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Introduction to Rock & Mountain
Climbing
Introduction to Rock & Mountain
Climbing

Ruth & John Mendenhall

Illustrated by Vivian Mendenhall
STACKPOLE BOOKS
Lanham • Boulder • New York • London
Published by Stackpole Books
An imprint of The Rowman & Littlefield Publishing Group, Inc.
4501 Forbes Boulevard, Suite 200, Lanham, Maryland 20706
www.rowman.com

Unit A, Whitacre Mews, 26-34 Stannary Street, London SE11 4AB

Distributed by NATIONAL BOOK NETWORK

Copyright © 1969 by The Stackpole Company

First Stackpole Books paperback edition 2017

All rights reserved. No part of this book may be reproduced in any form or
by any electronic or mechanical means, including information storage and
retrieval systems, without written permission from the publisher, except by
a reviewer who may quote passages in a review.

British Library Cataloguing in Publication Information Available

Library of Congress Cataloging-in-Publication Data

Standard Book Number 8117-0922-1 (cloth)
LCCN 69-16148

ISBN 978-0-8117-3754-8 (paperback: alk. paper)

ISBN 978-0-8117-6730-9 (electronic)

The paper used in this publication meets the minimum requirements of

American National Standard for Information Sciences—Permanence of
Paper for Printed Library Materials, ANSI/NISO Z39.48-1992.

Printed in the United States of America

Contents

1. The Sport of Mountain Climbing

Non-technical ascents. Rock climbing. Snow and ice.
Mountaineering. Misconceptions. Skills and Safety. Who climbs?

2. Rock Climbing for Beginners

Good and poor ways to start. Where to get instruction. Ground
work. Knots. Use of ropes. Moves on rock. Upper belays.
Climbing signals. Body rappels. First equipment: kletterschuhe,
hammer. pitons, carabiners, keepers, slings, rucksack. Multi-pitch
climbs. Routes. Third on the rope. Cautions and tips.

3. Gaining Experience on Rock

Intermediate climbing. Two- and three-man ropes. The leader’s
responsibilities. Pitons, why and where. Rope handling. Direct
aid. The second man in consecutive climbing. Belaying the
leader. The middle man. How to rappel safely. Sling rappels.
Choosing and caring for equipment: ropes, bolts, nuts, Swami
belts, hard hats, clothing. Where to go rock climbing.

4. Equipment and Techniques for Snow Climbing

Dangers. Equipment: ice axe, boots, crampons, rope, ice pitons.
Clothing. Sun protection. Where to learn. Ice axe techniques.
 Easy slopes. Self-arrests. Continuous and consecutive climbing.
Boot-axe belays. Team protection. Cramponing. Step cutting.
Descending and glissading.

5. Snow, Ice, and Glacier Terrain

Summertime snow and ice on peaks. Complexities. Changing
surfaces. Melt holes and moats. Avalanches, rockfalls, and
cornices. Effects of storms. Glaciers, what and where. Crevasses
and bergschrunds. Safe glacier travel. Crevasse crossings and
falls. Self- and team rescues. Weather problems. Finding the
return route.

6. Preparing for Mountain Ascents: Planning, Approach, and

High Camp
Selecting peak, route, and party. What to take. Objective and
subjective dangers. Mishaps, emergencies, and accidents.
Backpacking and camping equipment: packframe, sleeping bag,
mattress, and shelter. Personal and group gear. Cooking. Stoves
and fires. Food: types, amounts, menus, dehydrated foods,
packaging and protection. Approach to the climb. Establishing
high camp.

7. Climbing and Descending the Peaks

Making up ropes. Timetable. Summit pack. Early departure.
When to stay in camp. Talus. Pace and rests. Roping up. Carrying
the ice axe on rock. Easy but exposed climbing. Route finding.
Loose rock. Miseries. The summit. Turning back before the top.
Descent. Travel in the dark. Bivouacs.

8. Tips on Where to Climb, at Home and Abroad

Climbing classification systems: what are they; why so many?
Yosemite, ARS, and NCCS systems. Regulations on private
property, Indian reservations, and in national parks and
monuments. Canada: terrain; weather; guidebooks; climbing and
border regulations. Mexico: Baja California; the glacier peaks and
how to find them; Popocatepétl, Ixtaccihuatl, Orizaba; health;
 border regulations. Europe: huts; meals and bedding; getting
information; taking, renting, or buying equipment; clubs.

9. Sources of Information for Mountain Climbers

Clubs in colleges and universities. Local outing and climbing
organizations. Guide services and schools. Where to buy
equipment. Catalogues. Books on instruction, emergencies, and
camping. Journals and periodicals. Guidebooks. Maps.
chapter one

