LOCOMOTOR ATAXY. 309 



merit of the cold-water treatment, which, especially in the form of cold 

 douches to the back, has not come up to the expectations entertained 

 of it at the time it was fashionable, and the water-cure establishments 

 are now rarely patronized by tabes patients, who, for a time, all rushed 

 to them for treatment. In very recent cases only, sweating in moist 

 sloths and a subsequent short bath appear to be beneficial. 



If it be not a favorable time of year to send the patient to Wild- 

 bad, etc., or if these mineral waters do not seem indicated, or if they 

 nave done no good, we should try the administration of nitrate of 

 silver as recommended by Wunderlich. Nitrate of silver has long 

 held the reputation of being one of the most effective nervines ; and it 

 is not at all impossible or improbable that it exercises a modifying 

 influence on the nutrition of the nervous system; it is not these 

 reasons, however, but the fact that reliable observers have found some 

 benefit from the employment of the remedy in tabes dorsualis, that 

 induce me to use it in most cases of the disease. My experience of the 

 efficacy of the remedy, which I have given in a large number of cases, 

 in doses gradually increasing to half a grain daily as advised by 

 Wurtderlich, has not been particularly favorable. It is true that most 

 of my patients at the clinic have praised their state a time after using 

 the remedy, but I suspect that many did so to induce me to keep them 

 longer at the hospital. In other cases, the patients actually seemed 

 to move forward more nimbly; but here also it was possible that 

 either greater confidence or increased attention of the patient, with 

 the view of showing me improvement, had a favorable effect on the 

 attempts to walk. I shall continue for a time to prescribe nitrate of 

 silver to my tabes patients. 



My experience of the constant current of electricity is about the 

 same as it is in regard to nitrate of silver. I have no reason to doubt 

 that Remak, Benedikt, and others, have had some success with the 

 constant current which I consider to be a very active remedy, but thus 

 far I cannot claim any success from its use in tabes, although I have 

 had an excellent apparatus in my clinic these four years, and have 

 treated all my tabes cases with it in the manner advised by Remdk 

 This want of success will not prevent my continuing the use of galvan 

 ism in tabes for a time ; and, instead of letting the current act on the 

 spinal column as hitherto, I shall try the current through the spinal 

 nerves, as advised by Benedikt, not because I attach much importance 

 to the theories and the indications he gives for the treatment of, dif- 

 ferent diseases, with the current through the roots of the spinal nerves 

 (Ruckenmarks-Wurzelstr5men), through the spinal nerves (Rucken- 

 marks-NervenstrOmen), etc., but simply because I have no reason to 

 ioubt what he says on the subject. 



