The  treatment  should  be  directed  first  to  the  re-
moval or  palliation  of  the  cause.  The  fourth  class
as  classified  above,  is  sometimes  amenal^le  to  vibra-
tor}^ treatment.  A  very  severe  case  that  I  had  the
pleasure  of  curing  was  of  this  type.  It  was  caused
by  sitting  by  an  open  window  all  night.  The  arms
were  CA^en  jerked  up  spasmodically,  so  severe  were
the  spasms.
The  method  of  treatment  consists  of  the  applica-
tion of  interrupted  vibration  on  each  side  of  the
upper  portion  of  the  spine  employing  the  ball  vibra-


*  Goldthwait,  Painter   and   Osgood.     Diseases  of  the  Bones  and  Joints,
page  50.
VIBRATION  OF  THE  MUSCULAR  SYSTEM  297

tode  in  the  interspaces  from  the  occiput  as  low  as
the  insertion  of  the  trapezius.  Notice  which  points
elicit  muscular  spasm  and  apply  prolonged  inter-
rupted vibration  with  the  ball  vibratode  to  such  parts.
It  may  be  found  necessary,  if  the  spasm  is  not  suffi-
ciently controlled,  to  apply  prolonged  interrupted
vibration  over  the  involved  muscles  with  the  rubber-
covered  disc  vibratode.  With  a  fair  rate  of  speed
and  a  stroke  adapted  to  the  parts  treated  apply  inter-
rupted vibration  over  the  painful  sites  and  over  the
motor  points  of  the  affected  muscles  of  the  neck.  In
these  cases  painful  spots  are  often  found  in  the
vicinity  of  the  sixth  and  seventh  cervical  and  first
few  upper  dorsal  vertebrae,  as  well  as  in  the  region
of  the  first  and  second  cervical.  Movements  are  often
a  useful  adjunct  to  vibration.  Mitchell's*  move-
ments which  are  as  follows  are  recommended:  ''The
ordinary  movements  of  rotation,  forward  bending,
and  extension  of  the  head  are  the  needed  procedures.
