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tral nor peripheral nerve lesions, but in the variety of nerve disease that in our ignorance we have termed functional. Limited, however, as its value is in the graver forms of structural disease of the central and peripheral nervous sys- tem, it not infrequently acts with extraordinary efficiency Lipitor Mg and gives rise to expectations in succeeding cases that are too often far from being fulfilled. These discrepancies in results open up a field Lipitor Order of in- quiry which in itself might usefully occupy an evening for consideration. Facial paralysis is among the more impor- tant peripheral nervous diseases, and, from an experience in the electrical treatment of a very large number of cases, it has always seemed to me that such treatment very materi- ally hastened the progress toward cure in many of these cases, although in others no especial benefit seemed to be derived. Based perhaps on experience only in unfavorable cases, it has been denied that electricity has any influence over the process of nerve degeneration or recovery. It is interesting, therefore, to consider the questions: 1, Does electricity sensibly hasten recovery in cases of peripheral facial paralysis? 2. .In what class of cases is it especially serviceable ? A case briefly stated, one of many which Buy Lipitor form the ag- gregated text of these remarks, will emphasize ray mean- ing : April 20, 1889.] CORRESPONDENCE. 431 A short time ago I saw a woman suffering from typical facial paralysis of the right side. Seven weeks before, she awoke in the morning only to find her face paralyzed. She immediately went to her physician, who applied the faradaic current, and repeated the application daily, Sundays included, for seven weeks. At the end of that time there was no ira])rovement. He then came with her to my office, when I found no reaction to faradism, but, on the contrary, a greatly increased reaction to galvanism. The uninterrupted galvanic current was substituted for the faradaic, and in a few days a decided improvement was manifest. It required a decreasing strength of galvanism to produce contractions of the facial muscles, and on the sixth day farado-mnscular contractility appeared, and within a month the muscles contracted normally to both currents, and the paralysis had approximately disappeared. Such a case as this not only helps to answer in the af- Lipitor 20mg firmative the first question, Does electricity sensibly hasten recovery in peripheral paralysis? but also gives a clew as to the class of cases that most appreciate the beneficial influ- Order Lipitor Online ence of the current. The faradaic current causes contrac- tions through its action on the intramuscular Order Lipitor nerves, and not on the muscular fiber, while the galvanic acts power- fully on muscular fiber and Lipitor Buy less vigorously on intramuscular nerves. When, therefore, a muscle is deprived of its nerve influence in any way, the faradaic current is powerless to contract it, while galvanism not Lipitor Online only causes contractions, but calls them forth even more vigorously than in health, and this in proportion to the strength of the current and the slowness of the interruptions. In cases similar to the one to which allusion has been made the intramuscular nerves are undoubtedly paralyzed fiom the beginning, but the muscular fiber is intact, and, through checks to inhibi- tion or faulty nutrition, we see a remarkable increase of galvano-muscular contractility. While the cases, according to my observation, that respond most promptly to electrical treatment are those that present this anomalous reversal of muscular contractility to galvanic interrogation, rather than those where there exists an impaired reaction to both cur- rents, we yet find many cases of lost farado-muscular con- ti'actiiity associated with increased Buy Cheap Lipitor galvano-muscular con- tractility that show little tendency to Lipitor Purchase progress rapidly under electrical treatment. Such are the cases that we might naturally suppose to be dependent upon a neuritis within the Falloppian canal. I can not indeed see how electricity can be of much use in cases of facial paralysis caused by a neuritis within the bony canal and the consequent swelling and compression of the nerve fibers; but it is not difficult to understand how it can be of service Lipitor Buy Online if the nerve terminals Purchase Lipitor Online alone, or that por- tion of the nerve external to the Falloppian canal, are Cheap Lipitor mainly affected. Gowers, in his great and Online Lipitor conservative work on nervous Purchase Lipitor diseases, insists that there is no evidence that cold ever paralyzes the intramuscular nerves, and doubts whether inflammation ever affects the nerve after its emergence from the canal. If this is true, then it is ditiScult to account for some of the rapid recoveries that have taken place in cases that were apparently stationary, when subjected to the proper current. While admitting that electricity possesses only a limited ran^e of usefulness in severe lesions of either the central or peripheral nervous system, I think it is one Buy Lipitor Cheap of the most efficient remedies we possess for the relief of the various symptoms associated with these lesions, while Lipitor Cheap for the re- moval of the finer nutritive disturbances Cheap Lipitor Online that underlie many

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