The fact that such profound motor and sensory effects can be produced without the ordinary shocking, prickling, and other sensations, is a grateful surprise to the patient, and certainly enhances its value as a therapeutic means.

I have found no electrical application so valuable as a means of relieving a hyperesthetic condition of the abdominal sympathetic ganglia, especially the semilunary ganglia, the lumbar ganglia, and the lumbo-aortic plexus of the sympathetic.

It is equally efficacious in relieving pains beneath the shoulder blade and in the back, which are often erroneously attributed by patients to a diseased liver, but which are due, in a great majority of cases, to a congested and irritated condition of the abdominal sympathetic ganglia.

A rapidly alternating sinusoidal current is one of the most efficacious means with which I am acquainted for the relief of the peculiar sensation known as "heaviness," of which dyspeptic patients often complain. This sensation is due to a perverted condition of the sensory nerves of the stomach. Its relief by a rapidly interrupted current is an evidence of the penetrating power of this current.

The rapidly interrupted current may be applied to the stomach either externally by means of a flat sponge electrode, one over the stomach and the other over the spine opposite, or internally by means of a properly formed electrode placed inside a stomach tube, with a flat sponge electrode either over the stomach or the spine opposite the stomach. I have applied the sinusoidal current in this månner in a large number of cases for the relief of stomach symptoms, especially in cases in which examination of the stomach fluid by the method of quantitative analysis, which I have elsewhere described, showed deficiency in that form of stomach work which consists in the combination of free chlorine with albumen, as shown by the diminished amount of the combined albumen. (To be continued.)

THE EFFECTS OF CONDIMENTS UPON STOMACH DIGESTION.

AT the present time a series of very interesting experiments is being conducted in the laboratory, the purpose of which

is to determine the effects of condiments

upon peptic digestion. Five healthy young men whose stomach formulæ have been determined by means of the standdard test breakfast, have been made to take in various quantities, with the test breakfast, black pepper, red pepper, pepper sauce, mustard, and other like substances, and the results upon the chemical processes of the stomach have been carefully noted. A very constant and characteristic effect has been observed in the increase of a certain element of the stomach work, but a notable decrease in another direction. The diminution of stomach work, as will be shown in a more detailed account of these experiments which will be given in a future number, is in the useful work of the stomach, by which the chlorine is made to combine with the albumen; in other words, although condiments of various sorts have the effect to increase the amount of free hydrochloric acid in the gastric juice, and the amount of chlorine liberated from the fixed chlorides, the amount of chlorine which enters into

the useful stomach work of digestion is notably diminished.

This method of investigating the effects of various substances upon digestion is one which affords an opportunity for the most useful and extended studies in practical dietetics. A large number of observations of various sorts have already been made in the laboratory, and we hope to be able to give at an early date an extended account of the important data collected, some of which are exceedingly interesting from a practical standpoint as well as from scientific and theoretical considerations.

AMERICAN ELECTRO-THERAPEUTIC

ASSOCIATION.

AT the annual meeting of the American Electro-Therapeutic Association, held in New York City last fall, committees were appointed to make a study of the adoption to medical uses of various electrical appliances, as follows:

COMMITTEE ON STANDARD COIL.

Dr. W. J. Morton, 19 East 28th St., New York. Dr. A. H. Goelet, 351 West 57th St., New York. Dr. Wm. F. Hutchinson, Providence, R. I. Dr. G. Betton Massey, 212 South 15th St., Philadelphia.

Dr. A. E. Kennelly, Chief Electrician Edison Laboratory, Orange, N. J.

COMMITTEE ON STANDARD METERS.

Dr. Margaret A. Cleaves, 68 Madison Ave., New York.

Dr. H. E. Hayd, 78 Niagara St., Buffalo, N. Y. Dr. Wellington Adams, 2741 Olive St., St. Louis, Mo.

Dr. W. F. Robinson, 214 State St., Albany, New York.

COMMITTEE ON STANDARD ELECTRO-STATIC OR

INFLUENCE MACHINES.

