and physical training for future work, the son or daughter about to enter business or society, the business man in enforced detention from his active interests, the workman losing his needed wages, the wife or mother on whom the home de pends to all these alike the period of convalescence, of reconstruction, possesses an enormous material importance.

The sequelae of acute and shortlived diseases often prove more tedious and disastrous to the patient than the initial invasion. States of anemia, of deficient innervation, of organic and functional debility, of lessened tissue resistance, are created which unfit the individual for the duties of life, or render undue exertion dangerous; and out of which the slow processes of imperfectlyaided nutrition conduct him with faltering and leaden step. Relapses occur which

renew and prolong anxiety, and when recovery is complete (?) there may or may not be the fullest possible restoration of anatomical integrity and the processes that maintain sound health. I need mention no more than the frequently protracted convalescence from typhoid states, from influenza, from scarlet fever, diphtheria, dysentery to call to the mind of the observant practitioner an endless procession of illustrative cases. So, too, in many chronic cachexias, whether the cause is removed or not, "vitalization of tissue is what these patients need." They need fortifying against toxic attack. For obvious

reasons

the specialist, surgeon and consultant, does not usually concern himself with hygienic and general measures directed to the ultimate removal of the effects of a disease which no longer exists, or of a cause which he has employed his special skill to eliminate. This is the province of the physician, and in a great measure his success in practice will be proportioned to the care with which he finishes up his cases.

It is now my intention to pass over the familiar tonic agents, because we all know them, and to speak of one of great value, but as yet too vaguely appreciated in general practice. It

is one of the curious phases of medicine to-day that it often reserves the aid of electricity till all else has failed, till organic lesions have obliterated nerve cells and nerve fibres, both functionally and structurally, and then demands that electricity, to prove its power, shall in effect "reconstruct an organized animal tissue from its ashes." I shall not debate the question of whether this medicinal agent can create something out of nothing-life out of local death-for only its opponents seem to expect that; but it is my purpose to refer in brief to one of its humbler yet still valuable properties. Says a prominent teacher of therapeutics: "One characteristic and almost invariable effect, due to electric stimulation of the peripheral nerves and their endorgans, is the improved nutrition of the patient. It is a matter of common observation in a clinic where the poor are treated by electricity alone, and in a great variety of methods, local and general, that they make a rapid increase in weight and general health, irrespective of the progress which may ensue in the disease for which they are under treatment." Indeed, the latter may be an incurable one, but we can often treat the patient when we cannot successfully treat the disease, and even in such cases the results may be exceedingly gratifying. Phthisis in its first and second stages is in point.

In a recent paper read before the neurological section of the American Medical Association, Dr. Rockwell emphatically states: "It has always seemed to me that the most important thing in the use of electricity in medicine, the fundamental idea upon which all its therapeutics is based, is its nutritional power. It is this idea which, in connection with Dr. Beard, I enunciated many years ago, and upon which I have based almost everything I have said or written upon the subject since." My own experience of several years devoted especially to the uses of medical electricity has afforded me ample proof of the correctness of the above views; and I may say in passing that I value the services of this agent far more for its utility in a thousand practical

or

every-day cases than for its power to occasionally benefit an advanced stage of some rare and incurable lesion of the central nervous system. In the widening range of currents now offered to the expert in electrotherapeutics there is an opportunity to select our method according to our case. Local applications for specific local purposes are not here referred to by the author, although certain local methods extend their influence into the general nutrition; but of the effects of what is known as general electrification, whether by galvanic, static, sinusoidal faradic currents, I propose to speak particularly. They are all valuable tonics. In convalescence they may be considered alterative, tonic and restorative, capable of doing excellent service unaided by drugs, and more directly in the line of hygienic and climatic influences. If bodies in low states of health are found to be negatively charged, then the positive charge (which is the rule in health) derived from the static machine is in the nature of a change of climate, and in fact is quite often as beneficial. The pre-eminent place in nutritional effects must be allowed to the constant galvanic current when the central nervous system is principally at fault, but when the debility is rather muscular, circulatory or functional, then my preference is for an interrupted current capable of producing a powerful impression on the peripheral nerve filaments and stirring to their depths the trophic centres. The induction apparatus which I designed a year or so ago, and made by the Kidder Manufac turing Company, is excellently adapted, by its ease of adjustment and manipulation, to general faradic treatment. But in September, 1893, I described a new method of administering an interrupted (oscillating) static current, and it is this, method originated by me, which I employ in the large class of cases requiring an energetic re-invigoration of vitality. Administered without the removal of any of the patient's clothing and involving no tedious technique or bathtub apparatus, I nevertheless regard it as an efficient substitute for the d'Arsonval high frequency bath, for

