on amounts as large as four hundred and forty grains a day.
When education in balance, etc., was begun he could not walk without
aid, or more than a few steps in any way. In three months from the time
he went to bed he walked out-of-doors alone with no stick, and in five
months went back to work. The bladder did not improve much until after
regular washing out and intravesical galvanism were used, with full
doses of strychnia. He was soon able to empty the organ twice a day, and
since leaving the hospital writes that it gives him very little
annoyance, though as a measure of precaution he uses a catheter once
daily. His pains have entirely disappeared, and he is daily on horseback
for many hours.

In spastic paralysis, whether in the slowly-developing forms in which it
is seen in adults, due sometimes to multiple sclerosis, sometimes to
brain tumor, sometimes following upon a transverse myelitis, or in the
central paraplegia or diplegia of "birth-palsies," some very fortunate
results have followed the careful application of the principles of
treatment already described. Absolute confinement to bed is seldom
required or in adults desirable, though exercise should be carefully
limited to an amount which can be taken without fatigue, and some hours'
rest lying down is usually advantageous.

Assuming that the necessary treatment for the disease originating the
paralysis is to be carried on in the ordinary way, I will only describe
the special forms and methods of exercise I have found serviceable.
Whatever the cause, this will be much the same, though in birth-palsies
the teaching may have to include groups of muscles and instruction in
the co-ordination of actions which are not affected in adult subjects.

First, as to massage: the operator must direct his efforts primarily to
the relaxation of the tense muscles, secondarily to the strengthening of
the opponent groups, this last being of special importance where actual
contraction has taken place. He should make frequent attempts by
stretching the rigid groups to overcome the spasm, which in large
muscle-masses may be done by grasping with both hands, taking care not
to pinch, and pulling the hands apart in the line of the muscle's long
axis, thus stretching the muscles. Pressure will sometimes accomplish
the same end, and it will be found in certain cases that by kneading
_during action_,--that is, while the patient endeavors to produce
voluntary contraction,--the resul