1879J American Nervousness. 605 
reflex character coming from the stomach, or some part of 
the genital apparatus, or, if they are not reflex in their 
origin, are at least made worse by a reflex irritation. To 
know this fadf, and to adt upon it in the treatment of these 
cases, is indispensable for success. One may treat sweating 
hands and flushing face and various neuralgias and headache 
indifferently without any permanent effedt, until we attack 
and destroy the cause ; (4) those in whom the nervous 
diathesis predominates are likely to have functional nervous 
disease. 
In regard to the prognosis in cases, of this kind, this 
general statement is sustained by experience, viz. : All of 
these cases can be relieved; many of them can be absolutely 
or approximately cured ; but in all cases time and patience 
are necessary to bring about these results. I have watched 
these cases for years after they have left off treatment, and 
I keep up correspondence with patients who have been under 
my care, and thus have an opportunity to know what the 
issue is. Patients of this kind live to a good old age — may 
attain even unusual longevity, and may have their best health 
during the latter part of their lives. In regard to the details 
of treatment, I will state but a few fadts. 
First comes electricity in its various modes of application — 
central, general, and local. In the dosage, we are, in recent 
years, learning these four fadts : 1. That it is sometimes best 
to use it in exceedingly small doses, mild currents and short 
applications. 2. That it is sometimes well to use a very 
strong and painful current. 3. That applications may be 
protracted for hours in succession. 4. That applications may 
be made much more frequently than is the general custom. 
These four propositions apply to nearly all our remedies. 
In truth, we are widening and deepening the system and 
range of our therapeutic forces by modifications of the 
quantity and quality and mode of administration. I have 
long taught that for spasmodic difficulties, like local sprains 
of muscles, convulsive tic, facial spasms, &c., very mild 
galvanic currents are preferable ; but I have lately seen a 
case where very powerful and painful faradic currents, 
applied with the eledlric brush, or with the sponge, or both, 
and with as strong currents as could be borne, were more 
efficacious than the mild currents. Likewise in sciatica, 
and even other forms of neuralgia, painful currents that 
make a blister, or are at least very irritating to the skin, 
may succeed after mild applications have failed. An eledtro- 
puncture diredtly into the nerve itself will cure when the 
mild currents are powerless. 
