the body and
limbs; the numbness of the feet, often described as a feeling "like
walking with a pillow under the foot," still further incommodes his
walking.[30] The bladder control may be so enfeebled as to require
daily catheterization, and the bowels move only with enemas or
purgatives, and often without the patient's knowledge, owing to the
anaesthesia which affects the rectum and its vicinity.

One of the first things to attend to when patients are in this stage is
the bladder, as the retention is the only condition likely to produce
serious disorder. Cystitis is or may be present, and with the retention
is a constant threat to the kidneys. Catheterization and washing out
with an antiseptic must be regularly practised while treatment is used
to improve the condition.

For these patients rest in bed is a prime necessity in order to remove
all excuse for exertion. The method of application of massage has
already been suggested. Care must be taken that the patient eats well
and of the best food. Except for occasional gastric or intestinal crises
of pain, sometimes with vomiting, sometimes with diarrhoea, the
digestive functions are usually well performed, unless the stomach has
been greatly upset by over-use of iodide. The most liberal feeding
consistent with good digestion 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 r