ELECTRIZATION BY REFLEX ACTION. 145 



method Lad been free from danger, it is manifest that a proceed- 

 ing in which one rheophore was placed in the mouth and the 

 other in the anus would become unbearable, Avhen it was necessary 

 to repeat faradization very frequently for several days. It would 

 then always be necessary to have recourse to cutaneous precordial 

 faradization. 



d. The clinical history of the case of Madame X., and the con- 

 siderations which flow from it, show that it is important, in diph- 

 theritic poisoning, to diagnose exactly the kind of paralysis tliat is 

 symptomatic of a morbid condition of the medulla ; for upon this 

 diagnosis will depend special therapeutic indications. As we have 

 seen, the disorders of the cardiac circulation require to be en- 

 countered by faradization of the cutaneous precordial zone, which 

 is in reflex relation with the origin of the pneumogastrics ; and 

 paralysis of the intrinsic expiratory muscles, by ftiradization of a 

 cutaneous zone on the posterior surface of the chest, which is in 

 reflex relation with the nerves by which these muscles are con- 

 trolled. 



In September, 1869, in conjunction with ]MM. Millard and A. 

 Ollivier, I saw another case of diphtheritic poisoning ; one which 

 both confirms the foregoing observation and displays its import- 

 tance. 



Case IX. — Without entering fnlly into the history of this patient, I may 

 say that he appeared to liave contracted membranons angina by kissing 

 the mouth of one of his children who died from the disease. After having 

 passed through the period of the formation of false membranes, which put 

 his life in danger by obstructing the bronchi, and when making progress 

 towards convalescence, the patient was attacked, about the twenty-fifth day, 

 by paralytic symptoms which indicated the invasion of diphtheritic iDoisoning. 

 There was paralysis of the soft palate and jiharynx, diplopia, and slight 

 hemiplegia of the fifth, seventh, hypoglossal, and inferior laryngeal nerves. 

 Suddenly, on the twenty- eighth day, the intrinsic expiratory muscles were 

 struck with jiaralysis ; and, at the same time there was formed a considerable 

 quantity of mucus which, obstructing the bronchi and not being exi^elled, 

 threatened to prodtice asphyxia. The paralysis had appeared without fever ; 

 and we apprehended a speedy death. Ehctro-cutuneous excitation of the pos- 

 terior region of the thorax rapidly re-estahlished the expiratory power, and 

 procured the immediate expulsion of the bronchial mucus. It required to he con- 

 tinued for several days in order completely to overcome the jia^xdysis of the lung. 

 The patient is now in safety, although still under treatment for other con- 

 sequences of his illness (impairment of sensibility of the hands and feet, with 

 paresis of the limbs). The whole history of the case will probably be pub- 

 lished by M. Millard. 



If, in the foregoing instances, I had had to deal with paralysis of 

 the diaphragm, I should have employed cutaneous faradization 

 of the base of the thorax ; although it does not seem to me to be 

 proved that this cutaneous region is in reflex relation with the 

 origin of the phrenic nerve. My doubt uj^on the question is 



