Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.

there are two very different kinds of facial palsy; the one arising from a sudden cooling, and hence neuralgic, or from the severe local or protracted exposure to cold, and hence rheumatic ; or it is due to pressure somewhere along the bony exit of this nerve trunk, after its exit from the cranial cavity, as from a tumor or exostosis of bone, or from a syphilitic or scirrhous deposit in its sheath ; or it may arise from a neighboring bony caries and con- sequent suppuration; the other form — the symptomatic and grave kind — arises from an intra-cranial origin. Now, we will observe, first, in regard to this latter type of the disease, which arises from a brain origin, or from some injury to the intra-cranial portion of the seventh nerve, that we usually get some characteristic difference in the symptoms, as a loss of taste, with a numb sensation in the side of the tongue, caused by some intercepting influence that cuts off the physiological function of those nerve fibrils which come from the chorda tym- pani; there is also a difficulty of deglutition from paralysis of the digaslricus and stylo-hyoideus; the hearing is affected, and the uvulva hangs towards the sound side; and in some cases, although the patient can move the tongue, yet there is not the ability of covering the upper lip with it, so that its tip shall reach the septum of the nose. Wherever the tongue and the pharynx are involved in the paralytic affection, it should put us on our guard, as being indicative of some mischief in the brain. But the most distinctive characteristic difference between the two kinds of facial paralysis is, that a paralysis of the orbicularis palpebrum does not occur in a facial hemiplegia of a central origin. Therefore, if the eye cannot be shut, we may rest assured that the case is one of simple paralysis of the facial nerve, and is suitable for treatment. It is worthy of notice, that the grave symptoms of a lost taste, difficult deglutition, and deviation of the palate may possibly arise from poor dentistry plate work, such as is sometimes worn as temporary. The author has seen several such instances, and some of them very serious indeed, being of long standing. But it should be known that these are generally amenable to the so-called localized use of electro-mag- netism. But let us notice what further is not the simple paral- ysis of the porlio dura or facial nerve.