VALUE OF GALVANIC CURKENTS IN MEDICINE. 225 



not only retained, but by comparison with the sound side even heightened. 

 From the tenth week the excitabiUty by the continuous current, in ahnost the 

 whole territory of the facial nerve, markedly diminished, while the distortion 

 of the countenance improved. In the twelfth week the reaction to battery 

 currents wholly ceased, and in the fourteenth week not only was the normal 

 position of the face quite restored, but the mastery of the will over the para- 

 lysed muscles was regained. At the discharge of the patient in the seven- 

 teenth week the facial movements on the left side were almost faultless, 

 while the excitability for either induced or continuous cui-rents was wholly 

 wanting. 



Two years later, with completely normal motihty, the excitability for 

 electric currents was restored, and for both currents in the same proportion. 

 But the excitability displayed on the right (sound side), and the sensibility of 

 the left, were both far below the normal. 



To this case Ziemssen has added another, also affecting the facial nerve, 

 (which he also reports at length), and which was in many resj^ects clearer and 

 more transparent than the first, and is of especial importance with regard to 

 the signiticance of many of the phenomena in question. It was a purely 

 traumatic facial paralysis, produced by a surgical o^Deration, in wliich division 

 of the facial nerve, immediately after its exit from the canal of Falloi)ius, 

 coiild not be avoided. 



The details of this observation were unmistakeable and convincing. The 

 trunk of the facial nerve was certainly completely divided. At the end of the 

 thii'd week after the division, the excitabihty of the motor nerves by the will, 

 by the induced current and by the galvanic current, was lost, and was only 

 retained in a small degree in one branch for the galvanic current. The 

 l^aralysed muscles, on the contrary, had preserved their irritability to the 

 continuous current, and responded to direct galvanizing by a slow contraction 

 which, with a stronger current, passed into tetanus. The entrance con- 

 traction at closure of the circuit was lost, and the slow and continuing 

 contraction, that Wundt and Fick had determined experimentally to be due 

 to the muscular tissue trithout the agency of nerve, was retained. 



M. Meyer found that those cases of facial i^aralysis in which the reaction to 

 the interrupted current, although diminished, was not wholly lost, showed the 

 same diminution of reaction to the constant current also; and that such 

 cases admitted of a favourable prognosis, inasmuch as they usually ended in 

 recovery witliin a few weeks. Cases, on the contrary, in which, eight days 

 after their commencement, no reaction was iDroduced by the intermitting 

 current, but in which a weaker battery current produced active contractions, 

 were of far less favourable prognosis, in so far as their recovery was delayed 

 for months, or remained always imperfect. 



Meyer supposed the seat of the cause of the paralysis in the latter cases to 

 be in the triink of the facial nerve, within the petrous bone, and held that the 

 muscular contractions produced by feeble battery currents were reflex, with 

 the geniculate ganglion for their centre. Meyer sought the basis for this 

 hypothesis in the spasmodic character of the contractions as opposed to their 

 slower character on the healthy side, in the disproportionate measure of the 

 contraction, and lastly in the fact that it is necessary gradually to add more 

 elements in order to obtain a contraction, which allows of the conclusion that 

 the track is free. 



In respect of curative action, Meyer recommends the current which pro- 

 duces contractions with the least intensity as the best : that is, in the slighter 

 cases, the interrupted; in the more severe, the constant. Meyer saw con- 

 tractions cured, not only by the application of the induced, but also by the 

 use of the constant currents ; but they were generally removed surprisingly 

 quickly by the latter, even after they had existed for years. 



Ziemssen next reports an important case of facial paralysis reported by 

 Neumann, and differing in many points from the foregoing. 



HeiT H , 60 years old, contracted a paralysis of the left side of the face from 



exposure to cold, at the end of September, ISGB. It was at first attended by acute 



Q 