The Sport of Mountain Climbing

TO most people mountains are two-dimensional scenery, as pretty
as color pictures and no more real. To a small number of men and women,
however, each peak is a solid, unique, three-dimensional entity. These few
find in the mountains fundamentals that give deep meaning and joy to their
lives beyond and above all ordinary pursuits. They are the ones who climb.
And what is mountain climbing, besides getting to the top of peaks under
your own power? The sport has many facets. Non-technical ascents
resemble uphill hikes, often long and strenuous. They require little more
than energy and good outdoor common sense – including the judgment to
know where the non-technical climbing stops and the technical begins.
Technical climbing means climbing with a rope and other equipment on
terrain that is hazardous without protection. Between the two types there is
some overlap. Hiking and backpacking are involved in the approach to most
technical climbs. Some peaks have both easy and difficult routes to the
summit, or the route itself is a mixture of climbing problems. Non-technical
climbing often provides background skills, knowledge, and inspiration for
learning about technical aspects of the sport.
 Technical climbing is of two kinds. Rock climbing refers to scaling cliffs
with the protection of equipment and special techniques. It is frequently an
exuberant end in itself, but may also be an integral part of major ascents. In
snow, ice, and glacier work, ropes are also used for protection. Some of the
techniques are similar to those used on rock, but most of the equipment is
different. Both rock climbing, and snow and ice climbing, have their
partisans and specialists. Many climbers, especially those of long
experience, have an intense interest and competence in all phases of
mountain climbing. These are the mountaineers.
Roped climbing is a poorly understood sport in the United States, where
people say things to climbers like: “You must be Swiss (or French) – you
are wearing one of those hats (or baggy pants).”
Or, “I could never do that; heights make me want to jump off.”
Or, “But you don’t look like a mountain climber.”
Or, most frequently, “You ought to give up climbing. It is too
dangerous!”
Climbers do not think of themselves as curiosities or uicidal crackpots,
nor of their sport as a sensation. With such a general reaction to climbing, it
is no wonder that its enthusiasts become rather reticent and withdrawn with
outsiders (except perhaps for promoting the sensation theory through
photography).
A swimmer, skier, or ball player does not become really good at his sport
without a bent for it, and long training in muscle skills and techniques. A
climber too finds that a natural flair is helpful – but is indispensable only
for outstanding proficiency. Almost anyone can learn to climb competently
if he is fired with sufficient zeal and desire to put forth the effort. He must
develop skills in specialized, complicated, and sometimes controversial
techniques, through both instruction and long practice. He must become
familiar with equipment, its evolution, and how to use it. He must gain a
detailed knowledge of constantly changing natural conditions. If he seeks
really challenging ascents, he must prepare for extreme physical demands.
He must possess a high degree of determination and willppwer. And he
must be able to judge his own capacities and those of the people he climbs
with.
When all this knowledge, drive, and experience are fused together, the
climber is far safer on potentially dangerous cliffs or glaciers than a careless
hiker is on a trail. It should be reassuring to friends and relatives that this
training has, as its primary aim, safety in climbing. Only a fool really gets
his kicks out of risking his life, and most climbers are not fools.
Well, then, what are they? They seem full of paradoxes. They are
sometimes “loners,” and are certainly individualists who shudder at the
thought of regimentation. However, they readily accept teamwork, and
gather in organized or unorganized groups for companionship. Climbing
requires an unusual amount of physical fitness and stamina; yet many
climbers are students or professional men. The sport demands serious
attention to inherent hazard; yet climbers are humorous and lighthearted.
Some are world-famous in the climbing fraternity for their skills and
accomplishments; others have the capacity or desire to do only moderate
climbs, but may enjoy the sport just as much.
Climbers are not of uniform build, age, or sex. The majority are young
men in their late teens and early twenties, with a background of outdoor
pursuits in which skills adaptable to climbing have been developed. Some
start climbing later in life. Quite a few women and girls climb. Though they
seldom have the strength or desire to be rope leaders, they take their place
as team members with the same joys and obligations as their male
companions. Technical climbing is not a sport for children or for very
young teen-agers. They have neither the sustained interest nor the
endurance necessary, and cannot take a responsible place on a rope until
they reach fuller physical development and possess mature good judgment.
A climber’s role in his sport does not remain static. An enthusiastic and
talented beginner learns rapidly. Many climb fanatically for a few years and
then quit. Others find climbing such an absorbing way of life that they
pursue it for as long as physical capacities and time permit; experience, and
often endurance, increase with the years. A snow and ice climber may add
rock climbing to his repertoire, and a rock specialist may decide his forte is
mountaineering.
People seldom climb half-heartedly. Most are simply unaware of the
sport; some are intellectually intrigued but have no intention of becoming
involved; others are horrified. But a few are wild about it. Why do they like
to climb? Mountain climbing is a varied and challenging sport with great
esthetic and physical appeal. Each climb is an adventure of such a highly
personal nature that if you need to ask “Why?”, you will never get an
answer you fully understand. Climbers seldom try to explain their
motivation to non-climbers, though they speculate and philosophize among
themselves.
To each potential climber, the sport is an exciting new world. If it catches
your interest, you have an inkling of why. If you want to know how, learn –
but learn safely.
chapter two

Rock Climbing For Beginners

A POOR but not uncommon way to start rock climbing is to go
off with an equally inexperienced friend and an old rope, and try to work
out protective techniques on your own. The best way is to climb with
experienced, competent companions who have the advantage of several
years’ accumulated knowledge in modern techniques. Get instruction on the
cliffs from those who know how.

Who Teaches Rock Climbing?

The first problem is to find knowledgeable companions who are willing to
help you through the early stages of gaining experience. They may turn up
by lucky chance; more likely, you will have to go out and hunt for them.
You can hang around groups of climbers in popular climbing areas, ask
questions and exude interest and admiration until information and
assistance are offered. Climbers are easily identified by their clanking
equipment, coils of rope, and specialized footgear – not to mention their
rock-worn garb and air of physical fitness. Professional guides and climbing
schools are available in several major climbing areas (for a price, of
course). Some colleges Offer climbing and mountaineering courses. Or you
can look up a climbing club in your school or geographical area. Some
specialize in climbing only; some are sections of general outdoor clubs.
Each group has its own regulations and methods. All offer opportunities for
beginners to learn. Equally important, the members are available later as
companions on the many and varied climbs that go into making a skilled
climber. Much can be learned from books, but reading is no substitute for
actual climbing.

Ground Work
If determined, you will find yourself among climbers willing and able to
teach you. Your mentor may happen to be the type to take you at once on a
long climb, where by necessity you quickly find out something about
everything. It is more probable that you will spend hours on or near the
ground, learning the basic techniquas of safe climbing.
As an utter novice, you need not worry about providing equipment. Vear
old clothes adequate for the weather, and rubber-soled shoes. The group or
individual instructing provides the ropes. Though learners are expected to
use the ropes, the owners are fussy about their lifelines, which must be
treated with tender loving care: never stepped on, nor pulled needlessly in
the dirt, nor dragged over sharp edges.

Knots
The protective use of the rope naturally involves tying yourself onto it.
Knots used by climbers must be bombproof, foolproof, correctly and
quickly tied, and of a kind that can also be untied readily (without benefit of
a hatchet). Practice the knots at home, with a piece of string or rope, until
you can tie them under any conditions, no matter how adverse. The basic
climbing knots, illustrated in the first seven figures of Chapter 2 (Figures 2-
1 through 2-7), are drawn as they will look while you are tying them. Left-
handed people often prefer to tie them in reverse.
Bowline
For tying the end of the rope around your waist. Standardize your method
of tying it. For the version illustrated in Figure 2-1 , pass the rope behind
you from left to right. Now hold the long or “standing” part of the rope in
your left hand, and the short end in your right. With the left hand, make a
loop as shown. Put the end up through the loop, around the standing end,
and back down through the loop. After tying the knot, work it along the
rope until the waist loop is really snug. Test and set this knot with a good
tug. The bowline tends to loosen with use, and should be safeguarded in one
of the two ways illustrated in Figure 2-2: (1) Add one or two overhand
knots around the waist loop. (2) Thread the end back through the knot
before setting it. This is a less bulky method used by some experienced
climbers. The end goes over the right side of the waist loop; under the left
side; and up through the loop, parallel with the standing end. Several inches
of rope should remain after the knot is secured; otherwise retie the knot.
Check the bowline occasionally during a climb and tighten the waist loop as
necessary.
Bowline-on-a-Coil
Almost identical to the simple bowline, but more complicated to tie.
Wind the rope around your waist several times, an arrangement which is
more comfortable if you fall or must be held on the rope. Tie the knot
around the coil as illustrated in Figure 2-3, and secure it.