Dr. W. J. Morton, 19 East 28th St., New York. Dr. J. H. Kellogg, Battle Creek, Mich. Dr. G. Betton Massey, 212 South 15th St., Philadelphia.

Dr. Margaret A. Cleaves, 68 Madison Ave., New York.

COMMITTEE ON CONSTANT-CURRENT GENERATORS AND CONTROLLERS.

Dr. W. J. Herdman, 48 East Huron St., Ann Arbor, Mich., Rheostats and Dynamo Current Controllers.

Dr. Robert Newman, 68 West 36th St., New York, Primary Stationary Batteries.

Dr. Frederick Peterson, 201 West 54th St., N. Y. Secondary Batteries and Primary Portable Batteries.

COMMITTEE ON STANDARD ELECTRODES.

Dr. A. Lapthorn Smith, 248 Bishop St., Montreal, Canada.

Dr. R. J. Nunn, 119 York St., Savannah, Ga. Dr. Charles R. Dickson, 263 Victoria St., Toronto, Canada.

These committees are now at work preparing their respective reports, which will be presented at the meeting of the Association to be held at Chicago next September. All manufacturers of electrical appliances for medical use, who are interested in the reports of these committees, should correspond with the members, placing before them the merits of their several appli

ances.

TAXING BICYCLES.-The assessors of the city of Lowell, Mass., and, we are informed, those of the city of Paris also, have determined to place a tax on bicycles. Whether the tax is to be regulated by the price of the bicycle, or whether all bicycles are to be taxed alike, we have not learned; but the bicycles of Lowell and Paris are to be taxed. The result will probably be to limit the use of the bicycle in these localities. From our standpoint there is no more reason why the bicycle should be taxed than a wagon, or a wheelbarrow, or a baby cart. It is not simply a luxury, but a means of obtaining needed exercise, and a convenient vehicle for traveling where roads are sufficiently well made to render the use of the machine possible. bicycle is a labor-saving machine, as much as a mowing machine, a reaper, or a thrasher. Mounted on a bicycle, a man can travel six miles with no greater expenditure of energy than in walking one mile; hence the bicycle is a means by which energy may be saved for us in ways which are more profitable than locomotion. We hope the example of Lowell assessors will not be followed by the tax gatherers of any other city.

The

VOL. II.

ORIGINAL ARTICLES.

REPORT OF THREE CASES OF MULTIPLE NEURITIS.

BY W. H. RILEY, M. D.

Sanitarium, Battle Creek, Mich.

IT has only been during the past few years that the symptoms of the abovenamed disease have been correctly recognized and diagnosticated, even by even by neurologists. The symptoms presented had been for many years classified under the heads of "Alcoholic Paralysis," "General Spinal Paralysis," "Locomotor Ataxia," and others; and at the present time in general practice, multiple neuritis is frequently mistaken for some form of spinal trouble, or a very vague and indefinite idea is entertained as to the real nature of the disease, and the correct methods of its treatment. The following three cases are reported,

1. For the purpose of briefly directing attention to some of the prominent symptoms and the course of the above disease. 2. To illustrate successful methods of treatment.

CASE I.

Mr. A., aged 33 years, an American by birth, a laborer by occupation, came to the Sanitarium for treatment of "paralysis of the upper and lower extremities," and gave the following history:

With the exception of slight ailments, the patient had always enjoyed good health up to the beginning of the present trouble. The disease with which he is now suffering began about ten weeks ago, by persistent vomiting, attended with nausea, which continued at short intervals for twenty-four hours. At this time he had a very sore throat, and was obliged to take his bed for one week, with a temperature of 100° to 101° F. While in bed,

his throat continued sore.

NO. 6.

