by excluding from his book the term &#8220;therapeutic
+effects&#8221; altogether. Where he finds it necessary
+<span class="pagenum"><a name="Page_53" id="Page_53">[53]</a></span>to say anything of the physiological effects of a
+remedy, in addition to those &#8220;on man in health,&#8221;
+he speaks&mdash;still under the head of &#8220;physiological
+effects&#8221;&mdash;of those &#8220;on man when sick.&#8221; When,
+setting aside its empirical employment, we come then
+to inquire what it is that furnishes us with the true
+indications for the use of a remedy, analysis of the
+question leads us invariably back to its physiological
+effects. If I have failed nevertheless to include the
+few effects which I am about to touch on, under the
+head of &#8220;physiological effects,&#8221; I have done so
+simply in compliance with universal usage, and as a
+matter of convenience for reference.</p>
+
+<p>I will now, without further digression, proceed to
+the consideration of those effects of electric baths not
+yet enumerated.</p>
+
+<p>As a fitting precursor to the enumeration of the
+therapeutic properties of the remedy under consideration,
+it may be well to dwell for a moment on
+what is among its most prominent characteristics; I
+have reference to its great value as a</p>
+
+
+<h3>DIAGNOSTIC.</h3>
+
+<p>In explanation of this, I will state that in a very
+large number of cases of disease of an obscure nature,
+and where, to be candid, the electric bath was employed
+<span class="pagenum"><a name="Page_54" id="Page_54">[54]</a></span>empirically, or, if you please, tentatively, it
+has served to point out the <i>locus morbi</i>. The number
+of cases in which I have made this observation,
+has been sufficiently large to establish beyond a
+doubt the fact, that as a rule the electric current
+makes itself more decidedly and often even painfully
+felt in any part where a morbid condition exists;
+whether this be of an inflammatory, neuralgic, rheumatic,
+traumatic, congestive or other nature, the
+result is the same. It appears to be somewhat
+analogous to the &#8220;tenderness on pressure&#8221; that
+we find present in many of these conditions. In
+<i>an&aelig;sthesi&aelig;</i> even the current makes itself conspicuous
+by the <i>absence</i> of its normal effects. The value of
+this will at once be recognized in connection with a
+method of electric application which at one and the
+same time acts on every portion of the body. Local
+electrization is accompanied by like phenomena,
+<i>when we happen to strike the right spot</i>. The superiority
+of the bath as a means of diagnosis is
+found in the circumstance that here we <i>must</i>
+touch it.</p>
+
+<p>The great importance of this feature of the
+electric bath will at once be realized by every physician
+of much experience, for there can be none
+such who has not frequently met with subacute or
+<span class="pagenum"><a name="Page_55" id="Page_55">[55]</a></span>chronic conditions the etiology of which was more
+or less obscure.</p>
+
+<p>One of the most important effects in its therapeutic
+application of the electric bath, is its superior
+excellency as an</p>
+
+
+<h3>EQUALIZER OF THE CIRCULATION;</h3>
+
+<p class="continued">so far as I know, it is more potent, constant and
+comprehensive in this respect than any other agent.
+Where an imperfect circulation of the blood is due
+to irremovable organic causes, the results obtained
+will of course be transient only. In all other cases,
+however, favorable results, more or less perfect according
+to the nature of the case, may be reliably
+looked for. Both currents act very well in this respect,
+though on the whole I look upon the galvanic
+as superior to the faradic current.</p>
+
+<p>As a theory of this effect of the currents I
+would offer the following, viz: That the galvanic
+current acts by stimulating the vasomotor centres
+and peripheral nerves, by giving tone to the mucular
+coats of blood vessels, and by counter-irritation.
+That the <i>faradic</i> current stimulates the vasomotor
+centres little, if at all, does not influence the coats
+of vessels, except such as are close to the skin, but
+tonicizes these latter more effectually than the galvanic
+<span class="pagenum"><a name="Page_56" id="Page_56">[56]</a></span>current; that it stimulates the peripheral
+nerves to some extent, though far inferior in this
+respect to the galvanic current; but that when employed
+of sufficient intensity it superadds to those
+mentioned a strictly mechanical action, which consists
+in forcing static blood from the capillary into
+the general circulation through the medium of muscular
+contractions.</p>
+
+<p>As a</p>
+
+
+<h3>GENERAL COUNTER-IRRITANT</h3>
+
+<p class="continued">the <i>galvanic</i> bath has few if any superiors. The
+degree of counter-irritation can be very nicely determined
+by regulating the intensity of the current.
+The characteristic tingling sensation of the galvanic
+current is felt over the entire surface, corresponding
+in degree of course to the intensity of the current;
+while the redness of the skin, bearing a like relation
+to the intensity of the current, is observable more
+especially near the electrodes, being particularly
+conspicuous over the entire back. Concentrated
+local counter-irritation can be obtained by the use
+of the surface board.</p>
+
+<p>The counter-irritant effects of the galvanic bath,
+differ from those of ordinary counter-irritants in
+their freedom from pain, even the slight burning
+<span class="pagenum"><a name="Page_57" id="Page_57">[57]</a></span>sensation accompanying strong currents ceasing
+with the application. The redness remains quite
+a while and the stimulus to the peripheral circulation
+causes the persistence for some time of a &#8220;glowing&#8221;
+sensation all over the body.</p>
+
+<p>In the chapter on physiological effects enough
+has been stated to make it apparent that as a</p>
+
+
+<h3>GENERAL INVIGORANT AND TONIC</h3>
+
+<p class="continued">the electric bath can have few if any superiors. In
+the healthy organism, however, the stimulant and
+tonic effects of the baths are much less marked than
+they are where the general condition is &#8220;below par.&#8221;
+In health there is little or no margin for improvement.
+The results obtained are <i>temporary</i> stimulation,
+and a permanent invigoration which partakes
+more of artificial development than anything else.
+It is analogous to the development by gymnastic or
+other exercise of a previously healthy set of muscles.
+Where we meet with atonic conditions however,
+with debility, malnutrition, want of energy or general
+asthenia of an obscure nature, and amenable to electric
+influence, the tonic effects of the baths become
+striking and brilliant. I have observed cases where
+patients fairly bloomed up under their influence
+and acquired actually more physical strength and
+<span class="pagenum"><a name="Page_58" id="Page_58">[58]</a></span>weighed more than before they became sick. When
+we consider how in such conditions as those mentioned,
+patients are made to swallow pills and mixtures
+for months or years, or, more appropriately,
+and if they can afford it, are sent abroad, we can
+realize the importance of an agent by means of which
+the desired end can be obtained more conveniently,
+certainly, economically and in a shorter time than by
+any other means. There is no rule without its exceptions,
+and I freely admit that in many instances
+where persons are, as the saying is, &#8220;run down,&#8221; a
+sojourn in some mountainous region or a course of
+sea-bathing, etc., would do them more good than
+anything else, electric baths included. The results
+obtained from these last are however sufficiently uniform
+to justify us in looking for very favorable results
+in every case.</p>
+
+<p>In the preceding chapter I have already dwelt
+on the</p>
+
+
+<h3>HYPNOTIC AND SEDATIVE INFLUENCE</h3>
+
+<p class="continued">of the baths. It is only necessary to state here that
+this influence manifests itself still more decidedly in
+corresponding morbid conditions than in health.
+The greater the degree of restlessness, irritability or
+wakefulness, the more strikingly does the soothing
+<span class="pagenum"><a name="Page_59" id="Page_59">[59]</a></span>and hypnotic influence of the baths&mdash;appropriately
+administered, of course&mdash;become apparent.</p>
+
+
+<h3>IMPROVEMENT OF NUTRITION,</h3>
+
+<p class="continued">as manifested by rapid increase of weight, and which
+I have likewise touched upon in the preceding chapter,
+is a reliable, constant effect of electric baths.
+Where previous loss of weight is due to an incurable
+organic disease, it is, if at all obtained, of course
+much less in degree, as well as transient. When due,
+however, as is frequently the case, to causes that are
+amenable to electrical influence, the increase in weight
+is marked, and has a tendency to be permanent.</p>
+
+<p>It will be seen that the few therapeutic effects
+which I have here enumerated, are in reality nothing
+more than intensified physiological effects, there
+being about them nothing that might be termed
+specific. It may be asked in reply: why then did I
+devote any space to them at all? I will answer that
+I thought best to point out some general therapeutic
+USES for which electric baths may be made available,
+and the indications for which are furnished by so
+great a number of pathological conditions, that
+omitting special reference to them would have led to
+a great deal of tautology in the chapter on &#8220;special
+therapeutics.&#8221;</p>
+
+<p><span class="pagenum"><a name="Page_60" id="Page_60">[60]</a></span>Before leaving the subject of &#8220;general uses&#8221; of
+the baths, I will dwell for a moment on their admirable
+adaptability as a</p>
+
+
+<h3>PROPHYLACTIC.</h3>
+
+<p class="continued">Every physician is fully aware of the fact that disturbances
+of the circulation constitute one of the
+most frequent causes of disease. There are, indeed,
+comparatively few pathological conditions that do
+not bring with them congestion of some more or less
+important organ. A remedy then which more than
+any other has a tendency to equalize the circulation,
+and thus counteract a condition which as cause or
+effect, or both, is an almost universal concomitant of
+disease, and which in addition to this is so admirable
+and physiological a stimulant and tonic, can hardly
+be surpassed as a prophylactic by any other uncombined
+remedy.</p>
+
+<div class="footnotes"><p class="footnotetitle">Footnotes:</p>
+
+<div class="footnote"><p><a name="Footnote_9_9" id="Footnote_9_9"></a><a href="#FNanchor_9_9"><span class="label">[9]</span></a> Dr. Hermann Nothnagel: Handbuch der Arzneimittellehre.
+Berlin, 1870.</p></div>
+</div>
+
+
+
+
+<h2><span class="pagenum"><a name="Page_61" id="Page_61">[61]</a></span><a name="CHAPTER_V" id="CHAPTER_V"></a>CHAPTER V.</h2>
+
+<p class="subheader">SPECIAL THERAPEUTICS AND CLINICAL RECORD.</p>
+
+
+<p class="newsection"><span class="uppercase"><span class="dropcap">I</span> have</span> thought it best for practical purposes, to
+accompany the consideration of the treatment of
+special diseases by the histories of illustrative cases,
+where I had such at command.</p>
+
+<p>Before entering on the subject proper, I wish to
+offer some general considerations that may influence
+and guide us in determining when, where and why
+to employ electric baths as a remedy.</p>
+
+<p>To realize thoroughly the indications in given
+cases for the employment of electric baths, we must
+first of all be more or less familiar with the effects
+and uses of the electric current as well as those of
+the ordinary warm bath. We must realize the fact
+that here we not only have these two forces united,
+but that the more important of the two, the electric
+current, here acts directly (locally) as well as indirectly
+(through the nervous centres) on every portion
+of the body&mdash;a circumstance of great importance
+in differentiating indications on the one hand
+<span class="pagenum"><a name="Page_62" id="Page_62">[62]</a></span>for the baths, on the other for local electrization. In
+view of these circumstances we are fully justified in
+looking for results far more comprehensive than any
+that might be obtained singly from either of the two
+remedies that are here combined. There can be no
+doubt that in many cases the resisting power of
+a disease is sufficient to withstand two remedies
+brought singly and alternately to combat it, whereas
+the simultaneous combined action of these remedies
+may be fully adequate to overcome this resisting
+power.</p>
+
+<p>Approaching in its effects more closely to the
+electric bath than any other remedy, is the process
+known as &#8220;general faradization,&#8221; to which I have
+already alluded (<a href="#Page_36">p.&nbsp;36</a>). In choosing between this and
+the bath, I state it as my conviction that, while there
+may be a small proportion of cases in which general
+faradization, so-called, is preferable, in almost all the
+cases where both these remedies are applicable, the
+faradic bath deserves the preference&mdash;it is a <i>more
+complete</i> faradization.</p>
+
+<p>We need never be afraid of ordering electric
+baths on the score of any imagined exertion or discomfort
+attaching to them. The most delicate, the
+aged and children alike, bear them with far more
+ease, comfort and impunity than any ordinary warm
+<span class="pagenum"><a name="Page_63" id="Page_63">[63]</a></span>bath, or any but the mildest local electrization. The
+entire absence of shock or pain of any kind whatsoever,
+is always an agreeable surprise to those who,
+urged by their physicians, have with fear and trembling
+submitted themselves to a treatment, the mere
+name of which filled their minds with extravagant&mdash;and,
+it is useless to say, groundless&mdash;visions of painful
+shocks. Thanks to the tonic effects of the current,
+they are by the feeble and infirm borne much
+better than the ordinary warm bath. There is likewise
+much less liability to get cold after the electric
+bath. The stimulus which the current furnishes to
+the peripheral circulation is a powerful protection
+against cold, so that even in midwinter I see people
+daily take electric baths at an average temperature
+of 95&deg;, and enjoy apparent immunity from colds.</p>
+
+<p>Having once determined on the use of the baths
+in a given case, we have to observe certain points in
+their application.</p>
+
+<p>In the first place, guided by what we know of the
+relative effects of galvanism and induced electricity,
+we must decide which of these two currents to use,
+and if both, in which order. We must determine on
+the direction and intensity of the currents, as well as
+on the duration of the baths.</p>
+
+<p>Next we must use our judgment as physicians,
+<span class="pagenum"><a name="Page_64" id="Page_64">[64]</a></span>in deciding whether a given case promises to get
+well under electro-balneological treatment alone, or
+whether auxiliary treatment may not be required to
+bring it to a favorable issue.</p>
+
+<p>With respect to the frequency of the applications,
+I will say that while there are some cases where a
+bath twice a week is sufficient, and others where a
+bath every day is imperatively necessary, in far the
+greater majority of cases suitable for electro-balneological
+treatment, a bath every alternate day is
+<i>sufficient</i>, but a bath every day is <i>better</i>&mdash;it leads to
+more rapid as well as certain results.</p>
+
+<p>In most of the cases, a daily bath for a few days
+or a week, followed by one every other day for a
+time, and, when the cure is about completed, a bath
+twice a week, to <i>consolidate</i> and <i>confirm</i> the good
+results obtained, has done me the best service.</p>
+
+<p>I would dwell particularly on the necessity of
+<i>perseverance</i> in this treatment. The majority of
+cases that have come under my observation in this
+connection, have been of a more or less chronic nature.
+In many of these, where medicinal and other
+treatment had been unavailingly gone through with
+for weeks, months and even years, I have found existing
+the most absurd expectations with regard to
+the effects of the baths. People who had made the
+<span class="pagenum"><a name="Page_65" id="Page_65">[65]</a></span>tour of almost all the watering-places of Europe
+without obtaining the slightest benefit, have come
+to me imbued with the idea&mdash;whence derived I
+know not&mdash;that one or two baths should greatly improve,
+and two or three more cure them; and
+when these expectations were not realized, they
+would promptly discontinue treatment, fully satisfied
+that electric baths were no more capable of
+benefiting them than &#8220;all the other things.&#8221; I do
+not mean to be understood for a moment as intending
+to imply that ideas of this nature are shared by
+the profession; I mention them simply in order to
+show the necessity on the part of physicians to disabuse
+in this respect the minds of those patients
+whom they may send for electro-balneological treatment.</p>
+
+<p>In appropriate cases, the use of the bath should
+not be too long deferred. I have had frequent occasion
+to become cognizant of the fact, that cases
+have been sent by physicians to take the baths only
+after prolonged ineffectual treatment of another nature
+had been gone through with, and where negative
+or at best tardy results took the place of the
+brilliant results that might have been obtained, had
+the cases been sent earlier. I do not mention this
+in a fault-finding spirit; to do so would be unjust.
+<span class="pagenum"><a name="Page_66" id="Page_66">[66]</a></span>The remedy under consideration has up to the
+present time been too little known, the indications
+for its employment&mdash;in the absence of statistics&mdash;on
+too uncertain a basis, to expect from any but specialists
+the early realization in any case of its appropriateness.
+I trust however that in the future,
+from being a &#8220;dernier ressort,&#8221; it will come to take
+its proper place among other remedies, to be administered
+&#8220;when it will do the most good.&#8221;
+When this comes to pass, the results obtained, satisfactory
+as they are even now, will become as brilliant
+and well-authenticated as those of every other
+remedy from which experience has taught us how
+to reap the greatest advantage.</p>
+
+<p>In the following &#8220;clinical record&#8221; I shall not
+omit to cite cases where the baths were unsuccessful,
+wherever it shall appear to me that the citation
+of such cases may be of assistance in arriving at a
+true estimation of the therapeutic value of the
+remedy.</p>
+
+<p>In giving the histories of cases, it will scarcely be
+necessary to enter very minutely into details; the
+demands of the present work will be fully met if
+sufficient is said of a case to illustrate the effects of
+the baths in the class of cases that it represents.</p>
+
+<p>Finally, I wish it understood that in a few of the
+<span class="pagenum"><a name="Page_67" id="Page_67">[67]</a></span>conditions in which I shall advise the employment of
+the baths, I have had no personal experience in their
+use, but base my opinions on what I know of their
+effects, together with what is known of the results
+obtained in analogous conditions by local electrical
+methods.</p>
+
+
+
+<h3 class="special">SPECIAL DISEASES.</h3>
+
+
+<h3>RHEUMATISM.</h3>
+
+<p>Its great frequency, the pain and discomfort
+which it occasions, and its many, often dangerous
+<i>sequel&aelig;</i>, added to its frequent obstinacy under the
+most varied treatment, render rheumatism one of the
+most formidable diseases that we have to encounter.
+The long list of remedies that have from time to
+time been employed in its treatment, bear witness by
+their very number to the little reliance that can be
+placed in any one of them. A remedy then which
+can be <i>relied on</i> to exercise a favorable influence in
+all the forms of rheumatism&mdash;acute, subacute and
+chronic&mdash;as well as on most of its sequel&aelig;, should of
+right become a welcome addition to our armamentarium
+in the treatment of this disease; and such is
+the electric bath. The treatment of the sequel&aelig; I
+shall speak of under separate heads. The disease
+<span class="pagenum"><a name="Page_68" id="Page_68">[68]</a></span>itself I will divide into three classes, viz: <i>a</i>) acute, <i>b</i>)
+subacute and <i>c</i>) chronic rheumatism.</p>
+
+<p><i>a</i>) <span class="smcap">Acute Rheumatism.</span>&mdash;A few years ago the
+use of electricity in acute inflammatory conditions
+was scouted by most of the profession, and had it not
+been for the quiet and patient labors of a few progressive
+spirits, we would at the present day be still
+deprived of the benefits which we reap from it in
+these conditions. Even to-day, the number of those
+who are satisfied of the utility of electricity in this
+respect is comparatively small. Only two years ago,
+I attended a gentleman who was suffering from a
+very severe attack of rheumatic gout. I had both a
+galvanic and a faradic battery at his house, which, in
+addition to appropriate medicinal treatment, I applied
+daily to the affected joints,&mdash;using mainly the
+faradic current. Being compelled at the time to go
+to the country, the case during my absence drifted
+into the hands of a gentleman, a professor at one of
+the medical colleges, of high standing in the profession
+and considered one of our leading medical men,
+who ridiculed and promptly discontinued the use of
+electricity in the case. He gave it as his opinion
+that it did more harm than good, and I have no
+doubt he did so conscientiously&mdash;however unprofessional
+his conduct may have been, in this as well as
+<span class="pagenum"><a name="Page_69" id="Page_69">[69]</a></span>other respects. The contributions of others have
+since then vindicated my views in this respect.
+Among others, Dr. Drosdoff<a name="FNanchor_10_10" id="FNanchor_10_10"></a><a href="#Footnote_10_10" class="fnanchor">[10]</a> of St. Petersburg has
+given a number of cases of acute articular rheumatism
+from the clinique of Professor Botkin, in which the
+faradic current was employed either alone or in conjunction
+with other treatment. From among the
+deductions which he makes from a series of careful
+experiments in this respect, I quote a few&mdash;such as
+bear directly on our subject, and to which I affix my
+own numbers.</p>
+
+<div class="blockquot">
+<p>1) &#8220;The sense of pain as the result of electric irritation is
+considerably diminished, and sometimes entirely lost, in joints
+attacked by acute articular rheumatism, so that the patient experiences
+no pain, even when the distance between the coils
+equals naught<a name="FNanchor_11_11" id="FNanchor_11_11"></a><a href="#Footnote_11_11" class="fnanchor">[11]</a>, and both closure and opening are accompanied
+by the evolution of numerous sparks. At the same time the
+slightest pressure of the affected parts gives rise to the most intense
+pain.&#8221;</p>
+
+<p>&#8220;The diminution of the electro-sensibility appears in the
+majority of cases to be in inverse proportion to the severity of
+the disease and the intensity of the pain produced by mechanical
+irritation.&#8221;</p>
+
+<p>2) &#8220;The enhanced tactile and thermic sensibility of the diseased
+<span class="pagenum"><a name="Page_70" id="Page_70">[70]</a></span>joints is diminished by a faradization lasting from 5 to
+10 minutes.&#8221;</p>
+
+<p>3) &#8220;From 5 to 10 minutes faradization causes a reduction of
+the previously heightened temperature of the diseased joints to
+the normal standard, or even below this.&#8221;</p>
+
+<p>4) &#8220;The subjective rheumatic pains which are augmented
+by pressure and motion, are diminished by faradization. This
+diminution is sometimes so considerable, that the joint, which
+prior to the faradization admitted of no movement, is able to
+execute passive and active movements with tolerable facility.&#8221;</p>
+
+<p>5) &#8220;The rheumatic pains as well as the temperature of the
+affected joints remain diminished after the faradization for 3, 4
+and even 5 hours; they then gradually return to the previous
+height. At the same time the duration of the paroxysms of
+pain becomes shortened, and the intensity of this diminished.&#8221;</p>
+
+<p>6) &#8220;Although the rheumatic process takes a more rapid
+course under the influence of faradization, and incommodes the
+patient less, we have nevertheless made the observation in one
+case, that the tendency to recurrence is not diminished. The
+attacks however become more brief and milder.&#8221;</p>
+
+<p>7) &#8220;From what has here been said it follows, that daily faradizations,
+lasting 5&ndash;10 minutes, diminish the severity of acute
+articular rheumatism, restore the perverted cutaneous sensibility,
+and cause a reduction of the temperature of the affected
+joints.&#8221;</p>
+
+<p>8) &#8220;Several of those suffering from the pathological processes
+mentioned, received no medication in addition to the faradization,
+and yet made a tolerably rapid recovery.&#8221;</p>
+</div>
+
+<p>I might adduce further testimony of the value
+<span class="pagenum"><a name="Page_71" id="Page_71">[71]</a></span>of electricity in recent cases of rheumatism, were it
+necessary to do so. The results in my own cases
+however have long since satisfied me of the utility
+in this respect of faradic not only, but also of mild
+constant currents. Accepting this as matter of fact,
+let us next inquire where and why we are to give
+<i>general</i> electrization&mdash;in other words, the electric
+bath&mdash;the preference over local applications.</p>
+
+<p>Where the manifestations of the disease are
+limited to a single joint, or at best a very few joints,
+or where we have to do with a case of muscular
+rheumatism&mdash;to one group of muscles, local electrization,
+as <i>symptomatic</i> treatment, will answer. Where
+on the one hand however many joints, on the other
+the muscles of entire limbs, or even more, are involved,
+the advantages of a method by means of
+which we reach all the affected parts at once, thus
+effecting in, say ten minutes, that which where, for
+example, six joints are involved, would by the ordinary
+method require sixty minutes, are readily realized.
+There is, however, another reason why the baths
+are preferable in rheumatism to local applications.
+Rheumatism is a constitutional disease with local
+manifestations. The metastatic character of muscular
+rheumatism especially appears to indicate the
+greater importance of general as compared to local
+<span class="pagenum"><a name="Page_72" id="Page_72">[72]</a></span>treatment. Pre-supposing, then, that electricity exercises
+the favorable influence on rheumatism which
+clinical results would appear to demonstrate, it follows
+that the electric bath, while it furnishes symptomatic
+(local) treatment equally well with local
+applications, does something more; it meets the <i>indicatio
+morbi</i> likewise. The warm bath no doubt
+contributes its due share in bringing about the favorable
+results obtained.&mdash;Where the disease then does
+not confine the patient to bed, the electric bath will
+be found a most valuable remedy.</p>
+
+<p>The following directions will be found to answer
+best in the great majority of cases: The temperature
+of the water should range from 90&deg; to 98&deg;&nbsp;F; a mild
+constant current, descending, should be applied for ten
+minutes; this to be followed by a faradic current of
+as great an intensity as the patient can bear <i>without
+the slightest degree of discomfort</i>. In the application
+of the faradic current, the surface board (see <a href="#Page_12">p.&nbsp;12</a>)
+may advantageously be had recourse to for the purpose
+of more concentrated influence on affected parts,
+to each of which it may be applied for a few minutes;
+the entire faradization may last from ten to fifteen
+minutes. When coming from the bath, the patient
+should be received in a warm blanket, anything like
+a chill being carefully guarded against. In cases
+<span class="pagenum"><a name="Page_73" id="Page_73">[73]</a></span>where the cutaneous secretion is of an abnormally
+acid character (which is often so marked as to become
+apparent through the sense of smell), bicarbonate
+of soda or potassa may be added to the bath.
+As appears from the foregoing, the entire duration
+of the bath is from twenty to twenty-five minutes.
+The baths should be taken daily until all urgent
+symptoms have disappeared; after this, every two or
+three days as required, until an entire cure is wrought.</p>
+
+<p>As the results of this or similar treatment, conjoined
+with the requisite medicinal or other measures,
+I may state:</p>
+
+<p><i>a</i>) Considerable abridgment of the period of the
+disease;</p>
+
+<p><i>b</i>) Sequel&aelig; are less constant;</p>
+
+<p><i>c</i>) The tendency to recurrence is very much diminished;</p>
+
+<p><i>d</i>) A relapse, if it does occur, is comparatively
+mild.</p>
+
+<p>With regard to <i>b</i> and <i>c</i>, let it be understood that
+I speak within the restrictions of a period of observation
+extending over two and a half years only.</p>
+
+
+<h3><i>b</i>) <span class="smcap">Subacute rheumatism.</span></h3>
+
+<p>In the subacute variety, the electro-balneological
+treatment is similar to that in acute cases, with the
+<span class="pagenum"><a name="Page_74" id="Page_74">[74]</a></span>difference however, that here not so much care is
+necessary with regard to the intensity of the currents.
+Muscular contractions, as induced by strong
+faradic currents, are to be dreaded in direct proportion
+to the acuteness of the inflammation, <i>resp.</i> the
+sensitiveness of the inflamed tissues.</p>
+
+<p>It will be understood, I hope, that the electro-balneological
+treatment as laid down above, though
+it applies to the majority, does not apply to all cases.
+Special complications may make it expedient in individual
+cases to modify the treatment more or less.
+The course to be pursued in these instances may
+however be safely left to the judgment of the attending
+physician.</p>
+
+<p><i>c</i>) <span class="smcap">Chronic Rheumatism.</span> In this affection the
+course to be pursued varies from that indicated in
+the acute and subacute varieties. We have here
+little or no constitutional disturbance, and need have
+no fear of doing any harm by strong currents. On
+the contrary, I have found that mild currents rarely
+do any good. By far the greater majority of the
+cases that have come under my observation were of
+the muscular type, the algic portion of the symptoms
+approaching those of neuralgia rather than subacute
+rheumatism. Of chronic articular rheumatism I have
+treated but very few cases. Although in some of
+<span class="pagenum"><a name="Page_75" id="Page_75">[75]</a></span>the cases the treatment under consideration was
+attended with brilliant results, I freely admit that in
+some instances the results were imperfect, in others
+again entirely negative. This I found true more
+especially of cases that involved tendons. I must
+add, however, that in perhaps the greater majority
+of the unsuccessful cases the fault lay with the patients
+themselves, who, finding they were not benefited
+as rapidly as they had expected, discontinued
+treatment before this had had time to effect any
+thing.</p>
+
+<p>In accordance with a theory which I have formed
+in regard to the pathology of chronic rheumatism,
+and which I am not yet prepared to promulgate (nor
+is it necessary here), I have of late been in the habit
+of administering in this disease, baths calculated to
+stimulate as much as possible the circulation of the
+blood. The best manner of applying the baths to
+this end will be found further on, under &#8220;Inequalities
+of the Circulation.&#8221; In addition to this I cause
+the galvanic (anode) as well as strong faradic currents
+to be applied to the affected parts by means
+of the surface board. Where there is any thickening,
+effusion or other similar concomitant of the
+disease, iodine may be added, as hereinbefore directed.</p>
+
+<p><span class="pagenum"><a name="Page_76" id="Page_76">[76]</a></span>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&mdash;sometimes
+even from one bath, permanent progressive
+improvement need never be looked for from less
+than about a month&#8217;s treatment&mdash;more or less, according
+to the nature etc. of the case.</p>
+
+<p>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&#8217;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
+<span class="pagenum"><a name="Page_77" id="Page_77">[77]</a></span>would yet be premature to cite it before I shall be
+able to state the final result.<a name="FNanchor_12_12" id="FNanchor_12_12"></a><a href="#Footnote_12_12" class="fnanchor">[12]</a></p>
+
+<div class="blockquot">
+<p><span class="smcap">Case I.</span>*<a name="FNanchor_13_13" id="FNanchor_13_13"></a><a href="#Footnote_13_13" class="fnanchor">[13]</a>&mdash;<span class="smcap">Subacute Rheumatism.</span> Mr.&nbsp;F., from the
+<i>clientele</i> 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.&nbsp;M.&#8217;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.&nbsp;M. sent patient to take
+electric baths. On May 25th Mr.&nbsp;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
+<span class="pagenum"><a name="Page_78" id="Page_78">[78]</a></span>tender a condition to bear the contractions induced by the faradic
+current. In the subsequent baths both currents were used,
+according to indications.</p>
+
+<p><span class="smcap">Case II.</span>*&mdash;<span class="smcap">Subacute Rheumatism.</span> Mr. B&mdash;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.</p>
+
+<p><span class="smcap">Case III.</span>&mdash;<span class="smcap">Subacute Rheumatism.</span> J.&nbsp;H.&nbsp;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 diarrh&oelig;a. This
+clung to him for five months&mdash;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
+<span class="pagenum"><a name="Page_79" id="Page_79">[79]</a></span>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.</p>
+
+<p><span class="smcap">Case IV.</span>&mdash;<span class="smcap">Chronic Rheumatism.</span> Mr.&nbsp;K., from the <i>clientele</i>
+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.</p>
+
+<p><span class="smcap">Case V.</span>&mdash;<span class="smcap">Chronic Rheumatism.</span> Mr.&nbsp;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.&nbsp;L. has frequently
+taken baths since then, solely however for the sake of
+their general tonic effects.</p>
+</div>
+
+
+<h3><span class="pagenum"><a name="Page_80" id="Page_80">[80]</a></span>CHOREA.</h3>
+
+<p>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 <i>without</i> 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
+<span class="pagenum"><a name="Page_81" id="Page_81">[81]</a></span>head-electrode, the other connected with the surface
+board, applied for five minutes to the epigastrium,
+five minutes to the sacral region. In an&aelig;mic persons
+the current should be descending, in all others,
+ascending. This concluded, a strong general<a name="FNanchor_14_14" id="FNanchor_14_14"></a><a href="#Footnote_14_14" class="fnanchor">[14]</a> 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.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case VI.</span>* Hugh O&mdash;l, aet. 12 years, from the <i>clientele</i> of
+Dr. <span class="smcap">J.&nbsp;O. Farrington</span>, 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
+<span class="pagenum"><a name="Page_82" id="Page_82">[82]</a></span>recovery. His intellect, which had been somewhat impaired,
+was considerably improved.</p>
+
+<p><span class="smcap">Case VII.</span> J.&nbsp;G., aet. 9 years, was sent for electrical treatment
+on September 22d, 1874, by Dr. <span class="smcap">Krehbiel</span>. 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&mdash;which Dr.&nbsp;K. attended to&mdash;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.</p>
+</div>
+
+
+<h3>HYSTERICAL AFFECTIONS.</h3>
+
+<p>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
+<span class="pagenum"><a name="Page_83" id="Page_83">[83]</a></span>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 <i>recent</i> 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
+<span class="pagenum"><a name="Page_84" id="Page_84">[84]</a></span>that, of the cases that are merely functional in
+their nature, by far the greater majority will yield completely
+to judicious electro-balneological treatment.</p>
+
+<p>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.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case VIII.</span>* Mrs.&nbsp;A., aet. 28, married, sterile, from the
+<i>clientele</i> of Dr. <span class="smcap">Kremer</span>, 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 <i>pruritus</i>,
+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.</p>
+
+<p><span class="smcap">Case IX.</span>* Mrs.&nbsp;E., from the <i>clientele</i> of Dr. <span class="smcap">Krehbiel</span>,
+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.</p>
+</div>
+
+
+<h3><span class="pagenum"><a name="Page_85" id="Page_85">[85]</a></span>NEURASTHENIA.<br />
+
+<span class="smcap">(Nervous Exhaustion.)</span></h3>
+
+<p>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 <i>general</i> nervous exhaustion, however,
+that electric baths exercise this salutary influence, but
+in the condition known as <i>cerebral exhaustion</i> 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,
+<span class="pagenum"><a name="Page_86" id="Page_86">[86]</a></span>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.</p>
+
+<p>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
+<span class="pagenum"><a name="Page_87" id="Page_87">[87]</a></span>for the first few baths, however, to cause any
+but <i>slight</i> 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.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case X.</span> <i>Cerebral Exhaustion.</i>&mdash;K.&nbsp;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&mdash;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
+<span class="pagenum"><a name="Page_88" id="Page_88">[88]</a></span>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: &#8220;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&mdash;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.&#8221;</p>
+
+<p>When Mr.&nbsp;S. came to consult me, he had but lately returned
+from Europe, whence, he stated, his physicians had sent him
+home to die. His complexion was sallow, sickly; skin of face
+plentifully wrinkled; features wearing the air of suffering and
+anxiety that so frequently accompanies painful chronic conditions.
+He had for some time past suffered from excessive cerebro-spinal
+<span class="pagenum"><a name="Page_89" id="Page_89">[89]</a></span>irritability, for the relief of which cantharidal collodion
+had been employed in the cervico-spinal region (the same had
+also been used in the hepatic region, to meet the diagnostic
+views of some one of his medical attendants). He had a remittent
+chronic intestinal catarrh, with&mdash;noticeably during the periods
+of exacerbation&mdash;abundant discharge of a glairy mucus.
+The appetite was very capricious&mdash;not to say poor, and he was
+obliged to be exceedingly careful in his diet. He was not capable
+of any continued mental application. The muscular system
+was weak and flabby. All the vegetative functions were more
+or less impaired.</p>
+
+<p>On June 3d, 1874, Mr.&nbsp;S., by my directions, took an electric
+bath. He continued the baths daily for some weeks; then
+every two or three days, all the time steadily improving. He
+had some adjuvant medicinal treatment, probably similar to
+what he had already had in Europe. He states, however, that
+his improvement commenced with the first bath he took; and
+the baths certainly constituted the main treatment throughout.
+He gained daily in every respect. Mind and body were invigorated;
+his muscles increased in size and hardness; color gradually
+returned to his cheeks, etc. He continued the baths with more
+or less regularity until the close of the year, taking in all sixty-one
+baths. He was then in a better condition than he had been
+for many years. Thinking a trip to Europe would benefit him,
+I advised him to go there and remain a few months. He left
+early in January and returned in the beginning of April, 1875.
+He had been very well during his absence, until within a few
+weeks prior to his departure from Europe, when he experienced
+a severe attack of cerebro-spinal congestion, which caused him
+much suffering. On his return he resumed the baths, and continued
+<span class="pagenum"><a name="Page_90" id="Page_90">[90]</a></span>them throughout the spring, continually gaining in
+strength and weight. At the beginning of last summer he was
+practically well. He has regained his normal weight (120
+pounds). As a criterion of his bodily vigor, I will simply state
+that I have seen him lift, with ease, 350 pounds, which, for a
+person of his weight, is not bad. His mental force is as good
+as it has ever been. The digestive disturbances have disappeared;
+he can eat things which for years he had been compelled
+to eschew. To use his own words: &#8220;I am well.&#8221; In
+view of the fact that he had already received, at the hands of
+competent men, all sorts of internal as well as external treatment,
+I believe I am justified in attributing his cure almost entirely
+if not solely to the baths.</p>
+
+<p><span class="smcap">Case XI.</span> Mr. *&nbsp;*&nbsp;*, aet. about 50, lawyer, of large, vigorous
+frame, came to consult me January 4th, 1875. He complained
+of symptoms that are the frequent results of prolonged
+mental over-taxation. His intellect was as good as ever, but
+he lacked his wonted mental endurance and power of application.
