Twitching and vibration under the skin.

Nux vom.

drawing in the muscles, as if pulled by a rope. Puls.
here and there in the body. Ratanh.

whole body. Nitr.

now of the upper lip, then of the hands, fingers or thighs, especially on the left side, and always toward the left. Sabad.

of the muscles, jerks through the body, evenings in bed. Ran, bulb.

of the whole body or of single limbs. Thuja.

violent, of the limbs and face, with stiff stretching out of the body.

Lach.

with starting of the whole body, evenings on going to sleep. Stront.

Uneasiness general, with twitching of the muscles and sticking pains in various parts of the body, occasionally extending up along each side of the forehead. Scutell.

Unrest through the whole body, with indescribably disagreeable sensation. Meph. put.

Unsteadiness of the whole body; cannot stand; seems to be falling; jerking, jumping of the tendons. Hyosc.

Urinary difficulties.

Berb. vul.

Urine light-colored, increased in quantity; great muscular debility. Picric ac.

Vertigo and dimness of sight. Gels.

Vibration in different muscles; twitching of the muscles here and there; much visible twitching in the body, in the face, in the arms and hands. Zine met.

fine, nervous, as if going into the interior of the bones, causing great anxiety. Meph. put.

Vital activity excessively augmented; hastiness in all movements. Menyanth.

turgor, diminution of. Hydrocyan, ac.

Walk, cannot, from spinal affection. Hyper. perf.

complete incapacity to, also with inability to carry out easy movements and manipulations. Sec. c.

Wants to sit erect. Lact. vir.

Weakness, attacks of faintlike. Carb. veg.

does not allow him to stand long; it makes him perspire and tremble. Therid.

great, and exhaustion from loss of animal fluids and after severe diseases. China.

long-lasting, with great inclination to perspire when moving about and during sleep. China. nervous. Dig. pur.

Weakness, with sensation of lameness through all the limbs.
Colch

of the whole body, with shaking, trembling and running of
tears from the eyes, forenoons. Ol. an.
sensation of, throughout the whole body, like a languishing
of all strength, with an inclination to lie down or sit,
which produces a sort of semiconsciousness, as if going
to sleep. Tarax.

sudden general, at noon, with trembling and sensation of
bulimia, more while standing. Zinc. met.

towards evening, with shuddering and cold between the shoulders at every motion, with staggering and stitches in the temples, forehead and vertex.

Tabac.

tremulous; the weakness and tiredness manifests itself mostly as heaviness. Puls.

Weariness, great, after slight exertion.

Spig.

and desire to lie down. Plant. m.

as after a long journey; especially bad in the knees, with drowsiness and listlessness. Nux mosch.

general, or now more in the upper, then more in lower extremities. Sec. c.

sensation of, in the eyes, arms, bend of the knees, etc., with overexcitability of the nerves; oversensitiveness of all the senses. Valer. off. throughout the whole body; restlessness of the body; inclination to move the affected parts. Rhus tox.

with frequent yawning, pressing in the left half of the head, sparks before the eyes and lamelike immobility of the limbs of the right side. Stront.

with irresistible drowsiness. Stann.

of the whole body; she scarcely dares to raise the arm. Sulph. ac.

with trembling of the knees while standing, and trembling of the hands while writing. Oleand.

like heaviness of the body. Squilla.

with aversion to everything, with drowsiness, general dulness, sadness and loss of memory. Opium.

with trembling at every motion; deficient vitality like internal chilliness, with almost constant alternation of cold and heat; pale countenance, with blue borders around the eyes, and with dread of heat when it is cold, and of cold when it is warm. Sulph.

LXV.

ELECTRICITY AS AN ADJUNCT IN THE TREATMENT OF SPINAL DISEASES.

BY J. H. BUFFUM, M.D., PITTSBURG, PA.

It is in cases of paralysis, whether from cerebral or spinal lesion, that electricity micets its most important indications, and without this useful adjunct we would be enabled by our remedies only to relieve the central lesions, without effecting a cure of the paralyzed muscles and restoring their lost volitional contractility.

