Studies in Denervation: H.-the Effect of Electrical Stimulation on the Circulation and Recovery of Denervated Muscle.

ONE of the commonest adjuncts to the treatment of peripheral nerve injuries is the electrical stimulation of the paralysed muscles. Despite the nearly universal employment of this procedure for over 40 years there is still doubt as to its value. That the experience gained in the last war resulted in no definite decision is evident from the conflicting views expressed by W. J. Turrell, W. R. Bristow, F. Hernaman-Johnson and others in a discussion of a paper by Burke (1918). At present it would appear that the majority of physiotherapists as oepresented by Kovacs (1940), Cowan (1940), and Mennel (1942) regard the treatment as being of value.. However, Langley and Hashimoto (1918) have stressed the difficulty of assessing its worth in the human because of the many variable factors affecting the recovery of function after lesions of peripheral nerves. A demonstration of this variability of recovery is given in Fig. 1, in which is plotted the time to the first return of voluntary power of the extensor carpi radialis in an unselected group of patients with lesions of the musculo-spiral nerve. The cases without division of the nerve show a wide distribution unrelated to the level of the lesion and they are therefore unsatisfactory for evaluating the effects of therapy. The cases in which the musculo-spiral nerve was sutured ran a fairly predictable course, and since the results of therapeutic procedures must be evaluated in the human, such cases are considered the only suitable material for such an investigation.