+His mind was perfectly clear, but unable to work. It
+was a case of &#8220;<i>limited</i> cerebral exhaustion.&#8221; Physical nutrition
+was pretty good; yet his color was not normal, being rather
+paler than it had been and has since become again. His flesh
+was flabby. There were vague neurotic disturbances, etc., etc.
+He had until recently occupied a leading public position, and
+the onerous duties that devolved on him in connection with
+this, evidently stood in direct etiological relation to his trouble.
+I ordered an electric bath every other day. This was complied
+with until the end of February, when the patient had apparently
+entirely recovered his health, mentally as well as physically.
+I saw him not very long ago; he looked the picture of health,
+<span class="pagenum"><a name="Page_91" id="Page_91">[91]</a></span>and told me that he was and had been since I saw him, perfectly
+well in every respect.</p>
+
+<p><span class="smcap">Case XII.</span> Mr.&nbsp;L., aet. 23, presented himself for treatment
+in October, 1874. He had at various times made the attempt
+to study some profession, but had never been able to
+concentrate his mind sufficiently on any object to enable him to
+persevere in its pursuit. He was fretful, irritable and vacillating;
+would desire one thing to-day, another to-morrow; never
+long of the same mind. Melancholia, digestive disturbances
+and hypochondriacal phenomena accompanied this condition.
+No organic disease was discoverable. On October 1st he took
+his first bath. Very shortly after this he commenced the study
+of medicine. He improved rapidly in every respect. During
+the month of October he had six baths, which resulted in complete
+and permanent relief of all the symptoms. He progressed
+satisfactorily in his studies, and is at the present time taking his
+second course in one of our city medical colleges.</p>
+</div>
+
+
+<h3>AGRYPNIA.<br />
+
+<small>(INSOMNIA; SLEEPLESSNESS).</small></h3>
+
+<p>Although, as a rule, but the symptom of some
+definite pathological condition, agrypnia is of such
+frequent occurrence, and so detrimental to the general
+health, that it appears to me to merit special
+consideration. This holds good especially in this
+connection, because, even where electric baths fail
+to influence the disease giving rise to the insomnia,
+they almost invariably remove this, irrespective of its
+<span class="pagenum"><a name="Page_92" id="Page_92">[92]</a></span>cause. Even where, the disease itself remaining uncured,
+the insomnia must return sooner or later, the
+sleep is very much improved while the baths are
+being had recourse to. We must of course endeavor
+in all cases to relieve the original disease, and, where
+the baths are not adapted to this purpose, resort to
+other and appropriate means. It will be found of no
+small service to us in the therapeutical management
+of every case, to be enabled to procure for the patient,
+without the aid of medicinal hypnotics, sufficient
+of sleep during treatment.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case XIII.</span> Mr.&nbsp;A., from the <i>clientele</i> of Dr. <span class="smcap">Leonard
+Weber</span>, was sent by Dr.&nbsp;W. to take electric baths. He suffered
+from chronic spinal congestion. Among the most prominent
+and annoying symptoms was <i>agrypnia</i>. It was for the relief of
+this symptom chiefly that Dr.&nbsp;W. ordered him the baths. He
+began to improve in this respect from the time he took his first
+bath, and although the disease itself remained uncured, he enjoyed
+good sound sleep while he was under treatment, his general
+health improved, and he frequently spoke of the notable
+benefits that he received from the baths. He continued them
+until his departure for Europe, where, by direction of his physician,
+he went last spring. I have not seen him since, but Dr.&nbsp;W.
+tells me that he is doing well.</p>
+
+<p><span class="smcap">Case XIV.</span> Mr.&nbsp;D. was brought on Sept. 30th, 1874, by
+his physician, Dr. <span class="smcap">Hogan</span>. He was in the incipient stage of
+<i>delirium tremens</i>. Had not slept for some nights. Dr.&nbsp;H. had
+administered successively opiates, chloral and bromides in full
+<span class="pagenum"><a name="Page_93" id="Page_93">[93]</a></span>doses, without effect. On the evening of above date the patient
+had a bath, in which the descending galvanic current was
+used. As a result, he slept well that night. The baths were
+repeated on the two succeeding days, with like effect. As the
+disease developed however it became necessary to send the patient
+to an asylum, whence he returned cured in a short time.
+The effect of the baths in this case, where full doses of the
+most powerful hypnotics of the materia medica had failed, was
+remarkably illustrative of their hypnotic power.</p>
+</div>
+
+
+<h3>AN&AElig;MIA.</h3>
+
+<p>As is well known to the profession, an&aelig;mia
+forms the basis of a great number of morbid conditions.
+Hysteria, general debility, emaciation, sterility,
+various nervous affections, phthisis, in short, a perversion
+of almost any of the various physiological
+functions may be the direct result of an&aelig;mia. On
+the other hand, an&aelig;mia may be only a symptom or
+sequel of some other morbid condition&mdash;but of such
+cases I do not now speak. I have to do here only
+with those cases where an&aelig;mia is the primary and
+etiological of a group of symptoms, and where therefore
+it is to this that the treatment must be mainly
+directed. Now let us see what this treatment is. Dr.
+<span class="smcap">Flint</span><a name="FNanchor_15_15" id="FNanchor_15_15"></a><a href="#Footnote_15_15" class="fnanchor">[15]</a> suggests the following therapeutic measures:
+&#8220;<i>first</i>, a nutritious alimentation, into which meat
+<span class="pagenum"><a name="Page_94" id="Page_94">[94]</a></span>should enter largely; <i>second</i>, the use of tonics and stimulants
+to render the digestive functions more active;
+<i>third</i>, iron as a special remedy&mdash;the effect of which is
+often remarkable; and, <i>fourth</i>, a regimen calculated
+to increase the energy of the assimilative functions,
+consisting of exercise in the open air, recreation, etc.&#8221;
+This agrees mainly with the views of other writers.
+It may conveniently be condensed under two heads,
+instead of four, namely: <i>first</i>, to secure for the patient
+appropriate food and adopt the best means to
+insure its assimilation; <i>second</i>, the administration of
+iron. As to the ingestion of appropriate food, open
+air exercise, etc., patients are of course to receive the
+necessary directions. The remainder of the therapeutic
+indications, as given above, are admirably met
+by electric baths. As we have seen in a preceding
+chapter (<a href="#Page_43">p.&nbsp;43</a> et seq.), they are a tonic and stimulant
+of the first order, and as nearly as possible a specific
+for the furtherance of the digestive and assimilative
+processes. When impregnated with iron, they constitute
+a treatment for an&aelig;mia which, in conjunction
+with the requisite diet and other hygienic measures, is
+inferior to no other. It will moreover be found very
+efficacious in counteracting secondary an&aelig;mia, and
+thus, by maintaining the general strength of the patient,
+often enable nature and appropriate treatment
+to cope successfully with the original disease.</p>
+
+<div class="blockquot">
+<p><span class="pagenum"><a name="Page_95" id="Page_95">[95]</a></span><span class="smcap">Case XV.</span> Mrs.&nbsp;S., aet. 22, four years married. I was
+called to see her on October 2d, 1874. She then had a spontaneous
+miscarriage, the fifth since her marriage. She asked
+me whether nothing could be done to enable her to carry a child
+to full term, as both she and her husband were very desirous
+to have offspring. In pursuance of my directions, she presented
+herself at my office about ten days after I first saw her.
+On examination I found no organic trouble, no uterine displacement,
+nor any other local trouble to account for her premature
+confinements. Involution had progressed normally. The only
+deviation from the normal that I could discover about the uterus
+was undue paleness of the cervical portion. Her appearance
+was very decidedly an&aelig;mic; features pale, flabby; lips whitish
+blue; physical energy much depressed. She had had but very
+slight loss of blood on the occasion of her recent miscarriage;
+certainly not enough to account for her an&aelig;mic appearance.
+Viewing her case as one of idiopathic an&aelig;mia, I ordered her
+electric baths strongly impregnated with iron. In addition to
+this, the regimen usual in such cases, and also strychnia and
+phosphorus internally. She took her first bath on Oct. 14th;
+then one bath weekly until she had taken six baths, the last of
+which was administered on the 24th of November. During all
+this time she kept steadily improving. The an&aelig;mic appearance
+and symptoms gradually receded, and, soon after she had
+taken her last bath, I discharged her, as far as the an&aelig;mia was
+concerned&mdash;cured. While she was under treatment she had, by
+my advice, refrained entirely from sexual intercourse. Early in
+the spring of 1875 she called to tell that she was again pregnant,
+and in November, 1875, I delivered her of a healthy male child,
+at full term.</p>
+</div>
+
+
+<h3><span class="pagenum"><a name="Page_96" id="Page_96">[96]</a></span>PARALYSES AND PARESES.</h3>
+
+<p>I include these under one head, because not
+only is their origin frequently identical, but, chiefly,
+because the therapeutic indications are almost always
+the same in both. Whatever the cause in any
+given case, whether cerebral, spinal or peripheral,
+organic or functional; whatever the treatment that
+may be indicated&mdash;and this should never be neglected&mdash;for
+the primary trouble, the direct electrical
+treatment of the paralysis, sub-paralysis or paresis,
+being purely <i>symptomatic</i> treatment, remains in
+the great majority of cases essentially the same.
+The objects to be aimed at are two, viz: <i>first</i>, a normal
+state of nutrition of the affected muscles; <i>second</i>,
+their normal contractility. In other words, we
+are to endeavor to prevent atrophy of the affected
+muscles, or, where this has already taken place to
+some extent, to restore their normal bulk; and,
+<i>second</i>, we must strive to restore the more or less
+impaired contractility of the paralytic or paretic
+muscles. Even where symptomatic treatment for
+these purposes is the <i>only</i> treatment employed in a
+case, we frequently meet to a great extent the <i>indicatio
+morbi</i>, by favorably influencing, either in a reflex
+or direct manner, the primary disease. This is true
+<span class="pagenum"><a name="Page_97" id="Page_97">[97]</a></span>of <i>local</i> electrizations of the affected parts; it holds
+good much more strongly however of <i>electric baths</i>,
+because here, in addition to the reflex influence
+that we get from local applications, we have also the
+direct influence of the electric current on the spinal
+cord and posterior portion of the brain not only,
+but on the sympathetic system and all the important
+organs contained in the thoracic and abdominal
+cavities. The great importance of this is apparent,
+when we reflect that in very many if not most cases
+of disease of the nervous system, central or peripheral,
+electricity in an appropriate form is a useful
+therapeutic agent, and that moreover the great majority
+of functional paralytic disorders respond
+favorably to its influence. As for any harm being
+done by it in those rare cases where its use may
+be contra-indicated, I admit that such may accrue
+from the administration of electric baths without
+medical supervision; it is entirely obviated however
+where the baths are under the supervision of a physician,
+who does not, like a layman, indiscriminately
+admit to their use any and everybody who is willing
+to pay for their administration, but will carefully discriminate,
+and conscientiously exclude those cases
+in which general electrization might result injuriously.
+In such cases a tolerably accurate diagnosis is as
+<span class="pagenum"><a name="Page_98" id="Page_98">[98]</a></span>a rule readily made, and will enable the physician to
+separate the suitable from the unsuitable cases.</p>
+
+<p>As to the mode of administration of the baths
+in cases of the class under consideration, the use of
+both currents is requisite; the galvanic as a nutrient,
+the faradic as an excito-motor agent. Where,
+as is sometimes the case, faradic irritability is extinct,
+or so slight as to be practically unavailable,
+the (slowly) interrupted galvanic current must take
+the place of the faradic, until faradic irritability has
+become re-established. As to the intensity, direction,
+etc., of the currents, each individual case has
+its own laws, which must be recognized by the supervising
+physician.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case XVI.</span>&mdash;<i>Infantile paralysis.</i> Albert Pichl, aet. 22
+months, was sent me by Dr. <span class="smcap">Lilienthal</span>, October 3d, 1874.
+Had complete paralysis of right leg (of four weeks standing),
+with considerable atrophy of the entire leg as well as the gluteal
+region of the corresponding side. The temperature of the
+leg was much lower than that of the healthy limb. <i>Faradic irritability
+was entirely extinct.</i> The treatment was begun by
+galvanizations of the lower (lumbar and sacral) portion of the
+spinal cord, and the use of the interrupted galvanic current on
+the affected muscles. This was at first done daily. The contractility
+of the muscles gradually but slowly improved, but
+neither the atrophy nor temperature of the limb appeared visibly
+affected by the treatment. With a view to favorably influencing
+<span class="pagenum"><a name="Page_99" id="Page_99">[99]</a></span>these conditions, I ordered him galvanic baths. He had
+a bath every alternate day. The result was favorable and rapid.
+The leg became sensibly and permanently warmer after each
+bath, and commenced steadily to increase in bulk. Faradic irritability
+soon returned. The local applications were continued
+several times a week for some time, and then gradually abandoned,
+the baths being meantime continued regularly. The
+boy very soon began to walk, and in December active treatment
+was discontinued. At that time, faradic irritability having
+long since become completely re-established, I caused the
+child&#8217;s father to purchase a faradic battery to use at home. The
+limb was eventually entirely restored in every respect, with the
+exception of a slight abduction of the foot, for which I referred
+the patient to Dr. <span class="smcap">Gibney</span>. I saw the child recently; he remains
+well.</p>
+
+<p><span class="smcap">Case XVII.</span>* <i>Sub-hemiplegia from cerebral hemorrhage.</i>
+Mrs.&nbsp;S., aet. 30, married, from the practice of Dr. <span class="smcap">Krehbiel</span>,
+was sent by Dr.&nbsp;K. to take baths, July 3d, 1874. It was a routine
+case, differing in no respect from what is ordinarily witnessed
+as a sequence of cerebral hemorrhage. Six baths, taken
+at intervals of two and three days, restored almost entirely the
+muscular power of the affected side. The patient subsequently
+made a complete recovery without further treatment.</p>
+
+<p><span class="smcap">Case XVIII.</span> <i>Paralysis from insolation.</i> Mr.&nbsp;P., proof-reader
+aet. about 40, had suffered for some time from sub-paraplegia,
+the result of insolation. He was sent to take baths in May, 1874,
+by his physician, Dr. <span class="smcap">Schirmer</span>. Electro-balneological treatment
+in this case met with no success.</p>
+
+<p><span class="smcap">Case XIX.</span> <i>Lead paralysis.</i> Mr.&nbsp;M., aet. about 35, painter,
+was referred to me for treatment May 15th, 1874, by Dr.
+<span class="pagenum"><a name="Page_100" id="Page_100">[100]</a></span><span class="smcap">Mohn</span>. The extensors of one (I believe it was the right) arm
+were paralyzed. The characteristic blue line about the gums
+was clearly defined. I ordered an electric bath daily. The
+descending galvanic current was used for twenty minutes each
+bath. From half to one ounce of iodide of potassium was added
+to each bath. The blue line became less distinct from day to
+day, until, after eleven baths, it had entirely disappeared. The
+object for which I had ordered the baths having now been accomplished,
+I treated the affected muscles with the faradic current.
+A short course of this treatment sufficed to remove the
+paralysis from all but one finger (it was either the middle or
+ring finger), the extensors of which had probably undergone fatty
+degeneration.</p>
+</div>
+
+
+<h3>NEURALGI&AElig;.</h3>
+
+<p>The great variety of causes that may give rise to
+neuralgia, precludes the possibility of any specific for
+this symptom. In discussing its electro-balneological
+treatment, I would observe <i>a primo</i> that I cannot,
+in the light of my personal experience, agree with
+those who claim for electrical treatment good results
+in a <i>majority</i> of cases.<a name="FNanchor_16_16" id="FNanchor_16_16"></a><a href="#Footnote_16_16" class="fnanchor">[16]</a> On the other hand it cannot
+be denied that, either as a palliative or curative
+measure, electricity, employed in an appropriate form
+and manner, is of inestimable value in many cases,
+and frequently succeeds where all other remedies
+are of no avail. Where we know the cause of a neuralgia,
+<span class="pagenum"><a name="Page_101" id="Page_101">[101]</a></span>it is of course comparatively easy for us to
+determine whether or not electricity promises to avail
+anything. But even where the nature of the cases
+appeared to indicate its use, the failures, in my hands
+at least, have outnumbered the successes. The brilliant
+results&mdash;sometimes almost instantaneous&mdash;that
+we obtain now and then, should not lead us into
+overlooking our failures. Undoubtedly the circumstance
+that most of the cases that have come under
+my observation were of a very obstinate nature, referred
+to me by other physicians after varied unsuccessful
+treatment, has much to do with the formation
+of my views as expressed above, and future experience
+may perhaps lead me to modify them.</p>
+
+<p>Speaking still from my own experience, I will
+state that the cases that have proven the most amenable
+to treatment were, <i>first</i>, those of rheumatic
+origin; <i>second</i>, hysterical neuralgi&aelig;, and, <i>third</i>, cases
+where no assignable cause could be elicited. The
+most obstinate varieties were those of a malarial
+type (even when quinine in large doses or arsenic
+were employed in conjunction with galvanism) and
+those that depended on some form of chronic inflammation&mdash;<i>neuritis</i>,
+<i>periostitis</i>, etc. Of central neuralgi&aelig;,
+I have had excellent results in the sympathetic
+variety and in the pains of posterior spinal sclerosis,
+<span class="pagenum"><a name="Page_102" id="Page_102">[102]</a></span>while in the neuralgi&aelig; of cerebral origin (diffuse cerebral
+sclerosis, tumors, etc.) I have never met with
+any appreciable success.</p>
+
+<p>Where, then, we are able accurately to diagnose a
+case, there cannot be much doubt as to the appropriateness
+or not of electrical treatment, and in cases
+whose origin is obscure, which may be considered
+practically functional and therefore treated more or
+less empirically, electricity holds out as much or
+more hope than any other remedy. Whether electricity
+should be employed locally or in the form of
+baths, must depend on the features presented by
+each individual case. In neuralgia of the fifth pair&mdash;excepting
+those reflex cases where the <i>point d&#8217;origine</i>
+is to be sought for somewhere in the trunk or extremities,
+and those that depend on cerebral hyper&aelig;mia
+or an&aelig;mia, where the equalizing effects of the
+baths on the circulation are frequently of great benefit&mdash;these
+are generally useless. Of other neuralgi&aelig;,
+I have found the baths less successful in those of the
+superior than in those of the inferior spinal nerves.
+Lumbo-abdominal neuralgia and sciatica have yielded
+much more readily than brachial or dorso-intercostal
+neuralgia, etc., etc.</p>
+
+<p>The mode of administering the baths in neuralgi&aelig;
+does not possess enough of uniformity to render
+<span class="pagenum"><a name="Page_103" id="Page_103">[103]</a></span>suggestion in this respect of any value. I will state
+however that, as a rule, the best results have been
+obtained from the descending galvanic current.</p>
+
+<p>In chronic cases the baths should be administered
+daily, and should not be discarded as unavailing until
+at least a dozen have been successively taken.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case XX.</span> <i>Sciatica.</i> Mr.&nbsp;R., a middle aged man, mechanic,
+was sent by Dr. <span class="smcap">Arcularius</span> Nov. 9th, 1874. Had
+post-rheumatic sciatica of some six weeks&#8217; standing. There
+were no remarkable features about the case, which however
+was sufficiently severe to disable him from pursuing his avocation.
+He took his first bath on the date above-mentioned. Another
+bath was administered next day, and three more every
+alternate day. He was then almost well. On Nov. 25th he returned,
+there remaining still some traces of the affection. Four
+more baths, the last of which was administered on Dec. 4th,
+sufficed to complete the cure.</p>
+
+<p><span class="smcap">Case XXI.</span> <i>Sciatica.</i> Mr.&nbsp;G., aet. about 35, saddler, was sent
+by Dr. <span class="smcap">Waechter</span>, March 6th, 1875. Had suffered from sciatica
+without discoverable cause for several years. For one year
+prior to his visit had been unable to work, and was confined to
+bed a great portion of the time. There was slight atrophy of
+the affected limb. He had had considerable medical (including
+local electrical) treatment, without avail. The baths were faithfully
+and persistently tried in this case, effecting however but
+slight improvement. Subsequent hypodermic injections, first of
+strychnia, then of atropia and finally of chloroform, the latter in
+<span class="pagenum"><a name="Page_104" id="Page_104">[104]</a></span>doses ranging from 30 to 60 minims, gave him only temporary
+relief. The patient was finally discharged uncured.</p>
+
+<p><span class="smcap">Case XXII.</span> <i>Lumbo-abdominal neuralgia.</i> Mr.&nbsp;W., aet.
+about 40, was brought by Dr. <span class="smcap">Marvin S. Buttles</span> in June,
+1875. He had been in poor health for a number of years, and
+was then in a very cachectic condition. There was considerable
+gluteal atrophy on the affected side. At Dr.&nbsp;B.&#8217;s suggestion
+he took a course of electric baths, with the happiest result.
+He improved steadily, and on the occasion of a late inquiry after
+I had not seen him for some months, Dr.&nbsp;B. told me that the
+patient had entirely recovered. His general condition as well
+as the neuralgia had been very favorably modified by the baths,
+and he is now in far better health than he has been for many
+years.</p>
+
+<p><span class="smcap">Case XXIII.</span>&mdash;<i>Lumbo-abdominal neuralgia.</i> Mr.&nbsp;G., aet.
+40, came to consult me in October, 1875. He had suffered from
+neuralgic pains, more particularly in the renal region of both
+sides, but also in the neighboring parts, for only one week.
+The case being so recent, I entertained a very favorable prognosis,
+which subsequently was amply verified. A bath on the
+12th of October and one on the 16th sufficed to effect a complete
+cure.</p>
+</div>
+
+
+<h3>ARTICULAR EFFUSIONS.</h3>
+
+<p>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&mdash;even
+<span class="pagenum"><a name="Page_105" id="Page_105">[105]</a></span>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.</p>
+
+<p>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.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case XXIV.</span>* <i>Specific synovitis of knee-joint, with considerable
+articular and peri-articular effusion.</i> Mr.&nbsp;C., from the
+practice of Dr. <span class="smcap">Sheppard</span>, aet. about 35. First saw patient at
+his house on Nov. 9th, 1873, in consultation with Dr.&nbsp;S. and
+Dr. <span class="smcap">Hutchinson</span>, of Providence, R.&nbsp;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
+<span class="pagenum"><a name="Page_106" id="Page_106">[106]</a></span>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.</p></div>
+
+
+<h3>IMPOTENCY.</h3>
+
+<p>The frequent obstinacy of this distressing condition
+under every variety of non-electrical treatment,
+is the cause of the frequency with which cases present
+themselves to the specialist. Unfortunately
+however but few of the referred cases are of recent
+origin. In almost all instances they have gone
+through a vast amount of medication and other
+treatment, and finally, either through their attending
+physicians or of their own accord, they come as
+a <i>dernier ressort</i> to seek relief from electrical treatment.
+I have already (<a href="#Page_47">p.&nbsp;47</a>) spoken of the comparative
+merits in this disease of local and general electrization.
+A few years ago I was ignorant of the
+<span class="pagenum"><a name="Page_107" id="Page_107">[107]</a></span>good effects of the baths in male impotency. I came
+to test and employ them here from two causes. In
+the first place, patients were sent me specially for
+electro-balneological treatment, ordered by their physicians;
+and, second, I began, when I became familiarized
+with the effects of the baths, to have recourse
+to them in cases where with local electrical and other
+treatment I had been unable to accomplish anything.
+My average results, without becoming uniformly
+successful, became so very much better, that after a
+brief but abundant experience with this treatment,
+I have come to consider it the most important we
+possess in this affection; one that will frequently
+succeed when everything else, including local electrization,
+has failed, and which, in cases where no incurable
+organic changes underlie the affection, will, if
+properly persisted in, either cure or improve to a
+great extent a large majority of the cases. I have
+even seen instances where, the sexual power having
+receded as the legitimate result of advancing age, it
+returned almost or quite perfectly and with seeming
+permanency under the influence of the baths. In
+the class of cases&mdash;and they are quite numerous&mdash;in
+which impotency (loss of the power of erection) occurs
+as a purely nervous symptom in comparatively
+young men; where its cause is sometimes purely
+<span class="pagenum"><a name="Page_108" id="Page_108">[108]</a></span>imaginative, at others the result of early excesses,
+the baths are attended with the most gratifying
+average results. Where the cause is purely psychical,
+a very few baths are sometimes sufficient to
+dispel the morbid phenomena. Where masturbation
+or excessive venery are at the bottom of the
+trouble, there is always a probability of more or less
+organic change in the lower portion of the spinal
+cord, and frequently also a secondary enfeeblement
+of the digestive functions, which render requisite a
+long and steadily continued use of the baths. Patients
+whose sexual power was intact, who took the
+baths for other purposes, have time and again called
+my attention to their aphrodisiac effects.</p>
+
+<p>While here the <i>general</i> electric influence is the
+main remedial agency, there is no reason why the possible&mdash;or,
+I should say, probable&mdash;good to be obtained
+from its <i>local</i> influence should not be realized&mdash;the
+less so that it is so facile to obtain this in the bath,
+by means of the surface board. While individual
+cases will undoubtedly call for modifications, I have
+found the following plan to answer best in certainly
+more than half the cases that have come under my
+observation: The first five minutes of the bath may
+be occupied by a general galvanic current of medium
+intensity, <i>descending</i> where the patient is of an irritable,
+<span class="pagenum"><a name="Page_109" id="Page_109">[109]</a></span><i>ascending</i> where of a phlegmatic temperament.
+The pole connected with the foot electrode should
+now be detached, and the surface board substituted.
+The second five or ten minutes may be consumed by
+running a galvanic current between the head electrode
+and the surface board, the latter applied alternately
+to the penis, scrotum, perineum and, where
+thought best, also to the lumbo-sacral region. Where,
+as is usual, the impotency is accompanied by a certain
+degree of cutaneous an&aelig;sthesia of the penis, but
+especially where the seminal secretion is scanty, the
+board should be positive (ascending current); where
+however nocturnal spermatorrh&oelig;a, premature discharges
+(before coition is possible) or other irritable
+phenomena characterize a case, the surface board
+should be negative (descending current). The head
+of the patient should rest on a sponge thoroughly
+saturated with water, and communicating with the
+water of the bath, so as to include the cerebellum in
+the direct circuit. The last five or ten minutes of
+the bath should be devoted to passing the faradic
+current between the head electrode and the surface
+board, this last applied about the genitals, but chiefly
+about the perineum, the current to be of sufficient
+intensity to contract the perineal muscles. With
+an&aelig;mic patients iron should be added to the baths.
+<span class="pagenum"><a name="Page_110" id="Page_110">[110]</a></span>These should be taken at first daily, later on every
+other day, then three times a week, and so on until
+it becomes apparent that all the good that can be
+obtained from them has been obtained&mdash;whether
+this be a perfect cure or only a certain degree of improvement.
+Where it is thought requisite, internal
+medication and various hygienic measures may be
+advantageously resorted to as adjuvants. While
+these will do no good when employed alone, they
+may serve to enhance the effects of the baths.</p>
+
+<p>In the following cases, I will include some where
+the impotency was not perfect, where the conditions
+were merely those of sexual debility. As there is
+here merely a difference in degree, it would be superfluous
+to separate the two conditions under distinct
+heads.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case XXV.</span>* <i>Perfect impotency.</i>&mdash;Mr.&nbsp;F., from the practice
+of Dr. <span class="smcap">Caro</span>, a robust gentleman, aet. thirty-six, full of
+muscular vigor. Had had syphilis, the symptoms of which had
+disappeared under Dr.&nbsp;C.&#8217;s treatment. For two years the power
+of erection as well as sexual appetite had become extinct&mdash;if we
+except an occasional imperfect spontaneous erection on waking
+up in the morning, and even this was of rare occurrence. Ordinary
+medication proving inadequate, Dr.&nbsp;C. sent patient to take
+electric baths. From March 7th to July 16th, Mr.&nbsp;F. used the
+baths, averaging about two weekly. He was then, and still remains,
+perfectly restored.</p>
+
+<p><span class="pagenum"><a name="Page_111" id="Page_111">[111]</a></span><span class="smcap">Case XXVI.</span> <i>Perfect impotency.</i> A.&nbsp;E.&nbsp;K., aet. 23, commercial
+traveler, applied to me for treatment in the spring of
+1873. His general health was very good. He had masturbated
+but little. Had been in full possession of his sexual power until
+almost twenty-two years of age, when he found that, without
+assignable cause, he had lost the power of erection. His general
+condition being, as far as discoverable, perfect in every
+respect, I instituted a local electrical treatment. This was continued
+for some time without avail. Strychnia was then administered
+with no better result, and after some months&#8217; treatment
+I told him that I could do nothing for him. He remained without
+any treatment whatever until the spring of 1874, when I
+advised him to try electric baths. He took in all about half a
+dozen baths, which resulted in his complete and thus far permanent
+restoration.</p>
+
+<p><span class="smcap">Case XXVII.</span> <i>Sexual debility.</i> Mr.&nbsp;W., aet. 32, married,
+manufacturer, consulted me in February 1875. Had gradually
+for about a year past lost sexual power. Was able to perform
+the marital act at rare intervals only, and when he did, felt exhausted
+the whole of the succeeding day. I ordered him electric
+baths. He took the first on February 22d, 1875. Between
+this date and March 22d, he took six baths. The sexual power
+had then fully returned. I must not omit to state that during
+the time he was under treatment he took, by my direction, gr.
+<span class="above">1</span>&#8260;<span class="below">25</span> phosphorus twice daily, which may have somewhat accelerated
+the result.</p>
+</div>
+
+
+<h3>CONSTIPATION.</h3>
+
+<p>Atony of the <i>muscularis</i> of the intestine is admittedly
+the direct cause, in most instances, of constipation.
+<span class="pagenum"><a name="Page_112" id="Page_112">[112]</a></span>It is the condition known as &#8220;torpor of the
+bowels.&#8221; It is ordinarily due to abnormal innervation
+of the parts. The inefficient innervation may
+be&mdash;and in females frequently is&mdash;reflex, or its cause
+may be sought for in the central nervous system.
+The condition of the voluntary abdominal muscles is
+likewise a factor in the alvine process. Sluggishness
+of the abdominal (portal) circulation is a not infrequent
+etiological concomitant of constipation, and,
+finally, the conditions grouped as &#8220;dyspepsia&#8221; may
+form the causative feature of a case. I have mentioned
+these different causes simply in order to account
+to some extent for the almost wonderful effects
+in this condition of electric baths. When we consider
+that in every one of the morbid conditions here
+enumerated, electricity is a very efficient remedy, and
+that for the resulting muscular atony it may be called
+a specific, it will not appear surprising that a mode of
+application which brings the electric influence to
+bear on both cause and effect&mdash;often on a combination
+of several of the causes enumerated, should be
+attended with such brilliant results. I have thus far
+met with no failure in the electro-balneological treatment
+of constipation.</p>
+
+<p>In the majority of cases the following method
+has proven the most efficient. The first ten minutes
+<span class="pagenum"><a name="Page_113" id="Page_113">[113]</a></span>of the bath should be devoted to the administration
+of a galvanic current, as intense as can comfortably
+be borne by the patient. The one pole should be
+connected with the head-electrode, the other, by
+means of the surface board, applied alternately, to
+the epigastrium, chiefly, and to the hypogastric
+region. The current should a portion of the time be
+ascending, the rest descending. Occasionally the
+current should be rapidly reversed by means of the
+commutator, the intensity however having been previously
+reduced, in order to avoid too severe a shock;
+this will cause efficient contractions of the abdominal
+<i>parietes</i>, and probably also of the intestinal <i>muscularis</i>.
+The second ten minutes of the bath should be
+devoted to faradization, employed in the same manner
+as the previous galvanization, only that here the direction
+of the current is immaterial, and no reversals
+are requisite. The current should be of sufficient
+intensity to produce energetic but not painful contractions
+of the abdominal parietes.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case XXVIII.</span> Mrs. *&nbsp;*, aet. 55, in average health, without
+however being robust, had suffered from constipation for about
+thirty years. She had had every possible medicinal treatment,
+with no avail. Nothing had ever ameliorated her condition.
+Without the aid of a cathartic, her bowels moved but once every
+week or ten days. She was of course compelled frequently to resort
+<span class="pagenum"><a name="Page_114" id="Page_114">[114]</a></span>to laxatives. In the fall of 1873 I ordered her electric baths.
+She was not very energetic in anything, and this lack of energy
+caused her to take the baths less frequently than I desired her
+to. Had she taken them regularly, she would probably have
+been restored in as many weeks as it took months to effect her
+restoration. As it was, she took some thirty baths in the
+course of about fifteen months. For nearly a year past she has
+had a passage every day with the utmost regularity. No adjuvant
+treatment was employed in this case.</p>
+
+<p><span class="smcap">Case XXIX.</span>* Emil Miller, a bright child two years of age,
+was brought for treatment July 7th, 1874. He had suffered from
+obstinate constipation almost from his birth. Had been under
+the care of several physicians, but had never received any benefit
+from treatment. Even with the aid of powerful cathartics,
+given in doses suitable for an adult rather than a child, defecation
+took place only once every three or four days, and was so
+exceedingly painful as to elicit cries of pain from the child.
+The feces were always hard and lumpy, and of an abnormally
+light color. A digital examination per rectum revealed considerable
+flaccidity. My diagnosis was <i>paresis of the muscularis
+of the intestine</i>. I ordered faradic baths. On July 12th the first
+bath was administered, and I must confess that the result was
+a perfect surprise to me. True, I had expected a cure to take
+place; but I had looked for gradual improvement, and was not
+prepared for a result such as was here obtained. <i>From the
+time the first bath was taken, defecation took place regularly
+once a day, without pain; the feces became perfectly normal both
+as to color and consistency, and the boy continues to the present
+day to defecate regularly and in every respect normally.</i> To insure
+permanency, the baths were continued, at first twice, then
+<span class="pagenum"><a name="Page_115" id="Page_115">[115]</a></span>once a week. They have now been discontinued for upwards of
+a year, there being no occasion for their further use. No other
+therapeutic measures, internal or external, were resorted to in
+this case, nor was any change made in the diet of the child.</p>
+</div>
+
+
+<h3>HYDRARGYROSIS.</h3>
+
+<p>The etiology of this condition requires no comment.
+I will simply relate a case illustrative of the
+eliminative effects of galvanic baths.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case XXX.</span>* <i>Mercurial Stomatitis.</i> Mr.&nbsp;S., about 35
+years of age, came to me for treatment in the fall of 1872. He
+then had indurated chancre, two buboes and syphilitic sore
+throat. He had had the chancre for six weeks before applying
+to me, but had been, he said, ashamed to consult a physician.
+Before medication had had time to make any impression on the
+disease, roseola appeared. The syphilis was very obstinate in
+this patient, compelling me to keep him under the influence of
+mercury for a long time. In October 1873, the patient presented
+himself with a very aggravated mercurial stomatitis. The
+customary remedies, internal as well as external, made little or no
+impression on the affection. On November 11th, I discontinued
+all other treatment, and ordered a course of galvanic baths.
+He took his first bath on the same day. This was repeated
+every alternate day until six baths had been taken, when all
+symptoms of the disease had disappeared. He has had no mercurial
+trouble since then. The descending galvanic current
+from a zinc-carbon battery was used throughout.</p>
+</div>
+
+
+<h3><span class="pagenum"><a name="Page_116" id="Page_116">[116]</a></span>LOCOMOTOR ATAXIA.</h3>
+
+<p>Were it not for the remarkable results obtained
+in the following case, I should not have felt justified
+in devoting any space to an allusion to this formidable
+disease. I insert the case as it was published in
+No. 216 of the &#8220;Medical Record.&#8221; I have to add
+that the patient, some six months ago, suffered a relapse,
+which however is not nearly as aggravated as
+his former condition, nor are the symptoms so pathognomonic.
+I had a letter from him about a week
+previous to my writing this, in which he states that
+he intends soon to come to the city for the purpose
+of taking another course of treatment. Even if the
+treatment however has not had the effect of curing
+the disease&mdash;and this I do not claim for it, it has
+been of sufficient importance if it has resulted in
+arresting for a time its progress, giving the patient
+temporary comfort, and prolonging life. Further
+trial may possibly have better results&mdash;in more recent
+cases&mdash;with respect to permanency.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case XXXI.</span>* Mr.&nbsp;W., aet. 48, came to consult me January
+12th, 1874. He had then felt the symptoms of locomotor
+ataxia for about six years. Had been unable for several years
+to walk without the aid of a cane. When walking he dragged
+<span class="pagenum"><a name="Page_117" id="Page_117">[117]</a></span>his right leg along in a semicircle, and was able to accomplish
+very short distances only. There were almost complete an&aelig;sthesia
+and great paresis of the bladder. The same conditions
+were observable in regard to the bowels. An&aelig;sthesia of both
+lower extremities existed, complete in every respect in the right
+leg, almost so in the left. Dyspepsia and general debility and
+emaciation accompanied the disease. Treatment was begun on
+January 15th. I prescribed phosphorus and cod-liver oil, and
+passed a strong galvanic current through the spine for probably
+ten minutes. January 16th, a galvanic bath was administered.