electric baths in general as given in this country, for the Kellogg sinusoidal application, and, for the most part, for general faradization. If direct muscle massage is indicated the static spark is demonstrably one of the most effective methods of producing it, and we have but to add its local influence to the general administration to secure nutritional alterations of a pronounced character. Regarding the muscular contractions produced by the local spark as a gross massage of the tissues it is considered that in the general vibratory administration of a rapidly alternated potential we subject the constituent particles of the tissues to an insensible molecular massage, the benefits of which are apparent in the vaso-motor system; in better circulation, in increased excretion, in better oxidation, better appetite, better digestion, better sleep, more cheerfulness, more vital energy, in short, in an increased functional stimulation and general progressive improvement. This is just what we want in convalescence from acute prostrating diseases; just what we want also in every case of lessened tissue resistance when restorative measures are indicated and are practicable.

Mr. B-, age 30, spare build, nervous temperament, excessive smoker, occupation sedentary, consulted the author December 5, 1893. Had been out of bed but one week since an attack of pneumonia. Presented evidences of great debility. Came espe cially for electrical treatment of his right arm, which was in a state of fatigue paralysis from long-continued excessive use. Apart from his local needs he was submitted to general static treatment. My case book shows that on December 18, after nine sittings, he had gained six pounds in weight and "100 per cent. in sense of well-being" and energy. Under regular treatment by nutritional electrization his convalescence rapidly proceeded, despite his immediate return to his desk employment, until with practically no other exercise than that afforded by the static massage given intercurrently with the general administration he became more athletic than at any previous time. While his muscular

strength and endurance were being developed to a high state it was remarked that his pallor gave place to that color of health which is usually conferred only by outdoor life. In fact, the effect of sunlight vibrations had been simulated by the vibrating electric current, which Tesla declares he will turn into sunlight if he can only make the vibrations fast enough. This complexion effect I have frequently noticed and it is a very remarkable and suggestive one. Mr. B— was under treatment for his arm for three months. His general recovery of vigor was apparently established in half that time. It is unnecessary to follow the details of his improvement, but during the course of the three months I had a number of opportunities to demonstrate the quick corrective influence of vibratory static electrization in temporary functional derangement. An instance or two may be cited: January 6, 1894, Mr. B- called at 5 o'clock P. M., stating that he had been obliged to work all the preceding night, and, as usual, all day. To use his own expression, he felt "bunged up and wanted some static." Fifteen minutes of vibratory potential alternation removed entirely his sense of fatigue and imparted something to the tissues, which (whatever electricity is) had a sustaining effect besides the mere restfulness. On the eighth he reported that he went home, "slept like a top and awoke next day feeling finely." At another time he appeared at my office with acute myalgia from sitting with a draft on his back all day during repairs to the building where he was employed. The usual general elec trization, with counter irritant short sparks to the affected muscles entirely corrected the myalgia and restored his customary sense of wellbeing. Recent lumbagos generally yield to static electricity in from one to three seances.

