ELECTRIZATION BY REFLEX ACTION. 143 



point of origin of the nervous fibres wliich supply the intrinsic 

 expiratory muscles, or bronchial muscles of Reisse>sen. 



h. Every one must perceive the practical bearings of the fore- 

 going physiological considerations ; which lead directly to the 

 following conclusions. 1. Electro-cutaneous excitation of the pre- 

 cordial region around the apex of the heart is one of the best 

 means by which to encounter syncope from arrest of the heart's 

 action, or other functional disorder of the cardiac circulation^ 

 symptomatic of a paralytic condition of the vagus, without organic 

 lesion. 2. Electro-cutaneons excitation of the posterior region of 

 the chest exerts a special therapeutic action, in the treatment 

 of paralysis of the intrinsic expiratory muscles. 



The following, in a few words, is the physiological explanation 

 of the facts above stated. In the case of Madame X., the slight 

 electro-cutaneous excitation of the precordial region, acting in a 

 reflex manner upon the ganglion of the pneumogastric, restored to 

 the nerve the power, of which its paralytic state had deprived it, 

 to control the action of the heart. It had, in other phrase, put 

 the heart once more under a curb, and hence followed regulation 

 of the cardiac circulation, and disappearance of the grave nervous 

 disorders that were symptomatic of pneumogastric paralysis. A 

 similar theory is applicable to the therapeutic influence exerted 

 by electro-cutaneous excitation of the back of the chest over 

 paralysis of the power of expiration. 



c. The case affords also valuable instruction, with regard to 

 the choice of a method of electrization, and with regard to the 

 manner of its application under similar circumstances. 



When it was decided, in consultation with my colleagues, that 

 reflex faradization of the medulla oblongata was indicated in the 

 case of Madame X., I at first proposed to them to pass an induced 

 current from the mouth to the anus. (I shoAved them that with 

 my water moderator, or with a band of wetted linen in the circuit, 

 the current could be so reduced as to be scarcely appreciable 

 by the tongue, and could be gradually increased.) Notwithstand- 

 ing the assurance that I possessed (from experiments that I had 

 made upon animals, and even upon man), that I could regulate at 

 will the degree of this reflex excitation, I proposed to commence 

 by slight action upon the skin of the precordial region, in order to 

 discover what was the degree of excitability or of tolerance of the 

 patient. It will be remembered that, after having used at first in 

 this way a very feeble current, the intensity of which was pro- 

 gressively increased, the disorder of the cardiac circulation was 

 relieved in a short time. 



This result so far exceeded my expectations that I was at first 