Butterfly
Usually used for the middle man in rock climbing, when three people are
tied into one rope. It is a symmetrical knot which is equally strong when
pulled from either side. Make sure the waist loop is tightened before
starting to climb. This knot tends to tighten in use, and is not secured (see
Fig. 2-4).

Overhand
Used to prevent many other knots from slipping (see Fig. 2-2).

Water Knot
Used for joining ends of flat sling material. Tie an overhand knot, and
thread the other end through it in the opposite direction, as shown in Figure
2-5. Make sure the two parts of the sling lie flat against each other
throughout the knot.

Flemish Bend
Used to join two ropes of the same or unequal diameters. It is similar to
the water knot, but start by tying a figure-8 knot in one of the ends, leaving
an ample end for a safety knot. Thread an end of the other rope through the
knot in the opposite direction, as shown in Figure 2-6. The standing parts of
the ropes pull against each other. Make sure the two ropes lie parallel
throughout the entire knot. Tighten and test by pulling hard on the standing
ends of both ropes, especially when the diameters are unequal. Secure on
each side with one or more overhand knots.
Prusik
Formed by twisting a loop of light rope around a fixed rope hanging
vertically, as illustrated in Figure 2-7. The prusik knot has the property of
remaining in place when weighted, but slipping easily up or down when
unweighted. This makes it possible to stand in loops, and ascend a rope in
an emergency. The average person is physically unable to climb a long rope
hand over hand; also, if you use your climbing rope for handholds, slack
accumulates below, and you are no longer protected with an upper belay
(see Upper Belays, later in this chapter). Prusik slings vary in size to fit the
person. They should be approximately six feet in circumference, made from
quarter-inch rope. Manila holds best, but nylon will serve if the sling is
passed around the rope a third time. Even flat slings will work, but require
more effort.
One of the standard techniques for ascending a rope with prusiks is to use
three slings. Attached at intervals to the vertical rope, these form a chest
loop for balance, and two footsteps. To ascend, stand with all your weight in
the lowest sling, while raising the next one as high as you can step. Transfer
your weight to the upper footstep, and raise the chest loop as high as you
can. Next pull up the rope below so you can reach the second foot loop, and
slip it up as far as possible. Stand in both loops. Repeat. Prusiking can be
practiced from the limb of a tree. The average prusik on rock is easier, as
you are less apt to twirl around.
Another random document with
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Another patient aged twenty-seven had whooping cough, which
lasted six weeks, and was followed by severe pain in the back. For
this she consulted various physicians, being treated for Pott's
disease and spinal irritation. She, however, continued to grow worse,
and every jar and twist gave severe pain. At this time she had lost
much flesh, had pain in her back and elsewhere, and was subject to
numerous and violent spasms. When first seen by the physician who
consulted me she was complaining of pains in her legs, hips, and left
shoulder, which she considered rheumatic, and with pain in the
abdomen. Examination of the back with the patient on her side
showed a slight prominence over the position of the first or second
lumbar vertebra. The spot was painful on pressure, and had been so
ever since the attack of whooping cough three years before. A tap on
the sole of either foot made her complain of severe pain in the back.
The same result followed pressure on the head. The patient was
unable to stand or walk, but occasionally sat up for a short time,
although suffering all the time. There was no muscular rigidity. The
limbs and body were quite thin, but, so far as could be detected, she
had no loss of motor or sensory power. At times, when the pains
were worse, the arms would be flexed involuntarily, and she stated
that once the spine was drawn back and a little sideways. The pain
in the hips was augmented by pressure. During the application of a
plaster bandage she had a sort of fit and fainted, and the application
was suspended. She soon recovered consciousness, but refused to
allow the completion of the dressing. I diagnosticated the affection as
largely hysterical, and a few months later received word that the
patient was on her feet and well.

Kemper109 relates the case of a lady who eventually died of sarcoma

of the vertebræ, the specimens having been examined by J. H. C.
Simes of Philadelphia and myself. She was supposed at first and for
some time to be a case of hysteria with spinal irritation. In the case
of a distinguished naval officer, who died of malignant vertebral
disease after great suffering a short time since, this same mistake
was made during the early stages of the disease: his case was
pronounced to be one of neurasthenia, hysteria, etc. before its true
nature was finally discovered. The absence of muscular rigidity in the
back and extremities is the strongest point against vertebral disease
in these cases.
109 Journal of Nervous and Mental Diseases, vol. xii., No. 1, January, 1885.

In hysterical hemianæsthesia, ovarian hyperæsthesia, hystero-

epileptic seizures, ischuria, and other well-known hysterical
symptoms have usually been observed. The anæsthesia in
hysterical cases is most commonly on the left side of the body, but it
may happen to be so located in an organic case, so that this point is
only one of slight value.

Some older observers, as Briquet, who is quoted and criticised by

Charcot, believed that hemianæsthesia from encephalic lesions
differed from hysterical hemianæsthesia by the fact that in the former
case the skin of the face did not participate in the insensibility, or that
when it existed it never occupied the same side as the insensibility of
the limbs. Recently-reported cases have disproved the accuracy of
this supposed diagnostic mark. In his lectures, delivered ten years
ago, Charcot observed that up to that period anæsthesia of general
sensibility alone appeared to have been observed as a consecutive
on an alteration of the cerebral hemispheres, so that obtunding of
the special senses would remain as a distinctive characteristic of
hysterical hemianæsthesia. He, however, expected that cases of
cerebral organic origin would be reported of complete
hemianæsthesia, with derangements of the special senses, such as
is presented in hysteria. His anticipations have been fulfilled. In the
nervous wards of the Philadelphia Hospital is now a typical case of
organic hemianæsthesia in which the special senses are partially
involved.

Paralysis and contractures, if present, are apt to be accompanied in

cases of organic hemianæsthesia, after time has elapsed, by marked
nutritive changes, by wasting of muscle, and even of skin and bone.
This is not the case in hysteria.

