An international system of electro-therapeutics / ... By Horatio R. Bigelow ... and thirty-eight associate editors.
- Bigelow, Horatio R. (Horatio Ripley)
- Date:
- 1894
Licence: Public Domain Mark
Credit: An international system of electro-therapeutics / ... By Horatio R. Bigelow ... and thirty-eight associate editors. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
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![Starr quotes a similar case from Mayer1 and another from Mundel.* Although diphtheritic paralysis be most frequently due to a peripheral neuritis, the disease sometimes attacks the anterior horns of the cord. The case, then, does not differ, except in etiology, from ordinary cases of poliomyelitis.3 The usually favorable termination of diphtheritic paralysis, as contrasted with the usually serious prognosis in atrophic paralysis, would alone suffice to indicate that the cord is only exception- ally affected in the former disease. The tendency of diphtheritic paralysis to spontaneous recovery makes it difficult to estimate the real value of electric treatment. The experiment of Professor Thacher's has been already quoted, where, in a diphtheritic paralysis of four limbs, faradic electricity was applied to each alternately for a certain number of days, and the gain in muscular strength during this period, compared with that of a period without treatment. Starr, usually quite skeptical in regard to therapeutic values of electricity, cites this experiment as proving a positive nutritive influ- ence of electrical treatment.4 Baginsky employs a weak faradic current to the muscles in all cases of diphtheritic paralysis, but associates with it the administration of strychnine, and the latter custom is general.5 Diphtheritic paralysis is only dangerous when attacking the cardiac muscle or the muscles of respiration, and for these dangers strychnine is a more powerful remedy than electricity7, provided it have time to act; while for heart-failure electricity' cannot be used at all. Toxic paralyses are all peculiar in the circumstance that they begin under the influence of a poison then cir- culating in the blood. Whether recovery begins with the moment of elimination of this poison is not known ; it certainly, however, will not begin before. Electric treatment should be conducted according to the rules for treating peripheral neuritis. Weak galvanic currents should be passed through the nerves of the paralyzed limb or limbs,6 but faradic contractions, though often attainable, should be avoided. Static elec- tricity may also be used as a general nerve-tonic. The poison sometimes, though rarely, attacks the respiratory ganglia of the medulla in such a way as to simulate—say, rather, to cause—an acute bulbar paralysis.7 This bulbar form may be mistaken for a capillary bronchitis. But in the respiratory system, as elsewhere, the habitual localization of the diph- theritic poison is peripheric ; it is the diaphragm or the intercostal mus- cles which fail. In this case, intermittent faradization of the phrenic nerve may serve to antagonize the action of the diphtheritic poison just 1 Virchow's Archiv, 1888. * Neurol. Centralblatt, 1885. ' Kidd insisted that the anterior {ranglion ce]js 0f the cor(j were always attacked in diph- theritic paralysis. This opinion was justly opposed by Buzzard and Parker. Lancet, 1883 4 Medical News, 1889. ' Archiv f. Kinderheilkunde. 1891. • Archambault, Gaz. des hOpitaux, 1882; so, also, A. Jacobi, Archives of Pediatrics, 1889. 1 Guthrie, Lancet, April, 1891.](https://iiif.wellcomecollection.org/image/b21033705_1146.jp2/full/800%2C/0/default.jpg)
