146 LOCALIZED ELECTRIZATION. 



due to the failure of excitation of this region, in a case of dia- 

 phragmatic paralysis from diphtheritic poisoning, which was only 

 cured by faradization of the phrenic nerve itself 



Case X. — A little girl four months old, who had suffered from diarrhoea for 

 several days, became the subject of a rather large ulceration, covered with 

 false membrane, in the neighbourhood of the umbiUcus. Altliough the cliild 

 had had neither crou^i nor angiua, the diphtheritic nature of this false mem- 

 brane was not doubted by MM. Barthez and Trousseau. Some days later, 

 the cliild was attacked by general paralysis, which continued for forty-eight 

 hours, and was followed by complete aphonia, with extreme difficulty of re- 

 spiration and deglutition. Every attempt at sucking brought on cough and 

 choking; and under these jDcrilous conditions, I was called to the case. I 

 found, besides the conditions mentioned above, paralysis of the diaphragm, 

 the signs of which will be described hereafter. After having tised electro- 

 cutaneous excitation of the base of the thorax, without any appreciable result, 

 I applied faradization to the phrenic nerves, and the diaphragmatic respira- 

 tion soon became normal. The paralysis returned several times, but was 

 always overcome in the same manner. After faradization of the soft palate, 

 the pharynx, and the anterior surface of the neck at the larjmgeal level, the 

 infant sucked better and its voice improved. It was completely cui-ed by a 

 few applications. 



Before leaving the subject, I should remark that, in the history 

 of diplitheria, the varieties of paralysis incidental to the period of 

 poisoning have not been analysed, or rather, have escaped observa- 

 tion, I hope it will suffice to have mentioned them, in order, for 

 the future, to call attention to their occurrence. I believe they 

 are not extremely rare; for, during the short time that my own 

 inquiries have been directed to the subject, I have met with 

 several examples. 



B. — I come now to the therapeutic effect of excitation of the 

 medulla oblongata by reflex action, by the aid of cutaneous fara- 

 dization, in a kind of apnoea, a neurosis characterized by the 

 absence of the hesoin de respirer, and which, for a certain time, 

 renders the respiratory movements infrequent, or even suspends 

 them. I will cite, as an example, an instance in which I observed 

 this singular functional disoixler, and cured it by cutaneous pre- 

 cordial faradization, and by faradization of the diaphragm. 



Case XI. — Neurosis characterized hy a kind of apnoea. Cure hy cutaneous 

 faradization of the precordial region, and hy faradization of the 2}hrenic nerve. 

 The patient was a young man of 17, of nervous temperament, in whom there 

 was developed, after a disorder of the chest (pneumonia ?) a singular derange- 

 ment of the respiratory fmictions. At intervals, he ceased to breathe for from 

 thirty to sixty seconds, without feeling the least inconvenience, although a 

 slight degTee of cyanosis became apparent in his lips and face. Then, after 

 this temporary arrest, came a deep, siispirious, noisy inspiration, such as it 

 would be difficult to imitate by intentionally making an exaggerated sigh ; 

 and this singular, and as if spasmodic inspiration, would then be repeated 

 many times in succession. At the commencement, tbis sequence of events 

 only took place five or six times a day ; but the recurrences become more and 

 more frequent until they were almost continual, and were most remarkable 