November 28, 1894, Miss W-, convalescent from intermittent fever and still having recurring chills, was referred to me for quick restoration, if possible. She informed me that she had engaged to deliver an important lecture in about a week, and was ex

ceedingly anxious to get her strength back, so she could do it. She could barely sit up half the day, and her voice tired so easily that to use it for talking to an audience was out of the question. Nevertheless, assured of her co-operating as fully as pos sible in our effort to hasten recovery I began to give her two half-hour nutritional treatments daily-one in the morning and one at the time of usual exacerbation. She was placed in a reclining steamer chair on the static platform and enjoyed perfect rest while being treated. Anti-malarial remedies were also pushed. On several occasions a vigorous spark application seemed to abort a commencing chill. Her vocal cords were also treated with a static induced current. The results were most happy. In twenty-four hours she was making visible progress. My record of December 17 is as follows: "Miss W- has felt entirely recovered for several days; needs no more static. Two treatments daily for a week, with a second week of one treatment per day, restored her quickly from a condition of extreme debility. She was continued upon a course of iron and quinine to prevent relapse. Four months later she reported herself in uninterrupted health.

The profound restfulness and comfort produced by vibratory potential alternation elicits many expressions of satisfaction from patients. Employed conjointly with other indicated therapeutic and hygienic measures in debilitated states I know of no method of electrical treatment preferable to it in many cases. In either acute exhaustion, fatigue from worry and work, brain fag, or more chronic conditions of debility, neurasthenia and anemia it is extremely useful.

Two years ago I reported a case of nearly lifelong chorea in a single lady now 52 years old, and prior to my treatment extremely neurasthenic, anemic, emaciated and weak. She has been under occasional observation since my report, and has held the decided benefit obtained during her two months static treatment. Mr. B-, from whom I recently heard,

also informs me that he has remained in splendid health. So much for the permanency of effects in these

cases.

While at times a patient will be found who does not seem to respond readily to the tonic influence of general electrization, yet this is no more than must be said of other time-tried agents, which will fail us repeatedly. I have found general electrization to be particularly disappointing when the condition known to the laity as biliousness is present, even in so mild a degree as to cause scarcely a noticeable malaise. A torpid liver will defeat a static machine single-handed, as it were; and, until the portal circulation is unloaded and proper means employed to regulate hepatic action, the patient will hardly respond happily to any tonics, either of the materia medica or electrical currents. At least this is my experi ence repeatedly. From a large number of cases of all sorts I will now cite two instances of the power of a vibratory, high potential, high fre quency electrization to correct in a single application an acute exhaustion, and without any of the reaction which may follow alcoholic or drug stimulants.

November 29, 1895. Mrs. D—, aged 45. On the 24th had a severe diarrhea, which lasted three days; since then some diarrhea, total anorexia and great prostration; could scarcely walk from the car to my office, and was assisted by a relative. Prescribed suitable remedies, but also at once gave her fifteen minutes of vibratory positive electrization. It toned up her strength so that she got home easily, and the improvement which began immediately increased steadily throughout the afternoon. As it was several hours before she procured and commenced taking the internal remedies, the restorative action of the electrization could not be attributed to them. I speak of this particular case because she was requested to observe the effect of the static application very carefully and report to me the result.

The following case is also interesting, by way of comparison: Mrs. J-, neurotic, subject to the disturb

in

ances of the menopause, has occasional attacks of what may, for lack of better diagnosis, be termed spinal hyperemia. The pain from occiput to lower dorsal spine becomes tense; movement of the head is unbearable, and she generally spends a day or more in bed. Four years ago when similarly troubled she was treated by labile applications along the spine of a mild, rapidly-interrupted primary induction current, and after a month's treatment had no return of the symptoms until lately. Last week the pain appeared again, and I this time applied a stable galvanic current with an electrode at each terminus of the affected region, and tested both Lowenfeld's advice as to polarity and the reverse. There seemed to be no difference in effect; as is the case in many theoretical reasonings about current direction. More than a half hour was devoted to the seance before the patient was sufficiently comfortable, but relief went on gradually and for several days she was free from the distress. The next time it recurred (which it usually does after fatigue and excitement) I resolved to try the effect of my vibratory method. Sparks and ordinary static applications had previously proven less efficacious than coil cur rents. December 19, Mrs. J— stopped at my office on her way to a she reception, which was very anxious to attend, but her spinal hyperemia had suddenly developed and threatened to prevent her pleasure. She was given twelve minutes of positive potential alternations, with speedier relief than the galvanic had afforded. She hurried away before relief was absolutely complete, but it became so soon after she got into the open air. She attended the reception, and afterward said to me: "Doctor, that static is a marvel; I never had a twinge, but felt finely all the evening."

