606 LEWELLYS F. BAKKEE 



kathode. The current is strengthened until it reaches about five milli- 

 amperes; there will then result, on interruption and new closure, almost 

 always a ka&odal closure contraction (KCC). The strength of the cur- 

 rent is then diminished until contraction is no longer perceptible, when 

 this limit value is read on the galvanometer and recorded. 



The direction of the current is then changed so that the stimulating 

 electrode becomes the anode, and an initial current with a current-strength 

 of five milliamperes is again employed. If a contraction follow, the 

 examiner observes whether it is a closure contraction (ACC) or an open- 

 ing contraction (AOC). Each of these is then carefully followed until, 

 on diminishing the current, it just disappears, the limit value being 

 recorded in each instance. 



The stimulating electrode is next made again the kathode; a current 

 of five milliamperes in strength is passed through, and the examiner 

 simply observes whether an opening contraction or a tetanus follows, for 

 these two responses to currents of this strength are fairly equivalent signs 

 of marked hyperexcitability. 



All the findings are now recorded in the accompanying scheme (Fig. 

 8) which keeps kathodal closure (KCC), anodal closure (ACC), anodal 

 opening (AOC), and kathodal opening (KOC) beside one another and 

 is subdivided for recording current strengths of from zero to five milli- 

 amperes. Kathodal closure tetanus (KCTe) can be marked in place of 

 kathodal opening contraction (KOC) by making use of an especial 

 sign. 



An example, illustrating the results obtained on galvanic examination 

 of a child that bad been under observation for almost a year and upon 

 whom seventy-four u\sts had been made, is given in the accompanying 

 figure. The interest in this child lay in the fact that in the course of 

 the observation, a tetanoid state appeared, lasted for a certain period, and 

 again completely passed oft', apparently a unique observation as far as 

 the electrical records are concerned. The child showed at first only 

 closure contractions; then anodal opening contraction (AOC) appeared; 

 and, later on, other symptoms of the tetanoid disease became evident, 

 namely, the facial phenomenon and eclamptic attacks. About this time, 

 Thiemich's phenomenon of kathodal opening contraction (KOC) first 

 became observable. Actual tetany contractures and Trousseau's phe- 

 nomenon were, not present. After some weeks there was a rapid decrease 

 in the phenomena of hyperexcitalrility, which died down in serial sequence 

 the reverse of that in which they had appeared. Finally, the anodal 

 opening contraction (AOC) ;dso disappeared, not to reappear. 



Von Pirquet wii:: led through this observation to wonder whether or 

 not the anodal opening contraction (AOC) has also a pathological signif- 

 icance, since it hoth preceded and followed the high grade excitability 

 characterized by the kathodal opening contraction (KOC). Against the 



