After subsidence of the acute stage and after all tenderness, redness in skin, pain in parts, etc., have disappeared, systematic massage and the use of fara dic stimulation to the muscles will has ten restoration of functibn in muscles and cutaneous surface.
Static electricity has been successfully used for the cure of neuritis. The spark may be applied directly to the tender points even in the earliest stage. The patient may be connected with the prime conductor of the machine so that lie does not form a part of the circuit, but is sub jected to pow erful electrical surgings that are painless. Under this treatment relief is immediate, cure occurs usually within a short period, and it is not neces sary for the patients to remain absolutely at rest. , W. J. Morton and W. Snow (Med. Record, Apr. 15, '99).
Multiple Neuritis.
Synonyms.—Polyneuritis; dissemi nated neuritis; peripheral neuritis.
Definition.—This disease is a paren chymatous neuritis affecting many pe ripheral nerves at or about the same time.
Varieties. — Numerous varieties and for-ms of multiple -neuritis are recog nized, and of these the more important have received distinguishing names, as is mentioned below. The varieties, as in the case of simple neuritis, arise from differences in nature, causation, severity, and location of the morbid process. The causes of multiple neuritis are: bacterial infection, toxic substances in the blood, anmmia, and dyscrasic states; in short, any state of toxcemia or malnutrition.
During pregnancy, and also after par tnrition, patients sometimes sillier from peripheral neuritis, which cannot be traced to any of the usual pauses. This "puerperal neuritis" has been distin guished from neuritis caused by alcohol, lead, diphtheria, or septic:mina, and was described by Mains as a multiple neu ritis clue to the circulation in the blood of a poison produced by the patient herself during gestation. It is quite dis tinct from "obstetrieal neuritis," whieh is due to injury of nerve-trunks in the pelvis by iin4ruments or by the child's head dining labor, or to pelvic inflam matory conditions following., labor. The symptoms and course of the disease are extreniely like those of alcoholic neuritis. so much so that the diagnosis can only be made by excluding alcohol and ot her possible causes. Turney (St. Thomas's Ifosp. Reports, vol. xxv, '98).
Main causes known to produce multiple neuritis: 1. Toxic eases due to the ac tion of a poison derived from without the body: (a) nictallic—arsenie, lead, mercury, copper. phosphorus, and silver: (b) carbonic. oxide gas, bisillpliide of carbon. and nitro benzol. 2. Toxamlic eases from infecl ion.
this class are included all cases due to the development and action in the organism of some bacterial poisons either of external or of internal origin. 3. The third class of eases of multiple neuritis IS allied 1 o 1 he seemill class, for, while not truly toxaquic lir infeetions, it is a class which Reinak terms ilys• erasic. There are certain diseases the presence of which in the syslent preilis poses 141 nervou_s affections. and
t .• i- now 'mind(' multiple neuritis. S....um f s, in them-elves of bacterial Lim Illus. tuberculosis is surely and ism po-sibly -o. 4. In this elass NN I` to place many cases for which Ati l'a 111.. discovered. These are"idiopathic- eases. but as onr knovdedge of the eall.,CS Of the disease rcases this class diminishes. -W. A.
Nledical News, Jan. 25, too2).
Symptoms and Diagnosis.—The dis: taSe mav come on suddenly and reach (-reatest intensity within a few days kacute bacterial infections), or may show a slow and insidious onset (alcoholic and eaehectic forms). The characteristic and ever-present features of the clinical pict ure are the abnormalities of nerve-reac tion: i.e., alterations in sensory, motor, ntlex and trophic function of the nerves involved. The extraneural symptoms vary with the cause and nature of the initial morbid impulse. In the typical acute "idiopathic" cases and in cases ac companying acute infectious diseases the attack comes on with fever and the other usual features of the onset of an acute infectious malady. A chill may be the xirst indication. Headache and aching in the back and limbs are frequent, as are also loss of appetite, furred tongue, con stipation and other evidences of gastro intestinal disturbance. The real nature of the case may be obscure for the first few days, but within this time the true neuritic symptoms make their appear ance, and all doubt is quickly removed. Pain along the course of the nerves in legs or arms, or both, is noted, with tenderness in the muscles as well as in the nerve-trunk. Perversions of sensa tion now appear, in the form of tingling, forrnication, diminution in tactile sense, or hyperTsthesia or in rare cases anws thesia. In addition to the above-men tioned tenderness on pressure the mus cles in the parts affected become relaxed and flabby; there is weakness or even in severe cases complete paralysis. This muscular weakness begins most fre quently in the legs, extending upward by degrees, reaching the arms, when these become affected, some time after the symptoms in the legs are well established. In many eases typical "wrist-drop" and "foot-drop" are shown. The paralysis may reach the muscles of phonation, deglutition, and respiration, resulting in some degree of impairment of these functions. In severe cases, especially in those of rapid onset, the pneumogas tric nerve may be involved, resulting in marked tachycardia. Trophic dis orders are also of frequent occurrence, such as cedema, glossy skin, and herpetic eruptions in the area affected. The ten don-reflexes are usually diminished or abolished. In all save the milder cases there are changes in the electrical reac tions similar to those of simple neuritis. The muscles lose their faradic excita bility and with the galvanic current show a slow, worm-like contraction, with anodal closing contraction greater than the reaction to cathodal closure.