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iii
A PRACTICAL TREATISE

ON THE

MEDICAL & SURGICAL USES

OF

Pipl CL CI sy.

INCLUDING:

 

 

LOcALIZED AND GENERAL FARADIZATION ; LOCALIZED AND CENTRAL
GALVANIZATION ; ELECTROLYSIS AND GALVANO-CAUTERY.

BY

GEO. M. BEARD, A.M., M.D.,

MEMBER oF THE NEW YORK SOCIETY oF NEUROLOGY AND ELECTROLOGY: FELLOW OF THH NEW
‘ORK ACADEMY OF MEDICINE: MEMBER OF THE NEW YORK COUNTY MEDICAL
SOCIETY; PHYSICIAN TO DEMILT DISPENSARY, DEPARTMENT OF
BLECTRO-'THERAPEUTICS AND NERVOUS DISEASES, ETC.

AND

A. D. ROCKWELL, A.M., M.D.,

‘EMB) i) THE NEW YORK SOCIETY OF NEUROLOGY AND ELECTROLOGY: FELLOW OF THE NEW
a ii YORK ACADEMY OF MEDICINE: MEMBER OF THE NEW YORK COUNTY MEDICAL
SOCIETY ; ELECTRO-THERAPEUTIST TO THE WOMAN'S HOSPITAL
OF THE STATE OF NEW YORK.

Second Edition, Revised, Enlarged, and mostly Re-written.

WITH NEARLY TWO HUNDRED ILLUSTRATIONS.

NEW YORK:

WILLIAM WOOD & CO., 27 GREAT JONES ST.
1875. 4 EHiHE LE

NIV REPTY
|. RAKY
-
ane

A .%337%0

COPYRIGHT,
WILLIAM WOOD & CO.

1875.

J. F. Trow & Son,
PRINTERS AND BOOKBINDERS,
205 to 213 East Twelfth Street,

 
TO

JOHN T. METCALPE, M.D.

PROFESSOR OF CLINICAL MEDICINE IN THE COLLEGE OF PHYSICIANS
AND SURGEONS, NEW YORK,

TH1s Work 1S DEDICATED,

WITH THE GRATEFUL ESTEEM
OF

THE AUTHORS
PREFACE TO THE SECOND EDITION.

A FEw weeks after the publication of the first edition of this work, in
1871, we were informed by the publishers that a new edition would be
called for. From that time to the present moment much force has
been expended on the thorough revision of the work in all its depart-
ments. As much time and toil, it is safe to say, have been given to this
edition as to the first ; and ‘the work as it now stands represents our
accumulated and thoroughly sifted experience from our entrance upon
this specialty, as well as a full and exhaustive résumé of all that has
been accomplished by other authorities everywhere.

About one year ago, while this edition was in press, we amicably dis-
solved the professional association that had existed for six years, and
during which all our writings on this subject had appeared. This dis-
solution of our business relations has not affected the present work
except so far as to delay somewhat its publication.

The success of the first edition of this work has far surpassed our
highest hopes ; and our belief is that it may have done something to
raise the standard of electro-therapeutics as well as to popularize it.
More than a year since, the work was translated into German by Dr.
Vater, of Prague, who has confirmed all that we have claimed in regard
to the efficacy of general electrization, and who has followed up the
translation by a series of elaborate articles, didactic and clinical, on
general electrization and central galvanization in the Al/gemeine
Wiener Zeitung.

The use of general faradization as a constitutional tonic in a
wide variety of affections is now well established and the effects
that we have claimed for it have been confirmed in full detail by com-
petent observers at home and abroad. This method of using electricity
has also attained a wide popularity, and its introduction into therapeu-
tics may be said to have marked a radical and important advance.

The section on Electro-physics is much enlarged. Observation has
convinced us that the one great defect in those who practise electro-
therapeutics is ignorance of the physical relations of electricity. From
Vi PREFACE TO THE SECOND EDITION.
I

this source flow at least half the blunders, discouragements, and ill-
success that novices in this branch so painfully experience. The undu-
latory theory of the electrical force that is adopted in this edition is, so
far as can now be seen, consistent and harmonious, and it explains
better than any other theory the varied and complex phenomena of
électro-physiology and electro-therapeutics.

The chemistry of the batteries, it will be seen, is explained in full
detail, and in accordance with recent chemical facts and nomenclature.

To Ohm’s Law, at once so important and so difficult, a separate and
special chapter: has been assigned; and no effort has been spared to
make it clear in all its practical relations to all trained minds who will
give it close and careful attention.

In the preparation of the section on Electro-physics we have been
favored with the advice and suggestions of a number of our most dis-
tinguished physicists and mathematicians ; and especially are we indebt-
ed to Prof. Henry T. Eddy, of Cincinnati, who has interested himself in
the attempt here made to put the most recent theories and facts of
electro-physics in a shape at once clear, compact, and trustworthy.

The need of a section of this kind has been most urgent, for the
treatises on the physics of electricity that have been most accessible
are either far behind the time or have been expressed so blindly
as to be of little value to electro-therapeutists. Even the best of the
more recent writers on the physics of electricity, as Fleming Jenkins,
and Latimer Clarke, have not adapted their works to the wants of those
who use electricity in therapeutics.

Electro-physiology is largely rewritten and considerably enlarged.
It includes a large number of our own experiments, mostly made dur
ing the past three years, as well as a compact résumé of all the more
recent studies in this branch by European and American observers.
The general relation of electro-physiology to electro-therapeutics has
been brought into prominence at every point.

The method of central galvanization that we have systematized and
introduced to the profession since the publication of the first edition is
here described and illustrated in full detail. The great practical
advantages of this method of galvanization over localized galvanization
of the nerve-centres—and in many cases over general faradization—are
already well understood by many of our leading electro-therapeutists.

There are now introduced into science, six methods of using electri-
city for the treatment of disease: localized faradization and localized
galvanization, general faradization, central galvanization, and, in electro-
surgery, electrolysis and galvano-cautery.
PREFACE TO THE SECOND EDITION. vii

In the chapter on Apparatus we have endeavored to represent with
fairness and impartiality the- best workmanship and the most recent
improvements. The fact of the superiority of continuous over separate-
coil Faradic-machines in the treatment of sensitive patients is here for
the first time brought out and emphasized.

A new chapter on General Suggestions has been added, in which the
attempt has been made to answer in detail the various practical queries
that so annoy the beginner in electro-therapeutics.

In the section on Electro-surgery the principles of galvano-cautery,
of ordinary electrolysis, and of the method of electrolysis of the base
have been described and illustrated, and in the clinical portions all varie-
ties of results have been presented from a very large experience in this
department, so that one may learn both what can be done and what
cannot be done by electricity in surgical diseases.

In the clinical part of electro-medicine a number of entirely néw
chapters have been added, and all of the chapters have been recast.
The number of cases has been increased nearly twofold, the failures
and successes being fairly represented.