+Towards the close of the bath (which occupied twenty minutes),
+patient thought he felt some sensation in his legs. The baths
+were taken every two or three days, alternating with strong galvanizations
+of the spine. While taking his second bath, patient
+remarked that &#8220;his right leg felt warm for the first time in six
+years.&#8221; The treatment as described was continued for about six
+weeks, during the latter part of which the local applications were
+gradually diminished in frequency, the baths being continued
+regularly. Medication was discontinued about this time. About
+the middle of March. Mr.&nbsp;W. was enabled to resume his occupation
+(paymaster&#8217;s assistant on the Erie Railway). His improvement
+had been rapid and steady. All the symptoms gradually
+disappeared, and in the beginning of April the patient was,
+with the exception of some feebleness, consequent on his protracted
+illness, as well as ever. He continues so to the present
+day.<a name="FNanchor_17_17" id="FNanchor_17_17"></a><a href="#Footnote_17_17" class="fnanchor">[17]</a> He still takes two or three baths a month, but has
+had no other treatment since May (1874). He walks freely
+<span class="pagenum"><a name="Page_118" id="Page_118">[118]</a></span>without a cane, and talks jocosely of running footraces. All
+functions are performed normally.</p>
+
+<p>Although in this case the baths were not employed exclusively,
+yet they predominated in the treatment; and if the judgment
+of the patient, a very intelligent gentleman, is to be relied
+on, a large share of the success is due to the baths.</p>
+</div>
+
+
+<h3>CACHEXI&AElig;.</h3>
+
+<p>After what has been said in a preceding chapter
+of the tonic effects of electric baths, it would scarcely
+appear necessary to introduce the subject of cachexi&aelig;.
+If I do so nevertheless, it is only to be afforded the
+opportunity of relating the following case, which
+possesses sufficient interest to render its introduction
+here desirable. The first portion of it has already
+been published (Med. Record, No 216), but to this I
+have to add what occurred subsequently.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case XXXII.</span>* <i>Mercurio-syphilitic Cachexia.</i>&mdash;Mr.&nbsp;L., aet.
+27, had primary syphilis about four years ago. Subsequently
+had inveterate constitutional symptoms, for which he was under
+medical treatment both here and in Europe. When he had sojourned
+in the latter country some time, he was pronounced
+cured by his physicians. He married, and returned to this
+country in the fall of 1872. A few weeks after his return he fell
+into a gradual decline, which confined him to the house&mdash;and
+part of the time to bed&mdash;for eight months, during the latter portion
+of which he had discontinued all medical treatment. It
+was with difficulty that, assisted by his wife, he managed to
+<span class="pagenum"><a name="Page_119" id="Page_119">[119]</a></span>reach my office. I found him terribly enfeebled; greatly emaciated;
+sallow complexion. He was much annoyed by rheumatic
+pains, which I considered specific. His condition was so exceedingly
+low, that I decided to postpone all medication until he
+should be stronger. I ordered galvano-faradic baths, i.e. the
+galvanic current in the bath as an eliminative, the faradic as a
+tonic. The first bath was taken on November 20th, 1873. For
+one month he took the baths, and nothing else. He was then
+so much stronger, that I felt justified in instituting a mild specific
+course of treatment, the baths being continued as theretofore.
+At the end of two months the patient was nearly as strong as
+ever, was able to resume his occupation, and had gained twenty-seven
+pounds in weight.</p>
+
+<p>Thus far this case was published as above stated. For the
+sake of the interest attaching to it, I will now proceed to give
+its further history. Mr.&nbsp;L. remained to all appearances well
+until July, 1874, when he commenced to suffer from headache
+and constipation. On the 23d of August following, while I
+was absent from the city, he presented himself to the gentleman
+who attended to my practice during my absence, with paralysis
+of the external rectus muscle of the left eye. He also consulted
+a specialist, who pronounced the paralysis rheumatic. When I
+returned from the country he presented himself for treatment.
+I commenced a series of daily electric applications to the affected
+muscle, which failed to respond to the faradic current, but contracted
+very readily when the slowly interrupted galvanic current
+was employed. As I had strong suspicions that syphilis
+was at the bottom of the trouble, I also administered iodide of
+potassium in gradually increasing doses&mdash;not however until
+electrization and strychnia employed for some weeks had failed
+<span class="pagenum"><a name="Page_120" id="Page_120">[120]</a></span>to do any good. The administration of the iodide met with no
+better success. The patient&#8217;s general health gradually declined.
+On October 22d, he complained of numbness in the left leg,
+which gradually increased, the leg at the same time becoming
+paretic, so that the patient required the aid of a cane for ordinary
+locomotion. His condition now became rapidly worse. His
+movements became ataxic. An&aelig;sthesia of the bladder, paresis
+of this and the intestine, with obstinate constipation, loss of appetite,
+emaciation, etc., rapidly supervened. I suspected the
+development of <i>gummata</i> on the meninges of the brain and cord,
+and advised him to use the inunction cure, and to remain at
+home until he should be well. This, on account of the business
+losses which it involved, he was very much averse to doing. He
+consequently proposed a consultation with an eminent physician,
+which was had. This gentleman pronounced the case one of
+spinal (either multiple or posterior) sclerosis, and discarded the
+syphilitic theory. A consultation two days subsequently with
+another physician had a like result. In deference to the opinion of
+these gentlemen, I treated the patient in accordance with their
+diagnosis. This was in the second week of November. The patient
+became rapidly worse. He soon ceased to walk&mdash;he tumbled
+about. After six days&#8217; treatment, considering his life in
+imminent danger, I reiterated my advice to institute the inunction
+cure, and the patient then acquiesced. Nov. 24th I ordered
+a drachm of Unguent Hydrarg. to be used every evening; I
+could not however prevail on the patient to remain at home
+during the treatment. He continued to grow worse. Nov. 26th
+he had complete retention from vesical paralysis, and sent for
+me at night to relieve him. Thenceforth until he got nearly
+well he was obliged to use the catheter regularly. A few days
+<span class="pagenum"><a name="Page_121" id="Page_121">[121]</a></span>after this, fortunately for himself, he fell down as he was leaving
+a horse car, and sprained his ankle. I say <i>fortunately</i>, for this
+accident <i>compelled</i> him to remain at home. From this time he
+began to improve. December 2d I substituted for the ointment
+a twenty per cent solution of the oleate of mercury, of which he
+used a drachm morning and evening. The improvement from
+this day was exceedingly rapid. On the 4th of December he
+had regained control of the bladder. The constipation, which
+had been very obstinate, also began to yield. From this date
+he used the oleate only once daily, and discontinued it entirely
+on the 14th. On the 10th he had already resumed his
+avocation, and the same month absolutely danced at a ball.
+He took iodide of potassium for a time after his mercurial
+course. He has since been and is now in perfect health.</p>
+</div>
+
+
+<h3>DYSPEPSIA.</h3>
+
+<p>The remedies for this disease are unfortunately
+so numerous, there is so much temptation to try
+another where one remedy has failed, that it is seldom
+or never that an uncomplicated case of dyspepsia
+applies for electrical treatment. As a rule, the
+disease that furnishes cause for referring a case to
+the specialist, is some nervous trouble secondary to
+the dyspepsia.</p>
+
+<p>In regard to the influence of electric baths on dyspeptic
+conditions, whether complicated or not, I can
+however speak unqualifiedly in their favor. I know
+of no one other remedy that can at all approach
+<span class="pagenum"><a name="Page_122" id="Page_122">[122]</a></span>them in this respect. Whatever the secondary or
+other troubles of patients, any co-existing dyspepsia
+was in every instance either cured or greatly ameliorated.
+The improvement usually begins at once&mdash;after
+the first or second bath, and continues steadily.
+As I have not had occasion to treat by means
+of electric baths any uncomplicated cases of dyspepsia,
+I can adduce none. I may safely claim however
+for the baths a reliability and bespeak for them a
+confidence that I might claim or bespeak for no
+other remedy or plan of treatment whatsoever&mdash;assertions
+which would appear rash and venturesome,
+had I not at my command abundant clinical evidence
+to warrant my making them.</p>
+
+
+<h3>MELANCHOLIA.</h3>
+
+<p>A case of melancholia, highly illustrative of the
+effects in this condition of electric baths, came under
+my notice very recently. It may serve as a guide
+in the treatment of this and kindred conditions.</p>
+
+<div class="blockquot">
+<p><span class="smcap">Case XXXIII.</span> Mr.&nbsp;F., aet. 22, single, butcher, consulted
+me Oct. 21st, 1875, for melancholia and loss of memory, from
+which he had suffered for upwards of a year. He had frequently
+entertained the idea of suicide. A thorough examination
+revealed no trouble of any of the viscera. All functions appeared
+normal. He had never masturbated. There were no
+<span class="pagenum"><a name="Page_123" id="Page_123">[123]</a></span>collateral symptoms to furnish any evidence of organic cerebral
+trouble. I prescribed phosphorus and strychnia, and galvanized
+the brain twice a week. Two weeks of this treatment had completely
+negative results. I then ordered electric baths. Four
+baths resulted in a complete cure.</p></div>
+
+
+<h3>INEQUALITIES OF THE CIRCULATION.</h3>
+
+<p>As a very fruitful source of morbid conditions of
+almost every nature, abnormities of the circulation
+of the blood are well worthy our attention. As is
+the case with dyspepsia, so here likewise patients
+seldom present themselves for treatment unless some
+definite secondary pathological condition has supervened.
+We find these patients complaining of cold
+hands and feet, irregular and disturbed sleep, occasional
+local congestions, with vague, usually slight
+pains here and there, etc., etc. Where organic cardiac
+disease is at the bottom of the trouble, we cannot
+of course expect much permanent improvement.
+Although even here considerable relief is often afforded
+while the baths are being used, their discontinuance
+will in all probability be soon followed by a
+return of the former condition. Where, however,
+cases are not complicated by organic disease, where
+we have a &#8220;sluggishness&#8221; of the circulation, due
+either to vasomotor inertia or atony of the muscular
+coats of vessels, the electric bath will be found
+<span class="pagenum"><a name="Page_124" id="Page_124">[124]</a></span>reliably efficient. I have already (<a href="#Page_55">p.&nbsp;55</a>) alluded to
+this subject, and explained the probable &#8220;mode of
+action&#8221; here of the baths. I will now offer some
+suggestions as to the best method of administering
+them with a view to equalizing the circulation.</p>
+
+<p>We must here seek to stimulate the vasomotor
+system, both central and peripheral; to give tone to
+the coats of vessels, both by direct and indirect electric
+influence; through counter-irritation to relieve
+internal congestions, by causing an afflux of blood to
+the skin. These objects are best attained by means
+of the galvanic current, which should be employed
+of sufficient intensity to produce a rubefacient effect.
+The faradic current acts in the same direction,
+but far less energetically, if we except the vessels near
+the surface, the muscular coats of which are probably
+more efficiently tonicised by this than by the
+constant current. The faradic current however is
+applicable here in another way, and for a very important
+object. I refer to the <i>mechanical</i> counter-action
+of a sluggish circulation, through the agency
+of prolonged muscular contraction. This mechanical
+effect is not of course peculiar to the faradic current;
+it is shared by gymnastic and other exercises;
+but obtained in any other way whatsoever (with the
+exception, perhaps, of <i>massage</i>, which is however
+<span class="pagenum"><a name="Page_125" id="Page_125">[125]</a></span>much more troublesome as well as inferior, and
+moreover not always admissible) it involves, in order
+to produce perfect results, a considerable amount of
+bodily exertion, often beyond the physical power of
+persons who are in ill health, and bringing with it the
+risk of positive injury, through over-exertion, which
+with the <i>passive</i> contractions obtained by means of
+the faradic current, is entirely obviated. By administering
+the <i>general</i> faradic current in the bath, of
+sufficient intensity to <i>maintain</i> muscular contraction
+as long as the circuit remains closed, any stagnant
+blood in the lower extremities will be efficiently
+forced into the general circulation. After from
+three to five minutes of this faradization, the surface
+board may be successively applied for a minute or
+two each to the arms, abdomen, pectoral and dorsal
+muscles. I believe the <i>best</i> results can be obtained
+by first going through the faradic process, then subjecting
+the patient to general galvanization, as above
+indicated, and concluding by another but brief faradization.</p>
+
+
+<h3>AFFECTIONS OF THE SYMPATHETIC.</h3>
+
+<p>Last, but not least, I have some remarks to offer
+on the treatment by the electric bath of certain affections
+of the sympathetic nerve. While I do not
+<span class="pagenum"><a name="Page_126" id="Page_126">[126]</a></span>in any such cases accord to the baths the rank of
+an exclusive remedy or even a specific, their importance
+as an adjuvant is sufficient to entitle them
+to special consideration in this connection. In those
+neuroses of the sympathetic where electricity (galvanism)
+is indicated, the <i>greatest</i> benefit can be
+obtained from local applications. On the other
+hand the baths, employed in addition to local applications,
+will be found a very important factor in the
+treatment, possessing, as they do, two advantages,
+viz: <i>first</i>, by their means, the electric influence is
+brought to bear&mdash;in a much less concentrated form
+it is true&mdash;on the entire sympathetic system, from
+the <i>ganglion impar</i> to the <i>ganglion cervicale supremum</i>,
+and, by derived currents, on the cephalic ganglia
+also, at one and the same time; <i>second</i>, the rest
+of the body participates in the general nutrient and
+tonic effects of the bath equally with the sympathetic,
+the latter thus receiving a reflex benefit which
+local applications fail to furnish. There are, moreover,
+cases where hyper&aelig;sthetic conditions of the
+nerve do not admit of local applications, and where
+yet electricity is urgently called for. Thus I have
+at present under treatment a lad sixteen years of
+age, in whom both supreme cervical sympathetic
+ganglia as well as the ganglion impar were until recently
+<span class="pagenum"><a name="Page_127" id="Page_127">[127]</a></span>so susceptible that the mere adjustment of the
+electrodes caused him great pain, while on the other
+hand he bore the baths exceedingly well. In such
+cases, electric baths, suitably administered, frequently
+constitute in conjunction with proper medication,
+the most useful treatment.</p>
+
+<p>As to the mode of administration in sympathetic
+neuroses of the baths, the most direct manner in
+which to influence the diseased nerve, is by connecting
+one pole of a <i>galvanic</i> battery (I consider the
+faradic current next to useless here) to the head electrode,
+the other to the surface board, the latter applied
+portion of the time to the epigastrium (solar
+plexus), the balance to the coccyx (<i>ganglion impar</i>).
+This will include in the direct circuit the main portion
+of the sympathetic, the position in the tub of the
+bather bringing the cilio-spinal centre very close to
+the head-electrode. The direction of the current
+must be determined by the individual features presented
+by each case, as also the duration of the bath.</p>
+
+<div class="blockquot"><p><span class="smcap">Case XXXIV.</span> Mr.&nbsp;S., aet. 31, merchant, was referred to
+me April 3d 1874, by Dr. <span class="smcap">Krehbiel</span>. In January, 1874, Mr.&nbsp;S.,
+until then in the enjoyment of good health, woke up one morning
+to find, as he expressed it, &#8220;everything dark before his
+eyes.&#8221; He groped his way to the window, in order to open the
+blinds. When at the window, he felt as though about to fall
+<span class="pagenum"><a name="Page_128" id="Page_128">[128]</a></span>out&mdash;probably vertigo. He soon returned to an apparently normal
+condition, and went about his business as usual. A week
+after, he had a much more serious attack, which he describes as
+follows: &#8220;I had been playing whist during the evening (several
+hours), when suddenly, without premonition, I felt as though a
+champagne cork popped against the top of my head, inside.
+Accompanying this was an indefinable sensation about the heart
+as though the blood all rushed thence down to the feet. I did
+not lose consciousness; did not fall. I trembled all over, and a
+great fear came over me. Felt very weak all night; my pulse
+was very slow.&#8221; About two months subsequently, patient was
+referred to me, as above stated. He then had an uneasy look;
+an indefinable continual sense of fear; was excessively nervous
+in the forepart of the day; had brief attacks of tremor&mdash;usually
+every alternate morning, but not typical as to time of occurrence.
+The history exhibited neither syphilis, malaria nor intemperance.
+Had never had headache. Sleep good; appetite likewise. The
+most pathognomonic symptom, however, related to his pulse.
+This was abnormally slow, ranging from 44 to 54 (the latter
+only when standing or after walking) per minute. It was full
+and regular. There was no organic heart trouble. In the
+absence of any other symptom whatsoever pointing to irritation
+of the pneumogastric or spinal accessory, I was justified in excluding
+this as the possible cause of the cardiac infrequency. On
+the other hand, the pathogenetic manifestations appeared all to
+point to &#8220;asthenia of the sympathetic&#8221;&mdash;at any rate the portion
+of this whence the cardiac nerves take their origin, and I formed
+my diagnosis accordingly. In the beginning, the treatment
+consisted of bilateral ascending (from cilio-spinal centre to both
+mastoid foss&aelig;) galvanizations of the sympathetic, and galvanic
+<span class="pagenum"><a name="Page_129" id="Page_129">[129]</a></span>baths (head electrode negative, surface board positive, to epigastrium)
+on alternate days. Improvement in every respect was
+steady, though not rapid. At the end of three weeks, I supplemented
+this treatment by the administration of ergotin and nux
+vomica. At the expiration of two more weeks, the patient being
+nearly recovered, I discontinued these medicaments, substituting
+the valerianates of zinc and iron, and steadily maintaining
+meanwhile the electrical treatment as above indicated. After a
+short time recovery appeared complete, and patient was discharged
+from treatment. He returned however a few months
+subsequently, complaining of &#8220;faint spells&#8221; in the mornings,
+accompanied with excessive nervousness, and a renewed though
+moderate cardiac infrequency. Electrical treatment, similar to
+that above described, soon restored him. One or two more
+slight relapses occurred during the next six months. For over
+a year past however Mr.&nbsp;S. has been in the enjoyment of perfect
+and undisturbed health. His normal pulse ranges from 72 to 80.</p></div>
+
+<p>Whoever is familiar with the physiological effects
+of electric baths, will readily concede their great
+utility in a variety of conditions that I have not thus
+far specially alluded to. Of such I would mention
+<small>ASTHENI&AElig;, ATONIC AND DEBILITATED CONDITIONS
+GENERALLY,</small> including the state of <small>CONVALESCENCE
+FROM ACUTE DISEASES</small> and the <small>DECLINE OF ADVANCING
+AGE</small>; many cases of <small>CHRONIC HEADACHE</small>;
+some <small>INCLASSIFIABLE CONDITIONS OF MARASMUS</small>
+and <small>MALNUTRITION</small>, etc., etc. In all such cases,
+when purely functional and uncomplicated by incurable
+<span class="pagenum"><a name="Page_130" id="Page_130">[130]</a></span>organic disease, good results may be confidently
+looked for.</p>
+
+
+<p class="tbsection">With these remarks I conclude my subject.
+Whichever the errors that a too limited experience
+may have engendered&mdash;and I doubt not there are
+many, I cannot on reviewing my work accuse myself
+of lack of candor nor yet of undue enthusiasm.
+I have cited but a small proportion of the successful
+cases whereof I possess records; still I believe
+that I have adduced amply sufficient clinical proof
+of the great value as a remedial agent of electric
+baths, and of the desirability of their more general
+adoption. I would more especially call attention to
+the inappropriateness of deferring their employment
+until almost all other remedies have been exhausted;
+and when I reflect that pretty much all those
+cases that had been referred to me by other physicians
+had already had the doubtful benefit of almost
+every other conceivable treatment, while many of
+those who came of their own accord, had in addition
+made the rounds of all the quacks, and exhausted
+nearly all the nostrums that are to be found advertised
+in the columns of our daily papers, the wonder
+seems that the results obtained were as good as they
+have been. I sincerely trust that in the future physicians
+<span class="pagenum"><a name="Page_131" id="Page_131">[131]</a></span>will avail themselves more frequently than
+heretofore of a remedy that is certainly capable of
+accomplishing much good; and I hope that in addition
+to myself there will be found others, more competent,
+to devote themselves to the study of the subject.
+To these, and perhaps to myself at a future
+time, I relegate the task of correcting my errors
+and promulgating hitherto undiscovered truths.</p>
+
+<div class="footnotes"><p class="footnotetitle">Footnotes:</p>
+
+<div class="footnote"><p><a name="Footnote_10_10" id="Footnote_10_10"></a><a href="#FNanchor_10_10"><span class="label">[10]</span></a> Centralblatt f&uuml;r die medicinischen Wissenschaften, No.&nbsp;17,
+1875.</p></div>
+
+<div class="footnote"><p><a name="Footnote_11_11" id="Footnote_11_11"></a><a href="#FNanchor_11_11"><span class="label">[11]</span></a> The apparatus used in these experiments was that of Du
+Bois-Reymond, with a Grove&#8217;s element.</p></div>
+
+<div class="footnote"><p><a name="Footnote_12_12" id="Footnote_12_12"></a><a href="#FNanchor_12_12"><span class="label">[12]</span></a> Since writing the above, this case has had an entirely
+favorable termination.</p></div>
+
+<div class="footnote"><p><a name="Footnote_13_13" id="Footnote_13_13"></a><a href="#FNanchor_13_13"><span class="label">[13]</span></a> The cases distinguished by an asterisk were published in
+No. 216 of the &#8220;Medical Record.&#8221;</p></div>
+
+<div class="footnote"><p><a name="Footnote_14_14" id="Footnote_14_14"></a><a href="#FNanchor_14_14"><span class="label">[14]</span></a> Wherever I use the word &#8220;general&#8221; as descriptive of an
+electric current used in the bath, it is not as a characteristic,
+but merely to distinguish it from the instances where the surface
+board is employed.</p></div>
+
+<div class="footnote"><p><a name="Footnote_15_15" id="Footnote_15_15"></a><a href="#FNanchor_15_15"><span class="label">[15]</span></a> Austin Flint, M.D. A Treatise on the Principles and Practice
+of Medicine. Philadelphia, 1873. 4th ed. pp.&nbsp;63 and 64.</p></div>
+
+<div class="footnote"><p><a name="Footnote_16_16" id="Footnote_16_16"></a><a href="#FNanchor_16_16"><span class="label">[16]</span></a> See Beard and Rockwell, op. cit., 2d ed. p.&nbsp;472.</p></div>
+
+<div class="footnote"><p><a name="Footnote_17_17" id="Footnote_17_17"></a><a href="#FNanchor_17_17"><span class="label">[17]</span></a> This was written a year ago. See remarks preceding the
+case.</p></div>
+
+<!-- <p><span class="pagenum"><a name="Page_132" id="Page_132">[132]</a></span>[Blank Page]</p> -->
+</div>
+
+
+
+
+<h2 class="index"><span class="pagenum"><a name="Page_133" id="Page_133">[133]</a></span><a name="INDEX" id="INDEX"></a>INDEX.</h2>
+
+<hr style="width: 4em;" />
+
+<table class="index" summary="index">
+
+<tr><th colspan="2">A.</th></tr>
+<tr><td></td><td class="onpage"><small>PAGE</small></td></tr>
+<tr><td>Agrypnia</td><td class="onpage"><a href="#Page_92">92</a></td></tr>
+<tr><td>An&aelig;mia</td><td class="onpage"><a href="#Page_93">93</a></td></tr>
+<tr><td>Apparatus for baths</td><td class="onpage"><a href="#Page_7">7</a></td></tr>
+<tr><td>Articular effusions</td><td class="onpage"><a href="#Page_105">105</a></td></tr>
+
+<tr><th colspan="2">B.</th></tr>
+<tr><td>Bath-tub</td><td class="onpage"><a href="#Page_8">8</a></td></tr>
+<tr><td>Batteries</td><td class="onpage"><a href="#Page_16">16</a></td></tr>
+
+<tr><th colspan="2">C.</th></tr>
+<tr><td>Cachexi&aelig;</td><td class="onpage"><a href="#Page_118">118</a></td></tr>
+<tr><td>Chemicals in baths</td><td class="onpage"><a href="#Page_15">15</a></td></tr>
+<tr><td>Chorea</td><td class="onpage"><a href="#Page_80">80</a></td></tr>
+<tr><td>Circulation, effects on</td><td class="onpage"><a href="#Page_55">55</a></td></tr>
+<tr><td><span style="padding-left: 5ex; padding-right: 5ex;">"</span>inequalities of</td><td class="onpage"><a href="#Page_123">123</a></td></tr>
+<tr><td>Clinical Record</td><td class="onpage"><a href="#Page_61">61</a></td></tr>
+<tr><td>Conductivity of water, etc.</td><td class="onpage"><a href="#Page_13">13</a></td></tr>
+<tr><td>Constipation</td><td class="onpage"><a href="#Page_112">112</a></td></tr>
+<tr><td>Counter-irritant effects</td><td class="onpage"><a href="#Page_56">56</a></td></tr>
+
+<tr><th colspan="2">D.</th></tr>
+<tr><td>Debility, general</td><td class="onpage"><a href="#Page_129">129</a>&ndash;<a href="#Page_130">130</a></td></tr>
+<tr><td>Diagnostic uses</td><td class="onpage"><a href="#Page_53">53</a></td></tr>
+<tr><td>Digestive apparatus, effects on</td><td class="onpage"><a href="#Page_44">44</a></td></tr>
+<tr><td>Dyspepsia</td><td class="onpage"><a href="#Page_121">121</a></td></tr>
+
+<tr><th colspan="2">E.</th></tr>
+<tr><td>Electric Bath compared with</td></tr>
+<tr><td>other electrical methods</td><td class="onpage"><a href="#Page_32">32</a></td></tr>
+<tr><td>Electrodes</td><td class="onpage"><a href="#Page_10">10</a></td></tr>
+
+<tr><th colspan="2">G.</th></tr>
+<tr><td>General Therapeutics</td><td class="onpage"><a href="#Page_52">52</a></td></tr>
+
+<tr><th colspan="2">H.</th></tr>
+<tr><td>Hydrargyrosis</td><td class="onpage"><a href="#Page_115">115</a></td></tr>
+<tr><td>Hypnotic effects</td><td class="onpage"><a href="#Page_38">38</a>&ndash;<a href="#Page_58">58</a></td></tr>
+<tr><td>Hysterical affections</td><td class="onpage"><a href="#Page_82">82</a></td></tr>
+
+<tr><th colspan="2">I.</th></tr>
+<tr><td>Impotency</td><td class="onpage"><a href="#Page_106">106</a></td></tr>
+<tr><td>Insomnia</td><td class="onpage"><a href="#Page_92">92</a></td></tr>
+<tr><td>Invigorant properties</td><td class="onpage"><a href="#Page_57">57</a></td></tr>
+
+<tr><th colspan="2">L.</th></tr>
+<tr><td>Locomotor Ataxia</td><td class="onpage"><a href="#Page_116">116</a></td></tr>
+
+<tr><th colspan="2">M.</th></tr>
+<tr><td>Melancholia</td><td class="onpage"><a href="#Page_122">122</a></td></tr>
+<tr><td>Mind, effects on</td><td class="onpage"><a href="#Page_51">51</a></td></tr>
+
+<tr><td><span class="pagenum"><a name="Page_134" id="Page_134">[134]</a></span>Miscellaneous disorders</td><td class="onpage"><a href="#Page_129">129</a>&ndash;<a href="#Page_130">130</a></td></tr>
+<tr><td>Mode of administration</td><td class="onpage"><a href="#Page_19">19</a></td></tr>
+<tr><td>Muscular contractions</td><td class="onpage"><a href="#Page_50">50</a></td></tr>
+
+<tr><th colspan="2">N.</th></tr>
+<tr><td>Nervous Exhaustion</td><td class="onpage"><a href="#Page_84">84</a></td></tr>
+<tr><td>Neuralgi&aelig;</td><td class="onpage"><a href="#Page_100">100</a></td></tr>
+<tr><td>Neurasthenia</td><td class="onpage"><a href="#Page_84">84</a></td></tr>
+<tr><td>Nutrition, effects on</td><td class="onpage"><a href="#Page_59">59</a></td></tr>
+
+<tr><th colspan="2">P.</th></tr>
+<tr><td>Paralyses</td><td class="onpage"><a href="#Page_96">96</a></td></tr>
+<tr><td>Pareses</td><td class="onpage"><a href="#Page_96">96</a></td></tr>
+<tr><td>Physiological effects</td><td class="onpage"><a href="#Page_31">31</a></td></tr>
+<tr><td>Prophylactic influence</td><td class="onpage"><a href="#Page_60">60</a></td></tr>
+<tr><td>Pulse, effects on</td><td class="onpage"><a href="#Page_41">41</a></td></tr>
+
+<tr><th colspan="2">R.</th></tr>
+<tr><td>Rheumatism</td><td class="onpage"><a href="#Page_67">67</a></td></tr>
+<tr><td><span style="padding-left: 5ex; padding-right: 6ex;">"</span>acute</td><td class="onpage"><a href="#Page_68">68</a></td></tr>
+<tr><td><span style="padding-left: 5ex; padding-right: 6ex;">"</span>chronic</td><td class="onpage"><a href="#Page_74">74</a></td></tr>
+<tr><td><span style="padding-left: 5ex; padding-right: 6ex;">"</span>subacute</td><td class="onpage"><a href="#Page_73">73</a></td></tr>
+<tr><td><span style="padding-left: 5ex; padding-right: 6ex;">"</span>cases of</td><td class="onpage"><a href="#Page_77">77</a></td></tr>
+
+<tr><th colspan="2">S.</th></tr>
+<tr><td>Sedative effects</td><td class="onpage"><a href="#Page_48">48</a>&ndash;<a href="#Page_58">58</a></td></tr>
+<tr><td>Sexual apparatus, effects on</td><td class="onpage"><a href="#Page_46">46</a></td></tr>
+<tr><td>Sexual debility</td><td class="onpage"><a href="#Page_106">106</a></td></tr>
+<tr><td>Sleep, effects on</td><td class="onpage"><a href="#Page_38">38</a></td></tr>
+<tr><td>Special therapeutics</td><td class="onpage"><a href="#Page_61">61</a></td></tr>
+<tr><td>Stimulant effects</td><td class="onpage"><a href="#Page_43">43</a></td></tr>
+<tr><td>Surface board</td><td class="onpage"><a href="#Page_14">14</a></td></tr>
+<tr><td>Sympathetic, affections of</td><td class="onpage"><a href="#Page_126">126</a></td></tr>
+
+<tr><th colspan="2">T.</th></tr>
+<tr><td>Temperature, effects on</td><td class="onpage"><a href="#Page_41">41</a></td></tr>
+<tr><td>Tonic properties</td><td class="onpage"><a href="#Page_43">43</a>&ndash;<a href="#Page_57">57</a></td></tr>
+</table>
+
+
+<div class="note">
+<p><strong>Transcriber&#8217;s Notes:</strong> The table below lists all corrections applied to
+the original text.</p>
+
+<ul>
+<li><a href="#Page_29">p. 29</a>:  [normalized] the sub-acute symptoms &rarr; subacute</li>
+<li><a href="#Page_56">p. 56</a>:  GENERAL COUNTER IRRITANT &rarr; COUNTER-IRRITANT</li>
+<li><a href="#Page_56">p. 56</a>:  [normalized] the use of the surface-board &rarr; surface board</li>
+<li><a href="#Page_59">p. 59</a>:  does ... became apparent &rarr; become apparent</li>
+<li><a href="#Page_67">p. 67</a>:  [normalized] acute, sub-acute and chronic &rarr; subacute</li>
+<li><a href="#Page_73">p. 73</a>:  [normalized] bi-carbonate of soda or potassa &rarr; bicarbonate</li>
+<li><a href="#Page_107">p. 107</a>:  ordered by their physicians: &rarr; physicians;</li>
+</ul>
+</div>
+
+
+
+
+
+
+
+
+<pre>
+
+
+
+
+
+End of the Project Gutenberg EBook of The Electric Bath, by George M. Schweig
+
+*** END OF THIS PROJECT GUTENBERG EBOOK THE ELECTRIC BATH ***
+
+***** This file should be named 26366-h.htm or 26366-h.zip *****
+This and all associated files of various formats will be found in:
+        https://www.gutenberg.org/2/6/3/6/26366/
+
+Produced by Bryan Ness, Markus Brenner and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+book was produced from scanned images of public domain
+material from the Google Print project.)
+
+
+Updated editions will replace the previous one--the old editions
+will be renamed.
+
+Creating the works from public domain print editions means that no
+one owns a United States copyright in these works, so the Foundation
+(and you!) can copy and distribute it in the United States without
+permission and without paying copyright royalties.  Special rules,
+set forth in the General Terms of Use part of this license, apply to
+copying and distributing Project Gutenberg-tm electronic works to
+protect the PROJECT GUTENBERG-tm concept and trademark.  Project
+Gutenberg is a registered trademark, and may not be used if you
+charge for the eBooks, unless you receive specific permission.  If you
+do not charge anything for copies of this eBook, complying with the
+rules is very easy.  You may use this eBook for nearly any purpose
+such as creation of derivative works, reports, performances and
+research.  They may be modified and printed and given away--you may do
+practically ANYTHING with public domain eBooks.  Redistribution is
+subject to the trademark license, especially commercial
+redistribution.
+
+
+
+*** START: FULL LICENSE ***
+
+THE FULL PROJECT GUTENBERG LICENSE
+PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK
+
+To protect the Project Gutenberg-tm mission of promoting the free
+distribution of electronic works, by using or distributing this work
+(or any other work associated in any way with the phrase "Project
+Gutenberg"), you agree to comply with all the terms of the Full Project
+Gutenberg-tm License (available with this file or online at
+https://gutenberg.org/license).
+
+
+Section 1.  General Terms of Use and Redistributing Project Gutenberg-tm
+electronic works
+
+1.A.  By reading or using any part of this Project Gutenberg-tm
+electronic work, you indicate that you have read, understand, agree to
+and accept all the terms of this license and intellectual property
+(trademark/copyright) agreement.  If you do not agree to abide by all
+the terms of this agreement, you must cease using and return or destroy
+all copies of Project Gutenberg-tm electronic works in your possession.
+If you paid a fee for obtaining a copy of or access to a Project
+Gutenberg-tm electronic work and you do not agree to be bound by the
+terms of this agreement, you may obtain a refund from the person or
+entity to whom you paid the fee as set forth in paragraph 1.E.8.
+
+1.B.  "Project Gutenberg" is a registered trademark.  It may only be
+used on or associated in any way with an electronic work by people who
+agree to be bound by the terms of this agreement.  There are a few
+things that you can do with most Project Gutenberg-tm electronic works
+even without complying with the full terms of this agreement.  See
+paragraph 1.C below.  There are a lot of things you can do with Project
+Gutenberg-tm electronic works if you follow the terms of this agreement
+and help preserve free future access to Project Gutenberg-tm electronic
+works.  See paragraph 1.E below.
+
+1.C.  The Project Gutenberg Literary Archive Foundation ("the Foundation"
+or PGLAF), owns a compilation copyright in the collection of Project
+Gutenberg-tm electronic works.  Nearly all the individual works in the
+collection are in the public domain in the United States.  If an
+individual work is in the public domain in the United States and you are
+located in the United States, we do not claim a right to prevent you from
+copying, distributing, performing, displaying or creating derivative
+works based on the work as long as all references to Project Gutenberg
+are removed.  Of course, we hope that you will support the Project
+Gutenberg-tm mission of promoting free access to electronic works by
+freely sharing Project Gutenberg-tm works in compliance with the terms of
+this agreement for keeping the Project Gutenberg-tm name associated with
+the work.  You can easily comply with the terms of this agreement by
+keeping this work in the same format with its attached full Project
+Gutenberg-tm License when you share it without charge with others.
+
+1.D.  The copyright laws of the place where you are located also govern
+what you can do with this work.  Copyright laws in most countries are in
+a constant state of change.  If you are outside the United States, check
+the laws of your country in addition to the terms of this agreement
+before downloading, copying, displaying, performing, distributing or
+creating derivative works based on this work or any other Project
+Gutenberg-tm work.  The Foundation makes no representations concerning
+the copyright status of any work in any country outside the United
+States.
