Speaking still from my own experience, I will state that the cases that
have proven the most amenable to treatment were, _first_, those of
rheumatic origin; _second_, hysterical neuralgiæ, and, _third_, cases
where no assignable cause could be elicited. The most obstinate
varieties were those of a malarial type (even when quinine in large
doses or arsenic were employed in conjunction with galvanism) and those
that depended on some form of chronic inflammation—_neuritis_,
_periostitis_, etc. Of central neuralgiæ, I have had excellent results
in the sympathetic variety and in the pains of posterior spinal
sclerosis, while in the neuralgiæ of cerebral origin (diffuse cerebral
sclerosis, tumors, etc.) I have never met with any appreciable success.
Where, then, we are able accurately to diagnose a case, there cannot be
much doubt as to the appropriateness or not of electrical treatment, and
in cases whose origin is obscure, which may be considered practically
functional and therefore treated more or less empirically, electricity
holds out as much or more hope than any other remedy. Whether
electricity should be employed locally or in the form of baths, must
depend on the features presented by each individual case. In neuralgia
of the fifth pair—excepting those reflex cases where the _point
d’origine_ is to be sought for somewhere in the trunk or extremities,
and those that depend on cerebral hyperæmia or anæmia, where the
equalizing effects of the baths on the circulation are frequently of
great benefit—these are generally useless. Of other neuralgiæ, I have
found the baths less successful in those of the superior than in those
of the inferior spinal nerves. Lumbo-abdominal neuralgia and sciatica
have yielded much more readily than brachial or dorso-intercostal
neuralgia, etc., etc.
The mode of administering the baths in neuralgiæ does not possess enough
of uniformity to render suggestion in this respect of any value. I will
state however that, as a rule, the best results have been obtained from
the descending galvanic current.
In chronic cases the baths should be administered daily, and should not
be discarded as unavailing until at least a dozen have been successively
taken.
CASE XX. _Sciatica._ Mr. R., a middle aged man, mechanic, was
sent by Dr. ARCULARIUS Nov. 9th, 1874. Had post-rheumatic
sciatica of some six weeks’ standing. There were no remarkable
features about the case, which however was sufficiently severe
to disable him from pursuing his avocation. He took his first
bath on the date above-mentioned. Another bath was administered
next day, and three more every alternate day. He was then almost
well. On Nov. 25th he returned, there remaining still some
traces of the affection. Four more baths, the last of which was
administered on Dec. 4th, sufficed to complete the cure.
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