We may call especial, attention to the chapters on Diseases of the
Skin, wherein, besides many other cases, are detailed the remarkable
results of central galvanization in chronic eczema and prurigo, and to
the chapter on Diseases of Children, in which are recorded the results
of experiments in the treatment of whooping-cough, marasmus, and de-
bility, and also the fact of the remarkable tolerance of childhood to
electricity. Since the publication of the first edition ‘a number ‘of excel-
lent works on nervous diseases have appeared, and for that reason, as
well as for lack of space, the systematic remarks on certain diseases
have, in this edition, been mostly omitted, save some special points
wherein our views differ from those generally adopted.

Although the work is considerably enlarged yet this enlargement is
due more to the addition of new matter than to the retention of old. If
there are any who object to the size of the work, who seek for short
and ready methods to the science and art of electro-therapeutics, who
despise and deride the physical and physiological relations of electricity,
and who suppose that he who has held two sponges on a patient has
compassed the whole of electrology, we “can only reply that it is not for
such that this book was written, and we hope that nothing we may
write will encourage the increase of physicians of that character. The
ideal of every electro-therapeutist—certainly of every one who gives the
subject special attention—should be to become an electrologist, that is,
to be a master of electricity in its physical and physiological as well as
Vili PREFACE TO THE SECOND EDITION.

its purely diagnostic and therapeutic relations ; for all such this edi
tion is designed to be a work of exhaustive reference. Those, how
ever, whose aims are lower will here find the purely practical anc
clinical department clearly presented by a large variety of illustrations of
the various methods of application, and by details of more than two
hundred cases, including every type of medical and surgical disease, for
which electricity by any method of application has been used with any
encouraging results,

To those who, since the first edition of this work was out of press,
have grown weary in waiting for the long-promised appearance of the
second edition, we may express the hope that they will find in the
present treatise sufficient evidences of original experience and research
to fully account for, if not to justify the annoying delay.

GEO. M. BEARD, A. D. ROCKWELL,
53 West 33d Street, N. Y. 122 Madison Avenue, N. Y,
PREFACE TO THE FIRST EDITION.

THE object of this work is to present, in a compact, practical form,
all that is now known on the application of electricity to the treatment
of disease. The aim of the authors has been to combine their own
extensive and varied researches with localized and general electriza-
tion, and the labors of all other recent explorers in electro-therapeutics,
in a summary which should be at once practical and exhaustive, and
which should represent with strict impartiality all that has been really
accomplished in this department by ey school, in every country, and
by all methods.

For this undertaking the authors have been prepared by an experi-
ence acquired in more than 10,000 applications of electricity in a wide
variety of morbid conditions, and by personal observation of the
methods and the results of the recognized leaders in this important
field of science.

For convenience of reference, and in order to avoid repetition and
confusion, the work is divided into Electro-Physics, Electro-Physiology,
Electro- Therapeutics, and Llectro-Surgery. It is believed that by this
arrangement the work will be more acceptable both to the majority
who seek to consult the distinctively practical portions, and to the few
who may desire also to investigate the subject of electricity in its
physical and physiological relations.

General electrization, which the authors were the first in the profes-
sion to systematically investigate, is here, for the first time, described
and illustrated in systematic detail of its modus operandi and its very
remarkable effects in conditions of debility.

The general differential indications for the use of the two cur-
rents and for the use of localized and general applications, we have
sought to distinguish and elucidate by logical deductions from the
known principles of electro-therapeutics, and, above all, from extend-
ed experimental comparison. The knowledge of electro-therapeutical
anatomy, which is so essential for an intelligent electro-diagnosis in
therapeutics, we have endeavored to facilitate by concise and explicit
illustrations. The drawings for illustrations of the different methods
of electrization were made from photographs taken during the applica-
tions.
x PREFACE TO THE FIRST EDITION.

In the selection and detailed description of apparatus, both the tastes
of the specialist and the imperative needs of the general practitioner
have been constantly borne in mind ; and while nearly all the most im-
proved forms of machines for both currents have received notice,
minute description and illustration have been reserved only for those
that experience has shown unite in the highest degree the qualities of
convenience and compactness, with accessibility and uniformity of ac-
tion. When we began our experiments in this department, there was
in this country no satisfactory apparatus either for the faradic or the
galvanic current, and for this reason our ‘early observations were made
under exceeding disadvantages.

The difficulty has for a number of years been partly met by the
electro-magnetic apparatus of Kidder, which, for all the essential qual-
ities required, is as yet unsurpassed. We early became convinced that
scientific electro-therapeutics required also a galvanic apparatus which
should be at least more compact and more portable than those which
had been usually employed, and that to be forced to depend on appa-
ratus of foreign construction would both retard the progress and prac-
tically prohibit the popularization of electro-therapeutics. Amid many

‘discouragements which only those who have pursued similar investiga-
tions can well appreciate, we have striven to overcome this serious evil
and to prepare a galvanic apparatus which should be both simple and
enduring, and which could be used at the bedside as well as in the
hospital or consulting-room. Through the skill and intelligence of the
mechanician above-mentioned, we are now able to present an appa-
ratus for the galvanic current which, if not on the one hand so com-
pact, or on the other so elaborate as others to which we have called
attention, is yet, in the wide variety of size and shape of which it is
capable, in the simplicity of its construction, and the ease of its man-
agement, perhaps even better fitted to supply the general want.

Llectro-surgery, though a young and as yet but little developed
branch of electro-therapeutics, is yet of such intrinsic importance and
interest, and so fruitful in promise for the future, that it has been
deemed worthy of separate and special consideration.

In the preparation of the detailed and statistical reports of cases, we
have sought to give a picture that shall be so accurate, and so true to
experience, that it may be unfailingly recognized by all those who pur-
sue 2 similar line of experiment. The somewhat deserved reproach
against electro-therapeutists, that they publish only their most fortunate
results, we have endeavored to avert by giving prominence to failures
as well as to successes; by noting relapses as well as permanent re-
PREFACE TO THE FIRST EDITION. xi

coveries. We have been not unmindful of the fact that statistical re-
ports of the results of any method of treatment, however conscien-
tiously prepared, must be at best incomplete, and to a certain extent
illusory. Therapeutics is always a subject of vast complications. It
is probable that in some of the cases reported as absolute or approxi-
mate recoveries, nature and time, and in a few instances, perhaps,
other medicinal or hygienic treatment bore as large a share as the ap-
plications themselves. We have, however, endeavored to make all ’
proper allowances for the influence of these various factors ; and in
the few exceptional cases where medicinal has been combined with
electrical treatment, the fact has been mentioned, and cases of posi-
tive doubt have been excluded from consideration. For the study of
the special effects of electrical treatment, when used alone, we have
been peculiarly fortunate, since the vast majority of our cases had
abandoned medication before they were referred to our care. On the
other hand, it is indisputably true that some of the cases reported as
absolute failures, or as but slightly benefited, were kept from perfect
recovery by the indulgence of evil habits of hygiene; and it is fully
probable that some of them, as well as of those reported as unknown,
appreciated the after results of the treatment and went on to recovery.
Still further, it is in every way probable that some of the failures might,
by greater perseverance on the part of the patients, have been trans-
formed into perfect successes.

