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THE STRONG GALVANIC CURRENT IN THE
TREATMENT OF SCIATICA.
THE RESULTS IN THIRTY-TWO CASES.
By V. P. GIBNEY, A.M., M.D.,
Of thirty-two cases of sciatica treated by the strong galvanic current in the out-door department of the IIospital for the Ruptured and Crippled, it is my pleasure to present the following analysis :
Twenty-four were relieved of pain immediately after the first application, three were partially relieved, and five obtained little or no relief. The relief thus immediately obtained was temporary; the paroxysms, as a rule, returning within twelve hours, yet with less severity and shorter duration. In many instances the applications were repeated daily, and the paroxysms were soon broken up. To illustrate the speediness and permanency of cure in recently acute cases, the following furnishes an admirable example:
Case XX.—Mrs. M., æt. 50, applied for relief April 8, 1879. She had been suffering most acutely for three days with pain in the distribution of the sciatic nerve right side, and was unable to assign any cause for the attack. It was with great difficulty that she could walk at all, as the pain was aggravated by movement of the limb. If she attempted to stoop, a paroxysm Was excited. The patient was well developed, and seemed to be in a fair condition of health. Treatment was not begun until the day following, the 9th, and then as strong a current as she could endure was employed for five minutes. There was imme
' The first fifteen of the thirty-two cases are reported in detail in a paper read by the author, before the New York Academy of Medicine, February 6, 1879, and published in the American Practitioner, March and April, 1879.
diate and complete relief from the pain. She had four more applications on successive days, and never had any more pain after the third.
March 30, 1880.—Calls to-day, having just returned from San Francisco, Cal., to report her cure, and to express her gratitude to the hospital in a substantial manner. She states that she left New York very soon after the date of the last application of the current, in April, 1879; that she has been actively engaged during the year standing and walking all the day, and never in all this interval has she experienced the slightest twinge of pain or any lameness whatever. The relief was permanent, and now no evidences of sciatica can be found.
Other cases I could easily present wherein the relief has been quite as marked, yet the above will suffice to show how valuable an agent we have in the strong current if employed early in neuralgia.
Only twenty of the whole number were uncomplicated, and sixteen of this twenty were permanently relieved; in fact, were completely cured, while three could not be found. The presumption is, however, that these three were cured, inasmuch as there was no pain at the date of last application, and inasmuch as they have failed to return. One did not get permanent relief. I have made very diligent efforts to trace out the cases at long periods after treatment has been suspended. The efforts have been in a measure successful. Nine cases were found wherein from twelve to eighteen months bad elapsed between the suspension of treatment and the last examination; five with an interval of from ten to twelve months; two with eight to ten months interval, etc. The shortest interval was six weeks. Eight could not be found. These include the complicated and uncomplicated cases. Sixteen of those traced have had no relapse, and can with safety be pronounced permanently cured; four had no permanent relief; while seven had slight relapses, but of a very mild type, and insufficient to prevent them from work. We might speak of such cases as very much relieved but not absolutely cured. In five I could not hear whether any relapse had occurred. Let it be understood, now, that I have just been analyzing all classes of cases. It will be seen that the twenty uncomplicated cases were nearly all relieved.
The complications with which we had to deal were rheumatism, varicose veins, periarthritis, arthritis, malarial poisoning,
fracture of the neck of the femur with neuralgia of the obturator. Many of these cases were relieved of the pain by means of the galvanic current, and other remedies were employed to meet the special indications.
Before proceeding further with my analysis, a few cases by way of illustration may not be uninteresting.
CASE XXV. Mrs. X., æt. 31, was referred to me by Dr. Knight for the galvanic current October 30, 1879. The patient was a vigorous looking woman, the mother of a large family, and living in the interior of the State. She had been suffering for more than a year with pain throughout the right limb distinctly referred to the course of the sciatic nerve. At first there were remissions, but the pain after awhile became constant, and to this were added paroxysms violent in character. Two months ago she had a severe exacerbation of the neuralgia, the paroxysms being almost continuous, so frequent were they. This exacerbation lasted a week, and confined her to the bed.
Any movements about the room which jarred the bed caused the most intense suffering. This attack completely unnerved the poor woman, so to speak, and rendered her quite helpless. It is only a week or two now that she has been able to walk at all. The patient has been confined to the bed most of the time for a year, has been carried up and down stairs, and has been able to walk only short distances without pain. Her nights have been restless, and even when the pain was insignificant she would lie awake, unable to procure sleep.
On examination, the limb had a mottled appearance, the skin was cold to one's hand, and she complained herself of coldness of the limb, though at times warm and tingling, and at other times numb. Pressure over the sciatic nerve near its exit from the foramen was painful, and the sensations were distinctly referred to the terminal branches.
I adninistered this morning (Oct. 30) a current of twenty-seven cells, Leclanché, applying the positive pole over the trunk of the nerve as best I can, and the negative over the seat of greatest pain, viz., the popliteal space. The application lasts ten minutes, neither pole being moved the while, and there is very little pain experieuced, although a lively erythema soon appears around the negative electrode. She expresses herself as feeling greatly relieved immediately afterwards, and is certainly more supple.
Nov. 1st. She reports that the limb felt quite warm nearly all day yesterday; that she had very little pain, and that she could walk more easily than before. Current eleven minutes long this morning, and while the erythema is produced as on yesterday, she does not complain of the intensity.
3d. Yesterday (Sunday) no application was made. The report this morning is that she felt better on Saturday than she has for a year; could walk without fatigue a longer distance; the limb was warm and felt like the other one. Gets now twenty-seven cells (thirty heretofore) for only four minutes, she not being able to bear it longer. The limb last week was anæsthetic; now it is the reverse.
5th. Yesterday being a legal holiday, the office was not open ; yet she did not have any pain. Slept well on the night of the 3d, but last night (the 4th) she did not sleep, although free froni pain. A ten-minutes seance this morning, superficial vesication being produced under the negative electrode. The current caused considerable “burning” throughout the entire limb.
6th. Slept well all of last night; had no pain, and to-day the limb feels quite warm. With great difficulty tolerates twentyseven cells ten minutes this morning.
7th. Ilad a good night's rest, although she experienced a little pain around an eschar which has been produced in the popliteal space by the negative electrode. She reports, too, that she felt weak after the seance of yesterday. The electrode from the positive pole is now placed over the lumbar spine, and that from the negative over the nerve at its exit from the pelvis. Twentyseven cells are simply intolerable, and twenty-one cause her frequently to wince during the application. There is intense erythema around each electrode, but no eschar or vesication. She expresses great relief immediately afterwards, and has none of the weakness she experienced on yesterday.
8th. The patient continues to improve, and is so much encouraged that we permit her to return home in the country, and instruct her to report on the 10th or the 17th if practicable.
17th. Calls to-day and says that she has been free from pain since the 8th; has rested well nearly every night, and that she drove yesterday a distance of eighteen miles and had no pain of any kind. This she regarded as a crucial test, as it is something she has not been able to do for a long, long time. She reports additionally that her hip and limb feel quite vatural, that the