The curative action of electricity has been so efficient, complete and satisfactory, that cases which heretofore have been thought hopeless are now very often greatly relieved, if not permanently cured by its proper and persistent use in the hands of the educated profession.

Its administration in all cases must be made with that care and individualization which should characterize the prescription of any remedy in any case.

As yet the provings of this potent agent are in a very fragmentary condition, but with carefulness and observation these may be systematically enlarged, and we shall soon be able to fully define its prescription according to the law of similars.

Among the results to be obtained by the use of electricity, are the restoration of the ability of the paralyzed muscles to respond to the will, and the maintenance of the circulation, together with healthy nutrition within the affected organs. Electricity, therefore, is not indicated when the paralyzed muscles respond to the current as actively as the corresponding unparalyzed muscles, and still less is it required when the electric contractility and

Under these circumstances

sensibility are greater than normal. its employment may do harm. Again, it is very injurious to use the currents while the central lesion still exists, as will be recognized by the greater increased muscular irritability and rigidity of the paralyzed muscles in hæmorrhagic or acute inflammatory conditions of the nerve-centres.

The success of the electrical treatment in paralytic affections will depend on the exercise of judgment in determining the indications for it, and of tact in its employment. The advantage of experience in the practical application, together with the time which it requires, makes it desirable that some members of the profession should give it special attention. Unfortunately the employment of electro-therapeutics in this country is for the most part in the hands of uneducated practitioners, who know but little of the agent which they employ, and still less of the human organization.

"Die milde macht ist gross" is particularly true of the mild galvanic current, which is now known to be the best for cure, and which when uninterrupted causes little sensation of any kind, and the potentiation of which may be increased in a marvellous manner by the complete rheotomes which are now made.

It is the galvanic current which is the most useful in treating the diseases of the spinal cord, while the faradic current finds its place in relieving the effects of the lesion upon the peripheral muscles.

The fact that paralyzed muscles will not of themselves resume at once their normal condition, even after the conditions causing the paralysis are removed, is highly important. Nerves and muscles may become permanently paralyzed from disease. Having been for a long period paralyzed, they remain so indefinitely if proper efforts are not made for their restoration.

In treating the paralysis, resort to the use of electricity must not be had immediately, or too soon, for little or no result will be obtained by trying to rouse the paralyzed muscles while the causative conditions still sustain the paralysis, as restoration at that time is out of the question. After the paralysis has existed for some time, restoration must not be expected to take place spontaneously, but persevering efforts are often necessary for

recovery. When the paralysis has existed so long that the muscles and nerves have undergone degenerative changes, we cannot expect success.

The application of the faradic or galvanic current furnishes important information respecting the condition of the affected muscles. When a current of sufficient intensity is passed through healthy muscles, contractions are excited. This susceptibility to the electrical current is called electro-muscular contractility, or electric irritability. The passage of the current through the muscles causes more or less pain, not due to contraction excited by the current, and this pain denotes what is called electro-muscular sensibility.

The state of paralyzed muscles as regards electro-muscular contractility and electro-muscular sensibility must always be taken into account in the application of electricity. In muscular paralysis from intracranial affections, the paralyzed muscles, as a rule, respond not less, and in some cases even more, than in health, until they begin to suffer from prolonged inaction or defective nutrition. The electrical current in these cases is, to some extent, a test of the state of the muscles as regards their capacity for contracting under the influence of volition. There have been, however, exceptional cases reported where the volitional contractility is regained while the electro-contractility is defective or lost. It seems to be the rule, that when muscular paresis is due to intraspinal affections, to injury of nerves, or traumatic causes affecting the muscles themselves, the electrofunctions are impaired or lost irrespective of changes arising from defective or disordered nutrition.

In proportion as the muscles or nerves undergo degeneration of structure as an effect of long-continued paralysis, they respond feebly, or not at all, to the electrical current. Hence, in certain cases, electricity gives information of the hopelessness of paralysis. The electro-contractility of paralyzed muscles is sometimes lost, and the electro-sensibility remains intact; when this is the case, the prognosis is less unfavorable than when both are wanting. In cases in which the paralyzed muscles fail to respond to the electrical current from defective innervation, as an immediate or speedy result of morbid conditions affecting the spinal cord or