+
+1.E.  Unless you have removed all references to Project Gutenberg:
+
+1.E.1.  The following sentence, with active links to, or other immediate
+access to, the full Project Gutenberg-tm License must appear prominently
+whenever any copy of a Project Gutenberg-tm work (any work on which the
+phrase "Project Gutenberg" appears, or with which the phrase "Project
+Gutenberg" is associated) is accessed, displayed, performed, viewed,
+copied or distributed:
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+1.E.2.  If an individual Project Gutenberg-tm electronic work is derived
+from the public domain (does not contain a notice indicating that it is
+posted with permission of the copyright holder), the work can be copied
+and distributed to anyone in the United States without paying any fees
+or charges.  If you are redistributing or providing access to a work
+with the phrase "Project Gutenberg" associated with or appearing on the
+work, you must comply either with the requirements of paragraphs 1.E.1
+through 1.E.7 or obtain permission for the use of the work and the
+Project Gutenberg-tm trademark as set forth in paragraphs 1.E.8 or
+1.E.9.
+
+1.E.3.  If an individual Project Gutenberg-tm electronic work is posted
+with the permission of the copyright holder, your use and distribution
+must comply with both paragraphs 1.E.1 through 1.E.7 and any additional
+terms imposed by the copyright holder.  Additional terms will be linked
+to the Project Gutenberg-tm License for all works posted with the
+permission of the copyright holder found at the beginning of this work.
+
+1.E.4.  Do not unlink or detach or remove the full Project Gutenberg-tm
+License terms from this work, or any files containing a part of this
+work or any other work associated with Project Gutenberg-tm.
+
+1.E.5.  Do not copy, display, perform, distribute or redistribute this
+electronic work, or any part of this electronic work, without
+prominently displaying the sentence set forth in paragraph 1.E.1 with
+active links or immediate access to the full terms of the Project
+Gutenberg-tm License.
+
+1.E.6.  You may convert to and distribute this work in any binary,
+compressed, marked up, nonproprietary or proprietary form, including any
+word processing or hypertext form.  However, if you provide access to or
+distribute copies of a Project Gutenberg-tm work in a format other than
+"Plain Vanilla ASCII" or other format used in the official version
+posted on the official Project Gutenberg-tm web site (www.gutenberg.org),
+you must, at no additional cost, fee or expense to the user, provide a
+copy, a means of exporting a copy, or a means of obtaining a copy upon
+request, of the work in its original "Plain Vanilla ASCII" or other
+form.  Any alternate format must include the full Project Gutenberg-tm
+License as specified in paragraph 1.E.1.
+
+1.E.7.  Do not charge a fee for access to, viewing, displaying,
+performing, copying or distributing any Project Gutenberg-tm works
+unless you comply with paragraph 1.E.8 or 1.E.9.
+
+1.E.8.  You may charge a reasonable fee for copies of or providing
+access to or distributing Project Gutenberg-tm electronic works provided
+that
+
+- You pay a royalty fee of 20% of the gross profits you derive from
+     the use of Project Gutenberg-tm works calculated using the method
+     you already use to calculate your applicable taxes.  The fee is
+     owed to the owner of the Project Gutenberg-tm trademark, but he
+     has agreed to donate royalties under this paragraph to the
+     Project Gutenberg Literary Archive Foundation.  Royalty payments
+     must be paid within 60 days following each date on which you
+     prepare (or are legally required to prepare) your periodic tax
+     returns.  Royalty payments should be clearly marked as such and
+     sent to the Project Gutenberg Literary Archive Foundation at the
+     address specified in Section 4, "Information about donations to
+     the Project Gutenberg Literary Archive Foundation."
+
+- You provide a full refund of any money paid by a user who notifies
+     you in writing (or by e-mail) within 30 days of receipt that s/he
+     does not agree to the terms of the full Project Gutenberg-tm
+     License.  You must require such a user to return or
+     destroy all copies of the works possessed in a physical medium
+     and discontinue all use of and all access to other copies of
+     Project Gutenberg-tm works.
+
+- You provide, in accordance with paragraph 1.F.3, a full refund of any
+     money paid for a work or a replacement copy, if a defect in the
+     electronic work is discovered and reported to you within 90 days
+     of receipt of the work.
+
+- You comply with all other terms of this agreement for free
+     distribution of Project Gutenberg-tm works.
+
+1.E.9.  If you wish to charge a fee or distribute a Project Gutenberg-tm
+electronic work or group of works on different terms than are set
+forth in this agreement, you must obtain permission in writing from
+both the Project Gutenberg Literary Archive Foundation and Michael
+Hart, the owner of the Project Gutenberg-tm trademark.  Contact the
+Foundation as set forth in Section 3 below.
+
+1.F.
+
+1.F.1.  Project Gutenberg volunteers and employees expend considerable
+effort to identify, do copyright research on, transcribe and proofread
+public domain works in creating the Project Gutenberg-tm
+collection.  Despite these efforts, Project Gutenberg-tm electronic
+works, and the medium on which they may be stored, may contain
+"Defects," such as, but not limited to, incomplete, inaccurate or
+corrupt data, transcription errors, a copyright or other intellectual
+property infringement, a defective or damaged disk or other medium, a
+computer virus, or computer codes that damage or cannot be read by
+your equipment.
+
+1.F.2.  LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the "Right
+of Replacement or Refund" described in paragraph 1.F.3, the Project
+Gutenberg Literary Archive Foundation, the owner of the Project
+Gutenberg-tm trademark, and any other party distributing a Project
+Gutenberg-tm electronic work under this agreement, disclaim all
+liability to you for damages, costs and expenses, including legal
+fees.  YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
+LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
+PROVIDED IN PARAGRAPH F3.  YOU AGREE THAT THE FOUNDATION, THE
+TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
+LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
+INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
+DAMAGE.
+
+1.F.3.  LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
+defect in this electronic work within 90 days of receiving it, you can
+receive a refund of the money (if any) you paid for it by sending a
+written explanation to the person you received the work from.  If you
+received the work on a physical medium, you must return the medium with
+your written explanation.  The person or entity that provided you with
+the defective work may elect to provide a replacement copy in lieu of a
+refund.  If you received the work electronically, the person or entity
+providing it to you may choose to give you a second opportunity to
+receive the work electronically in lieu of a refund.  If the second copy
+is also defective, you may demand a refund in writing without further
+opportunities to fix the problem.
+
+1.F.4.  Except for the limited right of replacement or refund set forth
+in paragraph 1.F.3, this work is provided to you 'AS-IS' WITH NO OTHER
+WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO
+WARRANTIES OF MERCHANTIBILITY OR FITNESS FOR ANY PURPOSE.
+
+1.F.5.  Some states do not allow disclaimers of certain implied
+warranties or the exclusion or limitation of certain types of damages.
+If any disclaimer or limitation set forth in this agreement violates the
+law of the state applicable to this agreement, the agreement shall be
+interpreted to make the maximum disclaimer or limitation permitted by
+the applicable state law.  The invalidity or unenforceability of any
+provision of this agreement shall not void the remaining provisions.
+
+1.F.6.  INDEMNITY - You agree to indemnify and hold the Foundation, the
+trademark owner, any agent or employee of the Foundation, anyone
+providing copies of Project Gutenberg-tm electronic works in accordance
+with this agreement, and any volunteers associated with the production,
+promotion and distribution of Project Gutenberg-tm electronic works,
+harmless from all liability, costs and expenses, including legal fees,
+that arise directly or indirectly from any of the following which you do
+or cause to occur: (a) distribution of this or any Project Gutenberg-tm
+work, (b) alteration, modification, or additions or deletions to any
+Project Gutenberg-tm work, and (c) any Defect you cause.
+
+
+Section  2.  Information about the Mission of Project Gutenberg-tm
+
+Project Gutenberg-tm is synonymous with the free distribution of
+electronic works in formats readable by the widest variety of computers
+including obsolete, old, middle-aged and new computers.  It exists
+because of the efforts of hundreds of volunteers and donations from
+people in all walks of life.
+
+Volunteers and financial support to provide volunteers with the
+assistance they need, is critical to reaching Project Gutenberg-tm's
+goals and ensuring that the Project Gutenberg-tm collection will
+remain freely available for generations to come.  In 2001, the Project
+Gutenberg Literary Archive Foundation was created to provide a secure
+and permanent future for Project Gutenberg-tm and future generations.
+To learn more about the Project Gutenberg Literary Archive Foundation
+and how your efforts and donations can help, see Sections 3 and 4
+and the Foundation web page at https://www.pglaf.org.
+
+
+Section 3.  Information about the Project Gutenberg Literary Archive
+Foundation
+
+The Project Gutenberg Literary Archive Foundation is a non profit
+501(c)(3) educational corporation organized under the laws of the
+state of Mississippi and granted tax exempt status by the Internal
+Revenue Service.  The Foundation's EIN or federal tax identification
+number is 64-6221541.  Its 501(c)(3) letter is posted at
+https://pglaf.org/fundraising.  Contributions to the Project Gutenberg
+Literary Archive Foundation are tax deductible to the full extent
+permitted by U.S. federal laws and your state's laws.
+
+The Foundation's principal office is located at 4557 Melan Dr. S.
+Fairbanks, AK, 99712., but its volunteers and employees are scattered
+throughout numerous locations.  Its business office is located at
+809 North 1500 West, Salt Lake City, UT 84116, (801) 596-1887, email
+business@pglaf.org.  Email contact links and up to date contact
+information can be found at the Foundation's web site and official
+page at https://pglaf.org
+
+For additional contact information:
+     Dr. Gregory B. Newby
+     Chief Executive and Director
+     gbnewby@pglaf.org
+
+
+Section 4.  Information about Donations to the Project Gutenberg
+Literary Archive Foundation
+
+Project Gutenberg-tm depends upon and cannot survive without wide
+spread public support and donations to carry out its mission of
+increasing the number of public domain and licensed works that can be
+freely distributed in machine readable form accessible by the widest
+array of equipment including outdated equipment.  Many small donations
+($1 to $5,000) are particularly important to maintaining tax exempt
+status with the IRS.
+
+The Foundation is committed to complying with the laws regulating
+charities and charitable donations in all 50 states of the United
+States.  Compliance requirements are not uniform and it takes a
+considerable effort, much paperwork and many fees to meet and keep up
+with these requirements.  We do not solicit donations in locations
+where we have not received written confirmation of compliance.  To
+SEND DONATIONS or determine the status of compliance for any
+particular state visit https://pglaf.org
+
+While we cannot and do not solicit contributions from states where we
+have not met the solicitation requirements, we know of no prohibition
+against accepting unsolicited donations from donors in such states who
+approach us with offers to donate.
+
+International donations are gratefully accepted, but we cannot make
+any statements concerning tax treatment of donations received from
+outside the United States.  U.S. laws alone swamp our small staff.
+
+Please check the Project Gutenberg Web pages for current donation
+methods and addresses.  Donations are accepted in a number of other
+ways including including checks, online payments and credit card
+donations.  To donate, please visit: https://pglaf.org/donate
+
+
+Section 5.  General Information About Project Gutenberg-tm electronic
+works.
+
+Professor Michael S. Hart was the originator of the Project Gutenberg-tm
+concept of a library of electronic works that could be freely shared
+with anyone.  For thirty years, he produced and distributed Project
+Gutenberg-tm eBooks with only a loose network of volunteer support.
+
+
+Project Gutenberg-tm eBooks are often created from several printed
+editions, all of which are confirmed as Public Domain in the U.S.
+unless a copyright notice is included.  Thus, we do not necessarily
+keep eBooks in compliance with any particular paper edition.
+
+
+Most people start at our Web site which has the main PG search facility:
+
+     https://www.gutenberg.org
+
+This Web site includes information about Project Gutenberg-tm,
+including how to make donations to the Project Gutenberg Literary
+Archive Foundation, how to help produce our new eBooks, and how to
+subscribe to our email newsletter to hear about new eBooks.
+
+
+</pre>
+
+</body>
+</html>
diff --git a/26366-page-images/f001.png b/26366-page-images/f001.png
new file mode 100644
index 0000000..0cbb430
--- /dev/null
+++ b/26366-page-images/f001.png
diff --git a/26366-page-images/f002.png b/26366-page-images/f002.png
new file mode 100644
index 0000000..d399431
--- /dev/null
+++ b/26366-page-images/f002.png
diff --git a/26366-page-images/f003.png b/26366-page-images/f003.png
new file mode 100644
index 0000000..c29b85e
--- /dev/null
+++ b/26366-page-images/f003.png
diff --git a/26366-page-images/f004.png b/26366-page-images/f004.png
new file mode 100644
index 0000000..65fb7dc
--- /dev/null
+++ b/26366-page-images/f004.png
diff --git a/26366-page-images/f005.png b/26366-page-images/f005.png
new file mode 100644
index 0000000..b01bb9f
--- /dev/null
+++ b/26366-page-images/f005.png
diff --git a/26366-page-images/f006.png b/26366-page-images/f006.png
new file mode 100644
index 0000000..836c706
--- /dev/null
+++ b/26366-page-images/f006.png
diff --git a/26366-page-images/p007.png b/26366-page-images/p007.png
new file mode 100644
index 0000000..2196977
--- /dev/null
+++ b/26366-page-images/p007.png
diff --git a/26366-page-images/p008.png b/26366-page-images/p008.png
new file mode 100644
index 0000000..49e5960
--- /dev/null
+++ b/26366-page-images/p008.png
diff --git a/26366-page-images/p009.png b/26366-page-images/p009.png
new file mode 100644
index 0000000..d74457c
--- /dev/null
+++ b/26366-page-images/p009.png
diff --git a/26366-page-images/p010.png b/26366-page-images/p010.png
new file mode 100644
index 0000000..74f3446
--- /dev/null
+++ b/26366-page-images/p010.png
diff --git a/26366-page-images/p011.png b/26366-page-images/p011.png
new file mode 100644
index 0000000..4ce78e0
--- /dev/null
+++ b/26366-page-images/p011.png
diff --git a/26366-page-images/p012.png b/26366-page-images/p012.png
new file mode 100644
index 0000000..e5caf28
--- /dev/null
+++ b/26366-page-images/p012.png
diff --git a/26366-page-images/p013.png b/26366-page-images/p013.png
new file mode 100644
index 0000000..430cfab
--- /dev/null
+++ b/26366-page-images/p013.png
diff --git a/26366-page-images/p014.png b/26366-page-images/p014.png
new file mode 100644
index 0000000..d182cbd
--- /dev/null
+++ b/26366-page-images/p014.png
diff --git a/26366-page-images/p015.png b/26366-page-images/p015.png
new file mode 100644
index 0000000..c7e5bcd
--- /dev/null
+++ b/26366-page-images/p015.png
diff --git a/26366-page-images/p016.png b/26366-page-images/p016.png
new file mode 100644
index 0000000..d69340f
--- /dev/null
+++ b/26366-page-images/p016.png
diff --git a/26366-page-images/p017.png b/26366-page-images/p017.png
new file mode 100644
index 0000000..8f34bf3
--- /dev/null
+++ b/26366-page-images/p017.png
diff --git a/26366-page-images/p018.png b/26366-page-images/p018.png
new file mode 100644
index 0000000..8e5bd6b
--- /dev/null
+++ b/26366-page-images/p018.png
diff --git a/26366-page-images/p019.png b/26366-page-images/p019.png
new file mode 100644
index 0000000..a9b84ad
--- /dev/null
+++ b/26366-page-images/p019.png
diff --git a/26366-page-images/p020.png b/26366-page-images/p020.png
new file mode 100644
index 0000000..b78c793
--- /dev/null
+++ b/26366-page-images/p020.png
diff --git a/26366-page-images/p021.png b/26366-page-images/p021.png
new file mode 100644
index 0000000..18a4807
--- /dev/null
+++ b/26366-page-images/p021.png
diff --git a/26366-page-images/p022.png b/26366-page-images/p022.png
new file mode 100644
index 0000000..e311740
--- /dev/null
+++ b/26366-page-images/p022.png
diff --git a/26366-page-images/p023.png b/26366-page-images/p023.png
new file mode 100644
index 0000000..8af3c42
--- /dev/null
+++ b/26366-page-images/p023.png
diff --git a/26366-page-images/p024.png b/26366-page-images/p024.png
new file mode 100644
index 0000000..c45d278
--- /dev/null
+++ b/26366-page-images/p024.png
diff --git a/26366-page-images/p025.png b/26366-page-images/p025.png
new file mode 100644
index 0000000..a98d12f
--- /dev/null
+++ b/26366-page-images/p025.png
diff --git a/26366-page-images/p026.png b/26366-page-images/p026.png
new file mode 100644
index 0000000..b7060ab
--- /dev/null
+++ b/26366-page-images/p026.png
diff --git a/26366-page-images/p027.png b/26366-page-images/p027.png
new file mode 100644
index 0000000..3ad9e77
--- /dev/null
+++ b/26366-page-images/p027.png
diff --git a/26366-page-images/p028.png b/26366-page-images/p028.png
new file mode 100644
index 0000000..b818505
--- /dev/null
+++ b/26366-page-images/p028.png
diff --git a/26366-page-images/p029.png b/26366-page-images/p029.png
new file mode 100644
index 0000000..2f468d1
--- /dev/null
+++ b/26366-page-images/p029.png
diff --git a/26366-page-images/p030.png b/26366-page-images/p030.png
new file mode 100644
index 0000000..f4caa2c
--- /dev/null
+++ b/26366-page-images/p030.png
diff --git a/26366-page-images/p031.png b/26366-page-images/p031.png
new file mode 100644
index 0000000..d597db6
--- /dev/null
+++ b/26366-page-images/p031.png
diff --git a/26366-page-images/p032.png b/26366-page-images/p032.png
new file mode 100644
index 0000000..4d05dd0
--- /dev/null
+++ b/26366-page-images/p032.png
diff --git a/26366-page-images/p033.png b/26366-page-images/p033.png
new file mode 100644
index 0000000..2186434
--- /dev/null
+++ b/26366-page-images/p033.png
diff --git a/26366-page-images/p034.png b/26366-page-images/p034.png
new file mode 100644
index 0000000..1f70ff5
--- /dev/null
+++ b/26366-page-images/p034.png
diff --git a/26366-page-images/p035.png b/26366-page-images/p035.png
new file mode 100644
index 0000000..54b6a5e
--- /dev/null
+++ b/26366-page-images/p035.png
diff --git a/26366-page-images/p036.png b/26366-page-images/p036.png
new file mode 100644
index 0000000..04d0053
--- /dev/null
+++ b/26366-page-images/p036.png
diff --git a/26366-page-images/p037.png b/26366-page-images/p037.png
new file mode 100644
index 0000000..f1e5b96
--- /dev/null
+++ b/26366-page-images/p037.png
diff --git a/26366-page-images/p038.png b/26366-page-images/p038.png
new file mode 100644
index 0000000..7a034a5
--- /dev/null
+++ b/26366-page-images/p038.png
diff --git a/26366-page-images/p039.png b/26366-page-images/p039.png
new file mode 100644
index 0000000..d77e34d
--- /dev/null
+++ b/26366-page-images/p039.png
diff --git a/26366-page-images/p040.png b/26366-page-images/p040.png
new file mode 100644
index 0000000..e14ec66
--- /dev/null
+++ b/26366-page-images/p040.png
diff --git a/26366-page-images/p041.png b/26366-page-images/p041.png
new file mode 100644
index 0000000..1bbf756
--- /dev/null
+++ b/26366-page-images/p041.png
diff --git a/26366-page-images/p042.png b/26366-page-images/p042.png
new file mode 100644
index 0000000..e474565
--- /dev/null
+++ b/26366-page-images/p042.png
diff --git a/26366-page-images/p043.png b/26366-page-images/p043.png
new file mode 100644
index 0000000..bb6666f
--- /dev/null
+++ b/26366-page-images/p043.png
diff --git a/26366-page-images/p044.png b/26366-page-images/p044.png
new file mode 100644
index 0000000..a11ebc3
--- /dev/null
+++ b/26366-page-images/p044.png
diff --git a/26366-page-images/p045.png b/26366-page-images/p045.png
new file mode 100644
index 0000000..9e17368
--- /dev/null
+++ b/26366-page-images/p045.png
diff --git a/26366-page-images/p046.png b/26366-page-images/p046.png
new file mode 100644
index 0000000..a629f58
--- /dev/null
+++ b/26366-page-images/p046.png
diff --git a/26366-page-images/p047.png b/26366-page-images/p047.png
new file mode 100644
index 0000000..130935c
--- /dev/null
+++ b/26366-page-images/p047.png
diff --git a/26366-page-images/p048.png b/26366-page-images/p048.png
new file mode 100644
index 0000000..584891c
--- /dev/null
+++ b/26366-page-images/p048.png
diff --git a/26366-page-images/p049.png b/26366-page-images/p049.png
new file mode 100644
index 0000000..3419468
--- /dev/null
+++ b/26366-page-images/p049.png
diff --git a/26366-page-images/p050.png b/26366-page-images/p050.png
new file mode 100644
index 0000000..01cf52b
--- /dev/null
+++ b/26366-page-images/p050.png
diff --git a/26366-page-images/p051.png b/26366-page-images/p051.png
new file mode 100644
index 0000000..f1b58b2
--- /dev/null
+++ b/26366-page-images/p051.png
diff --git a/26366-page-images/p052.png b/26366-page-images/p052.png
new file mode 100644
index 0000000..ed8e86e
--- /dev/null
+++ b/26366-page-images/p052.png
diff --git a/26366-page-images/p053.png b/26366-page-images/p053.png
new file mode 100644
index 0000000..ca8f7db
--- /dev/null
+++ b/26366-page-images/p053.png
diff --git a/26366-page-images/p054.png b/26366-page-images/p054.png
new file mode 100644
index 0000000..71342bb
--- /dev/null
+++ b/26366-page-images/p054.png
diff --git a/26366-page-images/p055.png b/26366-page-images/p055.png
new file mode 100644
index 0000000..c55f245
--- /dev/null
+++ b/26366-page-images/p055.png
diff --git a/26366-page-images/p056.png b/26366-page-images/p056.png
new file mode 100644
index 0000000..8c1f655
--- /dev/null
+++ b/26366-page-images/p056.png
diff --git a/26366-page-images/p057.png b/26366-page-images/p057.png
new file mode 100644
index 0000000..9abd1fd
--- /dev/null
+++ b/26366-page-images/p057.png
diff --git a/26366-page-images/p058.png b/26366-page-images/p058.png
new file mode 100644
index 0000000..d6d2ca5
--- /dev/null
+++ b/26366-page-images/p058.png
diff --git a/26366-page-images/p059.png b/26366-page-images/p059.png
new file mode 100644
index 0000000..07df7df
--- /dev/null
+++ b/26366-page-images/p059.png
diff --git a/26366-page-images/p060.png b/26366-page-images/p060.png
new file mode 100644
index 0000000..73db4f6
--- /dev/null
+++ b/26366-page-images/p060.png
diff --git a/26366-page-images/p061.png b/26366-page-images/p061.png
new file mode 100644
index 0000000..7132c14
--- /dev/null
+++ b/26366-page-images/p061.png
diff --git a/26366-page-images/p062.png b/26366-page-images/p062.png
new file mode 100644
index 0000000..ff59356
--- /dev/null
+++ b/26366-page-images/p062.png
diff --git a/26366-page-images/p063.png b/26366-page-images/p063.png
new file mode 100644
index 0000000..cbb800c
--- /dev/null
+++ b/26366-page-images/p063.png
diff --git a/26366-page-images/p064.png b/26366-page-images/p064.png
new file mode 100644
index 0000000..3622fa0
--- /dev/null
+++ b/26366-page-images/p064.png
diff --git a/26366-page-images/p065.png b/26366-page-images/p065.png
new file mode 100644
index 0000000..21e895d
--- /dev/null
+++ b/26366-page-images/p065.png
diff --git a/26366-page-images/p066.png b/26366-page-images/p066.png
new file mode 100644
index 0000000..9819d0d
--- /dev/null
+++ b/26366-page-images/p066.png
diff --git a/26366-page-images/p067.png b/26366-page-images/p067.png
new file mode 100644
index 0000000..49dfc1d
--- /dev/null
+++ b/26366-page-images/p067.png
diff --git a/26366-page-images/p068.png b/26366-page-images/p068.png
new file mode 100644
index 0000000..a164481
--- /dev/null
+++ b/26366-page-images/p068.png
diff --git a/26366-page-images/p069.png b/26366-page-images/p069.png
new file mode 100644
index 0000000..9a15d0b
--- /dev/null
+++ b/26366-page-images/p069.png
diff --git a/26366-page-images/p070.png b/26366-page-images/p070.png
new file mode 100644
index 0000000..4d24087
--- /dev/null
+++ b/26366-page-images/p070.png
diff --git a/26366-page-images/p071.png b/26366-page-images/p071.png
new file mode 100644
index 0000000..6c9703a
--- /dev/null
+++ b/26366-page-images/p071.png
diff --git a/26366-page-images/p072.png b/26366-page-images/p072.png
new file mode 100644
index 0000000..b5caac1
--- /dev/null
+++ b/26366-page-images/p072.png
diff --git a/26366-page-images/p073.png b/26366-page-images/p073.png
new file mode 100644
index 0000000..eccbe3e
--- /dev/null
+++ b/26366-page-images/p073.png
diff --git a/26366-page-images/p074.png b/26366-page-images/p074.png
new file mode 100644
index 0000000..cf59701
--- /dev/null
+++ b/26366-page-images/p074.png
diff --git a/26366-page-images/p075.png b/26366-page-images/p075.png
new file mode 100644
index 0000000..cbbd971
--- /dev/null
+++ b/26366-page-images/p075.png
diff --git a/26366-page-images/p076.png b/26366-page-images/p076.png
new file mode 100644
index 0000000..58e2e5e
--- /dev/null
+++ b/26366-page-images/p076.png
diff --git a/26366-page-images/p077.png b/26366-page-images/p077.png
new file mode 100644
index 0000000..f1b74ab
--- /dev/null
+++ b/26366-page-images/p077.png
diff --git a/26366-page-images/p078.png b/26366-page-images/p078.png
new file mode 100644
index 0000000..c9439e9
--- /dev/null
+++ b/26366-page-images/p078.png
diff --git a/26366-page-images/p079.png b/26366-page-images/p079.png
new file mode 100644
index 0000000..0ba694f
--- /dev/null
+++ b/26366-page-images/p079.png
diff --git a/26366-page-images/p080.png b/26366-page-images/p080.png
new file mode 100644
index 0000000..1a9b0ed
--- /dev/null
+++ b/26366-page-images/p080.png
diff --git a/26366-page-images/p081.png b/26366-page-images/p081.png
new file mode 100644
index 0000000..dc39eca
--- /dev/null
+++ b/26366-page-images/p081.png
diff --git a/26366-page-images/p082.png b/26366-page-images/p082.png
new file mode 100644
index 0000000..6bbb67a
--- /dev/null
+++ b/26366-page-images/p082.png
diff --git a/26366-page-images/p083.png b/26366-page-images/p083.png
new file mode 100644
index 0000000..dc00cf8
--- /dev/null
+++ b/26366-page-images/p083.png
diff --git a/26366-page-images/p084.png b/26366-page-images/p084.png
new file mode 100644
index 0000000..8ec7316
--- /dev/null
+++ b/26366-page-images/p084.png
diff --git a/26366-page-images/p085.png b/26366-page-images/p085.png
new file mode 100644
index 0000000..8331d09
--- /dev/null
+++ b/26366-page-images/p085.png
diff --git a/26366-page-images/p086.png b/26366-page-images/p086.png
new file mode 100644
index 0000000..8ac47e9
--- /dev/null
+++ b/26366-page-images/p086.png
diff --git a/26366-page-images/p087.png b/26366-page-images/p087.png
new file mode 100644
index 0000000..99b6104
--- /dev/null
+++ b/26366-page-images/p087.png
diff --git a/26366-page-images/p088.png b/26366-page-images/p088.png
new file mode 100644
index 0000000..a6e4037
--- /dev/null
+++ b/26366-page-images/p088.png
diff --git a/26366-page-images/p089.png b/26366-page-images/p089.png
new file mode 100644
index 0000000..65eb1c0
--- /dev/null
+++ b/26366-page-images/p089.png
diff --git a/26366-page-images/p090.png b/26366-page-images/p090.png
new file mode 100644
index 0000000..9d4bd34
--- /dev/null
+++ b/26366-page-images/p090.png
diff --git a/26366-page-images/p091.png b/26366-page-images/p091.png
new file mode 100644
index 0000000..47272f9
--- /dev/null
+++ b/26366-page-images/p091.png
diff --git a/26366-page-images/p092.png b/26366-page-images/p092.png
new file mode 100644
index 0000000..6afee57
--- /dev/null
+++ b/26366-page-images/p092.png
diff --git a/26366-page-images/p093.png b/26366-page-images/p093.png
new file mode 100644
index 0000000..4ad386b
--- /dev/null
+++ b/26366-page-images/p093.png
diff --git a/26366-page-images/p094.png b/26366-page-images/p094.png
new file mode 100644
index 0000000..63682d2
--- /dev/null
+++ b/26366-page-images/p094.png
diff --git a/26366-page-images/p095.png b/26366-page-images/p095.png
new file mode 100644
index 0000000..3eecd86
--- /dev/null
+++ b/26366-page-images/p095.png
diff --git a/26366-page-images/p096.png b/26366-page-images/p096.png
new file mode 100644
index 0000000..63bf736
--- /dev/null
+++ b/26366-page-images/p096.png
diff --git a/26366-page-images/p097.png b/26366-page-images/p097.png
new file mode 100644
index 0000000..a1228f3
--- /dev/null
+++ b/26366-page-images/p097.png
diff --git a/26366-page-images/p098.png b/26366-page-images/p098.png
new file mode 100644
index 0000000..badb560
--- /dev/null
+++ b/26366-page-images/p098.png
diff --git a/26366-page-images/p099.png b/26366-page-images/p099.png
new file mode 100644
index 0000000..446c548
--- /dev/null
+++ b/26366-page-images/p099.png
diff --git a/26366-page-images/p100.png b/26366-page-images/p100.png
new file mode 100644
index 0000000..7725c5d
--- /dev/null
+++ b/26366-page-images/p100.png
diff --git a/26366-page-images/p101.png b/26366-page-images/p101.png
new file mode 100644
index 0000000..361da43
--- /dev/null
+++ b/26366-page-images/p101.png
diff --git a/26366-page-images/p102.png b/26366-page-images/p102.png
new file mode 100644
index 0000000..3f99c37
--- /dev/null
+++ b/26366-page-images/p102.png
diff --git a/26366-page-images/p103.png b/26366-page-images/p103.png
new file mode 100644
index 0000000..d41e04e
--- /dev/null
+++ b/26366-page-images/p103.png
diff --git a/26366-page-images/p104.png b/26366-page-images/p104.png
new file mode 100644
index 0000000..2c8eff9
--- /dev/null
+++ b/26366-page-images/p104.png
diff --git a/26366-page-images/p105.png b/26366-page-images/p105.png
new file mode 100644
index 0000000..d8a818c
--- /dev/null
+++ b/26366-page-images/p105.png
diff --git a/26366-page-images/p106.png b/26366-page-images/p106.png
new file mode 100644
index 0000000..0d91d38
--- /dev/null
+++ b/26366-page-images/p106.png
diff --git a/26366-page-images/p107.png b/26366-page-images/p107.png
new file mode 100644
index 0000000..5520afc
--- /dev/null
+++ b/26366-page-images/p107.png
diff --git a/26366-page-images/p108.png b/26366-page-images/p108.png
new file mode 100644
index 0000000..7c383e6
--- /dev/null
+++ b/26366-page-images/p108.png
diff --git a/26366-page-images/p109.png b/26366-page-images/p109.png
new file mode 100644
index 0000000..f48ea7e
--- /dev/null
+++ b/26366-page-images/p109.png
diff --git a/26366-page-images/p110.png b/26366-page-images/p110.png
new file mode 100644
index 0000000..25c28fa
--- /dev/null
+++ b/26366-page-images/p110.png
diff --git a/26366-page-images/p111.png b/26366-page-images/p111.png
new file mode 100644
index 0000000..d7c09ad
--- /dev/null
+++ b/26366-page-images/p111.png
diff --git a/26366-page-images/p112.png b/26366-page-images/p112.png
new file mode 100644
index 0000000..57b0096
--- /dev/null
+++ b/26366-page-images/p112.png
diff --git a/26366-page-images/p113.png b/26366-page-images/p113.png
new file mode 100644
index 0000000..99906dc
--- /dev/null
+++ b/26366-page-images/p113.png
diff --git a/26366-page-images/p114.png b/26366-page-images/p114.png
new file mode 100644
index 0000000..b790516
--- /dev/null
+++ b/26366-page-images/p114.png
diff --git a/26366-page-images/p115.png b/26366-page-images/p115.png
new file mode 100644
index 0000000..02c9157
--- /dev/null
+++ b/26366-page-images/p115.png
diff --git a/26366-page-images/p116.png b/26366-page-images/p116.png
new file mode 100644
index 0000000..290e1c0
--- /dev/null
+++ b/26366-page-images/p116.png
diff --git a/26366-page-images/p117.png b/26366-page-images/p117.png
new file mode 100644
index 0000000..f783ad2
--- /dev/null
+++ b/26366-page-images/p117.png
diff --git a/26366-page-images/p118.png b/26366-page-images/p118.png
new file mode 100644
index 0000000..ea4844a
--- /dev/null
+++ b/26366-page-images/p118.png
diff --git a/26366-page-images/p119.png b/26366-page-images/p119.png
new file mode 100644
index 0000000..562968f
--- /dev/null
+++ b/26366-page-images/p119.png
diff --git a/26366-page-images/p120.png b/26366-page-images/p120.png
new file mode 100644
index 0000000..90e4ec8
--- /dev/null
+++ b/26366-page-images/p120.png
diff --git a/26366-page-images/p121.png b/26366-page-images/p121.png
new file mode 100644
index 0000000..d941aae
--- /dev/null
+++ b/26366-page-images/p121.png
diff --git a/26366-page-images/p122.png b/26366-page-images/p122.png
new file mode 100644
index 0000000..a3f9493
--- /dev/null
+++ b/26366-page-images/p122.png
diff --git a/26366-page-images/p123.png b/26366-page-images/p123.png
new file mode 100644
index 0000000..84ec886
--- /dev/null
+++ b/26366-page-images/p123.png
diff --git a/26366-page-images/p124.png b/26366-page-images/p124.png
new file mode 100644
index 0000000..2c6bc74
--- /dev/null
+++ b/26366-page-images/p124.png
diff --git a/26366-page-images/p125.png b/26366-page-images/p125.png
new file mode 100644
index 0000000..22022e6
--- /dev/null
+++ b/26366-page-images/p125.png
diff --git a/26366-page-images/p126.png b/26366-page-images/p126.png
new file mode 100644
index 0000000..5d89e57
--- /dev/null
+++ b/26366-page-images/p126.png
diff --git a/26366-page-images/p127.png b/26366-page-images/p127.png
new file mode 100644
index 0000000..78bf4dc
--- /dev/null
+++ b/26366-page-images/p127.png
diff --git a/26366-page-images/p128.png b/26366-page-images/p128.png
new file mode 100644
index 0000000..f164a9f
--- /dev/null
+++ b/26366-page-images/p128.png
diff --git a/26366-page-images/p129.png b/26366-page-images/p129.png
new file mode 100644
index 0000000..00553ac
--- /dev/null
+++ b/26366-page-images/p129.png
diff --git a/26366-page-images/p130.png b/26366-page-images/p130.png
new file mode 100644
index 0000000..5c17aaa
--- /dev/null
+++ b/26366-page-images/p130.png
diff --git a/26366-page-images/p131.png b/26366-page-images/p131.png
new file mode 100644
index 0000000..44822ec
--- /dev/null
+++ b/26366-page-images/p131.png
diff --git a/26366-page-images/p132.png b/26366-page-images/p132.png
new file mode 100644
index 0000000..a2e4573
--- /dev/null
+++ b/26366-page-images/p132.png
diff --git a/26366-page-images/p133.png b/26366-page-images/p133.png
new file mode 100644
index 0000000..ea57ca0
--- /dev/null
+++ b/26366-page-images/p133.png
diff --git a/26366-page-images/p134.png b/26366-page-images/p134.png
new file mode 100644
index 0000000..5a84bb8
--- /dev/null
+++ b/26366-page-images/p134.png
diff --git a/26366.txt b/26366.txt
new file mode 100644
index 0000000..e464bb6
--- /dev/null
+++ b/26366.txt
@@ -0,0 +1,3663 @@
+The Project Gutenberg EBook of The Electric Bath, by George M. Schweig
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: The Electric Bath
+
+Author: George M. Schweig
+
+Release Date: August 20, 2008 [EBook #26366]
+
+Language: English
+
+Character set encoding: ASCII
+
+*** START OF THIS PROJECT GUTENBERG EBOOK THE ELECTRIC BATH ***
+
+
+
+
+Produced by Bryan Ness, Markus Brenner and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+book was produced from scanned images of public domain
+material from the Google Print project.)
+
+
+
+
+
+
+                                  THE
+                             ELECTRIC BATH
+
+                       ITS MEDICAL USES, EFFECTS
+                             AND APPLIANCE
+
+
+                                  BY
+
+                        GEORGE M. SCHWEIG, M.D.