The subsequent history of these two conditions is different. The

hysterical patient will often recover and relapse, or under proper
treatment may entirely recover; while all the treatment that can be
given in a case of organic hemianæsthesia will produce no decided
improvement, for there is a lesion in the brain which will remain for
ever. Hemianopsia, so far as I know, has not been observed in
hysterical hemianæsthesia.

In the monograph of Shaffer, with reference to both true and false

knee-joint affections certain conclusions are drawn which I will give
somewhat condensed:

Chronic synovitis produces very few if any subjective symptoms;

hysterical imitation presents a long train of both subjective and
objective symptoms and signs, the former in excess. Chronic ostitis
may be diagnosticated if muscular spasm cannot be overcome by
persistent effort; when the spasm does not vary night nor day; when
it is not affected by the ordinary doses of opium or chloral; when
reaction of the muscles to the faradic current is much reduced; when
a local and uniform rise of temperature over the affected articulation
is present; when purely involuntary neural symptoms, such as
muscular spasm, pain, and a cry of distress, are present. Hysterical
knee-joint is present, according to this author, when the muscular
rigidity or contracture is variable, and can be overcome by mildly
persistent efforts while the patient's mind is diverted, or which yields
to natural sleep, or which wholly disappears under the usual doses
of opium or chloral; when the faradic response is normal; when rise
of temperature is absent or a reduced temperature is present over
the joint; when variable and inconstant, emotional, and semi-
voluntary manifestations are present.

To recognize the neuromimesis of hip disease Shaffer gives the

following points: The limp is variable and suggests fatigue; it is much
better after rest; it almost invariably follows the pain. Pain of a
hyperæsthetic character is usually the first symptom, and it is found
most generally in the immediate region of the joint. “In place of an
apprehensive state in response to the tests applied will be found a
series of symptoms which are erratic and inconstant. A condition of
muscular rigidity often exists, but, unlike a true muscular spasm, it
can in most cases be overcome in the manner before stated. A very
perceptible degree of atrophy may exist—such, however, as would
arise from inertia only. A normal electrical contractility exists in all the
muscles of the thigh.”

In the neuromimesis of chronic spondylitis or hysterical spine the

pain is generally superficial, and is almost always located over or
near the spinous processes; it is sometimes transient, and frequently
changes its location from time to time; a normal degree of mobility of
the spinal column under properly directed manipulation is preserved;
the nocturnal cry and apprehensive expression of Pott's disease are
wanting.

With reference to the hysterical lateral curvature, Shaffer, quoting

Paget, says “ether or chloroform will help. You can straighten the
mimic contracture when the muscles cannot act; you cannot so
straighten a real curvature.”

In the diagnosis of local hysterical affections one point emphasized

by Skey is well worthy of consideration; and that is that local forms of
hysteria are often not seen because they are not looked for. “If,” says
he, “you will so focus your mental vision and endeavor to distinguish
the minute texture of your cases, and look into and not at them, you
will acknowledge the truth of the description, and you will adopt a
sound principle of treatment that meets disease face to face with a
direct instead of an oblique force.” According to Paget, the means for
diagnosis in these cases to be sought—(1) in what may be regarded
as the predisposition, the general condition of the nervous system,
on which, as in a predisposing constitution, the nervous mimicry of
disease is founded; (2) in the events by which, as by exciting
causes, the mimicry may be evoked and localized; (3) in the local
symptoms in each case.

Local symptoms as a means of diagnosis can sometimes be made

use of in general hysteria. A case may present symptoms of either
the gravest form of organic nervous disease or the gravest form of
hysteria, and be for a time in doubt, when suddenly some special
local manifestation appears which cannot be other than hysterical,
and which clinches the diagnosis. In a case with profound
anæsthesia, with paraplegia and marked contractures, with recurring
spasms of frightful character, the sudden appearance of aphonia and
apsithyria at once cleared all remaining doubt. Herbert Page
mentions the case of a man who suffered from marked paraplegia
and extreme emotional disturbance after a railway collision, who,
nine months after the accident, had an attack of aphonia brought on
suddenly by hearing of the death of a friend. He eventually
recovered.

To detect hysterical or simulated blindness the methods described by

Harlan are those adopted in my own practice. When the blindness is
in both eyes, optical tests cannot be applied. Harlan suggests
etherization.110 In a case of deception, conscious or unconscious, he
says, “as the effect of the anæsthetic passed off the patient would
probably recover the power of vision before his consciousness was
sufficiently restored to enable him to resume the deception.”
Hutchinson cured a case of deaf-dumbness by means of
etherization. For simulated monocular blindness Graefe's prism-test
may be used: “If a prism held before the eye in which sight is
admitted causes double vision, or when its axis is held horizontally a
corrective squint, vision with both eyes is rendered certain.” It should
be borne in mind that the failure to produce double images is not
positive proof of monocular blindness, for it is possible that the
person may see with either eye separately, but not enjoy binocular
vision, as in a case of squint, however slight. Instead of using a
prism while the patient is reading with both eyes at an ordinary
distance, say of fourteen or sixteen inches, on some pretext slip a
glass of high focus in front of the eye said to be sound. If the reading
is continued without change, of course the amaurosis is not real.
Other tests have been recommended, but these can usually be
made available.
110 Loc. cit.

The diagnosis of hysterical, simulated, or mimetic deafness is more

difficult than that of blindness. When the deafness is bilateral, the
difficulty is greater than when unilateral. The method by etherization
just referred to might be tried. Politzer in his work on diseases of the
ear111 makes the following suggestions: Whether the patient can be
wakened out of sleep by a moderately loud call seems to be the
surest experiment. But, as in total deafness motor reflexes may be
elicited by the concussion of loud sounds, care must be taken not to
go too near the person concerned and not to call too loudly. The
practical objection to this procedure in civil practice would seem to
be that we are not often about when our patients are asleep. In
unilateral deafness L. Müller's method is to use two tubes, through
which words are spoken in both ears at the same time. When
unilateral deafness is really present the patient will only repeat what
has been spoken in the healthy ear, while when there is simulation
he becomes confused, and will repeat the words spoken into the
seemingly deaf ear also. To avoid mistakes in using this method, a
low voice must be employed.
111 A Textbook of the Diseases of the Ear and Adjacent Organs, by Adam Politzer,
translated and edited by James Patterson Cassells, M.D., M. R. C. S. Eng., Philada.,
1883.