It is believed that these various errors to a certain extent counter-
balance each other, and that on the whole our statistical reports fairly
represent, so far as they go, the legitimate results of the electrical
treatment. And yet it should be considered that the majority of the
cases represented in our statistics were both long-standing and pecu-
liarly obstinate, and there is ground for the belief that those who treat
milder and more recent cases by the same methods, will obtain a larger
percentage of success.

It will be observed that throughout the work these leading ideas are
kept constantly in the foreground as the foundation principles on which
must rest the science of electro-therapeutics :—

1. That electrization, besides being merely a local stimulant, also
exercises an influence over general and local nutrition, at once unique
and unrivalled, and that entitles it to the highest rank among constitu-
tional tonics.

2. That the accepted system of making the applications exclusively
local is both illogical and inconsistent ; that in the use of electricity,
as of every other remedy, constitutional diseases should be treated

constitutionally. ,
xii PREFACE TO THE FIRST EDITION.

3. That the best method of bringing the whole system under the
direct influence of the current is by general electrization as here de-
scribed ; and that by the use of this method the success of electro-
therapeutics is materially enhanced, and its sphere very greatly widened,
so as to include a variety of frequent and distressing constitutional
mogbid conditions, for which merely localized electrization is but im-
perfectly indicated.

4. That, in determining the influence of the electrical applications
on conditions of disease the last appeal must be made, not to physics’
nor to physiology, nor to pathology, nor to any @ priori reasoning what-
ever, but solely and alone to clinical experience.

To those who. adhere to the long-accepted theory that electricity is
merely a means for local stimulation, and, as such, chiefly indicated in
the severe or incurable conditions of paralysis or chronic rheumatism,
or who hope to reduce electro-therapeutics to an exact science on the
basis of a complete physiology and pathology, the above propositions
must seem both radical and erroneous, and especially so if they have
studied the action of electricity on the body merely by localized appli-
cations. 3

Therefore with all the greater interest and pleasure have we ob-
served that, during the last few years, there has been in electro-thera-
peutical literature a manifest and increasing tendency to abandon the
narrow doctrines of merely local stimulation, to accept the fact which
experience everywhere confirms, that in electricity we have an unsur-
passed means of improving the general nutrition in the immense va-
riety of chronic morbid conditions where such results are chiefly indi-
cated ; and we express the confident hope that the abundant and varied
evidence with which in the present work we have been enabled to for-
tify these propositions, increased and enriched as it may be by the ex-
perience of the future, and harmonizing as it surely must with the gen-
eral progress of science, will materially aid in bringing nearer the day
of their universal acceptance.

Although this work is not intended to be in any sense a complete.
guide to the study of chronic diseases of the nervous system, yet some
general remarks on the nature, causation, and the diagnosis of the
principal of these diseases have been deemed both appropriate and
necessary, for the twofold reason that such knowledge is necessary for
an intelligent appreciation of the directions for the treatment, and also
because very many of the diseases here mentioned—such as nervous
dyspepsia, spinal irritation, neurasthenia, hypochondriasis, insomnia,
locomotor ataxy, muscular atrophy, spinal and infantile paralysis, as
well as some of the varieties of neuralgia—have not received in any one
PREFACE TO THE FIRST EDITION, xili

popular text-book the practical attention which their vast importance
in electro-therapeutics requires.

Scientific electro-therapeutics requires scientific diagnosis. He who
only knows how to apply electricity is not fit to do even that. Suc-
cessful results in electro-therapeutics can be and are obtained by the
most ignorant of charlatans, but to intelligently report these successes
or make them of value to science requires the best skill of the physi-
cian. Mere hand-books of electrical applications cannot be otherwise
than injurious to science. Other conditions being the same, the value
of reports of cases in electro-therapeutics is in direct proportion to the
accuracy and completeness of the diagnosis. For this reason it is that
electro-therapeutics is the most exacting and laborious of all the
special departments, for in a certain sense it trenches on and necessi-
tates a knowledge of all other departments.

In the strict sense of the word, therefore, the electro-therapeutist is
no specialist, since his idea! —which of course he can but imperfectly
fulfl—must be to know something of every department with which
electro-therapeutics brings him into relation. His ambition, like that
of Bacon, must be “to make all knowledge his province.”

Besides a thorough familiarity with the department of nervous dis-
eases, and especially with the recent methods of studying them by the
zesthesiometer, the ophthalmoscope, and by electricity, it is necessary
for the electro-therapeutist to avail himself of all the advances that are
made in the special departments of gynzecology, ophthalmology, otol-
ogy, laryngology, and dermatology, as well as general medicine and
surgery.

In respect to diagnosis we have ourselves been exceptionally fa-
vored, since the majority of our cases have obtained the opinion of one
or more acknowledged authorities in their respective departments.

That all the special views on the nature and treatment of the dis-
eases here mentioned should meet with universal acceptance, is more
than can be expected. Everywhere we tread on debatable ground.
In regard to the nature, the causation, the symptoms, the general treat-
ment, the divisions and the terminology of diseases, the choice of cur-
rents, the methods of applications, the relative merits of rival appa-
ratus,—in these and in many other subjects there is room for the
widest possible divergence of honest opinion among those whose abili-
ties and opportunities entitle their opinions to the highest respect.
On all these controverted themes we present nothing as a finality, noth-
ing which we shall not readily modify in the light of sufficient inductive
evidence.
XIV PREFACE TO THE FIRST EDITION.

More than almost any other department, electro-therapeutics has
suffered from its terminology. So large is the number of synonyms,
and so indefinite the meaning of many of the words and phrases
which have come into use, that intelligent conversation on the subject
has been well-nigh impossible. This crying evil, from the first, we
have sought to rectify, and with this view we have resolutely and uni-
formly distinguished the two currents as faradic and galvanic, discard-
ing entirely their various and complex synonyms. It is believed that
this and other changes which we have made are in the direction of
simplicity, and that they will shorten the labors of the student, and will
serve to recommend rather than repel the earnest inquirer.

It will be observed that in this work the future as well as the past
has been regarded, and that a number of diseases are mentioned, for
the sake chiefly of the promise and the hope which they offer for elec-
tro-therapeutics. The object of such mention is to inspire authorities
in the several departments to co-operate with electro-therapeutists in
the important and difficult task of submitting these diseases to faithful
and rigid experiment, and to those who may be induced to do so we
beg leave to offer these suggestions :—

First. That they do not suffer themselves to be misled or in any
way controlled by theoretical reasoning. Already the advance of elec-
tricity into the domain of medicine has been retarded, at least a quar-
ter of a century, by erroneous or undemonstrable theories concerning
the action of electricity or the nature of diseases, or more recently by
futile attempts to make electro-physiology a sufficient basis for electro-
therapeutics. It cannot be too often repeated, that the essence of
electro-therapeutics is clinical experience. Electro-physiology is a
science at once noble, interesting, and suggestive, but in its relations
to electro-therapeutics, with very few limitations indeed, it should fol-
low rather than precede, should explain rather than guide.