+
+   MEMBER OF THE NEW YORK COUNTY MEDICAL SOCIETY AND OF THE MEDICAL
+        JOURNAL ASSOCIATION OF THE CITY OF NEW YORK; ONE OF THE
+           PHYSICIANS TO THE NEW YORK LYING-IN ASYLUM, ETC.
+
+
+                               NEW YORK
+                          G. P. PUTNAM'S SONS
+                           182 FIFTH AVENUE
+                                 1877
+
+
+
+
+                              COPYRIGHT,
+                         G. P. PUTNAM'S SONS,
+                                 1876.
+
+
+
+
+                               PREFACE.
+
+
+In No 216 of "The Medical Record" (Dec. 15th, 1874) was published an
+article written by me, entitled "On some of the Uses of Galvanic and
+Faradic Baths."
+
+The interest manifested in the subject, as evidenced by numerous letters
+of inquiry since received from physicians in almost all parts of the
+United States, and some in Europe, has induced me to write the present
+treatise, in which I have endeavored to present to the profession, as
+far as lies in my power, all that is necessary to a full comprehension
+of the electro-balneological treatment.
+
+When it is considered that in the employment of electric baths I have
+been to a great extent groping in the dark, that I have been deprived of
+the advantage of having the experience of others to guide me, it will
+not appear surprising that I should have met with many disappointments.
+My failures have been illustrative of the fact that the electric bath is
+no more a panacea for all ills than any other remedial agent.
+Applicable as it is to a great variety of pathological conditions, it
+meets with many where it is destined to have negative or at best
+imperfect results. Far from discouraging me, however, failures have
+served to inspire me with fresh ardor to seek for light, and to
+persevere in my efforts to establish on the basis of statistical truth,
+the therapeutic merits of the agent which I employed.
+
+In view of the imperfectness of the results thus far obtained, I should
+consider the present work premature, did I not find a justification for
+it in my desire to induce other and abler observers to investigate the
+subject, and place it on whatever footing it may merit.
+
+To say that I am fully conscious of the shortcomings of my work, would
+be but feebly to express my convictions in this respect. I beg the
+reader however to consider that the subject is not a hackneyed one, that
+mine has not been the work of the compiler who remodels the brain-work
+of others. It may be crude and rough, it may lack the gloss and polish
+that is the result of much handling, but I have at least the
+consciousness that it has the merits of originality and candor.
+
+              NEW YORK.
+  160 Second Avenue. November, 1876.
+
+
+
+
+                               CONTENTS.
+
+
+                              CHAPTER I.
+
+                            THE APPARATUS.
+
+                                                                  PAGE
+
+_a_)--The tub. _b_)--The electrodes and connections.
+_c_)--The water. _d_)--Chemicals. _e_)--The batteries.               7
+
+
+                              CHAPTER II.
+
+MODE OF ADMINISTRATION                                              19
+
+
+                             CHAPTER III.
+
+                        PHYSIOLOGICAL EFFECTS.
+
+Characteristic differences between the electric bath and
+other methods of electrization--Effects on sleep; on general
+sensation; on the change of matter; on the pulse and
+temperature; as a stimulant and tonic; on general nutrition;
+on the digestive apparatus; on the sexual apparatus--Sedative
+influence--Affects cranial nerves--Cutaneous sensation--Its
+freedom from pain--Muscular contractions--Effects on the mind       31
+
+
+                              CHAPTER IV.
+
+                 GENERAL THERAPEUTIC EFFECTS AND USES.
+
+The electric bath as a diagnostic; as an equalizer of the
+circulation; as a general counter-irritant; as a general
+invigorant and tonic--Its hypnotic and sedative influence--Its
+improvement of nutrition--As a prophylactic                         52
+
+
+                              CHAPTER V.
+
+               SPECIAL THERAPEUTICS AND CLINICAL RECORD.
+
+General directions--Special diseases--Acute rheumatism--Subacute
+rheumatism--Chronic rheumatism--Cases of rheumatism--Chorea,
+with cases--Hysterical affections, with cases--Neurasthenia,
+with cases--Agrypnia, with cases--Anaemia, with case--Paralyses
+and Pareses, with cases--Neuralgiae, with cases--Articular
+effusions, with case--Impotency, with cases--Constipation, with
+cases--Hydrargyrosis, with case--Locomotor ataxia, with
+case--Cachexia, with case--Dyspepsia--Melancholia, with
+case--Inequalities of the circulation--Affections of the
+Sympathetic, with case--Miscellaneous conditions--Concluding
+remarks                                                             61
+
+
+
+
+                          THE ELECTRIC BATH.
+
+
+
+
+                              CHAPTER I.
+
+                            THE APPARATUS.
+
+
+To a proper comprehension of the succeeding chapters, it is necessary
+first of all to be familiar with the apparatus employed in carrying out
+electro-balneological treatment, and I therefore proceed to give a
+description of this.[1] It may conveniently be divided as follows, viz.
+
+    _a._ The tub;
+
+    _b._ The electrodes and connections;
+
+    _c._ The water;
+
+    _d._ Chemicals;
+
+    _e._ The batteries.
+
+(_a_) _The Tub._ This must be made of a non-conducting material. Of
+substances that will answer, I will mention: wood, porcelain, soapstone,
+vulcanized rubber, or glass. In choosing one of these materials, regard
+should be had to the facility of attaching the electrodes. In this
+respect wood deserves the preference over all the others mentioned.
+Where economy is to be studied, it has a further item in its favor.
+
+The tubs, which I have now in use for nearly three years are made of
+wood, and I find them to answer very well. It must not be forgotten,
+however, that a wooden tub requires to be well painted on the inside, in
+order to prevent its becoming water-soaked, because in that event it
+would become a conductor of electricity, and interfere to some extent,
+with the administration of the electric current in the bath.
+
+The shape and size of the tub may be the same as those of an ordinary
+bath tub. To suit individual cases however, its length may be made to
+vary. The only peculiarity in its construction is at the head. Here,
+instead of slanting, it is made square, and the slightly concave (from
+side to side) board against which the back of the bather is to rest, is
+fitted in afterwards. This is necessary, because it is very difficult to
+make a wooden tub with a slanting back water-tight. If the length of
+the tub from outside to outside is made to measure about five feet ten
+inches, the back-rest fitted in at a proper slant will bring the inside
+of the tub to about the right length for an average male adult. All
+around the upper edge of the tub runs a wooden coping, which must not be
+fastened down however until all the attachments for conducting the
+current are _in situ_. Along that portion of the top of the tub where
+required--and this will depend on the situation of the binding posts
+presently to be mentioned--and underneath the coping, runs a groove for
+the reception of the wires that are to connect the carbon electrodes on
+the inside of the tub with the binding posts on the outside. This groove
+is continued vertically along the inside of the back-rest and foot of
+the tub respectively, to communicate at either end with the bed for the
+reception of the carbon plates. These vertical grooves should at their
+lower end be a little over 1/4 inch deep, in order to admit of the wires
+being introduced beneath the carbons.
+
+The face of the foot of the tub and that of the back-rest, should have
+in their centres (from side to side) and commencing at about five inches
+from the bottom of the tub, a bed for the reception of the carbons. The
+dimensions of these receptacles must of course correspond to those of
+the carbon plates to be employed as electrodes. Those which I use
+measure 12x8" at the head, 8x6" at the foot of the tub. They are 1/4"
+thick. They are placed so as to have their long diameter correspond to
+the height of the tub. The bed which is to receive the carbon at the
+head of the tub must be deeper than 1/4" on account of the concavity of
+the back-rest.
+
+In order to adapt a tub to individuals of different lengths, it will be
+found advantageous to have two small vertical cleats on each side of the
+tub, near the foot and bottom, for the reception of a foot-board, which
+will practically shorten the tub and adapt it to persons of different
+lengths. This board may conveniently be six inches wide, and should have
+a number of perforations about an inch in diameter, for the transmission
+of the current to the feet. 1 1/4" pine plank is the most suitable wood
+to use in the construction of the tub. This is preferable to any of the
+hard woods, because of the greater facility of fitting in the electrodes
+etc. It is also the most economical.
+
+(_b_) _The electrodes and connections._ These consist of two carbon
+plates, two brass binding posts, and insulated wires to connect the
+carbons with the binding posts, and these with the battery. The carbons
+are such as are ordinarily employed in the construction of galvanic
+batteries, and can, as well as the wire and binding posts, be procured
+from any house that deals in telegraph material. Their size is to some
+extent optional; the dimensions I have given above however answer very
+well.
+
+The inside of the tub having received one or preferably two coats of
+paint, the carbons are now fitted in the receptacles provided for them.
+The next step is the attaching of the binding posts. These should be of
+the kind known as "single" binding posts with "wood screws." The most
+convenient location for them will be found on the coping covering the
+horizontal portion at the head of the tub. Here the coping, as it has to
+cover not only the upper edge of the head of the tub, but that of the
+back-rest also, is of necessity much wider than at any other portion,
+and thus affords most room for the binding posts.
+
+Having marked out then a site for the binding posts, say in the centre
+of the coping at the head of the tub--which should now be placed in
+position--and about two inches apart, the posts are laid aside to be put
+in place when the wires are all _in situ_, and the coping fastened down.
+
+In order to facilitate the description of the placing of the wires by
+means of which communication is to be established between the electrodes
+and the binding posts, I shall term the end of the wire that is to be
+attached to the electrodes the distal, that which is attached to the
+binding posts the proximal end. A gimlet hole sufficiently large to
+admit of the passage of one wire should be made half an inch outwards
+from the centre of the site of each binding post. The best wire to use
+is about No. 16 copper wire, coated with gutta percha or rubber. The
+site of the posts being as above suggested, it will be found that the
+wire which is to connect the head electrode with one post requires to be
+about 18 inches long, that which runs from the other post to the
+foot-electrode, between eight and nine feet. The distal ends of the
+wires should be stripped of their coating for a length of about three
+inches, the proximal ends for about two inches. The denuded portion of
+the distal ends should be rolled up in the form of a spiral coil; this
+will insure their constant impinging on the carbons more certainly than
+could be expected from a simple straight end of wire.
+
+The carbons having now been fitted in their beds, the distal end (coil)
+of the head wire is placed beneath the carbon, and the wire itself
+continued up along the vertical groove to either one of the gimlet
+holes. Through this, from within outward, the proximal end of the wire
+is now drawn and left for the present. The distal end of the second wire
+having now been placed beneath the carbon at the foot of the tub, this
+wire is continued up through the vertical groove, along the upper edge
+of the foot of the tub to the side nearest the binding post to which the
+wire is to be attached, along the groove on the upper edge of this side
+to the head of the tub, and thence to the respective gimlet hole, and
+through this, from within outward. The wires being now all in position,
+all the coping is next screwed or nailed down firmly, care being taken
+that the screws or nails used for this purpose do not injure any of the
+wires. The coping fastened down, the binding posts are now screwed down
+in the sites previously marked out for them. Before they are screwed
+_entirely_ down, the denuded portion of the proximal end of each wire is
+securely wound around the screw of the respective binding post, and the
+posts are then _firmly_ screwed down, holding the proximal ends of the
+wires in place. Connection is now established between the binding posts
+and the head and foot electrodes respectively. The vertical grooves are
+now to be filled in with putty and painted over, care being taken to
+keep the carbon free from paint. The last step towards completing the
+apparatus is to fasten the carbons in their beds. The simplest way of
+doing this is by stretching over each carbon a piece of muslin, folded
+double, and tacking this down around the edges. Zinc or galvanized iron
+tacks are best. Copper tacks should be avoided on account of their
+superior conductivity.
+
+In order to be able when required to localize the current in special
+portions of the body, it is well to be provided with what I have termed
+a "surface board." This is a piece of black walnut, say 14 in. long by 5
+in. wide, 3/4 thick, having in the centre a bed to accommodate a carbon
+plate, say 5 in. long by 2 in. wide, 1/4 thick. From the centre of this
+bed a gimlet hole pierces the board. The denuded end of an insulated
+wire is drawn through this gimlet hole from without inward (toward the
+bed) and twisted in the form of a spiral to prevent its slipping back,
+as well as to insure its more certain connection with the carbon. The
+carbon is now placed in the bed, and kept there by a piece of muslin
+drawn over it and tacked down. The wire should be of sufficient length
+to reach the battery. I shall speak further on of the use to be made of
+the surface board.
+
+
+_c_) _The Water._ The quantity of water may be the same as that in an
+ordinary bath. In those cases alone where it is intended to localize the
+current by means of the surface board, and to concentrate it _very
+strongly_ in one spot, the water in the tub should be left low enough to
+leave the particular spot to be treated uncovered by this; the surface
+board can then be applied to this spot without the loss to the current
+of strength, through derived currents, inevitable in its application
+under water.
+
+The temperature of the water may range from 85 deg. to 105 deg.
+Fahrenheit. As a rule the comfort of the patient may be consulted in
+this respect. There are certain cases, however, where an especially high
+or low temperature is indicated, and where the extremes mentioned have
+to be touched.
+
+
+_d_) _Chemicals._ Where these are added to the water of the bath, it is
+for one of three purposes: viz. 1)--To exercise a direct therapeutic
+influence on the patient, either internally by being absorbed, or
+externally by their action on the skin; 2)--Through chemical affinity to
+aid in eliminating certain metallic substances from the body; or 3)--To
+further the absorption of morbid deposits. The various indications in
+these respects will be treated of in their proper places.
+
+
+_e_) _The Batteries._ In the choice of this, the most important part of
+the electro-balneological apparatus, the greatest circumspection is
+necessary. Inferior instruments and such as are liable to get out of
+order frequently, have time and again been the means of discouraging the
+beginner in electro-therapeutics, and causing him to abandon the study
+of an art, the pursuit of which would have well repaid him for all his
+labor. Fortunately our manufacturers here in New York turn out very good
+instruments, and if a physician purchases an inferior one, the fault is
+his own.
+
+Two different currents are required for the baths, viz. 1)--The
+galvanic, which may be employed either in the constant or interrupted
+(by means of a rheotome) form; and 2)--the faradic or induced current.
+Several manufacturers of this city turn out good and serviceable faradic
+instruments. Those which I have been in the habit of using for some
+years past are manufactured by the Galvano-Faradic Manufacturing
+Company, and they have given me unvarying satisfaction. By means of a
+recently introduced attachment to their batteries, termed the "fine
+adjustment," a current of exquisite "fineness" (rapidity of
+interruption) is obtained, thus removing the only inferiority that has
+heretofore distinguished American from the best imported instruments.
+The instrument is very easy of management, and its liability to get out
+of order very small.
+
+As however the galvanic current is of vastly greater importance in a
+therapeutic respect, than the faradic, so also much greater care is
+required in the choice of a galvanic than a faradic battery. In making
+choice of a galvanic battery, we have to consider its relative quantity,
+intensity, constancy, permanency, economy of running expenses, and
+facility of management. We cannot be guided here by the same
+considerations that guide us in the choice of a battery for office use,
+where the _seances_ are usually brief and the elements taxed not nearly
+so much as in the administration of baths. It is not within the scope of
+this work to enter into a description of the various galvanic batteries
+that are in use. Neither do I believe that, in a therapeutic sense,
+there is much difference between the various batteries ordinarily found
+described in text-books on electro-therapeutics.
+
+Where the battery is to be stationary, a zinc-copper battery, such as
+the Hill battery for example, is preferable both on account of its
+constancy and the economy of running it. Of this there should be fully
+sixty cells, communicating with the bath through a current selector, by
+means of which the current from any desired number of cells can be
+obtained. The electro-susceptibility of different individuals varies to
+such an extent that this is absolutely necessary. Where a portable
+battery is desired, the Stoehrer zinc-carbon battery will be found the
+most useful.
+
+I have mentioned these two batteries simply because I have them in use,
+and they give me satisfaction. There are many others, however, that will
+answer equally well. On the whole, any battery possessing quantity and
+intensity in a medium degree will answer.
+
+
+    Footnotes:
+
+    [Footnote 1: A written description can never convey so true an
+    idea of anything, as an ocular inspection. I will therefore say
+    that it will afford me much pleasure to show any member of the
+    profession the apparatus I am about to describe, at my
+    residence.]
+
+
+
+
+                              CHAPTER II.
+
+                        MODE OF ADMINISTRATION.
+
+
+I shall describe under this head the _modus operandi_ of administering a
+routine galvanic or faradic bath. As it will become necessary to
+describe special modes of administration when speaking of the
+electro-balneological treatment of special diseases, the describing them
+now would only lead to tautologies that I am desirous of avoiding.
+
+Taking our cue from the indications to be met in each case, it becomes
+necessary, according to circumstances, to use either the galvanic
+current, the faradic, or both successively. As modifications of the
+application of the currents we have to consider 1) their intensity; 2)
+their direction, and 3) the duration of the application.
+
+The intensity of the galvanic current corresponds directly to the number
+of cells from which it is derived. It were vain however to attempt to
+express this in figures, because the electro-motive force of different
+batteries varies to so great an extent, that a number of cells of some
+batteries of low intensity yield a current so feeble as to be barely
+appreciable in the bath, while the same number of cells of a battery of
+high intensity, furnish a current that few persons can bear without
+pain. In thus comparing the Hill cell with the Stoehrer cell, I have
+found the ratio to be about as 1 to 2 1/2, i.e., as intense a current can
+be derived from twenty-four Stoehrer as from sixty Hill cells--and this
+is rather below than above the mark. Were all batteries alike in this
+respect, however, still no particular number of cells could be given as
+furnishing a current of suitable average intensity for the galvanic
+bath, because of the excessively great variations in the degree of
+electro-sensibility of different persons. This is so marked that I have
+seen persons in the bath tub who could bear no more than six Hill cells,
+diffused as was the current from these through the water and over the
+entire body; while on the other hand I have met with male patients on
+whom a current from thirty-two Stoehrer cells made not the slightest
+impression, and where I was compelled to supplement the current by that
+from a ten-cell quantity battery (zinc carbon elements 6 in. long by 4 1/2
+wide) in order to make them realize the presence of a current. These
+gentlemen had no cutaneous anaesthesia.
+
+In view of the facts just stated, I have found it impracticable, when
+giving directions for the administration of a galvanic bath, to indicate
+any certain number of cells to be used. I am in the habit of ordering
+the administration of a "mild," a "medium" or a "strong" current, as may
+be required in the respective cases; and in every instance it is the
+electro-sensibility of the patient that determines the number of cells
+requisite to obtain the desired result as represented by one of these
+terms. The same applies also to the faradic current.
+
+To determine the direction of the current is sufficiently simple. Where
+a descending current is desired, the binding post which represents the
+electrode at the head of the tub must be connected to the positive pole
+of the battery, the other binding post to the negative pole; where an
+ascending current is desired, the reverse of this is done.
+
+The duration of the bath varies with different cases. The average is
+about twenty minutes, though the time may range from ten minutes to an
+hour and a half.
+
+Where it is desired to give the patient a galvanic shock, it is only
+necessary rapidly to reverse the current by means of the commutator. The
+simultaneous contraction of almost the ENTIRE muscular system that
+accompanies the reversal of a current of sufficient intensity in the
+bath, affords a striking illustration of the _general_ effects of the
+galvanic bath. In cases where paralyzed muscles have lost their faradic
+irritability, galvanic interruptions are almost indispensable to
+successful treatment.
+
+I have before (page 14) described a "surface board," which I have
+devised for the purpose of localizing the current from one of the poles
+in any portion of the body where required. This proceeding should by no
+means be looked upon as a "local" method of electrization; on the
+contrary, it is just as much "general" as the ordinary electric bath.
+Whereas in local applications the current runs from one point of the
+body to another, in this case, supposing the spot where the surface
+board is applied to be the centre, and the rest of the body the
+periphery, a current runs between _every point_ of the periphery and the
+centre, its direction being centripetal when the surface board
+communicates with the negative, centrifugal when with the positive pole
+of the battery.
+
+The current is felt more or less intensely in proportion to the
+proximity to the body of the surface board. With the galvanic this is
+less noticeable than with the faradic current. When, for example, a
+faradic current of medium strength being employed, the surface board is
+held about six inches from the abdominal surface, little or no current
+is felt. Let the surface board be now gradually approximated to the
+abdomen, and the current will be felt more and more sensibly, until,
+when about an inch away from the skin, or touching this, its influence
+becomes so strong as to cause more or less energetic contractions of the
+abdominal muscles. Where the galvanic current is employed, the skin
+beneath the surface board will be found more or less reddened after a
+few minutes' application; the burning sensation ordinarily accompanying
+galvanic applications will also be experienced more or less intensely,
+in proportion to the strength of the current employed.
+
+Where the current is to be concentrated in a manner still more energetic
+than that described, this can be effected by raising the objective part
+above the surface of the water, and then applying the surface board. In
+this way the _entire_ strength of the current is concentrated in one
+spot, whereas, when the surface board is applied under water, a large
+portion of current is absorbed by this.
+
+This appears to me the fittest place to say a few words in regard to the
+relative conductivity of the human body and water--the latter at the
+temperature ordinarily employed in baths, say from 90 deg. to 95 deg.
+Fahrenheit. BEARD and ROCKWELL, in their work on Medical and Surgical
+Electricity,[2] state that "the human body is a better conductor of
+electricity than water at the same temperature." Certain phenomena
+connected with the administration of electric baths having forced upon
+me some doubts in this respect, I made very careful experiments, both
+with and without the aid of the galvanometer (Bradley's Tangent), to
+satisfy these. Without wearying the reader with details, I will state
+that the result of my experiments leaves no room for doubt that water at
+the temperatures stated--and still more so at 98 1/2 deg.--is superior
+to the human body as a conductor of electricity. I do not mean to be
+understood that water is a better conductor than _every constituent_ of
+the human body; blood, for example, is a better conductor. But when I
+speak of the body in this connection, I take it as we find it
+practically, i.e., with the resistance of the skin, and especially the
+epidermis, superadded to internal resistances. I have no doubt that
+with a flayed individual it would be otherwise. I will add, that it will
+give me great pleasure to repeat these experiments, which are
+sufficiently simple, in the presence of any of my _confreres_ who feel
+an interest in the subject.
+
+Having thus cursorily considered the manner of using the electric
+current in the administration of a "routine" bath, and there being no
+remarks required concerning the water employed, in addition to what has
+been said in the previous chapter, a few words are in place on the
+subject of chemicals. As has been previously stated (page 13) these are
+added: _a_) to be absorbed, and thus act medicinally on the patient;
+_b_) to act on the skin; _c_) through chemical affinity to facilitate
+the elimination from the body of certain metallic substances, and _d_)
+to further the absorption of morbid deposits. Of the many drugs and
+medicines that no doubt may be made to answer these various purposes, I
+have had personal experience with but few, and of these I will mention
+the leading ones only. A requisite of all chemicals to be employed is
+their ready solubility in water. Of substances intended for
+absorption[3] I have used but three, viz: iron, iodine, and extract of
+malt. The first of these I have employed in anaemic and enfeebled
+conditions generally, but especially in chlorosis and chlorotic
+hysteria, with marked success. It has the advantage, when administered
+in this manner, not only of sparing the alimentary canal the frequently
+injurious task of becoming the medium of its assimilation, but, in
+addition to this, I believe that it can in this way be introduced into
+the blood much more rapidly and in larger quantities than when given by
+the mouth. The preparation which I have found, all things considered,
+the most eligible for this purpose, is the "tartrate of iron and
+ammonia." This is very readily soluble, leaving no deposit, is
+assimilable, and not too expensive for the purpose. As, in my experience
+at least, it leaves nothing to wish for, I would consider it superfluous
+to discuss in this connection any of the other ferruginous preparations.
+
+Iodine I have employed with a view to its absorption in rheumatism and
+gout. I cannot speak favorably of it in this connection. I have not in a
+single instance found a bath charged with iodine, either in the form of
+the tincture or of iodide of potassium, followed by results in any way
+differing from those of the simple galvanic bath employed in the same
+cases.
+
+Extract of malt I have employed as a roborant, either alone or in
+conjunction with iron, in cases of debility and malnutrition, and found
+it of service.
+
+Where the absorption of substances is aimed at, the _galvanic_ current
+must be employed.
+
+Where we add substances to an electric bath with a view of producing
+some special action on the skin, we may be guided by the same principles
+that govern ordinary balneology. Thus to obtain counter-irritant
+effects, we may add mustard or common salt; to render the bath alkaline,
+bicarbonate of potassa or soda, etc., etc.
+
+An important object to be furthered by the addition to the galvanic bath
+of chemicals, is the elimination from the system of certain metallic
+substances. It will be found here that in practice we have to deal
+chiefly with two substances, viz: mercury and lead. That the elimination
+of these bodies by means of the galvanic bath is feasible, I shall
+endeavor to demonstrate further on. At present I have simply to consider
+the chemicals adapted for the purpose, and the manner of using them.
+
+To facilitate the extraction from the system of mercury, nitric-acid has
+been recommended by those who have heretofore instituted this treatment.
+While I cannot positively deny that this substance may aid in the
+elimination of the metal, I am compelled to state, after its trial in
+several cases, that I have obtained equally good results from the simple
+galvanic bath. In the light of my own limited experience, therefore, I
+cannot insist on the necessity of adding any chemical to a galvanic bath
+which is administered for the purpose of extracting mercury from the
+body.
+
+Where the elimination of lead is the object aimed at, I am, on the other
+hand, satisfied of the utility of adding certain chemicals to the water
+of the bath. Sulphuric acid has been suggested and used for this
+purpose. I can say nothing respecting its usefulness, as I have never
+tried it. Indeed, the results with iodide of potassium added to the bath
+have been so satisfactory, that I have had no occasion to try any other
+chemical, although almost any other of the preparations of iodine would
+probably answer equally well. The chemical affinity of iodine for lead
+affords a ready explanation of its usefulness in this respect. One ounce
+of iodide of potassium to each bath appears to me a suitable quantity.
+
+I have had no personal experience with any other cases of chronic
+metallic intoxication than those with lead and mercury.
+
+The absorption of morbid deposits (plastic exudations, etc.) can be
+materially furthered by adding to a galvanic bath some resolvent--above
+all, iodine.
+
+I have said above (page 26) that I had found no perceptible benefit from
+the addition of this substance to the galvanic bath in cases of
+rheumatism or gout. The contrary holds good however with respect to the
+frequent sequence of these diseases--articular deposits. When the acute,
+and to a great extent the subacute symptoms have subsided--and in
+chronic cases especially, and the disease has left effusions in various
+joints, iodine, which when employed in this manner, appears to have
+little or no influence on the pain accompanying these complaints, is a
+powerful adjuvant in promoting the absorption of the deposits. In
+chronic synovitis and all other articular affections accompanied by
+exudation, the same holds good.
+
+I have no doubt that future advances in this branch of science will
+develop the utility of numerous other drugs and chemicals as additions
+to the galvanic bath.--Before leaving this subject I must call attention
+to the influence which the addition to the bath of certain substances
+has on the conductivity of the water, resp. thus: the action of the
+current on the patient. I have found that when I caused salt or
+bicarbonate of soda to be added to the bath, the conductivity of the
+water became so much increased, so disproportionately greater than that
+of the body, as to render necessary the employment of very powerful
+currents in order to cause the patient to feel them.
+
+
+    Footnotes:
+
+    [Footnote 2: "Medical and Surgical Electricity." New York. 1875.
+    Wm. Wood & Co. pp. 431 and 432.]
+
+    [Footnote 3: For some experiments concerning the cataphoric
+    effects of the galvanic current, see an article by MUNK,
+    entitled "Ueber die galvanische Einfuehrung differenter
+    Fluessigkeiten in den unversehrten lebenden Organismus," in the
+    Allgemeine Medicinsche Central-Zeitung, No. 16, 1875.]
+
+
+
+
+                             CHAPTER III.
+
+                        PHYSIOLOGICAL EFFECTS.
+
+
+In accordance with the plan of the present work, the remarks I shall
+offer under this head are by no means intended to comprise all that is
+known at the present day of the physiological effects of electricity in
+general. It was my purpose when I undertook to write these pages, to
+offer to the profession a book confined to one subject; not a
+compilation, but a volume made up almost if not wholly of original
+matter, chiefly, if not entirely the result of my own observations and
+experience. For the general physiological effects then of electricity as
+well as for the theories of its action, I refer those interested to the
+many excellent works on the subject that have appeared within the last
+few years. I will treat here only of the physiological effects peculiar
+to the electric bath.
+
+The daily observations that I have had the opportunity of making in this
+respect, extending as they do over a period of upwards of two years,
+have not been as fruitful of results as might be expected. This is due
+mainly to the circumstance that but a small percentage--and these took
+the baths merely as a refreshing tonic--of those whom I have had the
+opportunity of observing, were in a condition that might be called
+normal. By far the greater majority were suffering from some complaint,
+in most instances of a neurotic or rheumatic nature, the presence of
+which, while it afforded admirable opportunity for observing therapeutic
+results, modified more or less the physiological effects of the baths,
+and served to deprive them of a uniformity which might to a great extent
+justly be looked for in healthy organisms. If, therefore, what I now
+contribute to the physiology of the subject is but little, it will I
+trust be at least found of practical utility in its applicability to the
+therapeutics of the subject.
+
+Before entering into details, it is necessary in the first place to
+inquire in what respects electric baths differ from other methods of
+electrization--especially those recently introduced as "general"--that
+their physiological effects should merit individual consideration. They
+differ in two ways. One of these is self-evident. To the effects of
+electricity are superadded those of the warm bath. The effects of the
+warm bath _per se_ are too familiar to every physician to require
+comment. Its effects in combination with electricity, however, may not
+be so generally known; and I therefore feel justified in quoting here a
+passage that bears directly on the subject, from a recent German work by
+Dr. Hartmann[4] of Wiesbaden.
+
+    "The last question, whether mineral water acts also by contact
+    with the skin, leads us to one of its most important
+    effects--that through electricity.
+
+    "Although this question has not as yet been finally disposed of,
+    we have still advanced far toward its solution, through the
+    admirable researches of HEYMANN and KREBS. Both observers have
+    furnished proof that the contact of the water of the bath[5]
+    with the human body gives rise to electric currents, which
+    currents must be looked upon as being the excitors of the
+    nerve-currents, the body acting merely as a conductor. From
+    these experiments we conclude that no particular difference
+    obtains between artificial and transported waters on the one,
+    and natural waters on the other hand, the assertions of
+    SCOUTETTENS notwithstanding, who in regard to electricity
+    claimed to have found a difference between the artificial and
+    transported waters and the natural ones.
+
+    "We gather moreover from the experiments, that the electric
+    current generated through the contact of the body with the water
+    of the bath is modified chiefly by the gases, next by the
+    temperature of the water, and lastly only by its salts.
+
+    "The effects of the bath depend on the strength of the electric
+    current generated and on the condition of the peripheral endings
+    of the nerves; the effect may be stimulating or soothing. The
+    strength of the current is governed, as we have seen, by the
+    quantity of gases present, the temperature and the salts.
+    Ordinary lukewarm baths, indifferent baths containing a small
+    amount of gases, are less stimulating than mineral baths
+    containing a larger proportion of gases.
+
+    "With regard to the relative condition of the peripheral
+    nerve-ends, experiments on the motor nerves go to show that
+    swelling of the terminal ends of these nerves may diminish their
+    excitability to the point of its complete extinction, while it
+    becomes increased by their exsiccation. This fact as to the
+    motor nerves is adopted by HEYMANN likewise as applying to the
+    nerves of sensation. If, now, we presuppose absorption or even
+    imbibition on the part of the skin, a swelling of the nerve-ends
+    is comprehensible, as the imbibed fluid reaches them. But,
+    according to HEYMANN, the peripheral nerve-ends, i.e., the
+    terminal bulbs of KRAUSE, of the sensory nerves, and the tactile
+    corpuscles of MEISSNER, become even without this presupposition
+    sufficiently impregnated with water while in the bath, because
+    here all insensible perspiration must cease, and in a bath of a
+    temperature lower than blood-heat transpiration cannot take
+    place, so that all transudation to the skin being retained
+    during the bath, those termini are surrounded by moisture and
+    therefore swell up.
+
+    "From this the writer concludes with regard to the effects of
+    the baths, that all baths in which the electric current produced
+    by contact of the water with the body preponderates over the
+    swelling of the nerve-ends, have a stimulant effect, while
+    those baths where the swelling preponderates over the electric
+    current, act as a sedative.
+
+    "Taking a brief and comprehensive review therefore of the
+    effects of mineral water baths, we have those resulting from the
+    temperature, from the contents of carbonic acid and salts, and
+    lastly from the electric current generated in the bath water;
+    each effect however resolving itself into an excitation of the
+    peripheral nerve-ends, which leads in a reflex manner to an
+    enhancement of the change of matter."
+
+From the foregoing quotation may be realized the importance which is
+attached to the electric current in the warm bath. And here let me ask
+the question: May not the remedial superiority, in many cases, of the
+mineral water bath over the ordinary warm bath be due mainly, if not
+solely, to the more abundant generation in the former of electricity? Or
+rather, is it not very likely that this is so? And if such is the case,
+it would appear evident that the mineral water bath, the electric
+properties of which, depending on the chemical changes going on between
+the gases and salts of the water on the one, and the cutaneous
+secretions and other constituents of the body on the other hand, are to
+a great extent beyond our control, must in turn be vastly inferior to a
+bath where the electric current is under our perfect control, and can be
+modified in intensity, direction and quantity to meet the individual
+requirements of every case. And such is the electric bath I am now
+describing.
+
+The second difference between the electric bath and all other methods of
+applying electricity is, that _the bath is the only method by means of
+which general electrization can be realized_. In making a distinction in
+this respect, it becomes necessary for me to advert more especially to a
+method first introduced to the profession in a systematized and
+scientific manner by Drs. BEARD and ROCKWELL,[6] and termed by them
+"General Faradization." The undoubted good results that have been
+obtained from this method--for the details of which I refer the reader
+to the latest work of the authors[7]--have caused it to be extensively
+adopted by the medical profession, both here and in Europe. It is,
+however, not with its results that I have to do at present, but with its
+appellation and true nature. General faradization, so-called, consists
+of a series of local faradizations, administered during one and the same
+seance, until the current has alternately been made to impinge upon and
+traverse the entire or at least a large portion of the body. This
+cumulative procedure, it is true, approaches general electrization, as
+represented by the electric bath, more closely than any of the other
+local methods; yet it is not that which its name would imply, and I do
+not think it requires argument to make it apparent, that even this
+procedure differs vastly from the electric (whether galvanic or faradic)
+bath, where the current at one and the same time impinges directly on
+every peripheral nerve-end (excepting those of the head and face) and
+traverses every part of the body, obtaining--both as to reflex and
+direct effects--as a whole that which the method known as general
+faradization seeks to obtain by the cumulation of fractional portions.
+
+Having thus, I trust, established the individuality of the bath as an
+electric method, I will without further digression proceed to the
+consideration of its physiological effects.
+
+The physiological effects of the electric bath may be qualified on the
+one hand as either "immediate," or "remote," on the other as either
+"transient" or "permanent." Strictly to classify these is impracticable,
+and I will therefore be influenced in the order of their enumeration
+principally by their importance in a therapeutic respect.
+
+One of the most pronounced as well as uniform, and at the same time
+most important, effects of the electric bath, is its property as an
+
+
+                               HYPNOTIC.
+
+This somniferous influence, which is to some extent exercised by local
+electrization, is here distinguished by its far greater constancy as
+well as by its greater degree of perfection. That this difference should
+exist, appears quite natural, when it is considered that the same
+topical influences which produce it in local electrizations, and which I
+shall presently endeavor to analyze, are here brought to bear on the
+entire system. The hypnotic effect is both immediate and remote, and
+more or less permanent. When there is an immediate inclination to sleep,
+which may make itself manifest during the bath or immediately after
+this, it is generally accompanied by a
+
+
+                      PLEASANT SENSE OF FATIGUE,
+
+which cannot be likened to weariness, but rather to what we feel after
+moderate exercise; it is only in some instances, where an individual
+takes his first bath, or where, for therapeutic reasons, a strong
+faradic current--accompanied by responsive muscular contractions--is
+employed, that this feeling is intensified sufficiently to become
+unpleasant, calling for rest and recuperation, and must here be looked
+upon as analogous to the effects of _severe_ exercise. It invariably
+disappears after a brief rest.
+
+Experience and good judgment will enable us moreover in almost all cases
+to avoid effects of this kind. The immediate inclination to sleep is
+much more decided as well as constant when the bath is taken late in the
+day, than when taken in the forenoon. When the latter is the case
+however, the individual will as a rule become sleepy during the
+afternoon, or else at an earlier hour than usual in the evening, and
+sleep more soundly during the night. This is the effect of one bath. A
+series of baths will however produce more or less marked and permanent
+improvement in the sleep of individuals, where this has been below the
+normal standard. And this is among the most invariable of the effects of
+the electric bath, whether galvanic or faradic.