Mistakes in diagnosis where hysteria is in question are frequently

due to that association with it of serious organic disease of the
nervous system of which I have already spoken at length under
Complications. This is a fact which has not been overlooked by
authors and teachers, but one on which sufficient stress has not yet
been laid, and one which is not always kept in mind by the
practitioner. Bramwell says: “Cases are every now and again met
with in which serious organic disease (myelitis and poliomyelitis,
anterior, acute, for example) is said to be hysterical. Mistakes of this
description are often due to the fact that serious organic disease is
frequently associated with the general symptoms and signs of
hysteria; it is, in fact, essential to remember that all cases of
paraplegia occurring in hysterical patients are not necessarily
functional—i.e. hysterical; the presence of hysteria or a history of
hysterical fits is only corroborative evidence, and the (positive)
diagnosis of hysterical paraplegia should never be given unless the
observer has, after the most careful examination, failed to detect the
signs and symptoms of organic disease.”

PROGNOSIS.—Hysteria may terminate (1) in permanent recovery; (2)

in temporary recovery, with a tendency to relapse or to the
establishment of hysterical symptoms of a different character; (3) in
some other affection, as insanity, phthisis, or possibly sclerosis; (4) in
death, but the death in such cases is usually not the direct result of
hysteria, but of some accident. Death from intercurrent disorders
may take place in hysteria. It is altogether doubtful, however,
whether the affection which has been described as acute fatal
hysteria should be placed in the hysterical category. In the cases
reported the symptom-picture would in almost every instance seem
to indicate the probability of the hysteria having been simply a
complication of other disorders, such as epilepsy, eclampsia, and
acute mania.

As a rule, hysterical patients will not starve themselves. They may

refuse to take food in the presence of others, or may say they will not
eat at all; but they will in some cases at the same time get food on
the sly or hire their nurses or attendants to procure it for them. In
treating such cases a little watchfulness will soon enable the
physician to determine what is best to be done. By discovering them
in the act of taking food future deception can sometimes be
prevented. Hysterical patients do sometimes, however, persistently
refuse food. These cases may starve to death if let alone; and it is
important that the physician should promptly resort to some form of
forcible feeding before the nutrition of the patient has reached too
low an ebb. I have seen at least two cases of hysteria or hysterical
insanity in which patients were practically allowed to starve
themselves to death, but an occurrence of this kind is very rare.
Feeding by means of a stomach-tube, or, what is still better, by a
nasal tube, as is now so frequently practised among the insane,
should be employed. Nourishment should be administered
systematically in any way possible until the patient is willing to take
food in the ordinary way. In purposive cases some methods of
forcible feeding may prove of decided advantage. Its unpleasantness
will sometimes cause swallowing power to be regained.

Wunderlich112 has recorded the case of a servant-girl, aged nineteen,

who, after a succession of epileptiform fits, fell into a collapse and
died in two days. Other cases have been recorded by Meyer. Fagge
also speaks of the more chronic forms of hysteria proving fatal by
marasmus. He refers to two cases reported by Wilks, both of which
were diagnosticated as hysterical, and both of which died. Sir
William Gull describes a complaint which he terms anorexia nervosa
vel hysterica. It is attended with extreme wasting; pulse, respiration,
and temperature are low. The patients were usually between the
ages of sixteen and twenty-three: some died; others recovered under
full feeding and great care. In many of the reported fatal cases
careful inquiry must be made as to this question of hysteria being
simply a complication.
112 Quoted in The Principles and Practice of Medicine, by the late Charles Hilton
Fagge, M.D., F. R. C. P., etc., vol. i. 1886, p. 736.

Are not hysterical attacks sometimes fatal? With reference to one of

my cases this view was urged by the physician in attendance.
Gowers113 on this point says: “As a rule to which exceptions are
infinitely rare, hysterical attacks, however severe and alarming in
aspect, are devoid of danger. The attacks of laryngeal spasm
present the greatest apparent risk to life.” He refers to the paroxysms
of dyspnœa presented by a hemiplegic girl as really alarming in
appearance, even to those familiar with them. He refers also to a
case of Raynaud's114 in which the laryngeal and pharyngeal spasm
coexisted with trismus, and the patient died in a terrible paroxysm of
dyspnœa. The patient presented various other hysterical
manifestations, and a precisely similar attack had occurred
previously and passed away, but she had in the interval become
addicted to the hypodermic injection of morphia, and Raynaud
suggested that it might have been the effect of this on the nerve-
centres that caused the fatal termination. Such cases have been
described in France as the hydrophobic form of hysteria.
 113 Epilepsy and Other Chronic Convulsive Diseases, by W. R. Gowers, M.D.,
London. 1881.

114 L'Union médical, March 15, 1881.

Patients may die in hysterical as in epileptic attacks from causes not

directly connected with the disease. One of these sources of danger
mentioned by Gowers is the tendency to fall on the face sometimes
met with in the post-epileptic state. He records an example of death
from this cause. He also details a case of running hysteria or
hystero-epilepsy, in which, after a series of fits lasting about four
hours, the child died, possibly from some intercurrent accident.

TREATMENT.—Grasset,115 speaking of the treatment of hysteria, says

that means of treating the paroxysm, of removing the anæsthesia, of
combating single symptoms, are perhaps to be found in abundance,
but the groundwork of the disease, the neurosis or morbid state, is
not attacked. Here he indicates a new and fruitful path. In his own
summing up, however, he can only say that the hysterical diathesis
offers fundamental grounds for the exhibition of arsenic, silver,
chloride of gold, and mineral waters!
115 Brain, January, 1884.

No doubt can exist that the prophylactic and hygienic treatment of

hysteria is of paramount importance. To education—using the term
education in a broad sense—before and above all, the most
important place must be given. It is sometimes better to remove
children from their home surroundings. Hysterical mothers develop
hysterical children through association and imitation. I can scarcely,
however, agree with Dujardin-Beaumetz that it is always a good plan
to place a girl in a boarding-school far from the city. It depends on
the school. A well-regulated institution may be a great blessing in
this direction; one badly-managed may become a hotbed of hysteria.