_ Secondly. That they do not confine their attention too exclusively to
diseases which have a merely pathological interest. We but represent
the growing sentiment of the ablest medical thinkers of our time, when
we assert that in recent days, in nearly all departments, therapeutics
has been sacrificed to pathology, and that diseases, however prevalent,
and however painful, which offer no interesting pathological history,
are practically neglected. Now it is safe to assert that in this country
at least, there is immeasurably more suffering in the higher walks of life

¥

from the somewhat indefinite condition known as nervous dyspepsia °

than from all forms of paralysis combined; and any remedy which,
uke general electrization, promises almost sure relief for this condition,
PREFACE TO THE FIRST EDITION. XV

and which at the same time, by its powerful effects over nutrition,
tends to prevent or delay the visitation of incurable central lesions, is
surely worthy of careful study. It is especially unfortunate for the stu-
dent ‘of chronic diseases of the nervous system that nearly all the
works on practical medicine have been of foreign authorship, and have
been based on hospital rather than on private practice ; for the types
of disease are modified by social position and occupation as much as
by race or climate, and the nameless symptomis associated with chronic
nervous exhaustion which are found in every family among the higher
walks of American society, and in greater variety and severity than in
any other country, should receive the earnest attention of all practi-
tioners, if necessary even to the exclusion of the rare and exceptional
pathological cases to be found in our public institutions, however inter-
esting or suggestive they may be. As will be seen in the course of the
present work, this class of cases are, of all others, the most amenable
to electrical treatment, and therefore demand the special study of the
electro-therapeutist. Withal it should be remembered that electro-
therapeutics has not been entirely useless to pathology, since, in ob-
scure cases, the locality if not the precise nature of the disease, is in-
dicated by the results of treatment.

Thirdly. That unfavorable as well as favorable results be accurately
reported. Every failure which is published in detail is, in one way, as
much a fact for science as a success, since it reduces and guides the
labors of future experimenters. In our estimate of any remedy, it is im-
portant that we should know its weakness as well as its strength.
Those who know the most of electricity in its relations to medicine will
be the last to regard it as an unfailing specitic.

If investigations are everywhere pursued in this spirit and by those
most competent to make them, the reproach of Mr. Lecky, that “ The
medical powers of electricity, which of all known agencies bears most
resemblance to life, are unexplored,” will cease to be deserved.

To all who for the first time enter upon the study of this branch of
science, we cannot too strongly recommend the practice of sedf-expert-
mentation. Better than any experiments on animals, better even, in
many features, than extended investigations in the treatment of dis-
ease, is the precise and peculiar knowledge of the modus operandi of
the applications, and the sensations which they produce, which is ob-
tained through personal experience. 4

Compared with internal remedies, electricity has the great disadvan
tage that, on account of the necessary mechanical and technical diffi
culties in the way of its successful employment, it cannot be rapidly
xvi PREFACE TO THE FIRST EDITION.

popularized. Drugs for internal administration, like bromide of potas-
sium and hydrate of chloral, can spread over the earth in less time than
is required even for the specialist to master the elements of electro-
therapeutics. There is little doubt that if electricity could be given in
the form of pills or powders as successfully as it is now employed, its
use would be increased one thousand-fold.

Considering all the technical difficulties in the way of the rapid pop-
ularization of electro-therapeutics, its recent progress is something un-
paralleled in the history of science ; the dark days of its history are
over, and they can never return.

That an agent which, by the almost unanimous consent of the pro-
fession, was resigned to outsiders and to those who were always igno-
rant and usually unscrupulous ; which in text-books and lecture-rooms
was mentioned only in tones of warning or disrespect; and which in
this country, but a very few years since, was sunk so low that he who
attempted to raise it was believed thereby to imperil his professional
and social position—should, in so short a time, and against such in-
herent technical difficulties, assume a position side by side with its
sister branches, where it should be taught in our schools, incorporated
in text-books of general and special medicine, should occupy the at-
tention of some of the ablest leaders of modern thought, and should
arouse the enthusiasm of all ranks of the profession as no other special
department has ever done, might well have seemed past belief, even
to those who had the strongest faith in the liberality and activity of
our time.

The beneficent results of this progress will not be confined to elec-
tro-therapeutics ; they will react favorably on all departments, and es-
pecially on general therapeutics, by diffusing a wider liberality and a
broader spirit of inductive investigation. The paths of all future ex-
plorers in the scientific treatment of disease will have been made
easier and safer by the toils and the triumphs of this one department.
Henceforth the cause will need not so much energy as guidance; not
so nich enthusiasm as wisdom.

We take this occasion to express our thanks to the very many able
men in the profession who, in ways innumerable, and from the outset
of our investigations, have so warmly co-operated in our labors, and
whose intelligent sympathy and substantial encouragement for a cause
that was yet on its trial in America, have largely contributed to what-
ever degree of success we have been enabled to achieve.

G. M. B. anp A. D. R.
CONTENTS.

ELECTRO-PHYSICS.

CHAPTER I.

‘A KNOWLEDGE OF THE PRINCIPLES OF ELECTRO-PHYSICS NECESSARY TO
THE ELECTRO-THERAPEUTIST—DEFINITION OF ELECTRICITY—Mac-
NETISM. Polarity of magnets—Magnetic induction—Physical effects
of magnetization—Magnetic poles—Variations of the needle—Solar
origin of magnetism.

CHAPTER II.

FRICTIONAL, OR STATICAL, OR FRANKLINIAN ELECTRICITY. Statical in-

duction— Distribution of electricity ~Holtz’s machine— Electrophorus

CHAPTER III.

GALVANISM, OR VOLTAIC ELECTRICITY. Chemistry of the battery—Sim-
ple galvanic circles—Polarity of the circuit—Electro-chemical series—
Amalgamation—Polarity of electricity—Derived or branch currents—
Polarization of electrodes—Daniell’s and Grove’s batteries—Zinc-car-
bon batteries—Smee’s battery—Galvanometers— Volta’s researches...

CHAPTER IV.
ELECTROLYSIS (ELECTRO-CHEMISTRY). Laws of electrolysis—Theory of
electrolysis... .. miei telelersiee ue sedouadarvatbronsuas nate Siereseeeats aise soe ashee Siete
CHAPTER V.

INDUCED ELECTRICITY—CURRENT AND MAGNETO INDUCTION—ELECTRO-
‘MAGNETISM, Ampére’s theory of magnetism—Electro-magnetic helix
—Induction coils—Ruhmkorff’s coil—Magneto-electricity—History of
induction. .... eg iai Sara taal al whan p14 0 co sae seieabee ase chasers Gain ut as PAOLA IE

CHAPTER VI.
THERMO-ELECTRICITY. Thermo-multiplier—Thermo-electric batteries, . .