At the end of

The

one week he was able to be up, but in attempting to walk, noticed a "weakness in the knees." He would tire on the slightest exertion, and walking was an effort. He had a sensation as though the cords and muscles of the legs were getting too short. At times he suffered from a numbness, and burning and aching pains in the feet, which later traveled up the legs. Simultaneously with these symptoms in the feet and legs, 'were similar manifestations of the disease in the upper extremities. There was a numbness and soreness in the fingers and hands. fingers felt thick and clumsy, and a weakness, which showed itself most prominently in performing some delicate movement, such as writing or buttoning the clothing, was present. These symptoms continued and grew worse. The patient became weaker, and tired more easily on the slightest exertion. Walking was difficult, and his movements were all weak, incoordinated, and ataxic. At the end of a month the weakness was so great that he could walk no longer, and was obliged once more to take his bed. The pain continued, and increased in severity. The patient remained helpless in bed for several weeks, part of which time he could not move toes or feet. Finally he came to the Sanitarium for treatment, about ten weeks from the beginning of his trouble, and his condition on entrance is indicated in the report of

EXAMINATION.

The patient is a man of medium stature; height, five feet and seven inches; weight, 125 lbs.; thin in flesh; digestion somewhat impaired, bowels constipated; action of the heart somewhat weak; pulse 100, sitting; temperature normal. Other organs of the body are normal, except as indicated below.

Motor Symptoms. By the aid of support he can barely take a few steps at a

time. In attempting to walk, he broadens his base, staggers in his path, and keeps his eyes closely fixed on his movements. All his movements are weak and slow. He can only flex the ankles and extend the toes to the slightest degree in both feet. The paralysis of the muscles of the front of the leg, allow the foot to drop and the toes to scrape on the floor in an attempt to walk. He partially overcomes this difficulty by increased flexion of the thighs, which raises the foot and frees the toes from the floor.

Paralysis of the small muscles of the foot, especially the interossei, and the extreme weakness of the flexors of the ankles, together with the unopposed action of antagonistic muscles, has developed a deformed shape in the foot, which

Fig. 1. Shape of Foot in Case 1, of Multiple Neuritis. Paralysis of flexors of ankle and interossei muscles of foot, adductor and short flexors of great toe.

is illustrated in Fig. 1. In this figure it will be noticed that the foot is extended at the ankle, the arch of the foot is increased above, and the hollow of the sole of the foot is increased below. The four smaller toes are extended at the first joint, and flexed at the others. The adductor and short flexor of the great toe are also paralyzed, which allows it to take a somewhat different position than the other

they are done with the greatest difficulty. A careful test of the strength of the muscles in the upper and lower extremities with a mercurial dynamometer, shows their weakness even more conspicuously than in the ordinary movements. Such a test develops the fact that the weakness is greater in the muscles below the knee in the lower limbs, and below the elbow in the upper limbs. The symptoms are all most prominent in the extreme distal end of the upper and lower extremities. There is present in the limbs a twitching and jerking of muscular fibers, and sometimes of a bundle of muscular fibers. The knee jerk is absent in both legs. The plantar skin reflex is absent. Cremasteric and abdominal skin reflexes are present. The patient can stand but for a moment with his eyes open; he cannot stand or walk at all with his eyes closed. The electrical reaction of the muscles of the legs is decidedly diminished to both. faradic and galvanic currents.

Sensory Symptoms.-The sensory symptoms are quite as prominent as the motor symptoms. The patient suffers from dull, aching pains in the legs and arms, sometimes has sharp, shooting pains in the legs, resembling somewhat the pain of locomotor ataxia. The muscles of the legs, thighs, and forearms are sore and tender to pressure, and there is tenderness along the course of the affected nerves. He also complains of numbness, "deadness," and burning in the hands and feet.

In standing, or attempting to walk, he cannot tell from any sensation in his feet whether he is on a bare floor or a carpet. Anæsthesia is more or less complete in certain parts of the upper and lower extremities.

The disease has in this case selected certain branches of the nerves distributed to the skin of the extremities, so that by careful examination, areas where there is more or less complete anesthesia can be readily outlined on the limbs. These areas are represented by the shaded parts of Figs. 2 and 3. In the upper extremities in front, branches of the musculocutaneous nerve, which supply the skin on the outer or radial side of the forearm; branches of the median nerve, which are distributed to the palm of the hand, the thumb, and the palmar surface of the first two and one half fingers; and branches of the ulnar nerve, supplying the little finger, and half of the ring