Recently I made some investigations into the working of the public-

school system of Philadelphia, particularly with reference to the
question of overwork and sanitation.116 I had special opportunities
during the investigations to study the influences of different methods
of education, owing to the fact that the public-school system of
Philadelphia is just now in a transition period. This system is in a
state of hopeful confusion—hopeful, because I believe that out of its
present condition will come eventually a great boon to Philadelphia.
At one end of the system, in the primary and the secondary schools,
a graded method of instruction has been introduced. The grammar
and the high schools are working on an ungraded or differently
graded method. I found still prevailing, particularly in certain of the
grammar schools for girls, although not to the same extent as a few
years since, methods of cramming and stuffing calculated above all
to produce hysteria and allied disorders in those predisposed to
them.
116 The results of these investigations were given in a lecture which was delivered in
the Girls' Normal School of Philadelphia before the Teachers' Institute of Philadelphia,
Dec. 11, 1885.

Education should be so arranged as to develop the brain by a

natural process—not from within outward; not from the centre to the
periphery; not from above downward; but as the nervous system
itself develops in its evolution from a lower to a higher order of
animals, from the simple to the more complex and more elaborate.
Any system of education is wrong, and is calculated to weaken and
worry an impressionable nervous system, which attempts to overturn
or change this order of the progress of a true development of the
brain. To develop the nervous system as it should be developed—
slowly, naturally, and evenly—it must also be fed, rested, and
properly exercised.

In those primary schools in which the graded method was best

carried out this process of helping natural development was pursued,
and the result was seen in contented faces, healthy bodies, and
cheerful workers. In future the result will be found in less chorea,
hysteria, and insanity.

To prevent the development of hysteria, parents and physicians

should direct every effort. The family physician who discovers a child
to be neurotic, and who from his knowledge of parents, ancestors,
and collateral relatives knows that a predisposition to hysteria or
some other neurosis is likely to be present, should exercise all the
moral influence which he possesses to have a healthy, robust
training provided. It is not within the scope of an article of this kind to
describe in great detail in what such education should consist.
Reynolds is correct when he says that “self-control should be
developed, the bodily health should be most carefully regarded, and
some motive or purpose should be supplied which may give force,
persistence, unity, and success to the endeavors of the patient.” In
children who have a tendency to the development of hysteria the
inclinations should not always or altogether be regarded in choosing
a method or pursuing a plan of education. It is not always to what
such a child takes that its mind should be constantly directed; but, on
the contrary, it is often well to educate it away from its inclination.
“The worst thing that can be done is that which makes the patient
know and feel that she is thought to be peculiar. Sometimes such
treatment is gratifying to her, and she likes it—it is easy and it seems
kind to give it—but it is radically wrong.”

In providing for the bodily health of hysterical children it should be

seen that exercise should be taken regularly and in the open air, but
over-fatigue should be avoided; that ample and pleasant recreation
should be provided; that study should be systematic and disciplinary,
but at the same time varied and interesting, and subservient to some
useful purpose; that the various functions of secretion, excretion,
menstruation should be regulated.

The importance of sufficient sleep to children who are predisposed to

hysteria or any other form of nervous or mental disorder can scarcely
be over-estimated. The following, according to J. Crichton Browne,117
is the average duration of sleep required at different ages: 4 years of
age, 12 hours; 7 years of age, 11 hours; 9 years of age, 10½ hours;
14 years of age, 10 hours; 17 years of age, 9½ hours; 21 years of
age, 9 hours; 28 years of age, 8 hours. To carefully provide that
children shall obtain this amount of sleep will do much to strengthen
the nervous system and subdue or eradicate hysterical tendencies.
Gymnastics, horseback riding, walking, swimming, and similar
exercises all have their advantages in preventing hysterical
tendencies.
117 Education and the Nervous System, reprinted from The Book of Health by
permission of Messrs. Cassell & Co., Limited.

Herz118 has some instructive and useful recommendations with

reference to the treatment of hysteria in children. It is first and most
important to rehabilitate the weakened organism, and especially the
central nervous system, by various dietetic, hygienic, and medicinal
measures. It is important next to tranquillize physical and mental
excitement. This can sometimes be done by disregard of the
affection, by neglect, or by removal or threatened removal of the
child from its surroundings. Such treatment should of course be
employed with great discretion. Anæmia and chlorosis, often present
in the youthful victims of hysteria, should be thoroughly treated. Care
should be taken to learn whether children of either sex practise
masturbation, which, Jacobi and others insist, frequently plays an
important part in the production of hysteria. Proper measures should
be taken to prevent this practice. The genital organs should receive
examination and treatment if this is deemed at all necessary. On the
other hand, care should be taken not to direct the attention of
children unnecessarily to those organs when they are entirely
innocent of such habits. Painting the vagina twice daily with a 10 per
cent. solution of hydrochlorate cocaine has been found useful in
subduing the hyper-irritation of the sexual organs in girls accustomed
to practise masturbation. Herz, with Henoch, prefers the hydrate of
chloral to all other medicines, although he regards morphine as
almost equally valuable, in the treatment of hysteria in children.
Personally, I prefer the bromides to either morphia or chloral. Small
doses of iron and arsenic continued systematically for a long period
will be found useful. Politzer of Vienna regards the hydrobromate
and bihydrobromate of iron as two valuable preparations in the
hysteria of children, and exhibits them in doses of four to seven
grains three to four times daily.
 118 Wien. Med. Wochen., No. 46, Nov. 14, 1885.

Hysteria once developed, it is the moral treatment which often really

cures. The basis of this method of cure is to rouse the will. It is
essential to establish faith in the mind of the patient. She must be
made to feel not only that she can be helped, but that she will be.
Every legitimate means also should be taken to impress the patient
with the idea that her case is fully understood. If malingering or
partial malingering enters into the problem, the patient will then feel
that she has been detected, and will conclude that she had better get
out of her dilemma as gracefully as possible. Where simulation does
not enter faith is an important nerve-stimulant and tonic; it unchains
the will.

Many physicians have extraordinary ideas about hysteria, and

because of these adopt remarkable and sometimes outrageous
methods of treatment. They find a woman with hysterical symptoms,
and forthwith conclude she is nothing but a fraud. They are much
inclined to assert their opinions, not infrequently to the patient
herself, and, if not directly to her, in her hearing to other patients or
to friends, relatives, nurses, or physicians. They threaten, denounce,
and punish—the latter especially in hospitals. In general practice
their course is modified usually by the wholesome restraint which the
financial and other extra-hospital relations of patient and physician
enforce.