+
+I have formed a theory as to the _rationale_ of this influence, which I
+will offer as its probable explanation. We all know that sleep is a
+process designed by nature for the recuperation of the system after a
+certain period of activity. In other words, when the various functions
+have been more or less exercised for their daily allotted time--say
+seventeen hours--the respective organs need that profound rest which we
+know as sleep. Now, it is pretty well conceded by physiologists, that
+electricity stimulates the secretory as well as excretory organs; that
+it furthers endosmosis and exosmosis--by its electrolytic influence in a
+physical, by its influence on the nervous system in a catalytic manner,
+in short, and by virtue of these properties, that it greatly
+
+
+                     ENHANCES THE CHANGE OF MATTER
+
+and incites the various organs to so great an activity as to cause them
+to perform in a comparatively brief space of time--say an hour, the work
+of several hours. The natural sequence is obvious: _The want of rest--of
+sleep, is felt at a correspondingly earlier period._ I offer this as a
+probable explanation of the immediate or almost immediate disposition to
+sleep. As to the permanent improvement in sleep, where this has been
+below the normal standard, it must always be due to the removal of some
+morbid condition, and thus belongs among therapeutic results, rather
+than physiological effects. It is true that in many instances of
+_agrypnia_ we are unable to discover any pathological condition that
+would account for this symptom; but the probability is that here there
+is a sluggishness of some one or more of the functions, mental or
+physical, too obscurely manifested to be discovered by our present means
+of diagnosis, yet reached and rectified by a mode of electrization that
+traverses and permeates _every_ portion of the body.
+
+If this explanation of the hypnotic effect of the electric bath be not
+the true one, it is at least--so far as I know--the first attempt at
+accounting for a phenomenon that has been noticed as a result of even
+local applications of electricity by many observers, and about the
+pretty uniform occurrence of which there can be no doubt.
+
+With respect to the effect on the
+
+
+                        TEMPERATURE AND PULSE,
+
+I have made a number of observations, of which I have recorded
+twenty-two, made on persons where both were at or nearly at the normal
+standard. With regard to the frequency of the pulse, the results were
+conflicting and by no means reliable. In the majority of cases there was
+an increase, immediately after the bath, ranging from four to eighteen
+beats per minute. In others there was no change whatever, and in a few
+there was an absolute diminution in frequency; this last I believe
+however to be a therapeutic rather than physiological effect,
+manifesting itself only where there is pneumogastric asthenia, and
+attributable directly to electric stimulation of this nerve. Thus in one
+instance, which occurred in the person of a physician of this city, who
+had an intermittent pulse, the result was as follows: Immediately before
+bath: pulse 70, two intermissions; at the expiration of 15 minutes,
+during which he was under the influence of a descending galvanic
+current: pulse 65, two intermissions; at the end of ten more minutes,
+during which he received the faradic current: pulse 65, no
+intermissions; ten minutes after leaving the bath: pulse 66, no
+intermissions. As a rule then, we may look for an immediate and more or
+less transient moderate increase in frequency of the pulse. As for any
+permanent increase or reduction of the pulse, there is none as a
+physiological effect. Where such an one does take place, it is by the
+removal of some morbid influence on the heart, and must be looked upon
+as a therapeutic result.
+
+With respect to the temperature, the results were somewhat more uniform.
+I have found that where this is either normal or slightly below, the
+immediate but transient effect is to raise it from 2 to 6 tenths of a
+degree (Fahrenheit)--in most instances 4 tenths. In a very few cases it
+remained unchanged, and in one case, where before the bath the
+temperature was 100, at the close of the bath it was 99-3/5. Of
+permanent modifications of the temperature, the same holds good that I
+have said of permanent changes in the pulse. It must not be forgotten
+that the temperature of the water is undoubtedly an important factor in
+modifying the temperature of the body. In almost all instances where my
+observations were made, the temperature of the water was below that of
+the body, being 95 deg. or a little less. This, which has a tendency to
+lower the bodily temperature, is to some extent counterbalanced by the
+suppression of the insensible perspiration, so that modifications of
+temperature resulting from electric baths, the water of which is but few
+degrees below 98 1/2 deg., may justly be attributed to the influence of
+the electric current. The importance of the electric bath as a
+
+
+                   PHYSIOLOGICAL STIMULANT AND TONIC
+
+cannot be overrated. I deem it superior in this respect to any other
+known agent. This effect manifests itself _immediately_ by a feeling of
+exhilaration and unwonted vigor, _remotely_ by an improvement--where
+there is a margin for such--in the performance of some or all of the
+physiological functions, as well as by a gradual but nevertheless marked
+_increase in weight_.
+
+Most striking among the tonic influences of the baths, are those that
+occur within the sphere of the digestive and sexual apparatuses. I will
+first consider the effects on
+
+
+                       THE DIGESTIVE APPARATUS,
+
+which may be subdivided into those on _a_) the appetite, _b_) digestion,
+absorption and assimilation, and _c_) alvine excretion. The improvement
+of the appetite under electro-balneological treatment is one of the most
+constant effects of this. While a series of baths will produce permanent
+results in this respect, an increase of the appetite, in some instances
+amounting to positive hunger, is a tolerably uniform and more or less
+immediate result of each separate bath. The permanent improvement of the
+appetite is relative. Not very appreciable where this is normal, it
+becomes most marked where the appetite has from some cause been
+impaired. The effect on the appetite is _definite_. The effects on
+absorption and assimilation are _presumptive_; but when we couple the
+absence of any corresponding difficulty in digesting the increased
+supply of food, with the increase before alluded to in the weight of the
+body, their assumption becomes fully justifiable. It is these combined
+influences that make the electric bath so valuable a remedy in almost
+all forms of dyspepsia.
+
+The influence on the alvine process is if anything even more marked than
+that on the assimilative process. Where the action of the bowels is
+normal, it is not modified permanently by the electric bath, although we
+often have, as an immediate consequence, a cathartic effect that
+manifests itself as a more or less watery evacuation, either a few hours
+after the bath or on the succeeding day. Where the fecal process however
+is sluggish, the improvement resulting from the baths is very striking.
+I shall recur more fully to this subject under the head of constipation.
+
+The effects on the various functions connected with digestion are due
+doubtless to the combined influences of stimulation of the secretions of
+the alimentary canal and stimulation of the muscular coats of the
+stomach and intestines, as well as permanent tonization of the
+_muscularis_. While the enhancement of the secretions is undoubtedly due
+chiefly to the electric stimulus to the secreto-motor nerves, and the
+increased activity of the muscular coats to a like influence transmitted
+to their motor nerves, I believe the permanent tonization and
+invigoration of the muscular fibres to be mainly attributable to the
+direct trophic influence of the current traversing the parts
+themselves; and I have no doubt that this direct influence has much to
+do with the stimulation of the secretions and _peristalsis_ also. At any
+rate, I have never obtained from galvanization of the nervous centres,
+which I have practiced in a great number of cases, the striking effects
+on the alimentary processes which are so uniform a result of the baths.
+
+The influence on the
+
+
+                           SEXUAL APPARATUS
+
+of the electric bath does not manifest itself in so striking a manner as
+in the case of the organs of digestion. It is true I have seen
+individuals whose sexual functions were normal, have _stysis_ in the
+bath, but the mere cutaneous irritation of the electric current is here
+sufficient to account for a phenomenon which, where sexual irritability
+is intact, will follow any other local irritations.
+
+If not as immediately perceptible, the stimulant and permanent tonic and
+invigorating influences on the sexual organs are not much less constant
+than the corresponding influences on digestion. Careful observation,
+however, of a considerable number of cases where the sexual function was
+more or less impaired, has convinced me that while there can be no
+doubt that _direct_ influence on the innervation, tone and nutrition of
+the respective parts as well as the stimulus which the electric current
+furnishes to the seminal secretion, bear a share in the improvement that
+takes place, permanent beneficial results must be looked upon as chiefly
+the expression of improved nutrition and tonization of the system at
+large. I do not mean to be understood as wishing to put in negation the
+beneficial results that the local influence of electricity is capable of
+sometimes accomplishing in the sexual sphere. These results, however,
+are not of a physiological, but rather of a purely therapeutic nature,
+and are obtained there only where local morbid conditions exist. Now, in
+the great majority of the cases that have come under my observation, the
+causes of deterioration of the sexual capacity, though frequently
+obscure and indefinable, were certainly not local, but to be sought for
+in the general--most probably the nervous--system. In none but perhaps
+the very mildest and recent cases have I ever seen _rapid_ results
+follow electrical treatment of any kind whatsoever. In support of my
+assertion however that in the majority of cases the sexual sphere can be
+influenced only through the system at large, I will state _first_, that
+I have seen cases where local electrical treatment had utterly failed
+to do the slightest good, respond favorably to the baths, and _second_,
+that where success was met with, it was only after persistent treatment,
+continued long enough to modify favorably the condition of the entire
+organism, and through this the objective sphere.
+
+The stimulant and tonic effects under consideration, although shared to
+some extent by other methods of electrization, are here far more
+comprehensive and pronounced, a fact which is not surprising, when we
+reflect that in the electric bath not only are all the organs
+_indirectly_ influenced through stimulation of the nervous centres, but
+each separate organ is at the same time _directly_ acted upon by the
+current.
+
+A direct sequence of the stimulant and tonic effects of the electric
+bath is its
+
+
+                          SEDATIVE INFLUENCE.
+
+This sedative effect, whereof the hypnotic effect already spoken of is
+the supreme manifestation, must not be associated for a moment with any
+idea of depression, for here we have none such. In addition to what I
+have already said in endeavoring to account for the hypnotic influence
+of the baths, I refer the reader for further information to the
+admirable and lucid remarks on this subject by BEARD and ROCKWELL.[8]
+
+The _galvanic_ bath shares with other galvanic applications made in the
+cranial and upper spinal region, the effect of producing the galvanic
+_taste_, as also the _flashes_ when the current is interrupted, showing
+that the
+
+
+                            CRANIAL NERVES
+
+come within the sphere of its influence.
+
+A further effect peculiar to the galvanic bath is a sense of
+
+
+                               ITCHING,
+
+felt chiefly in the lower extremities and about the neck, and
+proportioned to the intensity of the current. Rather pleasant when mild
+or medium currents are used, under the influence of strong currents it
+may become so intense as to create an irresistible desire on the part of
+the bather to scratch especially the legs.
+
+A negative effect of the galvanic bath, even where very intense currents
+are used, is the
+
+
+                      ABSOLUTE FREEDOM FROM PAIN
+
+throughout the entire process. I wish this to be understood of course
+as holding good only when currents within the ordinary limits of
+intensity are employed. The strongest that I have used, and on which I
+base my statement, was that from 48 Stoehrer or 60 Hill cells. As
+stronger currents are not required for therapeutic purposes, what I have
+asserted remains practically true as applied within these limits.
+
+This absence of pain, which cannot be claimed for correspondingly
+intense local applications, is to be attributed to the _diffusion_ of
+the current throughout the body and its surface, as well as through the
+water of the bath. The redness of the _entire_ back after a galvanic
+bath, is among the proofs of this diffusion.
+
+Freedom from pain is a characteristic likewise of the faradic bath,
+_properly administered_. When too strong a faradic current however is
+incautiously administered, the resulting muscular contractions are
+accompanied by an amount of local pain proportioned to the violence of
+the contractions. By keeping the faradic current within proper limits,
+all pain can be avoided.
+
+With respect to
+
+
+                        MUSCULAR CONTRACTIONS,
+
+the effects of the electric bath may be distinguished from those
+obtained by other modes of faradization by their comprehensiveness.
+Many groups of muscles may be made simultaneously to contract by this
+means. The practical bearing of this on the therapeutics of _pareses_
+and _paralyses_, renders it an important characteristic of the bath.
+
+The physiological effects on
+
+
+                               THE MIND
+
+of electric baths, is a natural result of the enhanced tone and vigor of
+the physical system, and keeps pace with this. Mental buoyancy and even
+exhilaration are among the most common sequences of electric baths.
+Although indirect, these results are none the less decided.
+
+It has been my aim in the foregoing remarks to give the reader, as
+concisely as possible and within the limits which I set for myself in
+the beginning of the present chapter, a summary of the more important
+physiological effects of electric baths. As the isolated results of
+observations made in a limited field by one unaided individual, I trust
+the shortcomings of this chapter will be viewed indulgently. If what I
+have said of the physiological effects of electric baths proves the
+means of stimulating to further investigation more competent observers
+than myself, my labor, whatever its imperfections, will not have been in
+vain.
+
+
+    Footnotes:
+
+    [Footnote 4: Dr. Franz Hartmann; "Der acute and chronische
+    Gelenkrheumatismus," Erlangen, 1874; pp. 194 et seq.]
+
+    [Footnote 5: The Author here refers to mineral-water. Dr. S.]
+
+    [Footnote 6: The Medical Use of Electricity, with special
+    reference to general electrization as a tonic, etc. New York,
+    1867.]
+
+    [Footnote 7: Beard and Rockwell; Medical and Surgical
+    Electricity. N. Y. 1875.]
+
+    [Footnote 8: Op. cit. pp. 253. et seq.]
+
+
+
+
+                              CHAPTER IV.
+
+                 GENERAL THERAPEUTIC EFFECTS AND USES.
+
+
+The therapeutic uses of a remedy are based on what we know of its
+physiological effects. Many--or rather most--of the therapeutic effects
+of this as well as of most other remedies, correspond to certain
+physiological effects. Those therapeutic effects whereto we find none
+analogous among the physiological effects, are yet the results of the
+physiological tendencies of the remedy, and where these tendencies do
+not manifest themselves as results, it is because they find no field for
+action in the healthy organism. When they meet with the requisite
+pathological conditions, these tendencies make themselves manifest in
+the shape of definite results, commonly known as therapeutic effects.
+
+NOTHNAGEL, in his classical work,[9] recognizes this theory by excluding
+from his book the term "therapeutic effects" altogether. Where he finds
+it necessary to say anything of the physiological effects of a remedy,
+in addition to those "on man in health," he speaks--still under the head
+of "physiological effects"--of those "on man when sick." When, setting
+aside its empirical employment, we come then to inquire what it is that
+furnishes us with the true indications for the use of a remedy, analysis
+of the question leads us invariably back to its physiological effects.
+If I have failed nevertheless to include the few effects which I am
+about to touch on, under the head of "physiological effects," I have
+done so simply in compliance with universal usage, and as a matter of
+convenience for reference.
+
+I will now, without further digression, proceed to the consideration of
+those effects of electric baths not yet enumerated.
+
+As a fitting precursor to the enumeration of the therapeutic properties
+of the remedy under consideration, it may be well to dwell for a moment
+on what is among its most prominent characteristics; I have reference to
+its great value as a
+
+
+                              DIAGNOSTIC.
+
+In explanation of this, I will state that in a very large number of
+cases of disease of an obscure nature, and where, to be candid, the
+electric bath was employed empirically, or, if you please, tentatively,
+it has served to point out the _locus morbi_. The number of cases in
+which I have made this observation, has been sufficiently large to
+establish beyond a doubt the fact, that as a rule the electric current
+makes itself more decidedly and often even painfully felt in any part
+where a morbid condition exists; whether this be of an inflammatory,
+neuralgic, rheumatic, traumatic, congestive or other nature, the result
+is the same. It appears to be somewhat analogous to the "tenderness on
+pressure" that we find present in many of these conditions. In
+_anaesthesiae_ even the current makes itself conspicuous by the _absence_
+of its normal effects. The value of this will at once be recognized in
+connection with a method of electric application which at one and the
+same time acts on every portion of the body. Local electrization is
+accompanied by like phenomena, _when we happen to strike the right
+spot_. The superiority of the bath as a means of diagnosis is found in
+the circumstance that here we _must_ touch it.
+
+The great importance of this feature of the electric bath will at once
+be realized by every physician of much experience, for there can be none
+such who has not frequently met with subacute or chronic conditions the
+etiology of which was more or less obscure.
+
+One of the most important effects in its therapeutic application of the
+electric bath, is its superior excellency as an
+
+
+                     EQUALIZER OF THE CIRCULATION;
+
+so far as I know, it is more potent, constant and comprehensive in this
+respect than any other agent. Where an imperfect circulation of the
+blood is due to irremovable organic causes, the results obtained will of
+course be transient only. In all other cases, however, favorable
+results, more or less perfect according to the nature of the case, may
+be reliably looked for. Both currents act very well in this respect,
+though on the whole I look upon the galvanic as superior to the faradic
+current.
+
+As a theory of this effect of the currents I would offer the following,
+viz: That the galvanic current acts by stimulating the vasomotor centres
+and peripheral nerves, by giving tone to the mucular coats of blood
+vessels, and by counter-irritation. That the _faradic_ current
+stimulates the vasomotor centres little, if at all, does not influence
+the coats of vessels, except such as are close to the skin, but
+tonicizes these latter more effectually than the galvanic current; that
+it stimulates the peripheral nerves to some extent, though far inferior
+in this respect to the galvanic current; but that when employed of
+sufficient intensity it superadds to those mentioned a strictly
+mechanical action, which consists in forcing static blood from the
+capillary into the general circulation through the medium of muscular
+contractions.
+
+As a
+
+
+                       GENERAL COUNTER-IRRITANT
+
+the _galvanic_ bath has few if any superiors. The degree of
+counter-irritation can be very nicely determined by regulating the
+intensity of the current. The characteristic tingling sensation of the
+galvanic current is felt over the entire surface, corresponding in
+degree of course to the intensity of the current; while the redness of
+the skin, bearing a like relation to the intensity of the current, is
+observable more especially near the electrodes, being particularly
+conspicuous over the entire back. Concentrated local counter-irritation
+can be obtained by the use of the surface board.
+
+The counter-irritant effects of the galvanic bath, differ from those of
+ordinary counter-irritants in their freedom from pain, even the slight
+burning sensation accompanying strong currents ceasing with the
+application. The redness remains quite a while and the stimulus to the
+peripheral circulation causes the persistence for some time of a
+"glowing" sensation all over the body.
+
+In the chapter on physiological effects enough has been stated to make
+it apparent that as a
+
+
+                     GENERAL INVIGORANT AND TONIC
+
+the electric bath can have few if any superiors. In the healthy
+organism, however, the stimulant and tonic effects of the baths are much
+less marked than they are where the general condition is "below par." In
+health there is little or no margin for improvement. The results
+obtained are _temporary_ stimulation, and a permanent invigoration which
+partakes more of artificial development than anything else. It is
+analogous to the development by gymnastic or other exercise of a
+previously healthy set of muscles. Where we meet with atonic conditions
+however, with debility, malnutrition, want of energy or general asthenia
+of an obscure nature, and amenable to electric influence, the tonic
+effects of the baths become striking and brilliant. I have observed
+cases where patients fairly bloomed up under their influence and
+acquired actually more physical strength and weighed more than before
+they became sick. When we consider how in such conditions as those
+mentioned, patients are made to swallow pills and mixtures for months or
+years, or, more appropriately, and if they can afford it, are sent
+abroad, we can realize the importance of an agent by means of which the
+desired end can be obtained more conveniently, certainly, economically
+and in a shorter time than by any other means. There is no rule without
+its exceptions, and I freely admit that in many instances where persons
+are, as the saying is, "run down," a sojourn in some mountainous region
+or a course of sea-bathing, etc., would do them more good than anything
+else, electric baths included. The results obtained from these last are
+however sufficiently uniform to justify us in looking for very favorable
+results in every case.
+
+In the preceding chapter I have already dwelt on the
+
+
+                    HYPNOTIC AND SEDATIVE INFLUENCE
+
+of the baths. It is only necessary to state here that this influence
+manifests itself still more decidedly in corresponding morbid conditions
+than in health. The greater the degree of restlessness, irritability or
+wakefulness, the more strikingly does the soothing and hypnotic
+influence of the baths--appropriately administered, of course--become
+apparent.
+
+
+                       IMPROVEMENT OF NUTRITION,
+
+as manifested by rapid increase of weight, and which I have likewise
+touched upon in the preceding chapter, is a reliable, constant effect of
+electric baths. Where previous loss of weight is due to an incurable
+organic disease, it is, if at all obtained, of course much less in
+degree, as well as transient. When due, however, as is frequently the
+case, to causes that are amenable to electrical influence, the increase
+in weight is marked, and has a tendency to be permanent.
+
+It will be seen that the few therapeutic effects which I have here
+enumerated, are in reality nothing more than intensified physiological
+effects, there being about them nothing that might be termed specific.
+It may be asked in reply: why then did I devote any space to them at
+all? I will answer that I thought best to point out some general
+therapeutic USES for which electric baths may be made available, and the
+indications for which are furnished by so great a number of pathological
+conditions, that omitting special reference to them would have led to a
+great deal of tautology in the chapter on "special therapeutics."
+
+Before leaving the subject of "general uses" of the baths, I will dwell
+for a moment on their admirable adaptability as a
+
+
+                             PROPHYLACTIC.
+
+Every physician is fully aware of the fact that disturbances of the
+circulation constitute one of the most frequent causes of disease. There
+are, indeed, comparatively few pathological conditions that do not bring
+with them congestion of some more or less important organ. A remedy then
+which more than any other has a tendency to equalize the circulation,
+and thus counteract a condition which as cause or effect, or both, is an
+almost universal concomitant of disease, and which in addition to this
+is so admirable and physiological a stimulant and tonic, can hardly be
+surpassed as a prophylactic by any other uncombined remedy.
+
+
+    Footnotes:
+
+    [Footnote 9: Dr. Hermann Nothnagel: Handbuch der
+    Arzneimittellehre. Berlin, 1870.]
+
+
+
+
+                              CHAPTER V.
+
+               SPECIAL THERAPEUTICS AND CLINICAL RECORD.
+
+
+I have thought it best for practical purposes, to accompany the
+consideration of the treatment of special diseases by the histories of
+illustrative cases, where I had such at command.
+
+Before entering on the subject proper, I wish to offer some general
+considerations that may influence and guide us in determining when,
+where and why to employ electric baths as a remedy.
+
+To realize thoroughly the indications in given cases for the employment
+of electric baths, we must first of all be more or less familiar with
+the effects and uses of the electric current as well as those of the
+ordinary warm bath. We must realize the fact that here we not only have
+these two forces united, but that the more important of the two, the
+electric current, here acts directly (locally) as well as indirectly
+(through the nervous centres) on every portion of the body--a
+circumstance of great importance in differentiating indications on the
+one hand for the baths, on the other for local electrization. In view
+of these circumstances we are fully justified in looking for results far
+more comprehensive than any that might be obtained singly from either of
+the two remedies that are here combined. There can be no doubt that in
+many cases the resisting power of a disease is sufficient to withstand
+two remedies brought singly and alternately to combat it, whereas the
+simultaneous combined action of these remedies may be fully adequate to
+overcome this resisting power.
+
+Approaching in its effects more closely to the electric bath than any
+other remedy, is the process known as "general faradization," to which I
+have already alluded (p. 36). In choosing between this and the bath, I
+state it as my conviction that, while there may be a small proportion of
+cases in which general faradization, so-called, is preferable, in almost
+all the cases where both these remedies are applicable, the faradic bath
+deserves the preference--it is a _more complete_ faradization.
+
+We need never be afraid of ordering electric baths on the score of any
+imagined exertion or discomfort attaching to them. The most delicate,
+the aged and children alike, bear them with far more ease, comfort and
+impunity than any ordinary warm bath, or any but the mildest local
+electrization. The entire absence of shock or pain of any kind
+whatsoever, is always an agreeable surprise to those who, urged by their
+physicians, have with fear and trembling submitted themselves to a
+treatment, the mere name of which filled their minds with
+extravagant--and, it is useless to say, groundless--visions of painful
+shocks. Thanks to the tonic effects of the current, they are by the
+feeble and infirm borne much better than the ordinary warm bath. There
+is likewise much less liability to get cold after the electric bath. The
+stimulus which the current furnishes to the peripheral circulation is a
+powerful protection against cold, so that even in midwinter I see people
+daily take electric baths at an average temperature of 95 deg., and enjoy
+apparent immunity from colds.
+
+Having once determined on the use of the baths in a given case, we have
+to observe certain points in their application.
+
+In the first place, guided by what we know of the relative effects of
+galvanism and induced electricity, we must decide which of these two
+currents to use, and if both, in which order. We must determine on the
+direction and intensity of the currents, as well as on the duration of
+the baths.
+
+Next we must use our judgment as physicians, in deciding whether a
+given case promises to get well under electro-balneological treatment
+alone, or whether auxiliary treatment may not be required to bring it to
+a favorable issue.
+
+With respect to the frequency of the applications, I will say that while
+there are some cases where a bath twice a week is sufficient, and others
+where a bath every day is imperatively necessary, in far the greater
+majority of cases suitable for electro-balneological treatment, a bath
+every alternate day is _sufficient_, but a bath every day is
+_better_--it leads to more rapid as well as certain results.
+
+In most of the cases, a daily bath for a few days or a week, followed by
+one every other day for a time, and, when the cure is about completed, a
+bath twice a week, to _consolidate_ and _confirm_ the good results
+obtained, has done me the best service.
+
+I would dwell particularly on the necessity of _perseverance_ in this
+treatment. The majority of cases that have come under my observation in
+this connection, have been of a more or less chronic nature. In many of
+these, where medicinal and other treatment had been unavailingly gone
+through with for weeks, months and even years, I have found existing the
+most absurd expectations with regard to the effects of the baths. People
+who had made the tour of almost all the watering-places of Europe
+without obtaining the slightest benefit, have come to me imbued with the
+idea--whence derived I know not--that one or two baths should greatly
+improve, and two or three more cure them; and when these expectations
+were not realized, they would promptly discontinue treatment, fully
+satisfied that electric baths were no more capable of benefiting them
+than "all the other things." I do not mean to be understood for a moment
+as intending to imply that ideas of this nature are shared by the
+profession; I mention them simply in order to show the necessity on the
+part of physicians to disabuse in this respect the minds of those
+patients whom they may send for electro-balneological treatment.
+
+In appropriate cases, the use of the bath should not be too long
+deferred. I have had frequent occasion to become cognizant of the fact,
+that cases have been sent by physicians to take the baths only after
+prolonged ineffectual treatment of another nature had been gone through
+with, and where negative or at best tardy results took the place of the
+brilliant results that might have been obtained, had the cases been sent
+earlier. I do not mention this in a fault-finding spirit; to do so would
+be unjust. The remedy under consideration has up to the present time
+been too little known, the indications for its employment--in the
+absence of statistics--on too uncertain a basis, to expect from any but
+specialists the early realization in any case of its appropriateness. I
+trust however that in the future, from being a "dernier ressort," it
+will come to take its proper place among other remedies, to be
+administered "when it will do the most good." When this comes to pass,
+the results obtained, satisfactory as they are even now, will become as
+brilliant and well-authenticated as those of every other remedy from
+which experience has taught us how to reap the greatest advantage.
+
+In the following "clinical record" I shall not omit to cite cases where
+the baths were unsuccessful, wherever it shall appear to me that the
+citation of such cases may be of assistance in arriving at a true
+estimation of the therapeutic value of the remedy.
+
+In giving the histories of cases, it will scarcely be necessary to enter
+very minutely into details; the demands of the present work will be
+fully met if sufficient is said of a case to illustrate the effects of
+the baths in the class of cases that it represents.
+
+Finally, I wish it understood that in a few of the conditions in which
+I shall advise the employment of the baths, I have had no personal
+experience in their use, but base my opinions on what I know of their
+effects, together with what is known of the results obtained in
+analogous conditions by local electrical methods.
+
+
+                           SPECIAL DISEASES.
+
+                              RHEUMATISM.
+
+Its great frequency, the pain and discomfort which it occasions, and its
+many, often dangerous _sequelae_, added to its frequent obstinacy under
+the most varied treatment, render rheumatism one of the most formidable
+diseases that we have to encounter. The long list of remedies that have
+from time to time been employed in its treatment, bear witness by their
+very number to the little reliance that can be placed in any one of
+them. A remedy then which can be _relied on_ to exercise a favorable
+influence in all the forms of rheumatism--acute, subacute and
+chronic--as well as on most of its sequelae, should of right become a
+welcome addition to our armamentarium in the treatment of this disease;
+and such is the electric bath. The treatment of the sequelae I shall
+speak of under separate heads. The disease itself I will divide into
+three classes, viz: _a_) acute, _b_) subacute and _c_) chronic
+rheumatism.
+
+_a_) ACUTE RHEUMATISM.--A few years ago the use of electricity in acute
+inflammatory conditions was scouted by most of the profession, and had
+it not been for the quiet and patient labors of a few progressive
+spirits, we would at the present day be still deprived of the benefits
+which we reap from it in these conditions. Even to-day, the number of
+those who are satisfied of the utility of electricity in this respect is
+comparatively small. Only two years ago, I attended a gentleman who was
+suffering from a very severe attack of rheumatic gout. I had both a
+galvanic and a faradic battery at his house, which, in addition to
+appropriate medicinal treatment, I applied daily to the affected
+joints,--using mainly the faradic current. Being compelled at the time
+to go to the country, the case during my absence drifted into the hands
+of a gentleman, a professor at one of the medical colleges, of high
+standing in the profession and considered one of our leading medical
+men, who ridiculed and promptly discontinued the use of electricity in
+the case. He gave it as his opinion that it did more harm than good, and
+I have no doubt he did so conscientiously--however unprofessional his
+conduct may have been, in this as well as other respects. The
+contributions of others have since then vindicated my views in this
+respect. Among others, Dr. Drosdoff[10] of St. Petersburg has given a
+number of cases of acute articular rheumatism from the clinique of
+Professor Botkin, in which the faradic current was employed either alone
+or in conjunction with other treatment. From among the deductions which
+he makes from a series of careful experiments in this respect, I quote a
+few--such as bear directly on our subject, and to which I affix my own
+numbers.
+
+    1) "The sense of pain as the result of electric irritation is
+    considerably diminished, and sometimes entirely lost, in joints
+    attacked by acute articular rheumatism, so that the patient
+    experiences no pain, even when the distance between the coils
+    equals naught[11], and both closure and opening are accompanied
+    by the evolution of numerous sparks. At the same time the
+    slightest pressure of the affected parts gives rise to the most
+    intense pain."
+
+    "The diminution of the electro-sensibility appears in the
+    majority of cases to be in inverse proportion to the severity of
+    the disease and the intensity of the pain produced by mechanical
+    irritation."
+
+    2) "The enhanced tactile and thermic sensibility of the diseased
+    joints is diminished by a faradization lasting from 5 to 10
+    minutes."
+
+    3) "From 5 to 10 minutes faradization causes a reduction of the
+    previously heightened temperature of the diseased joints to the
+    normal standard, or even below this."
+
+    4) "The subjective rheumatic pains which are augmented by
+    pressure and motion, are diminished by faradization. This
+    diminution is sometimes so considerable, that the joint, which
+    prior to the faradization admitted of no movement, is able to
+    execute passive and active movements with tolerable facility."
+
+    5) "The rheumatic pains as well as the temperature of the
+    affected joints remain diminished after the faradization for 3,
+    4 and even 5 hours; they then gradually return to the previous
+    height. At the same time the duration of the paroxysms of pain
+    becomes shortened, and the intensity of this diminished."
+
+    6) "Although the rheumatic process takes a more rapid course
+    under the influence of faradization, and incommodes the patient
+    less, we have nevertheless made the observation in one case,
+    that the tendency to recurrence is not diminished. The attacks
+    however become more brief and milder."
+
+    7) "From what has here been said it follows, that daily
+    faradizations, lasting 5-10 minutes, diminish the severity of
+    acute articular rheumatism, restore the perverted cutaneous
+    sensibility, and cause a reduction of the temperature of the
+    affected joints."
+
+    8) "Several of those suffering from the pathological processes
+    mentioned, received no medication in addition to the
+    faradization, and yet made a tolerably rapid recovery."
+
+I might adduce further testimony of the value of electricity in recent
+cases of rheumatism, were it necessary to do so. The results in my own
+cases however have long since satisfied me of the utility in this
+respect of faradic not only, but also of mild constant currents.
+Accepting this as matter of fact, let us next inquire where and why we
+are to give _general_ electrization--in other words, the electric
+bath--the preference over local applications.
+
+Where the manifestations of the disease are limited to a single joint,
+or at best a very few joints, or where we have to do with a case of
+muscular rheumatism--to one group of muscles, local electrization, as
+_symptomatic_ treatment, will answer. Where on the one hand however many
+joints, on the other the muscles of entire limbs, or even more, are
+involved, the advantages of a method by means of which we reach all the
+affected parts at once, thus effecting in, say ten minutes, that which
+where, for example, six joints are involved, would by the ordinary
+method require sixty minutes, are readily realized. There is, however,
+another reason why the baths are preferable in rheumatism to local
+applications. Rheumatism is a constitutional disease with local
+manifestations. The metastatic character of muscular rheumatism
+especially appears to indicate the greater importance of general as
+compared to local treatment. Pre-supposing, then, that electricity
+exercises the favorable influence on rheumatism which clinical results
+would appear to demonstrate, it follows that the electric bath, while it
+furnishes symptomatic (local) treatment equally well with local
+applications, does something more; it meets the _indicatio morbi_
+likewise. The warm bath no doubt contributes its due share in bringing
+about the favorable results obtained.--Where the disease then does not
+confine the patient to bed, the electric bath will be found a most
+valuable remedy.
+
+The following directions will be found to answer best in the great
+majority of cases: The temperature of the water should range from 90 deg.
+to 98 deg. F; a mild constant current, descending, should be applied for
+ten minutes; this to be followed by a faradic current of as great an
+intensity as the patient can bear _without the slightest degree of
+discomfort_. In the application of the faradic current, the surface
+board (see p. 12) may advantageously be had recourse to for the purpose
+of more concentrated influence on affected parts, to each of which it
+may be applied for a few minutes; the entire faradization may last from
+ten to fifteen minutes. When coming from the bath, the patient should be
+received in a warm blanket, anything like a chill being carefully
+guarded against. In cases where the cutaneous secretion is of an
+abnormally acid character (which is often so marked as to become
+apparent through the sense of smell), bicarbonate of soda or potassa may
+be added to the bath. As appears from the foregoing, the entire duration
+of the bath is from twenty to twenty-five minutes. The baths should be
+taken daily until all urgent symptoms have disappeared; after this,
+every two or three days as required, until an entire cure is wrought.
+
+As the results of this or similar treatment, conjoined with the
+requisite medicinal or other measures, I may state:
+
+_a_) Considerable abridgment of the period of the disease;
+
+_b_) Sequelae are less constant;
+
+_c_) The tendency to recurrence is very much diminished;
+
+_d_) A relapse, if it does occur, is comparatively mild.
+
+With regard to _b_ and _c_, let it be understood that I speak within the
+restrictions of a period of observation extending over two and a half
+years only.
+
+
+                       _b_) SUBACUTE RHEUMATISM.
+
+In the subacute variety, the electro-balneological treatment is similar
+to that in acute cases, with the difference however, that here not so
+much care is necessary with regard to the intensity of the currents.
+Muscular contractions, as induced by strong faradic currents, are to be
+dreaded in direct proportion to the acuteness of the inflammation,
+_resp._ the sensitiveness of the inflamed tissues.
+
+It will be understood, I hope, that the electro-balneological treatment
+as laid down above, though it applies to the majority, does not apply to
+all cases. Special complications may make it expedient in individual
+cases to modify the treatment more or less. The course to be pursued in
+these instances may however be safely left to the judgment of the
+attending physician.
+
+_c_) CHRONIC RHEUMATISM. In this affection the course to be pursued
+varies from that indicated in the acute and subacute varieties. We have
+here little or no constitutional disturbance, and need have no fear of
+doing any harm by strong currents. On the contrary, I have found that
+mild currents rarely do any good. By far the greater majority of the
+cases that have come under my observation were of the muscular type, the
+algic portion of the symptoms approaching those of neuralgia rather than
+subacute rheumatism. Of chronic articular rheumatism I have treated but
+very few cases. Although in some of the cases the treatment under
+consideration was attended with brilliant results, I freely admit that
+in some instances the results were imperfect, in others again entirely
+negative. This I found true more especially of cases that involved
+tendons. I must add, however, that in perhaps the greater majority of
+the unsuccessful cases the fault lay with the patients themselves, who,
+finding they were not benefited as rapidly as they had expected,
+discontinued treatment before this had had time to effect any thing.
+
+In accordance with a theory which I have formed in regard to the
+pathology of chronic rheumatism, and which I am not yet prepared to
+promulgate (nor is it necessary here), I have of late been in the habit
+of administering in this disease, baths calculated to stimulate as much
+as possible the circulation of the blood. The best manner of applying
+the baths to this end will be found further on, under "Inequalities of
+the Circulation." In addition to this I cause the galvanic (anode) as
+well as strong faradic currents to be applied to the affected parts by
+means of the surface board. Where there is any thickening, effusion or
+other similar concomitant of the disease, iodine may be added, as
+hereinbefore directed.
