ELECTRIZATION BY REFLEX ACTION. 135 



conducted according to tlie principles that I have laid down in 

 treating of this method of faradization. 



There are also circumstances in which electro-cutaneous excita- 

 tion ought to be employed concurrently with faradization of the 

 diaphragm. The latter is especially indicated in cases where it 

 is urgent to compel the mechanical entrance of air into the lungs ; 

 the former is useful, or even necessary, when, after we have re- 

 established the respiration and the cardiac circulation, and have 

 dissipated the cyanosis, the patient threatens to fall into a state of 

 coma, symptomatic of cerebral ischaemia, due to the poisoning 

 of the blood either by carbonic oxide, or by the accumulated 

 carbonic acid if the state of partial asj)hyxia has been of long 

 duration. Then electro-cutaneous excitation, especially if applied 

 to a certain zone of the precordial region, reacts upon those points 

 of the nervous centres which govern the innervation of the breath- 

 ing and of the heart's action. 



The therapeutic value of this method, in the treatment of 

 this kind of asphyxia, is placed beyond doubt by the following 

 history : — 



Case V. — Asphyxia hy carbonic oxide; absence of respiration ; Ju art's acti(,n 

 very feeble, and only discoverable by auscultation; cure by cutaneous faradization 

 of the p)recordial region. 



A pastrycook's boy, fifteen years old, of eccentric character, bad endeavom-ed 

 to drowu some imaginary troubles in driuk ; and had the notion, in his intoxi- 

 cation, to try to asphyxiate himself by creeping, during the night, into a sort 

 of hole situated over his master's oven, where he remained to sleep himself 

 sober. The next morning, the men who went to light the fire saw one of his 

 feet, and drew him, seemingly lifeless, from the place where he had passed the 

 night. Living in the same house, I was able to try, a few minutes later, to 

 recall him to life by faradization. His face was blue, there was no resjiira- 

 tion, a mirror held before his lips remained untarnished, no pulse could be 

 felt, the action of the heart was not discoverable by the hand, but on ausculta- 

 tion, feeble valvular sounds were heard. While 1 made this examination my 

 induction apparatus had been got ready by my son, who assisted me. I was 

 about to excite artificial respii-ation through the phrenic nerves, when I saw 

 that the rheophores had been forgotten. The danger being very m-gent, I 

 instantly applied the metallic extremity of one of the conductors of the in- 

 duced current of my instrument (at its maximum, and with rapid intermis- 

 sions) over the left nipple, and moved the other conductor about over the 

 apex of the heart. After a few seconds, slow and weak respiratory move- 

 ments appeared, and increased progressively in frequency and depth ; and, at 

 the end of a minute, the pnlse could be felt. Soon afterwards, the face 

 assumed a slight expression of pain. In a few minutes the patient uttered a 

 faint groan, and moved first the arms and then the trunk, as if to remove the 

 conductors from his chest. Then he gave a loud cry, kicking with his feet at 

 the people surromiding him, and began to reply to the questions that were 

 asked. In five or six minutes the respiration and circulation were re-estab- 

 lished, the colour of the face was natural, and the intelligence had returned. 



He appeared to be saved. However, I ordered sinapisms to be applied to 

 the limbs and the precordial region, and warned his master that lie might 

 fall back into a state of coma, from the toxic influence of the carbonic oxide. 

 In fact, a few minutes after the suspension of tlie cutaneous faradization, he 



