VALUE OF GALVANIC CURRENTS IN MEDICINE. 229 



8. The excitability for tlie coutiniioiTS current is not always simultaneously 

 equally increased in all branches of the paralysed nerves. In the less excitable 

 muscles and nerves the excitability increases, and then diminishes, later than 

 in those that were more excitable at the first. — (Ziemssen.) 



4. The contractions of the paralysed muscles, occasioned by battery 

 currents, do not occur with the same precision as in healthy muscles, but 

 appear somewhat drawn out. — (Bruckner, Ziemssen.) 



5. The contractions are iDroduced in many cases only by direct excitation of 

 the muscles; and not by excitation of the corresponding motor nerves. — 

 ( Neumann, Ziemssen'). 



(h.) With the return of motility. 



6. The excitability by the continuous current is gradually lost with the 

 return of voluntary movement; and the excitability by induced currents 

 gradually returns at the same time. — (Schuh, Zicmss' n.) 



7. The excitability by the continuous current is gradually lost with the 

 return of motility; but, in spite of the comi^lete restoration of motility, 

 the excitalnlity by the induced current does not return. The excitability 

 for both currents, first after the lapse of months or years, returns gradually 

 and uniformly to its normal standard. — {Ziemssen.) 



8. The excitability by the indiiced current does certainly return, but 

 remains less than in the homologous muscles of the healthy side, and is only 

 manifest on direct muscular excitation. The continuous current permanently 

 prodiices stronger contractions in the jiaralyscd than in the homologous 

 healthy muscles, but also only by direct excitation. — (Neumann.) 



9. The excitability by the continuous current remains undiminished ; but 

 the excitability by the induced current (for the present at least) does not 

 return. — (Eulenhurg, Ziemssen.) 



V. From a theraiaeutic poiut of view, in peripheral paralysis (supposing it 

 to be curable), that current is the most xiseful to which the muscles i^reserve 

 their excitability. Those paralyses, therefore, in which faradic contractility 

 is wholly or in part retained, shoiild be treated by induced currents ; and 

 those by galvanic currents in which the faradic contractility is lost, but the 

 galvanic contractiUty retained. 



In a further examination of the physical and physiological questions arising 

 out of the phenomena described, Ziemssen thinks (1), in accordance with 

 Neumann, that the physical difference between the action of continuous and 

 induced currents may be expressed as follows: — raraJysed nerves and muscles 

 lose, under certain circumstanct s, their excitability hy electric currents of mornen- 

 tary duration, even when these are applied in rapid succession and of great 

 strength. On the other hand, they retai?i their excitahility, and it may even he 

 increased above the normal for currents of longer duration, even ivhen the latter 

 possess very little intensity. (2.) Further, he concludes that in peripheral 

 paralysis, the disturbance of nutrition in the affected nerves atfords the most 

 important impulse for the genesis of the consecutive changes of excitability to 

 the electric currents ; and from the cases cited he thinks there is a clinical 

 basis, especially from the testing with electric currents, to distinguish several 

 degrees of lesion. 



First (Slightest) Degree. — MotiUty diminished or susi^ended. Excitability 

 for intermittent and constant currents normal. Inconsiderable disturbance 

 of nutrition, followed by speedy return of motility. The same phenomena 

 are present during the first week after severe injuries, so long as degeneration 

 has not yet occurred. 



Second Degree. — Motility suspended, faradic and galvanic contractihty 

 diminished. Shght disturbance of nutrition, early return of motility, and 

 improvement of the electro-muscular contractility under the employment 

 of the induced current. 



Third Degree. — Motility suspended. Excitability for the induced currit'Ut 

 lost, for the continuous current retained both by nerve and muscle. Severe 



