The rise of temperature thus caused is less constant, as well as less marked, than that occasioned by the muscle treatment.  I do not think it necessary to give the tables in full.  They show in the best cases, rises of one-fifth to four-fifths of a degree F., and were taken with the utmost care to exclude all possible causes of error.

The mode of treatment is as follows:  At the close of the muscle-electrization one pole is placed on the nape of the neck and one on a foot for fifteen minutes.  Then the foot pole is shifted to the other foot and left for the same length of time.

The primary current is used, as being less painful, and the interruptions are made as rapid as possible, while the cylinder or control wires are adjusted so as to give a current which is not uncomfortable.

It is desirable to have electricity used by a practised hand, but of late I have found that intelligent nurses may suffice, and this, of course, materially lessens the cost.  In very timid or nervous people, or those who at some time have been severely “shocked” by the application of electricity in the hands of charlatans, it is common to find the patient greatly dreading a return to its use.  In this case, if the battery be started and the poles moved about on the surface as usual, but without any connection being made, one of two things will happen,—­either the patient will naturally find it very mild, and will submit fearlessly to a gentle and increasing treatment, or else her apprehensions will so dominate her as to cause her to complain of the effects as exciting or tiring her, or as spoiling her sleep.  A few words of kindly explanation will suffice to show her how much expectation has to do with the apparent results, and she will be found, if the matter be managed with tact, to have learned a lesson of wide usefulness throughout her treatment.

However, there are occasional, though very rare, cases in which it is impossible to use faradism at all by reason of the insomnia and nervousness which result even after very careful and gentle application of the current.  On the other hand, some patients find the effect of the electric application so soothing as to promote sleep, and will ask to have it repeated or regularly given in the evening.

I have been asked very often if all the means here described be necessary, and I have been criticised by some of the reviewers of my first edition because I had not pointed out the relative needfulness of the various agencies employed.  In fact, I have made very numerous clinical studies of cases, in some of which I used rest, seclusion, and massage, and in others rest, seclusion, and electricity.  It is, of course, difficult, I may say impossible, to state in any numerical manner the reason for my conclusion in favor of the conjoined use of all these means.  If one is to be left out, I have no hesitation in saying that it should be electricity.

CHAPTER VIII.