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

may arise from otitis, caries, and necrosis of the petrous portion of the temporal bone, or from sanguinary congestion, or inflam- mation of the nerve sheath, <fcc, and this may sooner or later extend to the brain, according to the nature of the solution of continuity. Some such results we see soon followed by more grave symptoms, or even death. Other rare cases, after a time, appear to be attended with an irritative inter-cranial cicatrix, and hence there sets in a rigid and permanent contraction of some of the muscles of the face. It is obvious that any elec- trical treatment here is both useless and hazardous. But in others it happens that after this grave paralysis has con- tinued for a considerable time, the whole set of affected muscles take on a shade of improvement. And here we may find now and then a person we can save, by bringing electricity as a timely aid, if employed prudently, but perseveringly, and that with other rational treatment. There is the best of testimony that such recoveries are not rare, even after a half dozen or dozen years' standing. Dr. Duchenne lays down the rule that whenever the paralyzed muscles of the face, which give a pouty cast to the features, also respond "very sensitively" to electro-excitement, by such prompt contractions as show that their excitability remains in- tact or is exalted, it is evident, according to this experience, that the facial hemiplegia is due to a true cerebral source. But if the muscle orbicularis of the eyelid is paralyzed, and on the other hand if the muscles do not so respond to the electric ex- citement, we may then be quite certain that the facial hemi- plegia cannot be referred to a brain origin and source. In this latter case the affection arises from a pathological state of the facial portion of the seventh, or portio dura, nerve. He speaks of having repeatedly cured cases of paralysis of the tongue and face by the means of Faradaic currents. As regards the number and length of the treatments for such cases as where we are not quite certain as to their nature or state, it is thought most wise not to make the seance so long or so thorough ; and if not restored, after some ten to fifteen treat ments, it had better be omitted; and after some delay, it can be again repeated. (See pp. 240, 266, and Appendix D, Note 3.)