Goodell and, more recently, Playfair have pointed out the fact that some cases of disease of the uterine appendages such as would ordinarily be considered hopeless, except for surgical treatment, have in their hands recovered to all appearances entirely; and my own list of patients condemned to the removal of the ovaries but recovering and remaining well has now grown to a formidable length.  Playfair observes also that he believes it possible that in even very severe and extensive disease the health of the patient may be sufficiently improved to render operation unnecessary.[14]

In cases of floating kidney some very satisfactory results have been reached by long rest; and although it may be necessary to keep the patient supine for three months or more, the reasonable probability of permanent replacement of the organ is much greater than from operative attempts at fixation, apart from the danger and pain of surgical procedures.  Persons with floating kidney are nearly always thin, often giving a history of rapid loss of weight, have usually various symptoms of gastric and intestinal disturbance, and present therefore subjects in all ways suitable for a fattening and blood-making regime which shall furnish padding to hold the kidney firmly in its normal place.

The treatment of locomotor ataxia and some allied states by this method, with certain modifications, has yielded such good results that I now undertake with reasonable confidence the charge of such patients; and the subject is so important and has as yet influenced so little the futile drugging treatment of these wretched cases that it seems worth while to devote a special chapter to it, although the affections named can scarcely be said to be included under the head of neurasthenic disease.

In the following chapters I shall treat of the means which I have employed, and shall not hesitate to give such minute details as shall enable others to profit by my failures and successes.  In describing the remedies used, and the mode of using them in combination, I shall relate a sufficient number of cases to illustrate both the happier results and the causes of occasional failure.

The treatment I am about to describe consists in seclusion, certain forms of diet, rest in bed, massage (or manipulation), and electricity; and I desire to insist anew on the fact that in most cases it is the combined use of these means that is wanted.  How far they may be modified or used separately in some instances, I shall have occasion to point out as I discuss the various agencies alluded to.

CHAPTER IV.

Seclusion.