Although hysterical patients often do simulate and are guilty of fraud,

it should never be forgotten that some hysterical manifestations may
be for the time being beyond the control of patients. Even for some
of the frauds which are practised the individuals are scarcely
responsible, because of the weakness of their moral nature and their
lack of will-power. Moral treatment in the form of reckless harshness
becomes immoral treatment. The liability to mistake in diagnosis,
and the frequent association of organic disease with hysterical
symptoms, should make the physician careful and conservative. It is
also of the highest importance often that the doctor should not show
his hand. The fact that an occasional cure, which is usually
temporary, is effected by denunciation, and even cruelty, is not a
good argument against the stand taken here.

Harsh measures should only be adopted after due consideration and

by a well-digested method. A good plan sometimes is, after carefully
examining the patient, to place her on some simple, medicinal, and
perhaps electrical treatment, taking care quietly to prophesy a
speedy cure. If this does not work, in a few days other severe or
more positive measures may be used, perhaps blistering or strong
electrical currents. Later, but in rare cases only, after giving the
patient a chance to arouse herself by letting her know what she may
expect, painful electrical currents, the hot iron, the cold bath, or
similar measures may be used. Such treatment, however, should
never be used as a punishment.

The method of cure by neglect can sometimes be resorted to with

advantage. The ever-practical Wilks mentions the case of a school-
teacher with hemianalgesia, hemianæsthesia, and an array of other
hysterical symptoms who had gone through all manner of treatment,
and at the end of seven months was no better. The doctor simply left
her alone. He ordered her no drugs, and regularly passed by her
bed. In three weeks he found her sitting up. She talked a little and
had some feeling in her right side. She was now encouraged, and
made rapid progress to recovery. Neglect had aroused her dormant
powers. It must be said that a treatment of this kind can be carried
out with far more prospects of success in a general hospital than in a
private institution or at the home of a patient. It is a method of
treatment which may fail or succeed according to the tact and
intelligence of the physician.

I cannot overlook here the consideration of the subject of the so-

called faith cure and mind cure. One difference between the faith
cure as claimed and practised by its advocates, and by those who
uphold it from a scientific standpoint, is simply that the latter do not
refer the results obtained to any supernatural or spiritual agency. I
would not advise the establishment of prayer-meetings for the relief
of hysteria, but would suggest that the power of faith be exercised to
its fullest extent in a legitimate way.

A young lady is sick, and for two years is seen by all the leading
doctors in London; a clergyman is asked in and prays over her, and
she gets up and walks. The doctors all join in and say the case was
one of hysteria—that there was nothing the matter with her. Then,
says Wilks, “Why was the girl subjected to local treatment and doses
of physic for years? Why did not the doctors do what the parson
did?”

Tuke119 devotes a chapter to psychotherapeutics, which every

physician who is called upon to treat hysteria should read. He
attempts to reduce the therapeutic use of mental influence to a
practical, working basis. I will formulate from Tuke and my own
experience certain propositions as to the employment of
psychological measures: (1) It is often important and always
justifiable to inspire confidence and hope in hysterical patients by
promising cures when it is possible to achieve cures. (2) A physician
may sometimes properly avail himself of his influence over the
emotions of the patient in the treatment of hysterical patients, but
always with great caution and discretion. (3) Every effort should be
made to excite hysterical patients to exert the will. (4) In some
hysterical cases it is advisable to systematically direct the attention
to a particular region of the body, arousing at the same time the
expectation of a certain result. (5) Combined mental and physical
procedures may sometimes be employed. (6) Hypnotism may be
used in a very few cases.
119 Influence of the Mind upon the Body.

The importance of employing mental impression is thoroughly

exemplified, if nothing else is accomplished, by a study of such a
craze as the so-called mind cure. Not a few people of supposed
sense and cultivation have pinned their faith to this latest Boston
hobby. A glance at the published writings of the apostles of the mind
cure will show at once to the critical mind that all in it of value is
dependent upon the effects of mental impression upon certain
peculiar natures, some of them being of a kind which afford us not a
few of our cases of hysteria. W. F. Evans has published several
works upon the subject. From one of these120 I have sought, but not
altogether successfully, to obtain some ideas as to the basis of the
mind-cure treatment. It is claimed that the object is to construct a
theoretical and practical system of phrenopathy, or mental cure, on
the basis of the idealistic philosophy of Berkeley, Fichte, Schelling,
and Hegel. The fundamental doctrine of those who believe in the
mental cure is, that to think and to exist are one and the same, and
that every disease is a translation into a bodily expression of a fixed
idea of mind. If by any therapeutic device the morbid idea can be
removed, the cure of the malady is assured. When the patient is
passive, and consequently impressible, he is made to fix his
thoughts with expectant attention upon the effect to be produced.
The physician thinks to the same effect, wills it, and believes and
imagines that it is being done; the mental action to the patient,
sympathizing with that of the physician, is precipitated upon the
body, and becomes a silent, transforming, sanitive energy. It must
be, says Evans, “a malady more than ordinarily obstinate that is
neither relieved nor cured by it.”
120 The Divine Law of Cure.

Hysteria cannot be cured by drugs alone, and yet a practitioner of

medicine would find it extremely difficult to manage some cases
without using drugs. Drugs themselves, used properly, may have a
moral or mental as well as a physical influence. Among those which
have been most used from before the days of Sydenham to the
present time, chiefly for their supposed or real antispasmodic virtues,
are galbanum, asafœtida, valerian, castor and musk, opium, and
hyoscyamus. The value of asafœtida, valerian, castor, and musk is
chiefly of a temporary character. If these drugs are used at all, they
should be used in full doses frequently repeated. Sumbul, a drug of
the same class comparatively little used, is with me a favorite. It can
be used in the form of tincture or fluid extract, from twenty minims to
half a drachm of the latter or one to two drachms of the former. It
certainly has in many cases a remarkably calmative effect.
Opium and its preparations, so strongly recommended by some, and
especially the Germans, should not be used except in rare cases.
Occasionally in a case with sleeplessness or great excitement it may
be absolutely indispensable to resort to it in combination with some
other hypnotic or sedative. The danger, however, in other cases of
forming the opium habit should not be overlooked. According to
Dujardin-Beaumetz, it is mainly useful in the asthenic forms of
hysteria.