CHAPTER VII.
Oum’s LAW AND ITS PRACTICAL APPLICATION TO ELECTRO-THERAPEU-
tics. Electro-motive force—Tension or potential—Resistance—
Quantity or strength of current—Large cells zs. small cells,........66

14-24

25-52

53-58

59-71

72-76

77-95
xviii CONTENTS.

ELECTRO-PHYSIOLOGY.

 

CHAPTER I.

RELATION OF ELECTRO-PHYSIOLOGY TO ELECTRO-THERAPEUTICS—ANI-
MAL ELECTRICITY. Electric fishes—Galvani and Volta—Humboldt’s
and Aldini’s researches— Du Bois-Reymond’s discoveries — Experi-
ments of Trowbridge...........ceesceeeenecereeee racerbaraieas sees QQ-IIE
CHAPTER II.

ELECTROTONOS, ANELECTROTONOS, AND CATELECTROTONOS. Du Bois-
Reymond’s molecular theory of anelectrotonos—Effects of electrotonos
—Pfliiger’s contraction law... .....cscceesne en ceeteretcectenenes ITI-116

CHAPTER IIL
ACTION OF ELECTRICITY ON THE SKIN. Action of the faradic current—
Of the galvanic current—Electro-anzsthesia...........eceecee eee 117-123
CHAPTER IV.
ACTION OF ELECTRICITY ON THE BRAIN AND SPINAL CORD. Galvanization
of the brain—Experiments of Hitzig, Ferrier, and others, .... eeeeeee [24-127
CHAPTER V.
ACTION OF ELECTRICITY ON THE SYMPATHETIC AND PNEUMOGASTRIC.
Experiments with sphygmograph.............. iva iaieibienoaedneoen arses +» 128-139
CHAPTER VI.

ACTION OF ELECTRICITY ON THE NERVES OF SPECIAL SENSE. Action on
the optic nerve—On the auditory nerve—Brenner’s researches—Action
on the gustatory nerve.,......... aipsataleners aa co i alc eta aiacavaeere veee 140-152

CHAPTER VII.

ACTION OF ELECTRICITY ON MOTOR AND SENSORY .NERVES AND VOLUN-
TARY MUSCLES. Electro-muscular contractility—and electro-mus-
cular sensibility—Increase of temperature after muscular contraction
—Electro-physiological anatomy..........s0.c000 Jaye detape sais eeeee 153-169

CHAPTER VIII.

ACTION OF ELECTRICITY ON INVOLUNTARY MUSCLES. Experiments,..... 170-175

CHAPTER IX.
ACTION OF ELECTRICITY ON THE BLOOD, LExperiments,................ 176-179
CONTENTS. xix

CHAPTER X.
ELECTRO-CONDUCTIVITY OF THE HUMAN BODY. Modified by age and
temperament,...... aise swe eee SMe arses Dai diaieie ive dude Suyeutraniaee EOOmNOT

CHAPTER XI.

THE EFFECT OF ELECTRICITY ON NUTRITION. Mechanical, physical,
chemical, and physiological effects—Electrical endosmosis after physical
effects—Electrolysis of living substance—Circulation—Secretion—Ex-
cretion—A bsorption—Effects produced by increase in size and weight
—Reflex action—Experiments, ...... 0.0... cece esen ce ceececeeteees 188-206

CHAPTER XII.

RELATION OF ELECTRICITY TO LIFE. Electricity vs. nervous force—The-
ory of correlation of physical and vital forces—Electricity of plants.... 207-211

ELECTRO-THERAPEUTICS.

CHAPTER I.
HIsTORY OF ELECTRO-THERAPEUTICS. Era of Franklinic electricity—Era
of galvanization- --Era of faradization—Localized faradization and gal-
vanization—General faradization—Central galvanization—General re-
marks—Popularity of electro-therapeutics— Rapid progress of electro-
therapeutics in America... .. Raa aneutiiemamasatss sia ood sucnneeies 214-252

CHAPTER II.

GENERAL THERAPEUTICAL ACTION OF ELECTRICITY. Electricity a stimu-
lating sedative tonic—Is electricity transformed into nerve force ?—El-
ectricity compared with other tonics—Rationale of electrization,.... ++ 253-261

CHAPTER III.

GENERAL SUGGESTIONS IN REGARD TO THE USE OF ELECTRICITY AS A
THERAPEUTIC AGENT. Stage of disease when indicated—Differential
action of poles and of current direction—Both seat of disease and effects
to be treated—Healthy parts may be benefited—Dose of electricity—
Mild currents—Care in details of application—Time, frequency, and
regularity of applications—Combination of methods—How to judge
of effects—Good effects-—Bad effects—Regard for age—After effects—
Use of electricity by the laity—Abbreviations used in electro-therapeu-

LCS aye presiew ete oouste! sohislaie gy ebaye aah Wa MaMa Srniem ern eml Seeeeres sexes 262-296

CHAPTER IV.
COMPARATIVE VALUE OF THE GALVANIC AND FARADIC CURRENTS,—Ad-
vantages of galvanic over faradic—Advantages of faradic over galvanic
—Galvano-faradization........ {SAAS TOO ee Meme ERD a eel eonweeness 297=3903
XX CONTENTS.

CHAPTER V.

THE PRINCIPLES OF ELECTRO-DIAGNOSIS (ELECTRO-PATHOLOGY).—Modi-
fications of electro-sensibility—Electro-muscular sensibility and con-
tractility—Galvano vs, Farado-muscular contractility—Abnormal reflex
irritability—Diplegic contractions—Electro-bioscopy.......sss+eeees 304-318

CHAPTER VI.

“ELECTRO-THERAPEUTICAL ANATOMY. Motor points—Electro-sensibility
of surface of the body..... dee OEseee eee da bse tata pyetenehiveraevtevaouaeievsre . 319-326

CHAPTER VII.

APPARATUS FOR ELECTRO-THERAPEUTICS. Single and separate coil ma-
chines—Faradic apparatus—Rules for its use—Galvanic apparatus—
Directions for use—Cabinet battery—Rheostates—Galvanometers and
electrodes—Care of electrodes—European batteries .............+2.. 327-366

CHAPTER IX.

LocALizED ELECTRIZATION. Dry faradization—Electric moxa—Electriza-
tion with moistened electrodes—Direct and indirect electrization—Defi-
nition of terms—Details of applications—Electrization of the brain,
spine, cervical sympathetic, plexuses, nerves, muscles—Effects........ 367-382

CHAPTER X.
GENERAL FARADIZATION. Object proposed—Position of patient—Of
operator—Application to head and neck—Use of hand as an electrode—
Special rules observed—Persistence in treatment—Effects—Rationale of
effects... .......0005 Bear nloretimeniire airs Sei acsuc ules edeadek Ch ascyena a ibn ecebivarnises 383-407
CHAPTER XI.