+
+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 diarrhoea. 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
+anaemic 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.
+
+    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."
+
+    When Mr. S. came to consult me, he had but lately returned from
+    Europe, whence, he stated, his physicians had sent him home to
+    die. His complexion was sallow, sickly; skin of face plentifully
+    wrinkled; features wearing the air of suffering and anxiety that
+    so frequently accompanies painful chronic conditions. He had for
+    some time past suffered from excessive cerebro-spinal
+    irritability, for the relief of which cantharidal collodion had
+    been employed in the cervico-spinal region (the same had also
+    been used in the hepatic region, to meet the diagnostic views of
+    some one of his medical attendants). He had a remittent chronic
+    intestinal catarrh, with--noticeably during the periods of
+    exacerbation--abundant discharge of a glairy mucus. The appetite
+    was very capricious--not to say poor, and he was obliged to be
+    exceedingly careful in his diet. He was not capable of any
+    continued mental application. The muscular system was weak and
+    flabby. All the vegetative functions were more or less impaired.
+
+    On June 3d, 1874, Mr. S., by my directions, took an electric
+    bath. He continued the baths daily for some weeks; then every
+    two or three days, all the time steadily improving. He had some
+    adjuvant medicinal treatment, probably similar to what he had
+    already had in Europe. He states, however, that his improvement
+    commenced with the first bath he took; and the baths certainly
+    constituted the main treatment throughout. He gained daily in
+    every respect. Mind and body were invigorated; his muscles
+    increased in size and hardness; color gradually returned to his
+    cheeks, etc. He continued the baths with more or less regularity
+    until the close of the year, taking in all sixty-one baths. He
+    was then in a better condition than he had been for many years.
+    Thinking a trip to Europe would benefit him, I advised him to go
+    there and remain a few months. He left early in January and
+    returned in the beginning of April, 1875. He had been very well
+    during his absence, until within a few weeks prior to his
+    departure from Europe, when he experienced a severe attack of
+    cerebro-spinal congestion, which caused him much suffering. On
+    his return he resumed the baths, and continued them throughout
+    the spring, continually gaining in strength and weight. At the
+    beginning of last summer he was practically well. He has
+    regained his normal weight (120 pounds). As a criterion of his
+    bodily vigor, I will simply state that I have seen him lift,
+    with ease, 350 pounds, which, for a person of his weight, is not
+    bad. His mental force is as good as it has ever been. The
+    digestive disturbances have disappeared; he can eat things which
+    for years he had been compelled to eschew. To use his own words:
+    "I am well." In view of the fact that he had already received,
+    at the hands of competent men, all sorts of internal as well as
+    external treatment, I believe I am justified in attributing his
+    cure almost entirely if not solely to the baths.
+
+    CASE XI. Mr. * * *, aet. about 50, lawyer, of large, vigorous
+    frame, came to consult me January 4th, 1875. He complained of
+    symptoms that are the frequent results of prolonged mental
+    over-taxation. His intellect was as good as ever, but he lacked
+    his wonted mental endurance and power of application. His mind
+    was perfectly clear, but unable to work. It was a case of
+    "_limited_ cerebral exhaustion." Physical nutrition was pretty
+    good; yet his color was not normal, being rather paler than it
+    had been and has since become again. His flesh was flabby. There
+    were vague neurotic disturbances, etc., etc. He had until
+    recently occupied a leading public position, and the onerous
+    duties that devolved on him in connection with this, evidently
+    stood in direct etiological relation to his trouble. I ordered
+    an electric bath every other day. This was complied with until
+    the end of February, when the patient had apparently entirely
+    recovered his health, mentally as well as physically. I saw him
+    not very long ago; he looked the picture of health, and told me
+    that he was and had been since I saw him, perfectly well in
+    every respect.
+
+    CASE XII. Mr. L., aet. 23, presented himself for treatment in
+    October, 1874. He had at various times made the attempt to study
+    some profession, but had never been able to concentrate his mind
+    sufficiently on any object to enable him to persevere in its
+    pursuit. He was fretful, irritable and vacillating; would desire
+    one thing to-day, another to-morrow; never long of the same
+    mind. Melancholia, digestive disturbances and hypochondriacal
+    phenomena accompanied this condition. No organic disease was
+    discoverable. On October 1st he took his first bath. Very
+    shortly after this he commenced the study of medicine. He
+    improved rapidly in every respect. During the month of October
+    he had six baths, which resulted in complete and permanent
+    relief of all the symptoms. He progressed satisfactorily in his
+    studies, and is at the present time taking his second course in
+    one of our city medical colleges.
+
+
+                               AGRYPNIA.
+
+                      (INSOMNIA; SLEEPLESSNESS).
+
+Although, as a rule, but the symptom of some definite pathological
+condition, agrypnia is of such frequent occurrence, and so detrimental
+to the general health, that it appears to me to merit special
+consideration. This holds good especially in this connection, because,
+even where electric baths fail to influence the disease giving rise to
+the insomnia, they almost invariably remove this, irrespective of its
+cause. Even where, the disease itself remaining uncured, the insomnia
+must return sooner or later, the sleep is very much improved while the
+baths are being had recourse to. We must of course endeavor in all cases
+to relieve the original disease, and, where the baths are not adapted to
+this purpose, resort to other and appropriate means. It will be found of
+no small service to us in the therapeutical management of every case, to
+be enabled to procure for the patient, without the aid of medicinal
+hypnotics, sufficient of sleep during treatment.
+
+    CASE XIII. Mr. A., from the _clientele_ of Dr. LEONARD WEBER,
+    was sent by Dr. W. to take electric baths. He suffered from
+    chronic spinal congestion. Among the most prominent and annoying
+    symptoms was _agrypnia_. It was for the relief of this symptom
+    chiefly that Dr. W. ordered him the baths. He began to improve
+    in this respect from the time he took his first bath, and
+    although the disease itself remained uncured, he enjoyed good
+    sound sleep while he was under treatment, his general health
+    improved, and he frequently spoke of the notable benefits that
+    he received from the baths. He continued them until his
+    departure for Europe, where, by direction of his physician, he
+    went last spring. I have not seen him since, but Dr. W. tells me
+    that he is doing well.
+
+    CASE XIV. Mr. D. was brought on Sept. 30th, 1874, by his
+    physician, Dr. HOGAN. He was in the incipient stage of _delirium
+    tremens_. Had not slept for some nights. Dr. H. had administered
+    successively opiates, chloral and bromides in full doses,
+    without effect. On the evening of above date the patient had a
+    bath, in which the descending galvanic current was used. As a
+    result, he slept well that night. The baths were repeated on the
+    two succeeding days, with like effect. As the disease developed
+    however it became necessary to send the patient to an asylum,
+    whence he returned cured in a short time. The effect of the
+    baths in this case, where full doses of the most powerful
+    hypnotics of the materia medica had failed, was remarkably
+    illustrative of their hypnotic power.
+
+
+                                ANAEMIA.
+
+As is well known to the profession, anaemia forms the basis of a great
+number of morbid conditions. Hysteria, general debility, emaciation,
+sterility, various nervous affections, phthisis, in short, a perversion
+of almost any of the various physiological functions may be the direct
+result of anaemia. On the other hand, anaemia may be only a symptom or
+sequel of some other morbid condition--but of such cases I do not now
+speak. I have to do here only with those cases where anaemia is the
+primary and etiological of a group of symptoms, and where therefore it
+is to this that the treatment must be mainly directed. Now let us see
+what this treatment is. Dr. FLINT[15] suggests the following therapeutic
+measures: "_first_, a nutritious alimentation, into which meat should
+enter largely; _second_, the use of tonics and stimulants to render the
+digestive functions more active; _third_, iron as a special remedy--the
+effect of which is often remarkable; and, _fourth_, a regimen calculated
+to increase the energy of the assimilative functions, consisting of
+exercise in the open air, recreation, etc." This agrees mainly with the
+views of other writers. It may conveniently be condensed under two
+heads, instead of four, namely: _first_, to secure for the patient
+appropriate food and adopt the best means to insure its assimilation;
+_second_, the administration of iron. As to the ingestion of appropriate
+food, open air exercise, etc., patients are of course to receive the
+necessary directions. The remainder of the therapeutic indications, as
+given above, are admirably met by electric baths. As we have seen in a
+preceding chapter (p. 43 et seq.), they are a tonic and stimulant of the
+first order, and as nearly as possible a specific for the furtherance of
+the digestive and assimilative processes. When impregnated with iron,
+they constitute a treatment for anaemia which, in conjunction with the
+requisite diet and other hygienic measures, is inferior to no other. It
+will moreover be found very efficacious in counteracting secondary
+anaemia, and thus, by maintaining the general strength of the patient,
+often enable nature and appropriate treatment to cope successfully with
+the original disease.
+
+    CASE XV. Mrs. S., aet. 22, four years married. I was called to
+    see her on October 2d, 1874. She then had a spontaneous
+    miscarriage, the fifth since her marriage. She asked me whether
+    nothing could be done to enable her to carry a child to full
+    term, as both she and her husband were very desirous to have
+    offspring. In pursuance of my directions, she presented herself
+    at my office about ten days after I first saw her. On
+    examination I found no organic trouble, no uterine displacement,
+    nor any other local trouble to account for her premature
+    confinements. Involution had progressed normally. The only
+    deviation from the normal that I could discover about the uterus
+    was undue paleness of the cervical portion. Her appearance was
+    very decidedly anaemic; features pale, flabby; lips whitish blue;
+    physical energy much depressed. She had had but very slight loss
+    of blood on the occasion of her recent miscarriage; certainly
+    not enough to account for her anaemic appearance. Viewing her
+    case as one of idiopathic anaemia, I ordered her electric baths
+    strongly impregnated with iron. In addition to this, the regimen
+    usual in such cases, and also strychnia and phosphorus
+    internally. She took her first bath on Oct. 14th; then one bath
+    weekly until she had taken six baths, the last of which was
+    administered on the 24th of November. During all this time she
+    kept steadily improving. The anaemic appearance and symptoms
+    gradually receded, and, soon after she had taken her last bath,
+    I discharged her, as far as the anaemia was concerned--cured.
+    While she was under treatment she had, by my advice, refrained
+    entirely from sexual intercourse. Early in the spring of 1875
+    she called to tell that she was again pregnant, and in November,
+    1875, I delivered her of a healthy male child, at full term.
+
+
+                        PARALYSES AND PARESES.
+
+I include these under one head, because not only is their origin
+frequently identical, but, chiefly, because the therapeutic indications
+are almost always the same in both. Whatever the cause in any given
+case, whether cerebral, spinal or peripheral, organic or functional;
+whatever the treatment that may be indicated--and this should never be
+neglected--for the primary trouble, the direct electrical treatment of
+the paralysis, sub-paralysis or paresis, being purely _symptomatic_
+treatment, remains in the great majority of cases essentially the same.
+The objects to be aimed at are two, viz: _first_, a normal state of
+nutrition of the affected muscles; _second_, their normal contractility.
+In other words, we are to endeavor to prevent atrophy of the affected
+muscles, or, where this has already taken place to some extent, to
+restore their normal bulk; and, _second_, we must strive to restore the
+more or less impaired contractility of the paralytic or paretic muscles.
+Even where symptomatic treatment for these purposes is the _only_
+treatment employed in a case, we frequently meet to a great extent the
+_indicatio morbi_, by favorably influencing, either in a reflex or
+direct manner, the primary disease. This is true of _local_
+electrizations of the affected parts; it holds good much more strongly
+however of _electric baths_, because here, in addition to the reflex
+influence that we get from local applications, we have also the direct
+influence of the electric current on the spinal cord and posterior
+portion of the brain not only, but on the sympathetic system and all the
+important organs contained in the thoracic and abdominal cavities. The
+great importance of this is apparent, when we reflect that in very many
+if not most cases of disease of the nervous system, central or
+peripheral, electricity in an appropriate form is a useful therapeutic
+agent, and that moreover the great majority of functional paralytic
+disorders respond favorably to its influence. As for any harm being done
+by it in those rare cases where its use may be contra-indicated, I admit
+that such may accrue from the administration of electric baths without
+medical supervision; it is entirely obviated however where the baths are
+under the supervision of a physician, who does not, like a layman,
+indiscriminately admit to their use any and everybody who is willing to
+pay for their administration, but will carefully discriminate, and
+conscientiously exclude those cases in which general electrization might
+result injuriously. In such cases a tolerably accurate diagnosis is as
+a rule readily made, and will enable the physician to separate the
+suitable from the unsuitable cases.
+
+As to the mode of administration of the baths in cases of the class
+under consideration, the use of both currents is requisite; the galvanic
+as a nutrient, the faradic as an excito-motor agent. Where, as is
+sometimes the case, faradic irritability is extinct, or so slight as to
+be practically unavailable, the (slowly) interrupted galvanic current
+must take the place of the faradic, until faradic irritability has
+become re-established. As to the intensity, direction, etc., of the
+currents, each individual case has its own laws, which must be
+recognized by the supervising physician.
+
+    CASE XVI.--_Infantile paralysis._ Albert Pichl, aet. 22 months,
+    was sent me by Dr. LILIENTHAL, October 3d, 1874. Had complete
+    paralysis of right leg (of four weeks standing), with
+    considerable atrophy of the entire leg as well as the gluteal
+    region of the corresponding side. The temperature of the leg was
+    much lower than that of the healthy limb. _Faradic irritability
+    was entirely extinct._ The treatment was begun by galvanizations
+    of the lower (lumbar and sacral) portion of the spinal cord, and
+    the use of the interrupted galvanic current on the affected
+    muscles. This was at first done daily. The contractility of the
+    muscles gradually but slowly improved, but neither the atrophy
+    nor temperature of the limb appeared visibly affected by the
+    treatment. With a view to favorably influencing these
+    conditions, I ordered him galvanic baths. He had a bath every
+    alternate day. The result was favorable and rapid. The leg
+    became sensibly and permanently warmer after each bath, and
+    commenced steadily to increase in bulk. Faradic irritability
+    soon returned. The local applications were continued several
+    times a week for some time, and then gradually abandoned, the
+    baths being meantime continued regularly. The boy very soon
+    began to walk, and in December active treatment was
+    discontinued. At that time, faradic irritability having long
+    since become completely re-established, I caused the child's
+    father to purchase a faradic battery to use at home. The limb
+    was eventually entirely restored in every respect, with the
+    exception of a slight abduction of the foot, for which I
+    referred the patient to Dr. GIBNEY. I saw the child recently; he
+    remains well.
+
+    CASE XVII.* _Sub-hemiplegia from cerebral hemorrhage._ Mrs. S.,
+    aet. 30, married, from the practice of Dr. KREHBIEL, was sent by
+    Dr. K. to take baths, July 3d, 1874. It was a routine case,
+    differing in no respect from what is ordinarily witnessed as a
+    sequence of cerebral hemorrhage. Six baths, taken at intervals
+    of two and three days, restored almost entirely the muscular
+    power of the affected side. The patient subsequently made a
+    complete recovery without further treatment.
+
+    CASE XVIII. _Paralysis from insolation._ Mr. P., proof-reader
+    aet. about 40, had suffered for some time from sub-paraplegia,
+    the result of insolation. He was sent to take baths in May,
+    1874, by his physician, Dr. SCHIRMER. Electro-balneological
+    treatment in this case met with no success.
+
+    CASE XIX. _Lead paralysis._ Mr. M., aet. about 35, painter, was
+    referred to me for treatment May 15th, 1874, by Dr. MOHN. The
+    extensors of one (I believe it was the right) arm were
+    paralyzed. The characteristic blue line about the gums was
+    clearly defined. I ordered an electric bath daily. The
+    descending galvanic current was used for twenty minutes each
+    bath. From half to one ounce of iodide of potassium was added to
+    each bath. The blue line became less distinct from day to day,
+    until, after eleven baths, it had entirely disappeared. The
+    object for which I had ordered the baths having now been
+    accomplished, I treated the affected muscles with the faradic
+    current. A short course of this treatment sufficed to remove the
+    paralysis from all but one finger (it was either the middle or
+    ring finger), the extensors of which had probably undergone
+    fatty degeneration.
+
+
+                              NEURALGIAE.
+
+The great variety of causes that may give rise to neuralgia, precludes
+the possibility of any specific for this symptom. In discussing its
+electro-balneological treatment, I would observe _a primo_ that I
+cannot, in the light of my personal experience, agree with those who
+claim for electrical treatment good results in a _majority_ of
+cases.[16] On the other hand it cannot be denied that, either as a
+palliative or curative measure, electricity, employed in an appropriate
+form and manner, is of inestimable value in many cases, and frequently
+succeeds where all other remedies are of no avail. Where we know the
+cause of a neuralgia, it is of course comparatively easy for us to
+determine whether or not electricity promises to avail anything. But
+even where the nature of the cases appeared to indicate its use, the
+failures, in my hands at least, have outnumbered the successes. The
+brilliant results--sometimes almost instantaneous--that we obtain now
+and then, should not lead us into overlooking our failures. Undoubtedly
+the circumstance that most of the cases that have come under my
+observation were of a very obstinate nature, referred to me by other
+physicians after varied unsuccessful treatment, has much to do with the
+formation of my views as expressed above, and future experience may
+perhaps lead me to modify them.
+
+Speaking still from my own experience, I will state that the cases that
+have proven the most amenable to treatment were, _first_, those of
+rheumatic origin; _second_, hysterical neuralgiae, and, _third_, cases
+where no assignable cause could be elicited. The most obstinate
+varieties were those of a malarial type (even when quinine in large
+doses or arsenic were employed in conjunction with galvanism) and those
+that depended on some form of chronic inflammation--_neuritis_,
+_periostitis_, etc. Of central neuralgiae, I have had excellent results
+in the sympathetic variety and in the pains of posterior spinal
+sclerosis, while in the neuralgiae of cerebral origin (diffuse cerebral
+sclerosis, tumors, etc.) I have never met with any appreciable success.
+
+Where, then, we are able accurately to diagnose a case, there cannot be
+much doubt as to the appropriateness or not of electrical treatment, and
+in cases whose origin is obscure, which may be considered practically
+functional and therefore treated more or less empirically, electricity
+holds out as much or more hope than any other remedy. Whether
+electricity should be employed locally or in the form of baths, must
+depend on the features presented by each individual case. In neuralgia
+of the fifth pair--excepting those reflex cases where the _point
+d'origine_ is to be sought for somewhere in the trunk or extremities,
+and those that depend on cerebral hyperaemia or anaemia, where the
+equalizing effects of the baths on the circulation are frequently of
+great benefit--these are generally useless. Of other neuralgiae, I have
+found the baths less successful in those of the superior than in those
+of the inferior spinal nerves. Lumbo-abdominal neuralgia and sciatica
+have yielded much more readily than brachial or dorso-intercostal
+neuralgia, etc., etc.
+
+The mode of administering the baths in neuralgiae does not possess enough
+of uniformity to render suggestion in this respect of any value. I will
+state however that, as a rule, the best results have been obtained from
+the descending galvanic current.
+
+In chronic cases the baths should be administered daily, and should not
+be discarded as unavailing until at least a dozen have been successively
+taken.
+
+    CASE XX. _Sciatica._ Mr. R., a middle aged man, mechanic, was
+    sent by Dr. ARCULARIUS Nov. 9th, 1874. Had post-rheumatic
+    sciatica of some six weeks' standing. There were no remarkable
+    features about the case, which however was sufficiently severe
+    to disable him from pursuing his avocation. He took his first
+    bath on the date above-mentioned. Another bath was administered
+    next day, and three more every alternate day. He was then almost
+    well. On Nov. 25th he returned, there remaining still some
+    traces of the affection. Four more baths, the last of which was
+    administered on Dec. 4th, sufficed to complete the cure.
+
+    CASE XXI. _Sciatica._ Mr. G., aet. about 35, saddler, was sent
+    by Dr. WAECHTER, March 6th, 1875. Had suffered from sciatica
+    without discoverable cause for several years. For one year prior
+    to his visit had been unable to work, and was confined to bed a
+    great portion of the time. There was slight atrophy of the
+    affected limb. He had had considerable medical (including local
+    electrical) treatment, without avail. The baths were faithfully
+    and persistently tried in this case, effecting however but
+    slight improvement. Subsequent hypodermic injections, first of
+    strychnia, then of atropia and finally of chloroform, the latter
+    in doses ranging from 30 to 60 minims, gave him only temporary
+    relief. The patient was finally discharged uncured.
+
+    CASE XXII. _Lumbo-abdominal neuralgia._ Mr. W., aet. about 40,
+    was brought by Dr. MARVIN S. BUTTLES in June, 1875. He had been
+    in poor health for a number of years, and was then in a very
+    cachectic condition. There was considerable gluteal atrophy on
+    the affected side. At Dr. B.'s suggestion he took a course of
+    electric baths, with the happiest result. He improved steadily,
+    and on the occasion of a late inquiry after I had not seen him
+    for some months, Dr. B. told me that the patient had entirely
+    recovered. His general condition as well as the neuralgia had
+    been very favorably modified by the baths, and he is now in far
+    better health than he has been for many years.
+
+    CASE XXIII.--_Lumbo-abdominal neuralgia._ Mr. G., aet. 40, came
+    to consult me in October, 1875. He had suffered from neuralgic
+    pains, more particularly in the renal region of both sides, but
+    also in the neighboring parts, for only one week. The case being
+    so recent, I entertained a very favorable prognosis, which
+    subsequently was amply verified. A bath on the 12th of October
+    and one on the 16th sufficed to effect a complete cure.
+
+
+                         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.
+
+
+                              IMPOTENCY.
+
+The frequent obstinacy of this distressing condition under every variety
+of non-electrical treatment, is the cause of the frequency with which
+cases present themselves to the specialist. Unfortunately however but
+few of the referred cases are of recent origin. In almost all instances
+they have gone through a vast amount of medication and other treatment,
+and finally, either through their attending physicians or of their own
+accord, they come as a _dernier ressort_ to seek relief from electrical
+treatment. I have already (p. 47) spoken of the comparative merits in
+this disease of local and general electrization. A few years ago I was
+ignorant of the good effects of the baths in male impotency. I came to
+test and employ them here from two causes. In the first place, patients
+were sent me specially for electro-balneological treatment, ordered by
+their physicians; and, second, I began, when I became familiarized with
+the effects of the baths, to have recourse to them in cases where with
+local electrical and other treatment I had been unable to accomplish
+anything. My average results, without becoming uniformly successful,
+became so very much better, that after a brief but abundant experience
+with this treatment, I have come to consider it the most important we
+possess in this affection; one that will frequently succeed when
+everything else, including local electrization, has failed, and which,
+in cases where no incurable organic changes underlie the affection,
+will, if properly persisted in, either cure or improve to a great extent
+a large majority of the cases. I have even seen instances where, the
+sexual power having receded as the legitimate result of advancing age,
+it returned almost or quite perfectly and with seeming permanency under
+the influence of the baths. In the class of cases--and they are quite
+numerous--in which impotency (loss of the power of erection) occurs as a
+purely nervous symptom in comparatively young men; where its cause is
+sometimes purely imaginative, at others the result of early excesses,
+the baths are attended with the most gratifying average results. Where
+the cause is purely psychical, a very few baths are sometimes sufficient
+to dispel the morbid phenomena. Where masturbation or excessive venery
+are at the bottom of the trouble, there is always a probability of more
+or less organic change in the lower portion of the spinal cord, and
+frequently also a secondary enfeeblement of the digestive functions,
+which render requisite a long and steadily continued use of the baths.
+Patients whose sexual power was intact, who took the baths for other
+purposes, have time and again called my attention to their aphrodisiac
+effects.
+
+While here the _general_ electric influence is the main remedial agency,
+there is no reason why the possible--or, I should say, probable--good to
+be obtained from its _local_ influence should not be realized--the less
+so that it is so facile to obtain this in the bath, by means of the
+surface board. While individual cases will undoubtedly call for
+modifications, I have found the following plan to answer best in
+certainly more than half the cases that have come under my observation:
+The first five minutes of the bath may be occupied by a general galvanic
+current of medium intensity, _descending_ where the patient is of an
+irritable, _ascending_ where of a phlegmatic temperament. The pole
+connected with the foot electrode should now be detached, and the
+surface board substituted. The second five or ten minutes may be
+consumed by running a galvanic current between the head electrode and
+the surface board, the latter applied alternately to the penis, scrotum,
+perineum and, where thought best, also to the lumbo-sacral region.
+Where, as is usual, the impotency is accompanied by a certain degree of
+cutaneous anaesthesia of the penis, but especially where the seminal
+secretion is scanty, the board should be positive (ascending current);
+where however nocturnal spermatorrhoea, premature discharges (before
+coition is possible) or other irritable phenomena characterize a case,
+the surface board should be negative (descending current). The head of
+the patient should rest on a sponge thoroughly saturated with water, and
+communicating with the water of the bath, so as to include the
+cerebellum in the direct circuit. The last five or ten minutes of the
+bath should be devoted to passing the faradic current between the head
+electrode and the surface board, this last applied about the genitals,
+but chiefly about the perineum, the current to be of sufficient
+intensity to contract the perineal muscles. With anaemic patients iron
+should be added to the baths. These should be taken at first daily,
+later on every other day, then three times a week, and so on until it
+becomes apparent that all the good that can be obtained from them has
+been obtained--whether this be a perfect cure or only a certain degree
+of improvement. Where it is thought requisite, internal medication and
+various hygienic measures may be advantageously resorted to as
+adjuvants. While these will do no good when employed alone, they may
+serve to enhance the effects of the baths.
+
+In the following cases, I will include some where the impotency was not
+perfect, where the conditions were merely those of sexual debility. As
+there is here merely a difference in degree, it would be superfluous to
+separate the two conditions under distinct heads.
+
+    CASE XXV.* _Perfect impotency._--Mr. F., from the practice of
+    Dr. CARO, a robust gentleman, aet. thirty-six, full of muscular
+    vigor. Had had syphilis, the symptoms of which had disappeared
+    under Dr. C.'s treatment. For two years the power of erection as
+    well as sexual appetite had become extinct--if we except an
+    occasional imperfect spontaneous erection on waking up in the
+    morning, and even this was of rare occurrence. Ordinary
+    medication proving inadequate, Dr. C. sent patient to take
+    electric baths. From March 7th to July 16th, Mr. F. used the
+    baths, averaging about two weekly. He was then, and still
+    remains, perfectly restored.
+
+    CASE XXVI. _Perfect impotency._ A. E. K., aet. 23, commercial
+    traveler, applied to me for treatment in the spring of 1873. His
+    general health was very good. He had masturbated but little. Had
+    been in full possession of his sexual power until almost
+    twenty-two years of age, when he found that, without assignable
+    cause, he had lost the power of erection. His general condition
+    being, as far as discoverable, perfect in every respect, I
+    instituted a local electrical treatment. This was continued for
+    some time without avail. Strychnia was then administered with no
+    better result, and after some months' treatment I told him that
+    I could do nothing for him. He remained without any treatment
+    whatever until the spring of 1874, when I advised him to try
+    electric baths. He took in all about half a dozen baths, which
+    resulted in his complete and thus far permanent restoration.
+
+    CASE XXVII. _Sexual debility._ Mr. W., aet. 32, married,
+    manufacturer, consulted me in February 1875. Had gradually for
+    about a year past lost sexual power. Was able to perform the
+    marital act at rare intervals only, and when he did, felt
+    exhausted the whole of the succeeding day. I ordered him
+    electric baths. He took the first on February 22d, 1875. Between
+    this date and March 22d, he took six baths. The sexual power had
+    then fully returned. I must not omit to state that during the
+    time he was under treatment he took, by my direction, gr. 1/25
+    phosphorus twice daily, which may have somewhat accelerated the
+    result.
+
+
+                             CONSTIPATION.
+
+Atony of the _muscularis_ of the intestine is admittedly the direct
+cause, in most instances, of constipation. It is the condition known as
+"torpor of the bowels." It is ordinarily due to abnormal innervation of
+the parts. The inefficient innervation may be--and in females frequently
+is--reflex, or its cause may be sought for in the central nervous
+system. The condition of the voluntary abdominal muscles is likewise a
+factor in the alvine process. Sluggishness of the abdominal (portal)
+circulation is a not infrequent etiological concomitant of constipation,
+and, finally, the conditions grouped as "dyspepsia" may form the
+causative feature of a case. I have mentioned these different causes
+simply in order to account to some extent for the almost wonderful
+effects in this condition of electric baths. When we consider that in
+every one of the morbid conditions here enumerated, electricity is a
+very efficient remedy, and that for the resulting muscular atony it may
+be called a specific, it will not appear surprising that a mode of
+application which brings the electric influence to bear on both cause
+and effect--often on a combination of several of the causes enumerated,
+should be attended with such brilliant results. I have thus far met with
+no failure in the electro-balneological treatment of constipation.
+
+In the majority of cases the following method has proven the most
+efficient. The first ten minutes of the bath should be devoted to the
+administration of a galvanic current, as intense as can comfortably be
+borne by the patient. The one pole should be connected with the
+head-electrode, the other, by means of the surface board, applied
+alternately, to the epigastrium, chiefly, and to the hypogastric region.
+The current should a portion of the time be ascending, the rest
+descending. Occasionally the current should be rapidly reversed by means
+of the commutator, the intensity however having been previously reduced,
+in order to avoid too severe a shock; this will cause efficient
+contractions of the abdominal _parietes_, and probably also of the
+intestinal _muscularis_. The second ten minutes of the bath should be
+devoted to faradization, employed in the same manner as the previous
+galvanization, only that here the direction of the current is
+immaterial, and no reversals are requisite. The current should be of
+sufficient intensity to produce energetic but not painful contractions
+of the abdominal parietes.
+
+    CASE XXVIII. Mrs. * *, aet. 55, in average health, without
+    however being robust, had suffered from constipation for about
+    thirty years. She had had every possible medicinal treatment,
+    with no avail. Nothing had ever ameliorated her condition.
+    Without the aid of a cathartic, her bowels moved but once every
+    week or ten days. She was of course compelled frequently to
+    resort to laxatives. In the fall of 1873 I ordered her electric
+    baths. She was not very energetic in anything, and this lack of
+    energy caused her to take the baths less frequently than I
+    desired her to. Had she taken them regularly, she would probably
+    have been restored in as many weeks as it took months to effect
+    her restoration. As it was, she took some thirty baths in the
+    course of about fifteen months. For nearly a year past she has
+    had a passage every day with the utmost regularity. No adjuvant
+    treatment was employed in this case.
+
+    CASE XXIX.* Emil Miller, a bright child two years of age, was
+    brought for treatment July 7th, 1874. He had suffered from
+    obstinate constipation almost from his birth. Had been under the
+    care of several physicians, but had never received any benefit
+    from treatment. Even with the aid of powerful cathartics, given
+    in doses suitable for an adult rather than a child, defecation
+    took place only once every three or four days, and was so
+    exceedingly painful as to elicit cries of pain from the child.
+    The feces were always hard and lumpy, and of an abnormally light
+    color. A digital examination per rectum revealed considerable
+    flaccidity. My diagnosis was _paresis of the muscularis of the
+    intestine_. I ordered faradic baths. On July 12th the first bath
+    was administered, and I must confess that the result was a
+    perfect surprise to me. True, I had expected a cure to take
+    place; but I had looked for gradual improvement, and was not
+    prepared for a result such as was here obtained. _From the time
+    the first bath was taken, defecation took place regularly once a
+    day, without pain; the feces became perfectly normal both as to
+    color and consistency, and the boy continues to the present day
+    to defecate regularly and in every respect normally._ To insure
+    permanency, the baths were continued, at first twice, then once
+    a week. They have now been discontinued for upwards of a year,
+    there being no occasion for their further use. No other
+    therapeutic measures, internal or external, were resorted to in
+    this case, nor was any change made in the diet of the child.
+
+
+                            HYDRARGYROSIS.
+
+The etiology of this condition requires no comment. I will simply relate
+a case illustrative of the eliminative effects of galvanic baths.
+
+    CASE XXX.* _Mercurial Stomatitis._ Mr. S., about 35 years of
+    age, came to me for treatment in the fall of 1872. He then had
+    indurated chancre, two buboes and syphilitic sore throat. He had
+    had the chancre for six weeks before applying to me, but had
+    been, he said, ashamed to consult a physician. Before medication
+    had had time to make any impression on the disease, roseola
+    appeared. The syphilis was very obstinate in this patient,
+    compelling me to keep him under the influence of mercury for a
+    long time. In October 1873, the patient presented himself with a
+    very aggravated mercurial stomatitis. The customary remedies,
+    internal as well as external, made little or no impression on
+    the affection. On November 11th, I discontinued all other
+    treatment, and ordered a course of galvanic baths. He took his
+    first bath on the same day. This was repeated every alternate
+    day until six baths had been taken, when all symptoms of the
+    disease had disappeared. He has had no mercurial trouble since
+    then. The descending galvanic current from a zinc-carbon battery
+    was used throughout.
+
+
+                           LOCOMOTOR ATAXIA.
+
+Were it not for the remarkable results obtained in the following case, I
+should not have felt justified in devoting any space to an allusion to
+this formidable disease. I insert the case as it was published in No.
+216 of the "Medical Record." I have to add that the patient, some six
+months ago, suffered a relapse, which however is not nearly as
+aggravated as his former condition, nor are the symptoms so
+pathognomonic. I had a letter from him about a week previous to my
+writing this, in which he states that he intends soon to come to the
+city for the purpose of taking another course of treatment. Even if the
+treatment however has not had the effect of curing the disease--and this
+I do not claim for it, it has been of sufficient importance if it has
+resulted in arresting for a time its progress, giving the patient
+temporary comfort, and prolonging life. Further trial may possibly have
+better results--in more recent cases--with respect to permanency.
+
+    CASE XXXI.* Mr. W., aet. 48, came to consult me January 12th,
+    1874. He had then felt the symptoms of locomotor ataxia for
+    about six years. Had been unable for several years to walk
+    without the aid of a cane. When walking he dragged his right
+    leg along in a semicircle, and was able to accomplish very short
+    distances only. There were almost complete anaesthesia and great
+    paresis of the bladder. The same conditions were observable in
+    regard to the bowels. Anaesthesia of both lower extremities
+    existed, complete in every respect in the right leg, almost so
+    in the left. Dyspepsia and general debility and emaciation
+    accompanied the disease. Treatment was begun on January 15th. I
+    prescribed phosphorus and cod-liver oil, and passed a strong
+    galvanic current through the spine for probably ten minutes.
+    January 16th, a galvanic bath was administered. Towards the
+    close of the bath (which occupied twenty minutes), patient
+    thought he felt some sensation in his legs. The baths were taken
+    every two or three days, alternating with strong galvanizations
+    of the spine. While taking his second bath, patient remarked
+    that "his right leg felt warm for the first time in six years."
+    The treatment as described was continued for about six weeks,
+    during the latter part of which the local applications were
+    gradually diminished in frequency, the baths being continued
+    regularly. Medication was discontinued about this time. About
+    the middle of March. Mr. W. was enabled to resume his occupation
+    (paymaster's assistant on the Erie Railway). His improvement had
+    been rapid and steady. All the symptoms gradually disappeared,
+    and in the beginning of April the patient was, with the
+    exception of some feebleness, consequent on his protracted
+    illness, as well as ever. He continues so to the present
+    day.[17] He still takes two or three baths a month, but has had
+    no other treatment since May (1874). He walks freely without a
+    cane, and talks jocosely of running footraces. All functions are
+    performed normally.
+
+    Although in this case the baths were not employed exclusively,
+    yet they predominated in the treatment; and if the judgment of
+    the patient, a very intelligent gentleman, is to be relied on, a
+    large share of the success is due to the baths.
+
+
+                               CACHEXIAE.
+
+After what has been said in a preceding chapter of the tonic effects of
+electric baths, it would scarcely appear necessary to introduce the
+subject of cachexiae. If I do so nevertheless, it is only to be afforded
+the opportunity of relating the following case, which possesses
+sufficient interest to render its introduction here desirable. The first
+portion of it has already been published (Med. Record, No 216), but to
+this I have to add what occurred subsequently.
+
+    CASE XXXII.* _Mercurio-syphilitic Cachexia._--Mr. L., aet. 27,
+    had primary syphilis about four years ago. Subsequently had
+    inveterate constitutional symptoms, for which he was under
+    medical treatment both here and in Europe. When he had sojourned
+    in the latter country some time, he was pronounced cured by his
+    physicians. He married, and returned to this country in the fall
+    of 1872. A few weeks after his return he fell into a gradual
+    decline, which confined him to the house--and part of the time
+    to bed--for eight months, during the latter portion of which he
+    had discontinued all medical treatment. It was with difficulty
+    that, assisted by his wife, he managed to reach my office. I
+    found him terribly enfeebled; greatly emaciated; sallow
+    complexion. He was much annoyed by rheumatic pains, which I
+    considered specific. His condition was so exceedingly low, that
+    I decided to postpone all medication until he should be
+    stronger. I ordered galvano-faradic baths, i.e. the galvanic
+    current in the bath as an eliminative, the faradic as a tonic.
