The most important curative results are wrought by galvanism. As a rule, the large, two-fluid elements of the permanent battery are much more effective therapeutically than the small portable combinations. In the Siemens and Halske modification of the Daniell cup, which is so much employed by German electro-therapeutists, and which the author also uses, the resistance within the battery is very great, nearly equal, indeed, to the resistance of the body. Hence, the current is smooth and uniform, and hence, also, the good results obtained from it.

Allbutt made a number of experimental observations at the West Riding Lunatic Asylum on the therapeutical effects of electricity (galvanism) in psychical disorders, and he sums up his results as follows: Marked improvement in acute primary dementia; distinct improvement in mania, atonic melancholia, and perhaps recent secondary dementia; no change observed in chronic dementia and some cases of melancholia, and an unfavorable effect in hypochondriacal melancholia, and perhaps brain-wasting. In the cases reported by Allbutt, the current was sent through the head and through the cervical sympathetics. Benedict (page 222) reports three cases of mental disorder improved by galvanism.

I have observed excellent results in the mental and other symptoms—confusion of mind, impaired memory, hypochondriasis, vertigo, etc.—which result from imperfect nutrition of the brain, caused by atheromatous degeneration of the cerebral vessels. My method of application has consisted in transverse transmission of galvanism through the brain, using a current of sufficient intensity merely to cause slight giddiness, a faint metallic taste, and barely perceptible flashes of light.

Galvanization of the brain and of the cervical sympathetics is one of the measures to be resorted to in acute active or passive congestion of the brain. Wakefulness, when not reflex in origin, and when dependent simply on the state of the vascular supply, is often relieved by galvanization of the brain. Insomnia may be dependent on either active or passive congestion. In the first case a continuous current of moderate intensity should be passed through the superior ganglion of the sympathetic—the positive pole being placed in the auriculo-max-illary fossa, the negative on the seventh cervical vertebra; in the second case a mild current should be transmitted transversely through the brain, and be slowly interrupted.

To promote absorption of the clot in cases of cerebral haemorrhage, and to relieve the collateral oedema in embolism of the cerebral arteries, very mild galvanic currents may be employed. Caution is necessary, however, in employing galvanism in such cases. Strong currents and lengthened applications may do serious mischief; but the author believes, with Remak, that judicious application of galvanism will be useful. The immediate effects of the embolism, or of the haemorrhage, should be allowed to subside before commencing the use of electricity, and, if there be much headache and vertigo, the greatest circumspection will be necessary.

In hemiplegia the constant current may be applied to the brain, for the purpose of improving its nutrition, and the faradic or induced current to the muscles, to prevent wasting and loss of function from disuse. If the temperature of the paralyzed parts is lowered, the skin discolored and roughened, the muscles weak and flabby, much improvement in all these particulars will follow faradization. Large electrodes, well moistened, should be used, and all the muscles should in turn be made to contract—one pole being placed over the motor nerve, the other over the bellies of the affected muscles. In cases of hemiplegia, when the nutrition of the skin and muscles has been improved to the extent which faradization can accomplish, no advantage can accrue from further persistence in the applications. In faradizing the muscles in a case of hemiplegia, a current of just sufficient intensity to cause contractions should be used. Tetanic cramps fatigue the muscles, and are harmful. The so-called "late rigidity "—the muscular contractions which ensue after a time in hemiplegia, and which occur chiefly in the forearm and hands—is best treated by a continuous current to the contracted flexors, and an interrupted or faradic current to the relatively weaker extensors.

In recent affections of the spinal cord, as a rule, electricity is not indicated. In chronic myelitis, syphilitic diseases of the meninges, after a course of suitable specific treatment, and in some of the sequelae of acute meningitis, much good may be accomplished by the galvanization of the spine and the paralyzed muscles. The wasting of the affected muscles may be arrested and their nutrition raised to the normal, and the paralysis of the sphincters may, in many cases, be relieved. When the electro-contractility of the muscles is not impaired, and when they have not wasted, no good is to be accomplished by stimulating them with the electrical current.

That very troublesome disorder, spinal irritation, with its extensive irradiations of nerve-pain, is much benefited by an inverse galvanic current, according to Hammond, and this observation I have been enabled to confirm by my own experience. Hysterical paralysis of the extremities, accompanied or not with anaesthesia or hyperaesthesia, should be treated by galvanization of the spine and faradization of the muscles.

In paralysis from lead (dropped wrist), the muscles may be so far atrophied as not to respond to faradization, but may react when stimulated by a slowly-interrupted galvanic current. When this condition exists, the interrupted galvanic current must be first employed, and the cure be completed by the faradic current when the muscles are so far improved as to react to the latter.

The best example of a peripheral paralysis is that of the muscles of the face, from disease or injury of the facial nerve. From exposure to cold, or disease of the ear, or traumatic injury, the nerve is damaged, and the muscles to which it is distributed are paralyzed. In accordance with the law already given, such muscles do not respond to the faradic current, but do react to galvanism. The positive pole is placed over the pes anserinus, or on the mastoid process, and the negative is made to pass over the peripheral expansion of the nerve, so that all the muscles innervated by the nerve are brought into action. A current of sufficient intensity to induce muscular contraction must be employed. As in the case of other peripheral paralyses, after a time the affected muscles recover their power of response to faradism, when this form of current may be used to complete the cure. If the nerve has not been irremediably damaged, and if the paralysis has not existed so long that the electro-contractility is lost in consequence of atrophic degeneration of the muscles, a cure of facial paralysis may be effected by a persistent use of electricity.

Certain of the ocular paralyses, as of the third, fourth, and sixth nerves, are often cured by electricity (interrupted galvanic current). It is necessary, in order to obtain a successful result, that the remedy be employed in suitable cases. When these paralyses are dependent on cerebral tumors, syphilitic gummata, exostoses, etc., electricity can not be expected to cure; but the paretic state of the muscles, left after the removal of the gummata, may be promptly relieved by galvanization. The functional states of the above-mentioned nerves, of which paralysis may be a symptom, will certainly be cured by electricity. Faradism may sometimes succeed when galvanism fails in these cases (Althaus).

Cases of aphonia, when dependent on paralysis of the vocal cords, are sometimes cured by a single application, and few, indeed, resist the proper use of galvanism. The larynx may be faradized externally; the recurrent laryngeal may be galvanized by placing one rheophore over its trunk and the other over the larynx, or, what is better, an in-tra-laryngeal electrode (Mackenzie's) may be used.

Paralysis of the bladder and of the sphincter ani, even when symptomatic of spinal affections, may be greatly benefited, and the condition of the patient rendered much more comfortable, by an interrupted galvanic or faradic current applied by suitable insulated electrodes. Idiopathic cases of these affections may be cured in this way. Constipation, due to atony of the muscular layer of the large intestine, can be overcome by the same means. An insulated electrode is introduced into the rectum, and a large sponge-covered rheophore, well moistened, is passed over the abdomen so as to bring every part of the large intestine within the circuit.

The failure of respiration in opium narcosis can be most successfully obviated by faradization of the muscles of respiration. A strong faradic current is one of the most effective means of causing uterine contractions in cases of post-partum haemorrhage.