DIFFERENTIAL INDICATIONS FOR THE USE OF LOCALIZED AND GENER-
AL FARADIZATION. Cause of failures in electro-therapeutics—Com-
binationof the-method sy cis: wasieiserersiece gene's Gues ¥y Se ae REE REO 408-411

CHAPTER XII,
CENTRAL GALVANIZATION. Method—Details of the applications—Theory
of the method—Compared with localized galvanization—With general
faradization—Objections answered. ......... ccc cect ect eee teacees 412-425
\ : CHAPTER XIII.
THE USE OF STATICAL ELECTRICITY (FRANKLINIZATION). Methods—
Shocks from Leyden jar—Apparatus...........0ceccescceeeceucaes 426-430
CHAPTER XIV.
ELECTRIC BATHS. Method of giving—Effects—Rules for giving them.... 431-434

CHAPTER XV.
HYSTERIA AND ALLIED AFFECTIONS. Electro-diagnosis—Cases of hys-
teria— Hypochondriasis—Cases—Neurasthenia—Spinal irritation —Dif-
ferential diagnosis—Insomnia—Astraphobia (fear of lightning)........ 435-457
CONTENTS. Xxi

CHAPTER XVI.
[Nsanity. Methods used—Cases. . ° ++ 458-462

senna eee cee ee eee e ere re cenes

CHAPTER XVII.
CEREBRAL AND SPINAL CONGESTION, Prognosis and treatment—Cases,, 463-467

CHAPTER XVIII.

CHRONIC ALCOHOLISM, Cas€S......cceseces secs seer secseseevcescses 408-469

CHAPTER XIX.

NEURALGIA. Methods of treatment—General prognosis—Cephalalgia—
Cases—Sick headache (migraine)—Facial neuralgia—Gastralgia—Scia-
tica—Reflex neuralgia—Galvanic belts and disks. ...........00.--00- 470-491

CHAPTER XX.

ANAZHSTHESIA, Different kinds of sensibility—Farado-sensibility—Electro-
diagnosis—Prognosis—Cases...... 6 aa heen ares Biceresie ee beg iaberaiore oie seeee 492-497

CHAPTER XXI,

PARALYSIS. Paralysis from opium—Syphilitic paralysis—Lead paralysis—
Hysterical paralysis—Cases—Hemiplegia, treatment and accessories—
Cases of hemiplegia—Glosso-laryngeal paralysis— Paraplegia—Facial
paralysis-—Paralysis from pressure and cold—Reflex paralysis......... 498-526

CHAPTER XXII.

LOCOMOTOR ATAXIA (POSTERIOR SPINAL SCLEROSIS), Causes of the disease
—Electro-diagnosis—Prognosis—Treatment—Cases..... ....eeeeee + 527-535

CHAPTER XXIII.

PROGRESSIVE MUSCULAR ATROPHY. Prognosis and treatment—Cases—
Progressive myo-sclerotis paralysis (Pseudo-hypertrophic paralysis)..... 536-540

CHAPTER XXIV.

RHEUMATISM AND GOUT. Treatment—Prognosis—Cases—Myalgia—
Lumbago—Pleurodynia—Rheumatic gout........... stie ews eeeeceee 541-547

CHAPTER XXV.

SPASMODIC DISEASES. Writer’s cramp—Torticollis—Cases—Paralysis-
Agitans—Asthma-—Facial spasm—Hydrophobia—Epilepsy—Cases.... 548-559

CHAPTER XXVI.

DISEASES OF THE SKIN, General considerations—Methods of application—
Central galvanization—Eczema—Prurigo——Lichen—Anwsthesia—Acne
—Acne rosacea—Psoriasis pityriasis—-Herpes—Herpes frontalis—Ring-
worm—Scleroderma—Melanoderna—Elephantiasis—Case—A lopecia—
Permanence of results......... stacaiancit Saath nib Hua eyshg evans o oie Gielen « 560-574
XXil CONTENTS.

CHAPTER XXVII.
DISEASES OF THE ORGANS OF DIGESTION. Electro-diagnosis—General

principles of treatment—Dyspepsia—Cases—Constipation— Chronic .
diarrhoea—Jaundice—Ileus (invagination)—Regurgitation (vomiting)—
Flatulence,-—Sea sickness, ..........0 0008 See Cin Sisieiena eves weeeces 575-586

CHAPTER XXVIIL.

“DISEASES. OF WOMEN. Amenorrhcea—Dysmenorrhcea—Menorrhagia—
Leucorrhcea—Methods of treatment, external and internal—General
and central treatment—Franklinization Prognosis —Cases—Atrophy
and displacement of the uterus—Congestion and enlargement—Irrita-
tion and congestion of ovaries—Intra-uterine galvanic pessaries... ... 587-602

CHAPTER XXIX.
DISEASES OF CHILDREN, Chorea—Marasmus and Whooping-cough—In-
continence of urine--Vomiting and cholera-infantum—Paralysis—Mi-
croscopic examination of muscles—Treatment—Cases,....... cesses 603-616

CHAPTER XXX.

DISEASES OF THE GENITO-URINARY ORGANS.  Electro-diagnosis and
treatment of impotence—Aspermatism—Spermatorrhcea—Cases—Pa-
resis and paralysis of the bladder—Orchitis—Enlargement of the pros-
tate—Prolapsus ani—Prolapsus of the sphincter—Hemorrhoids....... 617-628

CHAPTER XXXI.

DISEASES OF THE LARYNX. Anemia—Aphonia — Treatment—Cases—
Spasinus-glottidis—Nervous cough—Hyperzesthesia—Aneesthesia...... 629-638

CHAPTER XXXII.

DISEASES OF THE EYE. General considerations—Paresis and paralysis of
muscles—Asthenopia—Amblyopia and amaurosis—Spasm of the lid
—Opacities of cornea and vitreous humor—Ptosis and mydriasis—
Myosis—Neuro-retinitis Strabismus, ..... 0.0... ecceceueeee aehote 639-647

4 CHAPTER XXXIIL
DISEASES OF THE EAR. General considerations and methods of applica-
tion——Pathological reactions—General results—Subacute and chronic
inflammation of middle ear—Tinnitus aurium —Hysterical deafness—
Chronic suppuration of the middle ear... 0... eee eee 648-660

CHAPTER XXXIV.

Mipwirery. Faradization for inertia uteri—Post-partum hemorrhage—
Deficient lacteal secretion—Sore nipples................ 0.0032... 661-663

CHAPTER XXXV.
ARTIFICIAL RESPIRATION BY ELECTRIZATION IN CASES OF APPARENT
DEATH FROM DROWNING, OR SUFFOCATION THROUGH POISONOUS
s
GASES, OR IN ASPHYXIA OF NEW-BORN INFANTS, ...,... veeees 664-666
CONTENTS. XXili

CHAPTER XXXVI.

DISEASES OF THE HEART AND LUNGS. Palpitation of the heart—Angina
pectoris—Consumption.... ice cea ccd eee eee eear todos dad dacceetes 667-671

CHAPTER XXXVIL.

