324 DISEASES OF THE PERIPHERAL NERVES. 



They not only consist in a lively erythema, a decided swelling of the 

 skin, and an increase of the subjacent tissue, but papules and blebs 

 arise on the skin, particularly at the positive pole ; if the action con- 

 tinues long, the surface of the elevations sloughs off. These changes 

 take place not only at the point of application, but occur equally or at 

 least similarly in the deeper parts, as is shown not only by the increase 

 in volume of the subcutaneous tissue and muscles, but also by the fol- 

 lowing experiments (JErU)^ which show a great deal about the mode 

 of action of the constant current in neuralgia and other neuroses, as 

 well as in some diseases of the muscles, joints, etc. If we cross the 

 forearms, placing the volar surfaces in contact, and apply the electrodes 

 to their dorsal surfaces, there will be reddening not only of the parts 

 to which the electrodes are applied, but of the corresponding points 

 on the anterior surfaces. Generally, relief immediately follows the ap- 

 plication of the constant current just as it does that of the induced 

 current ; but occasionally the pain is at first increased, and that should 

 not always induce us to stop the treatment. There seems to me no 

 doubt that the curative action of the constant current, in most cases 

 of neuralgia, is to be explained by the modification of the circulation, 

 endosmosis or change of tissue in the diseased nerve, its neurilemma, 

 or the parts around; this "catalytic action" may result from the 

 chemical disintegration induced through the nerves, or the attraction 

 of the constituents of the nutrient fluids toward the pole, or it may 

 occur in some other way. The swelling of the skin, and the eruption 

 of nodules and blebs on it after the application of the constant current, 

 do not prove its action on the vasomotor nerves any more than the 

 redness of the skin after a mustard plaster shows a similar action in oil 

 of mustard. I consider it perfectly unjustifiable, in most of the recent 

 writers on electrotherapeutics, to make a distinction between the effect 

 of the constant current in neuralgia, paralysis, etc., and its effect in dis- 

 turbances of nutrition. In most cases of neuralgia or other nervous 

 diseases, just as in the affections of the muscles, joints, etc., where 

 galvanism has proved useful, there is no molecular change or any alter- 

 ation in the electrical state of the nerves, but, as Remak distinctly 

 asserts, there are disturbances of nutrition, anomalies of circulation 

 and structure, exudations, etc. For the sake of the good cause, I can- 

 not help regretting the numerous attempts that have been made to 

 explain the benefits from the constant current in disease of the nerves 

 and muscles, by referring to the laws concerning the contractions at 

 the opening and closing of the current, concerning anelectrotonus and 

 catalectrotonus, or concerning the results of irritation and division of 

 the sympathetic, instead of resting solely on the evident results of clin- 

 ical observation. These very imperfect doctrines, which are founded 



