VALUE OF GALVANIC CUKRENTS IN MEDICINE. 221 



resistance as the electrodes move their jDlaces on the surface. Eemak assigns 

 it as a difference between his ' labile ' galvanic and the common induced 

 currents that, in the latter, the fall of the current is from its maximum to 

 nil ; but that, in the ' labile,' although the current certainly falls from its 

 height, it still remains always considerably more than nil. This distinction is 

 illusory. In the ' labile ' application w-e can no longer speak of constant 

 currents ; but only of continuous currents of irregularly oscillating strength. 

 After Eoseuthal, Oppenheimer, Sinsteden, and others, had confirmed my 

 opinion upon this point, Itemak confessed himself to have been in error. 



Disregarding only these obscurities about the methods of galvanizing, 

 Remak's doctrines, with regard to the antiparalytic curative effects, contain 

 yet many other points that jiistify considerable hesitation. This especially 

 applies to the centrijje/al action of the currents, which Eemak considers to 

 be partly due to a direct action on the brain and spinal cord, and to be 

 best explicable by an action on the vaso-motor nerves ; ])artly to reflex action. 



With regard to the first, Eemak deals entirely in hypotheses of the boldest 

 kind. He not only believes in producing a regulation of the circiilation in 

 the brain by galvanizing the plexuses or ganglia of the sympathetic (pre- 

 ferably the superior cervical ganglia) ; but also in diminishing, by the same 

 procedure, the irritation of the cerebral substance aroimd an apoplectic clot, 

 and in hastening the absorption of the blood, so as to prevent the occurrence 

 of contractions in the paralysed half of the body ; and this the more easily 

 and certainly, the more recent the paralysis. Eemak's method, in such cases, 

 consists in the ' labile ' api^lication of the electrodes over the cervical ganglia 

 of the sympathetic, w'ith the current of from 20 to 30 elements. 



Eemak also believes that he has obtained a curative action upon the spinal 

 cord, by the labile application of a current from 20 to 30 elements in the 

 neighbourhood of the solar plexus, and of the lumbar plexiises of the sympa- 

 thetic, in cases of ascending sjoinal paralysis, motor ataxy, hysterical para- 

 plegia, and other disorders of motion due to changes in the spinal cord. 



Even in the most superficial view, it excites suspicion to hear such pro- 

 found anatomical lesions described as being generally curable; esioecially 

 when no clinical evidence is forthcoming. It must, moreover, appear highly 

 improbable, a prioi-i, that it is generally possible, by the method described, to 

 produce excitation of the sympathetic ganglia and jDlexuses. The tension 

 of an electric current entering the body, as soon as it has passed through 

 the skin, undergoes such rapid diminution, that muscles or nerves, separated 

 from the surface by a moderately thick layer of w^ell conducting tissues (e. g., 

 of muscle), are no longer acted upon, unless extremely powerful currents 

 are employed. How much less is it to be expected that the comparatively 

 feeble current of a battery of twenty or thirty elements, in labile applica- 

 tion, can be made to reach the superior cervical ganglion, or still more the 

 coeliac plexus, with the tension necessary to produce any excitation. 



But, even assuming it to be proved, that a direct action of the current 

 upon these nervous organs is possible, there still remains the larger ques- 

 tion, whether excitation of the plexuses and ganglia of the sympathetic does 

 actually have, or could have, the action upon the central organs that Eemak 

 professes to have observed. Of the functions of the ganglia, we know what 

 amounts to nothing; and of the cervical sympathetic we know that its 

 division, in animals, or its paralysis from other causes, is followed by a dilata- 

 tion of vessels and increase of temperature in the corresponding half of the 

 face, and especially in the ear. Its ii-ritation, on the contrary, jiroduces 

 contraction of the vessels, diminution of the quantity of the blood and of 

 temperature in the same soft parts. If, therefore, Eemak obtains by gal- 

 vanism a dilatation of the intra-cephalic and intra-spinal bloodvessels, as he 

 in various places declares, tliis action must be considered evidence of a 

 paralysing, not of an exciting, influence of the current.^ Such a paralysing. 



^ [Upon this point, compare Duchenne upon the active dilatation of vessels, 

 p. 161, et seq.—H. T.] 



