is indicated, for it must be remembered that we are dealing with a disease in which degenerative changes play an important part.  The usefulness of electricity in ataxia has been denied by some authors, while others praise it indiscriminately.  Perhaps a reason for this difference of opinion may be found in its different effects upon individual patients; but I see few in whom I do not find electricity in one or another form helpful.  For pains I order the galvanic current through the affected nerves as strong as the man is able to bear.  If after a few days of this the pains are unchanged, a rapidly interrupted faradic current is tried, and failing to do good with this, I use light cauterization or a series of small blisters to the spine at the point of exit of the painful nerves.  Galvanization of the bladder with an intravesical electrode is sometimes of service to strengthen its capacity for contraction.  Faradism is applied in the form just described, using a wire brush as an electrode to the areas of numbness and anaesthesia.  Lately I have found that this current in a strength which would be very painful to the normal skin will in some instances relieve the feeling of pressure and dull discomfort about the rectum and perineum, and it has been successful when galvanism did no good.  In patients within reach of a static machine, this form may be used for the numbness if the others do not help it.

For the attacks of pain, if general, a prolonged hot bath lasting from ten to twelve minutes, at a temperature of 100 deg.  F. or even more, should be first tried; if this fail, antipyrin, phenacetin, acetanilid, or cannabis indica may be used, or, as a last resort, morphia.  For the local pains hot water is also useful, and in the intervals I order applications of hot water to the tender points, as hot as can be borne, alternating with ice-water, each rapidly applied three or four times.  In severe attacks, and with all due caution to avoid habituation, cocaine injections may be given.  In cases with high arterial tension the daily administration of nitroglycerin in full doses will not only lower the tension but decrease the pains in force and frequency.

For several years past in all patients with the general lowering of nervous force and vitality so common in this disease I have habitually used the testicular elixir of Brown-Sequard.  The ridiculous length to which organic therapeutics have been carried, the extravagant advertising claims, and an absurd expectation of impossible results have combined to make the profession shy of those organic preparations which have not very good evidence in their favor, and for some time I shared in this prejudice against the Brown-Sequard fluid.  A talk with that most distinguished physician and an examination of some of his cases led me to a trial for myself, and I am at present very well convinced that, whether a physiologic basis can reasonably be assumed or not, we have in the fluid a tonic remedy of great power.  While I have used it with good effect in other conditions, it is in ataxia that I have found it of most value.