140 LOCALIZED ELECTRIZATION. 



(probably of the anterior pyramids or their prolongations), I did not hesi- 

 tate to encounter it by the same means that had succeeded against the 

 l^aralysis of the nerves of the heart and lungs; by the electro-cutaneons 

 excitation practised by the hand over all the surface attacked by paralysis 

 of motion and of sensation. On this occasion, also, we were not deceived 

 in our hope ; for, after eight or ten minutes of this slight perijjheral exci- 

 tation, the sensibility had in great part returned, and voluntary movement 

 coon followed, although muscular faradization had not been practised. In 

 four hours the hemiplegia had completely disappeared. 



The hemiplegia, alas ! was soon replaced by new indications of pneumo- 

 gastric paralysis, more serious than those which had preceded them ; for 

 susi:)ens;on of the heart's action returned more often and continued longer. 

 I soon succeeded once more in removing this symptom, by slight faradi- 

 zation of the cutaneous precordial zone which, according to the therapeu- 

 tical results previously obtained in the case, seemed to be in relation with 

 the origin of the pneumogastric. Unfortunately, this renewed success lasted 

 only for about a quarter of an hour From tliis time we were compelled 

 to maintain, day and night, an incessant strife against the tendency to 

 stoppage of the heart. Every hour, or half hour indeed, the poor lady was 

 attacked by the same cardiac troubles, which became more and more pain- 

 ful, and drew groans from her. On these occasions the pulse, which became 

 small and irregular, improved again and again under the iniiuence of electro- 

 cutaneous excitation of the precordial region ; and the patient was able to 

 compose herself to the sleep of which she had siich need. 



After two days of this struggle against the diphtheritic poison, the electro- 

 cutaneous excitation seemed to have triimiphed anew. The symptoms of 

 pneumogastric paralysis had disappeared, and the rapid pulse had re- 

 turned to its normal state and so remained. 



But, unfortunately, this improvement was but a brief respite ; for nervous 

 disorders of a new kind shortly appeared, and this time aifectcd only the 

 respiration, which became sighing and more rapid. Ten or twelve normal 

 resi^iratory acts were followed by about the same number of abnormal move- 

 ments, which were more rapid in their character, and were each composed 

 of a full and long insjiiration, followed by a short and feeble expiration. 

 Madame X. was soon awakened by a most painful orthopnoea; she was suf- 

 focated, she said to me, as if between two mattresses. There was no blue- 

 ness of the lips, because the air that freely entered the bronchi was sufficient 

 for hsematosis ; although the air that there was no power to remove from 

 the smaller ramifications, had become irresjurable, and this occasioned the 

 dyspnoea. 



The electric hand moved over the precordial region afforded no relief. It 

 was only by exciting the skin of the posterior region of the chest, that I was 

 able, after the lapse of eight or ten minutes, to render the breathing regular. 



The paralysis of cx]m'atory power returned after the lapse of an hour ; 

 and shewed itself, as on its first appearance, by sighing respiration, soon 

 followed by most painful orthopnoea, producing groans. The horizontal 

 position, which she had long maintained for fear of syncope, became insup- 

 portable. She found no comfort but by sitting up in her bed, with the body 

 bent forward; an attitude that she maintained until I had restored the 

 breathing to its natural state. This paralysis of the bronchial muscles of 

 Eeissessen (the intrinsic expiratory) filled me from the first with g^-eat dis- 

 quietude, although the hffimatosis had not appeared to suffer, judging from 

 the colour of the lips and the face. But I could not fail to see the presence 

 of a new danger, fully as great as those from which the patient had escaped. 

 Indeed, from the weakness of her inspiratory movements, she had great 

 difficulty in expelling the abundant mucosity that had already formed in the 

 larynx. She could accomplish the expulsion only by very violent efforts, 

 which left her completely exhausted. There was only too much reason to 

 fear that, if this condition should be prolonged, the accumulation of mucosity 

 in the bronchi would become a cause of asphyxia. 