MISCELLANEOUS MEDICAL DISEASES. Seqnelze of cerebro-spinal and ther-
mic fever—Cases—Intermittent fever—Addison’s disease—Case--Dia-
betes—Exophthalmic goitre—Dropsical effusiotis—Brizht’s disease~—
Suppression of urine--Diabetes—Graves’ disease—Chronic rhinitis—
Catarrh of nose—Anosmia--Toothache—-Ozone and ozonized oxygen—
Hay fever--Fever and convalescence —--Obesity--Cirrhosis of the
NVOi)s esis: cried yavectinns Mew icelconc rey Boa ata mamnnrbensarnariot eaten aoe eda 672-689

ELECTRO-SURGERY.

CHAPTER I.
HISTORY OF ELECTRO-SURGERY. Early history—Later history—Surgical
and medical electricity compared ......... apehad see CaRota eA ReC Este 691-698

CHAPTER II.

ELECTROLYSIS. Its nature and general methods—Method of introducing the
needles—-Electrolyzing the base--Method of operating—Instruments—-
Theory of the method—Its advantages and disadvantages...........- 699-710

CHAPTER III.

GALVANO-CAUTERY. Advantages over actual cautery—Apparatus, handles,
burners, loops for Galvano-cautery—Care of batteries—Uses and advan-
tages of “the galvano-cautery—Rules for use of galvano-cautery, and
adaptation tu various departments—Statistics of cases,...........006 711-723

CHAPTER IV.
BENIGN AND MALIGNANT ‘TUMORS. Neevi (erectile tumors)—Goitres—
Benign cystic tumors—Malignant, cystic tumors—Hydatids of the liver
—--Fibroids—Fibroids of uterus—Lipomata (fatty) tumors—Adenitis,
—Ovarian tumors—Polypi—Epithelioma—Scirrhus and other malignant
growths—Cases—-Relief of pain of cancer by Seana
CPALIVE- CASES, 2.4 cae s s2G ou Bee Meas SRE See omens + 724-75 3

CHAPTER V.

ANEURISMS AND VARICOSE VEINS, Method of operating—Statistics of
aneurisms treated by electricity —Varicose veins ...........+002008 - 754-758

CHAPTER VI.
STRICTURES, Stricture of the urethra—Experiments and cases—Stricture
of the cesophagus.,... ok sdeaaeeotgnacinle sake Slee wyaenaeuiemiylstsiel ore shale Giese 759-763
XXiV CONTENTS.

CHAPTER VII.

ULcERS, FISTUL4E AND SINUSES. Ulcers—Bed-sores—Method of treat-
ment— Galvano-ozonization......... siavleusncnaasiavsnysnusyS4 Siva ESE 764-766

CHAPTER VIII.

,MISCELLANEOUS SURGICAL DISEASES. Stumps after amputation—He-
matecele—Gangrene—Carbuncles—F uruncles—Burns—Frost-bite (chil-
blains)—Synovitis—Hydrocele—Sprains—Strains of muscles—Spondy-
litis (Pott’s disease)—Spinal curvature—Pseudo-arthrosis (ununited
fracture)—Hernia—Morbus coxarius (disease of the hip-joint)—Club-
foot (talipes)—Warts—Dissolution of calculi in the bladder—Electric
explorer or probe—Extraction of foreign bodies by the electro-magnet
—Electro-chemical baths--Removal of poisonous metals from the body
—Faradic anzesthesia—Hydro-electrization—Electro-medication—Po-
LIST OF ILLUSTRATIONS.

1—Magnetic Tone, illustrated.............. Sid acon etauacera mates a acais tape anatase ae
2—- « Polarity, illustrated..... ... bvuraviash Gueiilesa CuouaMhaacans Scadatintuanavens »- 4
a ATMAUNTE: ois cdieeniawake andre enacts ot a Sa casastrocavanaies wie igrsters we 6
4—Insulated Conductor............. elie AusaliaouekGiekaeds sassanuases 10
5— Brass Hemispheres cose waxcwsiesalnna ke nseessens esate watemaseeare 17
6—Insulated: Cylinder... savssseascnrsiausn acasbenseredesecess pamee ae 18
7—Cylinder Electrical Machine........ 0... ...06 00 cece e nec e teen eens 19
S—Holtz's Machine. ssxvassigiwassatn sms wndeeenstneete teedeuneg aaa 20
G— Betinett!s: Blectrosco pe... iscsi siccacosn/svecs, avn: at oi basveusior@in ecerdis Soevbigucenceopenre-atd. 3 21
NO Wey deri Jae asi vavauscaveiacaratsic cathe ashcnrdnsrastiaancccdausipnoscenes icusvor ia Beadeccauevenseseause™ 22
TU Simple Galvanic: C1icley, 5c cscs erace des asersnaicr aubioitie win wen andrea itavvasavane or blecwror 28
12—-Compound Galvanic Circle... 0.0... cece ccc eee cece e ete en eens 34
13—Branch Current, illustrated... 0.0.0... cece eee e eee tenes hand vranstitan tease 35
14—Voltaic Pile............... exeraaue eieapcvens alates i aus anne rats aate Salekeb canals 36
15—Daniell’s Battery............. a aciuiisisae sare aa eh Cia tate Neate arena te .. 38
16—Grove’s Battery.............0008 Siecaseers si HIRT MOTE SRE ES 40
17—Bunsen’s Nitric-Acid Battery,.............000°- ee ee 40
18—Smee’s Battery......... (sla or stan-Sion Weim anticelbaarBepsaun ate BS aciersieeas econ esis ie 43
TOSSVOMAMELER. occiccdduaraineaabalesaatienuisecns Srenty Cosh talc claspanise Slsegeys hye caseduewensieaa 40
20—Astatic Galvanometer..... aa giasarerstecrsieten jet svesl Shae eit eaoneraorcantiatezare 47
21—Galvanic Frog......... Voww EGU Saereledealkre as Mie tigers 49
22—Phenomena of Electrolysis ..........0..5004 ideas aise enignareyieng 58
23—Electro-magnetic Helix......... SPAS R De ASR tle @iacieiaieve ensiace 61
24—Electro-magnet..... Di dagatesiensematase ae TS eae ssmwes ion ereen athens 61
25—Current Induction, illustrated. .........0. 62 ce ee eee ete nee e ec eeeee 62
26—lInduction, illustrated........... i aes eaacbeaaasd ganaraiaiapses ae SEIN aie eaarwante 63
27—Current-interrupter.----..... ee eee e eee reer eee Wyrr eee e reece cceee 64.
28-—Ruhmkorff’s Coil. .... Ane stWucuniesinoreenan ica ibrevercuavese Sivas eet 66
29—Horse-shoe Magnet... 2... sce seer rece eee e rece ee ere tenenerenee . 69
30—Thermo-electricity, illustrated......... araeaiids al Saudi go GeseaN WR Se venom ope 72
31—Thermo-multiplier .. 2.0.0... eee cece e eee nent e etter ence ee ecens 75
32—Farmer’s Thermo-electric Battery..........-seeee cere ceeereeeteeeeee 76
33—Electrotonos, illustrated ...... 6... cece ee eee eee teeter ec en ences 112
34—Anelectrotonos and Catelectrotonos, ifiustrated te eee ee 113
35~43—Sphygmographic Tracings...... osentuua davecousaoeetee a iene eae See wale aneeen son HBF

54—Electro-therapeutical Anatomy of the Human Body—anterior view...... 322
xxXvi LIST OF ILLUSTRATIONS.