One of the most gratifying exhibitions of the invigorating properties of this current I ever witnessed was in the case of a patient just out of bed from typhoid fever, and only able to mount the static platform by being partly lifted up to it. After the

third seance he stepped up to the chair unaided and gained strength visibly at each administration for several months.

In infantile marasmus, and in all cases of childhood debility amenable to tonic treatment (and diphtheretic prostration is a typical case in point) the infant can be held in the mother's arms upon the static platform and subjected to general electrization without alarm or conscious sensation of any kind, and without undressing. In this respect this method is unique among electrical applications, and may be employed with inestimable benefit.

In chlorotic condition, amenorrhea and derangements of schoolgirls, especially if a legacy from some earlier illness not yet outgrown, the nutritional value of electricity is of very great importance. It is vastly more useful, I repeat, when freely employed, as it should be in these cases, than when reserved for advanced stages of lateral sclerosis and spastic paraplegia. It is a sovereign tonic in the debility of old age, for the same reason that it serves us in convalescence. If individuals in general, of any age, were "finished up" through complete convalescence to the fullest possible restoration of strength by those whose skill was not found wanting in the acuter stages of disease, there would be less prevailing anemia, less neuralgia, less "nervous prostration," less dysmenorrhea, less headache and less poor eyesight in men and women; less hysterics, less dyspepsia, less disappointment in life, less surrender to the invasion of microbes, less catarrh, less phthisis, less insanity, less crime, less suicide."

I am accordingly an earnest advocate of nutritional remedies during convalescence, and in every depressed state where they are admissible. Not second in value to cod liver oil, the hypophosphites, phosphorus, iron or arsenic, but a useful adjunct to them all will be found the adminis tration of some form of medical electricity.

Another phase of the subject mav be said to relate to the effects upon

the human organism of the poison of grief. Grief and shock, from a medical standpoint, are conditions admirably considered in the following citation from the Medical Record of late date: "Recent medical observations show that the physical results of depressing emotions are similar to those caused by bodily accidents, fatigue, chill, partial starvation, and loss of blood. Birds, moles and dogs, which apparently died in consequence of capture, and from conditions that correspond in human beings to acute nostalgia and 'broken heart,' were examined after death as to the condition of their internal organs, and it was found that the nutrition of the tissues had been interfered with, and the substance proper of various vital organs had undergone the same kind of degeneration as that brought about by phosphorus or the germs of infectious disease. To urge work, study, travel, the vain search for amusements, is both useless and dangerous. For a time the whole organism is overthrown. Readjustment comes slowly. Sorrow, grief and all great misfortunes should be regarded as conditions similar to acute infectious diseases, which they resemble in result and, later, as convalescence from such diseases. Seclusion, rest, sleep, appropriate food, fresh air, sunshine, interests that tax neither mind nor body, these are requirements in this class of illness."

To the writer's therapeutics for this class of cases should be added general electrization. No one informed of its nerve-toning properties and nutritional effects could withhold from these patients a remedy equally indicated with sunshine, diversion and rest. I have had the opportunity of corroborating its effects in tranquillizing overwrought emotions, and in the profound melancholia of sorrow. Also in severe shock, two cases of which I recall very distinctly, and my views of the value of nutritional, sedative-tonic electrization have been confirmed by personal experience in a large number of instances. It is more rational and satisfactory to all concerned to