Of all drugs, the metallic tonics are to be preferred in the continuous

treatment of hysteria. Iron, although not called for in a large
percentage of cases, will sometimes prove of great service in the
weak and anæmic hysterics. Chalybeates are first among the drugs
mentioned by Sydenham. Steel was his favorite. The subcarbonate
or reduced iron, or the tincture of the chloride, is to be preferred to
the more fanciful and elegant preparations with which the drug-
market is now flooded. Dialyzed iron and the mallate of iron,
however, are known to be reliable preparations, and can be resorted
to with advantage. They should be given in large doses. Zinc salts,
particularly the oxide, phosphide, and valerianate; the nitrate or
oxide of silver, the ammonio-sulphate of copper, ferri-ferrocyanide or
Prussian blue,—all have a certain amount of real value in giving tone
to the nervous system in hysterical cases.

To Niemeyer we owe the use of chloride of sodium and gold in the

treatment of hysteria. He refers to the fact that Martini of Biberach
regarded this article as an efficient remedy against the various
diseases of the womb and ovaries. He believed that the
improvement effected upon Martini's patient was probably due to the
fact that this, like other metallic remedies, was an active nervine. He
prescribed the chloride of gold and sodium in the form of a pill in the
dose of one-eighth of a grain. Of these pills he at first ordered one to
be taken an hour after dinner, and another an hour after supper.
Later, he ordered two to be taken at these hours, and gradually the
dose was increased up to eight pills daily. I frequently use this salt
after the method of Niemeyer.
The treatment of hysteria which Mitchell has done so much to make
popular, that by seclusion, rest, massage, and electricity, is of value
in a large number of cases of grave hysteria; but the proper selection
of cases for this treatment is all important. Playfair121 says correctly
that if this method of treatment is indiscriminately employed, failure
and disappointment are certain to result. The most satisfactory
results are to be had in the thoroughly broken-down and bed-ridden
cases. “The worse the case is,” he says, “the more easy and certain
is the cure; and the only disappointments I have had have been in
dubious, half-and-half cases.”
121 The Systematic Treatment of Nerve-Prostration and Hysteria, by W. S. Playfair,
M.D., F. R. C. P., 1883.

Mitchell122 gives a succinct, practical description of the process of

massage: “An hour,” he says, “is chosen midway between two
meals, and, the patient lying in bed, the manipulator starts at the
feet, and gently but firmly pinches up the skin, rolling it lightly
between his fingers, and going carefully over the whole foot; then the
toes are bent and moved about in every direction; and next, with the
thumbs and fingers, the little muscles of the foot are kneaded and
pinched more largely, and the interosseous groups worked at with
the finger-tips between the bones. At last the whole tissues of the
foot are seized with both hands and somewhat firmly rolled about.
Next, the ankles are dealt with in the same fashion, all the crevices
between the articulating bones being sought out and kneaded, while
the joint is put in every possible position. The leg is next treated—
first by surface pinching and then by deeper grasping of the areolar
tissue, and last by industrious and deeper pinching of the large
muscular masses, which for this purpose are put in a position of the
utmost relaxation. The grasp of the muscles is momentary, and for
the large muscles of the calf and thigh both hands act, the one
contracting as the other loosens its grip. In treating the firm muscles
in front of the leg the fingers are made to roll the muscles under the
cushions of the finger-tips. At brief intervals the manipulator seizes
the limb in both hands and lightly runs the grasp upward, so as to
favor the flow of venous blood-currents, and then returns to the
kneading of the muscles. The same process is carried on in every
part of the body, and especial care is given to the muscles of the
loins and spine, while usually the face is not touched. The belly is
first treated by pinching the skin, then by deeply grasping and rolling
the muscular walls in the hands, and at last the whole belly is
kneaded with the heel of the hand in a succession of rapid, deep
movements, passing around in the direction of the colon.”
122 “Fat and Blood,” etc.

Massage should often be combined with the Swedish movement

cure. In the movement cure one object is to call out the suppressed
will of the patient. This is very applicable to cases of hysteria. The
cure of cases of this kind is often delayed by using massage alone,
which is absolutely passive. These movements are sometimes
spoken of as active and passive, or as single and duplicated. Active
movements are those more or less under the control of the individual
making or taking part in them, and they are performed under the
advice or direction, and sometimes with the assistance, of another.
They proceed from within; they are willed. Passive movements come
from without; they are performed on the patient and independently of
her will. She is subjected to pushings and pullings, to flexions and
extensions, to swingings and rotations, which she can neither help
nor hinder. The same movement may be active or passive according
to circumstances. A person's biceps may be exercised through the
will, against the will, or with reference to the will.

A single movement is one in which only a single individual is

engaged; speaking medically, single movements are those executed
by the patient under the direction of the physician or attendant; they
are, of course, active. Duplicated active movements require more
than one for their performance. In these the element of resistance
plays an important part. The operator with carefully-considered
exertion performs a movement which the patient is enjoined to resist,
or the latter undertakes a certain motion or series of motions which
the former, with measured force, resists. Still, tact and experience
are here of great value, in order that both direct effort and resistance
should be carefully regulated and properly modified to suit all the
requirements of the case. By changing the position of the patient or
the manner of operating on her from time to time any muscles or
groups of muscles may be brought into play. It is wonderful with what
ease even some of the smallest muscles can be exercised by an
expert manipulator.

The duplicated active movements are those which should be most

frequently performed or attempted in connection with massage in
hysterical patients. The very substance of this treatment is to call out
that which is wanting in hysteria—will-power. It is a coaxing,
insinuating treatment, and one which will enable the operator to gain
control of the patient in spite of herself. As the patient exerts her
power the operator should yield and allow the part to be moved.

Much of the value of massage and Swedish movements, in hysteria

as in other disorders, is self-evident. Acceleration of circulation,
increase of temperature, direct and reflex stimulation of nervous and
muscular action, the promotion of absorption by pressure,—these
and other results are readily understood. “The mode in which these
gymnastic proceedings exert an influence,” says Erb,123 “consists, no
doubt, in occasioning frequently-repeated voluntary excitations of the
nerves and muscles, so that the act of conduction to the muscles is
gradually rendered more facile, and ultimately the nutrition of the
nerves and muscles is augmented.”
123 Ziemssen's Cyclopædia.

The objects to be attained by the use of electricity are nearly the

same as from massage and duplicated active movements: in the first
place, to improve the circulation and the condition of the muscles;
and in the second place, to make the patient use the muscles. The
faradic battery should be employed in these cases, and the patient
should be in a relaxed condition, preferably in bed. A method of
electrical treatment introduced some years ago by Beard and
Rockwell is known as general faradization. This is sometimes used
in the office of the physician. In this method the patient is placed in a
chair with his feet on a large plate covered with chamois-skin; the