wo ways, i.e., first and chiefly, through reflex
influence from the entire periphery; second, by derived currents on the
brain directly. Whatever their mode of action, the results obtained are
of the most gratifying kind. The pitiable condition in which some
patients of this class present themselves, is familiar enough to every
physician; but it appears that the greater the degree of exhaustion and
the more prostrate the various functions, the more striking are the
effects of the baths. The patients seem to live up anew under their
influence. While in many if not most other complaints that come under
electro-balneological treatment, a certain number of baths are requisite
in order to get discernible effects, in the disease under consideration
each bath, except perhaps the first, is followed by more or less
immediate improvement, which, if the treatment is persevered in, remains
permanent.

It is almost unnecessary to say, that in the more advanced cases great
care is requisite in the administration of the baths. By
over-stimulation at first, much harm may be done, and the patient,
instead of getting better, get worse. In such cases very mild currents
should be employed in the beginning. As recuperation advances, stronger
currents may be gradually introduced. The intensity of the currents
should be carefully regulated to keep pace with the gradually increasing
capacity of the various organs to respond to the electric stimulus
without detriment. Both currents may be used from the first. The
galvanic current should precede the faradic, and be employed for not
more than ten minutes. Where irritability is a feature of the case, the
current should be descending; otherwise ascending. This may be followed
by the faradic current, not of sufficient intensity for the first few
baths, however, to cause any but _slight_ muscular contractions. In most
of these cases iron may be advantageously added to the bath. The
duration of the baths should at first not exceed fifteen minutes; in
some cases this even is too long, the patient complaining of being
fatigued perhaps after the lapse of ten minutes. When this is the case,
the bath should be at once terminated. It is in these instances not the
electric current, but the warm water bath, that gives rise to the sense
of fatigue. Later on in the treatment, the duration of the baths may be
from twenty to twenty five minutes, according to indications.

CASE X. _Cerebral Exhaustion._--K. S