ELECTRIZATION BY REFLEX ACTION. 141 



Sucli unfortunately was the case, although I had succeeded for the 

 moment in relieving the orthopnoea by slight electro-cutaneous excitation 

 of the dorsal surface of the trunk, and had thus obtained some hours of 

 repose. In the struggle in which I had been engaged against this paralysis 

 of the lung, I had retained, up to the last hour, the hope that by prolonging 

 the life of the patient wo should at last exhaust the deadly influence of the 

 diphtheritic poison, which had already been driven from other points of the 

 spinal cord. But we were at last compelled to recognize the near approach 

 of death, when bronchial rales and a slight lividity indicated the commence- 

 ment of asphyxia. From this time we had only to watch the progress of a 

 long and painful struggle. Death took place on the 2nd of April, about two 

 o'clock in the morning. 



BemarJcs. — The case is interesting from many points of view ; ^ but, 

 not to wander from my subject, it is necessary that I should bring 

 into relief the influence that was exerted by cutaneous faradization 

 over the grave disorders of the cardiac circulation, and over tlie 

 paralysis of the intrinsic expiratory muscles of Reissessen ; — in 

 other words, over the paralysis of the limg, which, at the last, 

 produced asphyxia and death. 



The results obtained, under these circumstances, by cutaneous 

 precordial faradization, so far surpassed my anticipations that I 

 should doubt them even now, had they not been witnessed also by 

 the learned physicians who called me to the case, 



a. Let us examine these results in their physiological aspect. 



The grave functional disorders of the cardiac circulation which, 

 in the case of Madame X., I had at first to combat ; that is, the 

 extreme rapidity, smallness, and irregularity of the pulse, with 

 syncope or the danger of syncope from stoppage of the heart, the 



* I have suppressed, in the above his- order. This was not mentioned in the 

 tory, many interesting details that were history of the case. 



not necessary to the demonstration of the j False membranes having been found 

 electro-therapeutic questions that are ; mingled in large quantity with the bloody 

 under discussion. There is. however, one stools, we all thought that the h?emor- 

 circumstitnce that deserves mention, on j rhage probably proceeded from those parts 

 account of its importance, and that is, the of the intestinal sm-face upon which the 

 absence of elevation of temperature dur- false membranes had been develojied. 

 ing the production of nervous disorders These false membranes having been ex- 

 of extreme malignity. I ascertained this ] pelled two days after the abortion, we 

 by the thermometer, in conjunction witli | were for an instant led to suppose that 

 M. Deseroizilles, who, during all the they might be uterine debris, that had 

 weeks of the illness, was scarcely ever ; passed from the vagina at the moment of 

 absent from the patient. If, then, the j the alvine evacuation ; but a microscopic 

 severity of the diphtheritic intoxication examination shewed them to jaossess all 

 could not be explained by excessive ele- | the anatomical characters of false mem- 

 vation of temperatm'e, it is jirobable that brane. Their development over so large 

 the poisonous action may be explained by a surface led us to fear that the degree of 

 some change in the blood, of the nature poisoning might be in proportion to the 

 of which we are ignorant. Such a hypo- extent of this surface, and made us better 

 thesis is supported by the chcumstance understand the full gravity of the case, 

 that there was an intestinal hfemorrhage Moreover, the presence of albumen, for 

 with severe colicky imius, and several some days, in the urine (another fact 

 successive evacuations, on the day follow- omitted from report), added still more to 

 ing the first appearance of nervous dis- , the peril in which IMadarae X. was placed. 



