words, upon terminal nerve filaments which are alone the seat of pain in this annoying disease. Every inch of skin covering painful parts should be carefully gone over with the current, exercising a steady, slight pressure, for about a half hour, and applications repeated twice daily until the case is well.

It is unusual for a violent attack to persist more than two days with this

treatment.

In hemorrhoids and rectal ulcers, I have of late been most fortunate with a low pressure negative galvanic current. An electrode of carbon, sufficiently large to distend the pouch moderately, is easily introduced, and a long sitting, 45 minutes, given with 20 m. a. of current. Sensation is one of gentle warmth and great comfort, and inspection of the parts afterwards shows mucous membrane comparatively pale and well contracted.

The ulcers rapidly heal, one case when there were two of a centimeter diameter each, disappearing after four sittings.

reversals at intervals of ten seconds. Each will be followed by a contractile wave in the course of the common duct and duodenum, and results are prompt. In two cases,no second application was needed, and in one, the patient passed some twenty stones of small size, at the next following stool.

I cannot find any current controller that is equal to the Massey graphite disc, as made by Flemming of Philadelphia, and I have tried many. It is free from the many objections that water rheostats are open to, and is absolutely efficient. The same praise may be awarded to Flemming's ammeter. It is the only meter I have found that is constant in its readings, and any two or three of these give similar results, whereas in Gaiffe's or Waite & Bartlett's, I have been unable to find accuracy.

Flemming is now making for me a set of resistance coils, measuring from 10 to 50,000 ohms, with which I shall make a series of tests as to the value of resistances in electro therapeutics, a point which I think has so far been overlooked. Readers of the

In impacted gall stones, when not so large as to be immovably fast in the duct, I find that sudden deep reversals of a strong galvanic current, say of 100 volts m. a. frequently dislodge them and clear the passage. Two electrodes of equal size are used, buttons of carbon an inch in diameter, thickly covered with absorbent cotton wetted with salt water. One is worked carefully and slowly down under the edge of the right lobe of the liver, aiming to reach the gall bladder as nearly as possible, and the other sunk as deeply into the left hypochondrium as possible without causing pain. When both are in position, one may be held by the patient or an assistant, swing the current on instantly, and make a dozen

may expect a full report in due time. A French confrere, Dr. Fontaine Atgier, has invented a new machine. for electro-therapeutics, which he calls the Voltagramme, and whose current he styles "oscillatory." He claims that, by using a double coil and special commutator, he collects from a faradic vibrator the current of opening only, thus making from a coil a close approach to the continous current from a cell. "If," says the doctor in L'Electro-Therapie, "the

current from a cell or cells be expressed by a straight line, that from the Volta-gramme may be indicated by a sinuous one, leaving a tendency to become straight." It may be measured by a galvanometer, and has a special influence upon striped muscles.

I shall be glad to give further notes of the new machine as they come along.

And, concluding, I beg to suggest to my readers the propriety of devoting more time to the study of electrophysics and practice of electro-therapy. The glittering successes obtained in electro surgery have no right to be continually quoted and the more modest and tenfold more numerous successes in medical cases ignored, merely because the former must be confined to the hands of a few experts, while the latter are accessible to every doctor who cares to learn to use electricity with ordinary intelligence. It is sick men who are to be cured, not specialists who are to be exploited.

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tunity to contribute to the increase of our knowledge of these subjects lies close to the hand of every general practitioner.

Recent studies of the etiology of disease have been chiefly directed toward discovering the pathogenetic relations of bacteria. That morbific micro-organisms have any special function in determining an attack of neuralgia has never been clearly demonstrated. It need not, therefore, excite surprise that there has been no very great progress, of late, in learning the causes of neuralgia. To one unacquainted with the inexactitude of medical science, it might perhaps seem probable that a knowledge of the causes of a disease would furnish a most valuable clue to the remedies which might be expected to promote a cure. But it must be confessed with regret that our present knowl

RALGIA.

BY GUSTAVUS ELIOT, A. M., M. D., NEW HAVEN, CONN.

THE

HE frequency with which neuralgic affections are observed in general practice entitles them to the most careful consideration. Few diseases, which involve so little danger to life, cause so much suffering and incapacitate one to so great a degree for the performance of accustomed duties. No anatomical structure has a wider distribution than the nerves. Wherever there are nerves, neuralgia may occur, and consequently no disease presents greater variety in the situations in which it is seen.

Nor is the opportunity for the advancement of our knowledge in this field a small one. The causes which produce, and the pathological changes which underlie, the important subjective symptoms, as well as the remedies which should be prescribed to effect a cure, are all in a state of humiliating uncertainty. The oppor

the most part exceedingly indefinite. For the last twenty-five years it has been the fashion to attribute the majority of the cases of neuralgia to the influence of malarial poison, and this delusion has been strengthened in the minds of that vast army of doctors who rarely think for themselves, by the relief which the victims of neuralgia frequently obtain from the use of quinine. This class of practitioners usually overlook the fact that there is a normal periodicity of nervous phenomena, whether physiological or pathological. They also neglect to consider that quinine has a wide range of usefulness outside of affections of unmistakeably malarial origin. Unquestionably malarial poison is in some localities, and at some seasons a prolific cause of certain forms of neuralgia. A distinguished Philadelphia professor (I think that it was Dr. H. C. Wood) is reported to have stated that ninetenths of the cases of supra-orbital neuralgia are of malarial origin. I