+    The first bath was taken on November 20th, 1873. For one month
+    he took the baths, and nothing else. He was then so much
+    stronger, that I felt justified in instituting a mild specific
+    course of treatment, the baths being continued as theretofore.
+    At the end of two months the patient was nearly as strong as
+    ever, was able to resume his occupation, and had gained
+    twenty-seven pounds in weight.
+
+    Thus far this case was published as above stated. For the sake
+    of the interest attaching to it, I will now proceed to give its
+    further history. Mr. L. remained to all appearances well until
+    July, 1874, when he commenced to suffer from headache and
+    constipation. On the 23d of August following, while I was absent
+    from the city, he presented himself to the gentleman who
+    attended to my practice during my absence, with paralysis of the
+    external rectus muscle of the left eye. He also consulted a
+    specialist, who pronounced the paralysis rheumatic. When I
+    returned from the country he presented himself for treatment. I
+    commenced a series of daily electric applications to the
+    affected muscle, which failed to respond to the faradic current,
+    but contracted very readily when the slowly interrupted galvanic
+    current was employed. As I had strong suspicions that syphilis
+    was at the bottom of the trouble, I also administered iodide of
+    potassium in gradually increasing doses--not however until
+    electrization and strychnia employed for some weeks had failed
+    to do any good. The administration of the iodide met with no
+    better success. The patient's general health gradually declined.
+    On October 22d, he complained of numbness in the left leg, which
+    gradually increased, the leg at the same time becoming paretic,
+    so that the patient required the aid of a cane for ordinary
+    locomotion. His condition now became rapidly worse. His
+    movements became ataxic. Anaesthesia of the bladder, paresis of
+    this and the intestine, with obstinate constipation, loss of
+    appetite, emaciation, etc., rapidly supervened. I suspected the
+    development of _gummata_ on the meninges of the brain and cord,
+    and advised him to use the inunction cure, and to remain at home
+    until he should be well. This, on account of the business losses
+    which it involved, he was very much averse to doing. He
+    consequently proposed a consultation with an eminent physician,
+    which was had. This gentleman pronounced the case one of spinal
+    (either multiple or posterior) sclerosis, and discarded the
+    syphilitic theory. A consultation two days subsequently with
+    another physician had a like result. In deference to the opinion
+    of these gentlemen, I treated the patient in accordance with
+    their diagnosis. This was in the second week of November. The
+    patient became rapidly worse. He soon ceased to walk--he tumbled
+    about. After six days' treatment, considering his life in
+    imminent danger, I reiterated my advice to institute the
+    inunction cure, and the patient then acquiesced. Nov. 24th I
+    ordered a drachm of Unguent Hydrarg. to be used every evening; I
+    could not however prevail on the patient to remain at home
+    during the treatment. He continued to grow worse. Nov. 26th he
+    had complete retention from vesical paralysis, and sent for me
+    at night to relieve him. Thenceforth until he got nearly well he
+    was obliged to use the catheter regularly. A few days after
+    this, fortunately for himself, he fell down as he was leaving a
+    horse car, and sprained his ankle. I say _fortunately_, for this
+    accident _compelled_ him to remain at home. From this time he
+    began to improve. December 2d I substituted for the ointment a
+    twenty per cent solution of the oleate of mercury, of which he
+    used a drachm morning and evening. The improvement from this day
+    was exceedingly rapid. On the 4th of December he had regained
+    control of the bladder. The constipation, which had been very
+    obstinate, also began to yield. From this date he used the
+    oleate only once daily, and discontinued it entirely on the
+    14th. On the 10th he had already resumed his avocation, and the
+    same month absolutely danced at a ball. He took iodide of
+    potassium for a time after his mercurial course. He has since
+    been and is now in perfect health.
+
+
+                              DYSPEPSIA.
+
+The remedies for this disease are unfortunately so numerous, there is so
+much temptation to try another where one remedy has failed, that it is
+seldom or never that an uncomplicated case of dyspepsia applies for
+electrical treatment. As a rule, the disease that furnishes cause for
+referring a case to the specialist, is some nervous trouble secondary to
+the dyspepsia.
+
+In regard to the influence of electric baths on dyspeptic conditions,
+whether complicated or not, I can however speak unqualifiedly in their
+favor. I know of no one other remedy that can at all approach them in
+this respect. Whatever the secondary or other troubles of patients, any
+co-existing dyspepsia was in every instance either cured or greatly
+ameliorated. The improvement usually begins at once--after the first or
+second bath, and continues steadily. As I have not had occasion to treat
+by means of electric baths any uncomplicated cases of dyspepsia, I can
+adduce none. I may safely claim however for the baths a reliability and
+bespeak for them a confidence that I might claim or bespeak for no other
+remedy or plan of treatment whatsoever--assertions which would appear
+rash and venturesome, had I not at my command abundant clinical evidence
+to warrant my making them.
+
+
+                             MELANCHOLIA.
+
+A case of melancholia, highly illustrative of the effects in this
+condition of electric baths, came under my notice very recently. It may
+serve as a guide in the treatment of this and kindred conditions.
+
+    CASE XXXIII. Mr. F., aet. 22, single, butcher, consulted me Oct.
+    21st, 1875, for melancholia and loss of memory, from which he
+    had suffered for upwards of a year. He had frequently
+    entertained the idea of suicide. A thorough examination revealed
+    no trouble of any of the viscera. All functions appeared normal.
+    He had never masturbated. There were no collateral symptoms to
+    furnish any evidence of organic cerebral trouble. I prescribed
+    phosphorus and strychnia, and galvanized the brain twice a week.
+    Two weeks of this treatment had completely negative results. I
+    then ordered electric baths. Four baths resulted in a complete
+    cure.
+
+
+                   INEQUALITIES OF THE CIRCULATION.
+
+As a very fruitful source of morbid conditions of almost every nature,
+abnormities of the circulation of the blood are well worthy our
+attention. As is the case with dyspepsia, so here likewise patients
+seldom present themselves for treatment unless some definite secondary
+pathological condition has supervened. We find these patients
+complaining of cold hands and feet, irregular and disturbed sleep,
+occasional local congestions, with vague, usually slight pains here and
+there, etc., etc. Where organic cardiac disease is at the bottom of the
+trouble, we cannot of course expect much permanent improvement. Although
+even here considerable relief is often afforded while the baths are
+being used, their discontinuance will in all probability be soon
+followed by a return of the former condition. Where, however, cases are
+not complicated by organic disease, where we have a "sluggishness" of
+the circulation, due either to vasomotor inertia or atony of the
+muscular coats of vessels, the electric bath will be found reliably
+efficient. I have already (p. 55) alluded to this subject, and explained
+the probable "mode of action" here of the baths. I will now offer some
+suggestions as to the best method of administering them with a view to
+equalizing the circulation.
+
+We must here seek to stimulate the vasomotor system, both central and
+peripheral; to give tone to the coats of vessels, both by direct and
+indirect electric influence; through counter-irritation to relieve
+internal congestions, by causing an afflux of blood to the skin. These
+objects are best attained by means of the galvanic current, which should
+be employed of sufficient intensity to produce a rubefacient effect. The
+faradic current acts in the same direction, but far less energetically,
+if we except the vessels near the surface, the muscular coats of which
+are probably more efficiently tonicised by this than by the constant
+current. The faradic current however is applicable here in another way,
+and for a very important object. I refer to the _mechanical_
+counter-action of a sluggish circulation, through the agency of
+prolonged muscular contraction. This mechanical effect is not of course
+peculiar to the faradic current; it is shared by gymnastic and other
+exercises; but obtained in any other way whatsoever (with the exception,
+perhaps, of _massage_, which is however much more troublesome as well
+as inferior, and moreover not always admissible) it involves, in order
+to produce perfect results, a considerable amount of bodily exertion,
+often beyond the physical power of persons who are in ill health, and
+bringing with it the risk of positive injury, through over-exertion,
+which with the _passive_ contractions obtained by means of the faradic
+current, is entirely obviated. By administering the _general_ faradic
+current in the bath, of sufficient intensity to _maintain_ muscular
+contraction as long as the circuit remains closed, any stagnant blood in
+the lower extremities will be efficiently forced into the general
+circulation. After from three to five minutes of this faradization, the
+surface board may be successively applied for a minute or two each to
+the arms, abdomen, pectoral and dorsal muscles. I believe the _best_
+results can be obtained by first going through the faradic process, then
+subjecting the patient to general galvanization, as above indicated, and
+concluding by another but brief faradization.
+
+
+                    AFFECTIONS OF THE SYMPATHETIC.
+
+Last, but not least, I have some remarks to offer on the treatment by
+the electric bath of certain affections of the sympathetic nerve. While
+I do not in any such cases accord to the baths the rank of an exclusive
+remedy or even a specific, their importance as an adjuvant is sufficient
+to entitle them to special consideration in this connection. In those
+neuroses of the sympathetic where electricity (galvanism) is indicated,
+the _greatest_ benefit can be obtained from local applications. On the
+other hand the baths, employed in addition to local applications, will
+be found a very important factor in the treatment, possessing, as they
+do, two advantages, viz: _first_, by their means, the electric influence
+is brought to bear--in a much less concentrated form it is true--on the
+entire sympathetic system, from the _ganglion impar_ to the _ganglion
+cervicale supremum_, and, by derived currents, on the cephalic ganglia
+also, at one and the same time; _second_, the rest of the body
+participates in the general nutrient and tonic effects of the bath
+equally with the sympathetic, the latter thus receiving a reflex benefit
+which local applications fail to furnish. There are, moreover, cases
+where hyperaesthetic conditions of the nerve do not admit of local
+applications, and where yet electricity is urgently called for. Thus I
+have at present under treatment a lad sixteen years of age, in whom both
+supreme cervical sympathetic ganglia as well as the ganglion impar were
+until recently so susceptible that the mere adjustment of the
+electrodes caused him great pain, while on the other hand he bore the
+baths exceedingly well. In such cases, electric baths, suitably
+administered, frequently constitute in conjunction with proper
+medication, the most useful treatment.
+
+As to the mode of administration in sympathetic neuroses of the baths,
+the most direct manner in which to influence the diseased nerve, is by
+connecting one pole of a _galvanic_ battery (I consider the faradic
+current next to useless here) to the head electrode, the other to the
+surface board, the latter applied portion of the time to the epigastrium
+(solar plexus), the balance to the coccyx (_ganglion impar_). This will
+include in the direct circuit the main portion of the sympathetic, the
+position in the tub of the bather bringing the cilio-spinal centre very
+close to the head-electrode. The direction of the current must be
+determined by the individual features presented by each case, as also
+the duration of the bath.
+
+    CASE XXXIV. Mr. S., aet. 31, merchant, was referred to me April
+    3d 1874, by Dr. KREHBIEL. In January, 1874, Mr. S., until then
+    in the enjoyment of good health, woke up one morning to find, as
+    he expressed it, "everything dark before his eyes." He groped
+    his way to the window, in order to open the blinds. When at the
+    window, he felt as though about to fall out--probably vertigo.
+    He soon returned to an apparently normal condition, and went
+    about his business as usual. A week after, he had a much more
+    serious attack, which he describes as follows: "I had been
+    playing whist during the evening (several hours), when suddenly,
+    without premonition, I felt as though a champagne cork popped
+    against the top of my head, inside. Accompanying this was an
+    indefinable sensation about the heart as though the blood all
+    rushed thence down to the feet. I did not lose consciousness;
+    did not fall. I trembled all over, and a great fear came over
+    me. Felt very weak all night; my pulse was very slow." About two
+    months subsequently, patient was referred to me, as above
+    stated. He then had an uneasy look; an indefinable continual
+    sense of fear; was excessively nervous in the forepart of the
+    day; had brief attacks of tremor--usually every alternate
+    morning, but not typical as to time of occurrence. The history
+    exhibited neither syphilis, malaria nor intemperance. Had never
+    had headache. Sleep good; appetite likewise. The most
+    pathognomonic symptom, however, related to his pulse. This was
+    abnormally slow, ranging from 44 to 54 (the latter only when
+    standing or after walking) per minute. It was full and regular.
+    There was no organic heart trouble. In the absence of any other
+    symptom whatsoever pointing to irritation of the pneumogastric
+    or spinal accessory, I was justified in excluding this as the
+    possible cause of the cardiac infrequency. On the other hand,
+    the pathogenetic manifestations appeared all to point to
+    "asthenia of the sympathetic"--at any rate the portion of this
+    whence the cardiac nerves take their origin, and I formed my
+    diagnosis accordingly. In the beginning, the treatment consisted
+    of bilateral ascending (from cilio-spinal centre to both mastoid
+    fossae) galvanizations of the sympathetic, and galvanic baths
+    (head electrode negative, surface board positive, to
+    epigastrium) on alternate days. Improvement in every respect was
+    steady, though not rapid. At the end of three weeks, I
+    supplemented this treatment by the administration of ergotin and
+    nux vomica. At the expiration of two more weeks, the patient
+    being nearly recovered, I discontinued these medicaments,
+    substituting the valerianates of zinc and iron, and steadily
+    maintaining meanwhile the electrical treatment as above
+    indicated. After a short time recovery appeared complete, and
+    patient was discharged from treatment. He returned however a few
+    months subsequently, complaining of "faint spells" in the
+    mornings, accompanied with excessive nervousness, and a renewed
+    though moderate cardiac infrequency. Electrical treatment,
+    similar to that above described, soon restored him. One or two
+    more slight relapses occurred during the next six months. For
+    over a year past however Mr. S. has been in the enjoyment of
+    perfect and undisturbed health. His normal pulse ranges from 72
+    to 80.
+
+Whoever is familiar with the physiological effects of electric baths,
+will readily concede their great utility in a variety of conditions that
+I have not thus far specially alluded to. Of such I would mention
+ASTHENIAE, ATONIC AND DEBILITATED CONDITIONS GENERALLY, including the
+state of CONVALESCENCE FROM ACUTE DISEASES and the DECLINE OF ADVANCING
+AGE; many cases of CHRONIC HEADACHE; some INCLASSIFIABLE CONDITIONS OF
+MARASMUS and MALNUTRITION, etc., etc. In all such cases, when purely
+functional and uncomplicated by incurable organic disease, good results
+may be confidently looked for.
+
+       *       *       *       *       *
+
+With these remarks I conclude my subject. Whichever the errors that a
+too limited experience may have engendered--and I doubt not there are
+many, I cannot on reviewing my work accuse myself of lack of candor nor
+yet of undue enthusiasm. I have cited but a small proportion of the
+successful cases whereof I possess records; still I believe that I have
+adduced amply sufficient clinical proof of the great value as a remedial
+agent of electric baths, and of the desirability of their more general
+adoption. I would more especially call attention to the
+inappropriateness of deferring their employment until almost all other
+remedies have been exhausted; and when I reflect that pretty much all
+those cases that had been referred to me by other physicians had already
+had the doubtful benefit of almost every other conceivable treatment,
+while many of those who came of their own accord, had in addition made
+the rounds of all the quacks, and exhausted nearly all the nostrums that
+are to be found advertised in the columns of our daily papers, the
+wonder seems that the results obtained were as good as they have been. I
+sincerely trust that in the future physicians will avail themselves
+more frequently than heretofore of a remedy that is certainly capable of
+accomplishing much good; and I hope that in addition to myself there
+will be found others, more competent, to devote themselves to the study
+of the subject. To these, and perhaps to myself at a future time, I
+relegate the task of correcting my errors and promulgating hitherto
+undiscovered truths.
+
+
+    Footnotes:
+
+    [Footnote 10: Centralblatt fuer die medicinischen Wissenschaften,
+    No. 17, 1875.]
+
+    [Footnote 11: The apparatus used in these experiments was that
+    of Du Bois-Reymond, with a Grove's element.]
+
+    [Footnote 12: Since writing the above, this case has had an
+    entirely favorable termination.]
+
+    [Footnote 13: The cases distinguished by an asterisk were
+    published in No. 216 of the "Medical Record."]
+
+    [Footnote 14: Wherever I use the word "general" as descriptive
+    of an electric current used in the bath, it is not as a
+    characteristic, but merely to distinguish it from the instances
+    where the surface board is employed.]
+
+    [Footnote 15: Austin Flint, M.D. A Treatise on the Principles
+    and Practice of Medicine. Philadelphia, 1873. 4th ed. pp. 63 and
+    64.]
+
+    [Footnote 16: See Beard and Rockwell, op. cit., 2d ed. p. 472.]
+
+    [Footnote 17: This was written a year ago. See remarks preceding
+    the case.]
+
+
+
+
+                                INDEX.
+
+
+                            A.
+                                                  PAGE
+    Agrypnia                                        92
+    Anaemia                                          93
+    Apparatus for baths                              7
+    Articular effusions                            105
+
+
+                            B.
+
+    Bath-tub                                         8
+    Batteries                                       16
+
+
+                            C.
+
+    Cachexiae                                       118
+    Chemicals in baths                              15
+    Chorea                                          80
+    Circulation, effects on                         55
+         "       inequalities of                   123
+    Clinical Record                                 61
+    Conductivity of water, etc.                     13
+    Constipation                                   112
+    Counter-irritant effects                        56
+
+
+                            D.
+
+    Debility, general                          129-130
+    Diagnostic uses                                 53
+    Digestive apparatus, effects on                 44
+    Dyspepsia                                      121
+
+
+                            E.
+
+    Electric Bath compared with other
+      electrical methods                            32
+    Electrodes                                      10
+
+
+                            G.
+
+    General Therapeutics                            52
+
+
+                            H.
+
+    Hydrargyrosis                                  115
+    Hypnotic effects                             38-58
+    Hysterical affections                           82
+
+
+                            I.
+
+    Impotency                                      106
+    Insomnia                                        92
+    Invigorant properties                           57
+
+
+                            L.
+
+    Locomotor Ataxia                               116
+
+
+                            M.
+
+    Melancholia                                    122
+    Mind, effects on                                51
+    Miscellaneous disorders                    129-130
+    Mode of administration                          19
+    Muscular contractions                           50
+
+
+                            N.
+
+    Nervous Exhaustion                              84
+    Neuralgiae                                      100
+    Neurasthenia                                    84
+    Nutrition, effects on                           59
+
+
+                            P.
+
+    Paralyses                                       96
+    Pareses                                         96
+    Physiological effects                           31
+    Prophylactic influence                          60
+    Pulse, effects on                               41
+
+
+                            R.
+
+    Rheumatism                                      67
+        "      acute                                68
+        "      chronic                              74
+        "      subacute                             73
+        "      cases of                             77
+
+
+                            S.
+
+    Sedative effects                             48-58
+    Sexual apparatus, effects on                    46
+    Sexual debility                                106
+    Sleep, effects on                               38
+    Special therapeutics                            61
+    Stimulant effects                               43
+    Surface board                                   14
+    Sympathetic, affections of                     126
+
+
+                            T.
+
+    Temperature, effects on                         41
+    Tonic properties                             43-57
+
+
+
+[Transcriber's Notes: The table below lists all corrections applied to
+the original text.
+
+p. 029: [normalized] the sub-acute symptoms -> subacute
+p. 056: GENERAL COUNTER IRRITANT -> COUNTER-IRRITANT
+p. 056: [normalized] the use of the surface-board -> surface board
+p. 059: does ... became apparent -> become apparent
+p. 067: [normalized] acute, sub-acute and chronic -> subacute
+p. 073: [normalized] bi-carbonate of soda or potassa -> bicarbonate
+p. 107: ordered by their physicians: -> physicians; ]
+
+
+
+
+
+End of the Project Gutenberg EBook of The Electric Bath, by George M. Schweig
+
+*** END OF THIS PROJECT GUTENBERG EBOOK THE ELECTRIC BATH ***
+
+***** This file should be named 26366.txt or 26366.zip *****
+This and all associated files of various formats will be found in:
+        https://www.gutenberg.org/2/6/3/6/26366/
+
+Produced by Bryan Ness, Markus Brenner and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+book was produced from scanned images of public domain
+material from the Google Print project.)
+
+
+Updated editions will replace the previous one--the old editions
+will be renamed.
+
+Creating the works from public domain print editions means that no
+one owns a United States copyright in these works, so the Foundation
+(and you!) can copy and distribute it in the United States without
+permission and without paying copyright royalties.  Special rules,
+set forth in the General Terms of Use part of this license, apply to
+copying and distributing Project Gutenberg-tm electronic works to
+protect the PROJECT GUTENBERG-tm concept and trademark.  Project
+Gutenberg is a registered trademark, and may not be used if you
+charge for the eBooks, unless you receive specific permission.  If you
+do not charge anything for copies of this eBook, complying with the
+rules is very easy.  You may use this eBook for nearly any purpose
+such as creation of derivative works, reports, performances and
+research.  They may be modified and printed and given away--you may do
+practically ANYTHING with public domain eBooks.  Redistribution is
+subject to the trademark license, especially commercial
+redistribution.
+
+
+
+*** START: FULL LICENSE ***
+
+THE FULL PROJECT GUTENBERG LICENSE
+PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK
+
+To protect the Project Gutenberg-tm mission of promoting the free
+distribution of electronic works, by using or distributing this work
+(or any other work associated in any way with the phrase "Project
+Gutenberg"), you agree to comply with all the terms of the Full Project
+Gutenberg-tm License (available with this file or online at
+https://gutenberg.org/license).
+
+
+Section 1.  General Terms of Use and Redistributing Project Gutenberg-tm
+electronic works
+
+1.A.  By reading or using any part of this Project Gutenberg-tm
+electronic work, you indicate that you have read, understand, agree to
+and accept all the terms of this license and intellectual property
+(trademark/copyright) agreement.  If you do not agree to abide by all
+the terms of this agreement, you must cease using and return or destroy
+all copies of Project Gutenberg-tm electronic works in your possession.
+If you paid a fee for obtaining a copy of or access to a Project
+Gutenberg-tm electronic work and you do not agree to be bound by the
+terms of this agreement, you may obtain a refund from the person or
+entity to whom you paid the fee as set forth in paragraph 1.E.8.
+
+1.B.  "Project Gutenberg" is a registered trademark.  It may only be
+used on or associated in any way with an electronic work by people who
+agree to be bound by the terms of this agreement.  There are a few
+things that you can do with most Project Gutenberg-tm electronic works
+even without complying with the full terms of this agreement.  See
+paragraph 1.C below.  There are a lot of things you can do with Project
+Gutenberg-tm electronic works if you follow the terms of this agreement
+and help preserve free future access to Project Gutenberg-tm electronic
+works.  See paragraph 1.E below.
+
+1.C.  The Project Gutenberg Literary Archive Foundation ("the Foundation"
+or PGLAF), owns a compilation copyright in the collection of Project
+Gutenberg-tm electronic works.  Nearly all the individual works in the
+collection are in the public domain in the United States.  If an
+individual work is in the public domain in the United States and you are
+located in the United States, we do not claim a right to prevent you from
+copying, distributing, performing, displaying or creating derivative
+works based on the work as long as all references to Project Gutenberg
+are removed.  Of course, we hope that you will support the Project
+Gutenberg-tm mission of promoting free access to electronic works by
+freely sharing Project Gutenberg-tm works in compliance with the terms of
+this agreement for keeping the Project Gutenberg-tm name associated with
+the work.  You can easily comply with the terms of this agreement by
+keeping this work in the same format with its attached full Project
+Gutenberg-tm License when you share it without charge with others.
+
+1.D.  The copyright laws of the place where you are located also govern
+what you can do with this work.  Copyright laws in most countries are in
+a constant state of change.  If you are outside the United States, check
+the laws of your country in addition to the terms of this agreement
+before downloading, copying, displaying, performing, distributing or
+creating derivative works based on this work or any other Project
+Gutenberg-tm work.  The Foundation makes no representations concerning
+the copyright status of any work in any country outside the United
+States.
+
+1.E.  Unless you have removed all references to Project Gutenberg:
+
+1.E.1.  The following sentence, with active links to, or other immediate
+access to, the full Project Gutenberg-tm License must appear prominently
+whenever any copy of a Project Gutenberg-tm work (any work on which the
+phrase "Project Gutenberg" appears, or with which the phrase "Project
+Gutenberg" is associated) is accessed, displayed, performed, viewed,
+copied or distributed:
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+1.E.2.  If an individual Project Gutenberg-tm electronic work is derived
+from the public domain (does not contain a notice indicating that it is
+posted with permission of the copyright holder), the work can be copied
+and distributed to anyone in the United States without paying any fees
+or charges.  If you are redistributing or providing access to a work
+with the phrase "Project Gutenberg" associated with or appearing on the
+work, you must comply either with the requirements of paragraphs 1.E.1
+through 1.E.7 or obtain permission for the use of the work and the
+Project Gutenberg-tm trademark as set forth in paragraphs 1.E.8 or
+1.E.9.
+
+1.E.3.  If an individual Project Gutenberg-tm electronic work is posted
+with the permission of the copyright holder, your use and distribution
+must comply with both paragraphs 1.E.1 through 1.E.7 and any additional
+terms imposed by the copyright holder.  Additional terms will be linked
+to the Project Gutenberg-tm License for all works posted with the
+permission of the copyright holder found at the beginning of this work.
+
+1.E.4.  Do not unlink or detach or remove the full Project Gutenberg-tm
+License terms from this work, or any files containing a part of this
+work or any other work associated with Project Gutenberg-tm.
+
+1.E.5.  Do not copy, display, perform, distribute or redistribute this
+electronic work, or any part of this electronic work, without
+prominently displaying the sentence set forth in paragraph 1.E.1 with
+active links or immediate access to the full terms of the Project
+Gutenberg-tm License.
+
+1.E.6.  You may convert to and distribute this work in any binary,
+compressed, marked up, nonproprietary or proprietary form, including any
+word processing or hypertext form.  However, if you provide access to or
+distribute copies of a Project Gutenberg-tm work in a format other than
+"Plain Vanilla ASCII" or other format used in the official version
+posted on the official Project Gutenberg-tm web site (www.gutenberg.org),
+you must, at no additional cost, fee or expense to the user, provide a
+copy, a means of exporting a copy, or a means of obtaining a copy upon
+request, of the work in its original "Plain Vanilla ASCII" or other
+form.  Any alternate format must include the full Project Gutenberg-tm
+License as specified in paragraph 1.E.1.
+
+1.E.7.  Do not charge a fee for access to, viewing, displaying,
+performing, copying or distributing any Project Gutenberg-tm works
+unless you comply with paragraph 1.E.8 or 1.E.9.
+
+1.E.8.  You may charge a reasonable fee for copies of or providing
+access to or distributing Project Gutenberg-tm electronic works provided
+that
+
+- You pay a royalty fee of 20% of the gross profits you derive from
+     the use of Project Gutenberg-tm works calculated using the method
+     you already use to calculate your applicable taxes.  The fee is
+     owed to the owner of the Project Gutenberg-tm trademark, but he
+     has agreed to donate royalties under this paragraph to the
+     Project Gutenberg Literary Archive Foundation.  Royalty payments
+     must be paid within 60 days following each date on which you
+     prepare (or are legally required to prepare) your periodic tax
+     returns.  Royalty payments should be clearly marked as such and
+     sent to the Project Gutenberg Literary Archive Foundation at the
+     address specified in Section 4, "Information about donations to
+     the Project Gutenberg Literary Archive Foundation."
+
+- You provide a full refund of any money paid by a user who notifies
+     you in writing (or by e-mail) within 30 days of receipt that s/he
+     does not agree to the terms of the full Project Gutenberg-tm
+     License.  You must require such a user to return or
+     destroy all copies of the works possessed in a physical medium
+     and discontinue all use of and all access to other copies of
+     Project Gutenberg-tm works.
+
+- You provide, in accordance with paragraph 1.F.3, a full refund of any
+     money paid for a work or a replacement copy, if a defect in the
+     electronic work is discovered and reported to you within 90 days
+     of receipt of the work.
+
+- You comply with all other terms of this agreement for free
+     distribution of Project Gutenberg-tm works.
+
+1.E.9.  If you wish to charge a fee or distribute a Project Gutenberg-tm
+electronic work or group of works on different terms than are set
+forth in this agreement, you must obtain permission in writing from
+both the Project Gutenberg Literary Archive Foundation and Michael
+Hart, the owner of the Project Gutenberg-tm trademark.  Contact the
+Foundation as set forth in Section 3 below.
+
+1.F.
+
+1.F.1.  Project Gutenberg volunteers and employees expend considerable
+effort to identify, do copyright research on, transcribe and proofread
+public domain works in creating the Project Gutenberg-tm
+collection.  Despite these efforts, Project Gutenberg-tm electronic
+works, and the medium on which they may be stored, may contain
+"Defects," such as, but not limited to, incomplete, inaccurate or
+corrupt data, transcription errors, a copyright or other intellectual
+property infringement, a defective or damaged disk or other medium, a
+computer virus, or computer codes that damage or cannot be read by
+your equipment.
+
+1.F.2.  LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the "Right
+of Replacement or Refund" described in paragraph 1.F.3, the Project
+Gutenberg Literary Archive Foundation, the owner of the Project
+Gutenberg-tm trademark, and any other party distributing a Project
+Gutenberg-tm electronic work under this agreement, disclaim all
+liability to you for damages, costs and expenses, including legal
+fees.  YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
+LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
+PROVIDED IN PARAGRAPH F3.  YOU AGREE THAT THE FOUNDATION, THE
+TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
+LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
+INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
+DAMAGE.
+
+1.F.3.  LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
+defect in this electronic work within 90 days of receiving it, you can
+receive a refund of the money (if any) you paid for it by sending a
+written explanation to the person you received the work from.  If you
+received the work on a physical medium, you must return the medium with
+your written explanation.  The person or entity that provided you with
+the defective work may elect to provide a replacement copy in lieu of a
+refund.  If you received the work electronically, the person or entity
+providing it to you may choose to give you a second opportunity to
+receive the work electronically in lieu of a refund.  If the second copy
+is also defective, you may demand a refund in writing without further
+opportunities to fix the problem.
+
+1.F.4.  Except for the limited right of replacement or refund set forth
+in paragraph 1.F.3, this work is provided to you 'AS-IS' WITH NO OTHER
+WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO
+WARRANTIES OF MERCHANTIBILITY OR FITNESS FOR ANY PURPOSE.
+
+1.F.5.  Some states do not allow disclaimers of certain implied
+warranties or the exclusion or limitation of certain types of damages.
+If any disclaimer or limitation set forth in this agreement violates the
+law of the state applicable to this agreement, the agreement shall be
+interpreted to make the maximum disclaimer or limitation permitted by
+the applicable state law.  The invalidity or unenforceability of any
+provision of this agreement shall not void the remaining provisions.
+
+1.F.6.  INDEMNITY - You agree to indemnify and hold the Foundation, the
+trademark owner, any agent or employee of the Foundation, anyone
+providing copies of Project Gutenberg-tm electronic works in accordance
+with this agreement, and any volunteers associated with the production,
+promotion and distribution of Project Gutenberg-tm electronic works,
+harmless from all liability, costs and expenses, including legal fees,
+that arise directly or indirectly from any of the following which you do
+or cause to occur: (a) distribution of this or any Project Gutenberg-tm
+work, (b) alteration, modification, or additions or deletions to any
+Project Gutenberg-tm work, and (c) any Defect you cause.
+
+
+Section  2.  Information about the Mission of Project Gutenberg-tm
+
+Project Gutenberg-tm is synonymous with the free distribution of
+electronic works in formats readable by the widest variety of computers
+including obsolete, old, middle-aged and new computers.  It exists
+because of the efforts of hundreds of volunteers and donations from
+people in all walks of life.
+
+Volunteers and financial support to provide volunteers with the
+assistance they need, is critical to reaching Project Gutenberg-tm's
+goals and ensuring that the Project Gutenberg-tm collection will
+remain freely available for generations to come.  In 2001, the Project
+Gutenberg Literary Archive Foundation was created to provide a secure
+and permanent future for Project Gutenberg-tm and future generations.
+To learn more about the Project Gutenberg Literary Archive Foundation
+and how your efforts and donations can help, see Sections 3 and 4
+and the Foundation web page at https://www.pglaf.org.
+
+
+Section 3.  Information about the Project Gutenberg Literary Archive
+Foundation
+
+The Project Gutenberg Literary Archive Foundation is a non profit
+501(c)(3) educational corporation organized under the laws of the
+state of Mississippi and granted tax exempt status by the Internal
+Revenue Service.  The Foundation's EIN or federal tax identification
+number is 64-6221541.  Its 501(c)(3) letter is posted at
+https://pglaf.org/fundraising.  Contributions to the Project Gutenberg
+Literary Archive Foundation are tax deductible to the full extent
+permitted by U.S. federal laws and your state's laws.
+
+The Foundation's principal office is located at 4557 Melan Dr. S.
+Fairbanks, AK, 99712., but its volunteers and employees are scattered
+throughout numerous locations.  Its business office is located at
+809 North 1500 West, Salt Lake City, UT 84116, (801) 596-1887, email
+business@pglaf.org.  Email contact links and up to date contact
+information can be found at the Foundation's web site and official
+page at https://pglaf.org
+
+For additional contact information:
+     Dr. Gregory B. Newby
+     Chief Executive and Director
+     gbnewby@pglaf.org
+
+
+Section 4.  Information about Donations to the Project Gutenberg
+Literary Archive Foundation
+
+Project Gutenberg-tm depends upon and cannot survive without wide
+spread public support and donations to carry out its mission of
+increasing the number of public domain and licensed works that can be
+freely distributed in machine readable form accessible by the widest
+array of equipment including outdated equipment.  Many small donations
+($1 to $5,000) are particularly important to maintaining tax exempt
+status with the IRS.
+
+The Foundation is committed to complying with the laws regulating
+charities and charitable donations in all 50 states of the United
+States.  Compliance requirements are not uniform and it takes a
+considerable effort, much paperwork and many fees to meet and keep up
+with these requirements.  We do not solicit donations in locations
+where we have not received written confirmation of compliance.  To
+SEND DONATIONS or determine the status of compliance for any
+particular state visit https://pglaf.org
+
+While we cannot and do not solicit contributions from states where we
+have not met the solicitation requirements, we know of no prohibition
+against accepting unsolicited donations from donors in such states who
+approach us with offers to donate.
+
+International donations are gratefully accepted, but we cannot make
+any statements concerning tax treatment of donations received from
+outside the United States.  U.S. laws alone swamp our small staff.
+
+Please check the Project Gutenberg Web pages for current donation
+methods and addresses.  Donations are accepted in a number of other
+ways including including checks, online payments and credit card
+donations.  To donate, please visit: https://pglaf.org/donate
+
+
+Section 5.  General Information About Project Gutenberg-tm electronic
+works.
+
+Professor Michael S. Hart was the originator of the Project Gutenberg-tm
+concept of a library of electronic works that could be freely shared
+with anyone.  For thirty years, he produced and distributed Project
+Gutenberg-tm eBooks with only a loose network of volunteer support.
+
+
+Project Gutenberg-tm eBooks are often created from several printed
+editions, all of which are confirmed as Public Domain in the U.S.
+unless a copyright notice is included.  Thus, we do not necessarily
+keep eBooks in compliance with any particular paper edition.
+
+
+Most people start at our Web site which has the main PG search facility:
+
+     https://www.gutenberg.org
+
+This Web site includes information about Project Gutenberg-tm,
+including how to make donations to the Project Gutenberg Literary
+Archive Foundation, how to help produce our new eBooks, and how to
+subscribe to our email newsletter to hear about new eBooks.
diff --git a/26366.zip b/26366.zip
new file mode 100644
index 0000000..5643fa8
--- /dev/null
+++ b/26366.zip
diff --git a/LICENSE.txt b/LICENSE.txt
new file mode 100644
index 0000000..6312041
--- /dev/null
+++ b/LICENSE.txt
@@ -0,0 +1,11 @@
+This eBook, including all associated images, markup, improvements,
+metadata, and any other content or labor, has been confirmed to be
+in the PUBLIC DOMAIN IN THE UNITED STATES.
+
+Procedures for determining public domain status are described in
+the "Copyright How-To" at https://www.gutenberg.org.
+
+No investigation has been made concerning possible copyrights in
+jurisdictions other than the United States. Anyone seeking to utilize
+this eBook outside of the United States should confirm copyright
+status under the laws that apply to them.
diff --git a/README.md b/README.md
new file mode 100644
index 0000000..a0bf965
--- /dev/null
+++ b/README.md
@@ -0,0 +1,2 @@
+Project Gutenberg (https://www.gutenberg.org) public repository for
+eBook #26366 (https://www.gutenberg.org/ebooks/26366)