PAGE
55—Electro-therapeutical Anatomy of the Human Body—posterior view..... 323
56—Kidder’s Faradic Machine......... cece cee ccceeeeeee ace voraslnadcerndunto 331
57—Faradic Machine (Galvano-Faradic Mnmutactadic Co. De daieiaih avecranetevensne 335
5s— es without the box..........ceeeeeneee Hearne aneares 336
5o— - (Thomas Hall) ec eccaececcin a eynwsguviave see cies +. 337
60—Zine-carbon Battery; 32 cells, .sc..cuscccasses as teste does nee eaenrnr «+ 339
61—-Galvanic Battery,-16 cells... 00.1... . cece cece ee rere eee e teeter ee eee « 340
62—Two Zinc-carbon Batteries, united, 18 cells....... i daveis aeRO SS severe 340
63—Galvanic Battery, 36 cells... .... cece cece cece tne ence eee enees 341
64—Kidder’s Zinc-carbon Battery, 18 cells... 2.2.0.0... cece ee ee inc orsioed ietteen’ 342
65—Cabinet Battery (Galvano-Faradic Manufacturing Co.)..... ay iou ers sayiauau diet 345
66—Portable Galvanic Battery (Drescher).............. siikanasievoenorac ees sieejoua2eay 349
67—Galvano-Faradic Machine, BE cere a fate jusatanaristgrentun phikevarteienalseeraibas 350
68—Portable Beetz-Lechanché Battery... ........ ce cece cece cece eee tener 351

. 69—-Brenner’s Apparatus (Galvano-Faradic Manufacturing Co.),........-++ » 352
70—Galvarometer used by the Authors (Chester & Co.) .... ..05 seeaseree 352
7i—Siemens’ Stopper-rheostats +0000. nexweswas saeawaee cia gevew sae eweseas 353
72—Hydro-rheostat (Galvano-Faradic Manufacturing Co.)..........000ee ees 354
73—Universal Handles for Electrodes........... eee. ee eeeees Pe eeeeeE es 355
m4— “ ge ‘¢ _ with Interrupter, insulated........... 355
75 Long Sponge: FlECtrode, «wes ative sessieinvsieiea ecouhnaoeneve ind ORR Ringer soa be sass caueie 356
76—Electrodes of various sizes to be attached to Universal Handles.......... 356
77—Hard Rubber Handle and Electrode. ........... 000 ceccee ese eceeeees 386
78—Sponge-holder, with sponge attached. ...... 0.0... cc eeee cece ce ceenees 356
79—Small Sponge Electrode... .... cece eee ee ee eee eee eee Seer otpine hs «. 356
862 Diichentiels: Ele ctiod enw cean neve ccantwreie saan 6 atnspewaeirenteatecrs 356
81—Rockwell’s Brass Ball Electrode for General Faradization, .... ehivgerenteeys 356
,82—Beard’s Stationary Electrode. .......... 0... ccc e eee ce ec eneeeee 357
83—Adjustable Electrode, with band......... 0... c cece cee e ee eee eee e ees 357
84—Beard’s Adjustable Electrode, with flannel cover........... 0000 ce eeuee 358
85—Flannel Cover for Electrode... .........0ceeeeece oo PERE Da 358
86—Adjustable Electrode, with sponge......... sasece Se sah RSI Heatntvevesecevnseia 359
87—Oblong Adjustable Electrode... 2... 0... 0. cece cece nee e cece ene ceeeee 359
OS — Metallic, Bash ses sot asecds ve fe WEE Seencn bean anpaa Bipeeis sarduotbentevarmibemmsnmedes ove 359
89— ‘¢ with brush pushed within the cylinder...... Seid Wes gaia + 359
go—Spinal Electrode... ........ eee eee stivexadvenumorint a oiawentatae éeugeean 359
g1—Beard’s Current-reverser.............00 06 crete eatanenoratinrergiay sieves saeroatis 360
92—Meyer & Meltzer’s Faradic Machine.......... 0... cu ceca cece ec eueece - 363
93—Foveaux’s Portable Galvanic Battery,...........ccccccseeceecccceees 365
94—Meyer & Meltzer’s Portable Apparatus .......... 0.00. ceee eee shad Sine 366
95—Galvanization of the Cervical Sympathetic........ 00.0... cece ee eees 372
96— ss ss ee «s including the Pneumogastric.. 373
97—Faradization of Facial Nerve and Muscles........... 0... cceeeeeeee wesw OS
g8— Muscular Faradization, with Metallic Electrodes. ............cececeeee 375
99—Faradization of muscles of thigh... ........ 0 1. e cece ace e nce ccceeee 376

too— ee ‘* Popliteal Nerve and serene ‘tcaclez,, iaicaish aotigrace ve ietedayy 376

ror—Spinal-cord-brachial plexus current..2...... sevannrshe Siavovsiehararaandielawlenstehuais 378

10z—Spinal-cord-medium neive current........ *SUeierstedeaiwmas oem wien 37S
LIST OF ILLUSTRATIONS. XXVil

to3—General Faradization, application to head...........cccecccecceuesecs 3s
1oq— . a #8 SPM sccaea ice ces eigoean insensedes 987
105—General Galvano-faradization, application to spine by sponge-holder...... 390
106—General Faradization, application to stomach...... 60845534 vite wA 394
1o7— ‘* cs we “ lower extremities .........cccceees 395
108—Central Galvanization, first stage... 0.0.0.0. cece eee ise Sra seuss anecceopanniy ny 412
tog— “ es second stage..... aie lanGa ax hysteininiets aarded we AIG
110o— * as thindvatagels soa scence doe.aet dace Salons srg ations 414,
im— * ss FOU CH StABE eck ens oy Gis How aan ane eecieinks or o. 415
112—Method of Franklinization,.......... a debes ate eG aves avesveuacs abiitierieiciane: «6 430
113—Electric Bath. ....... lon eesansas signet W oie sa darned ater terete a8 oem vee 432
PEAS Circle Disks 3 2scvie- ai evade ss Sai yiggin eek 6 pad GH aD ee ee - 544
115—Oblong Button Disk......... ana neseiae Be Re Ne ES Nota Bere ee 544
116—Elephantiasis of legs, before treatment by electricity................26 573
117-—Rectal Electrode, non-insulated...........0.4- oa eeialer lassie eadends cae SON
r18— “ | « insulated..........2006 Fie Dbwertinclanmaldinineaaa-t da wile’ 581
t19—Double Rectal Electrode..... sini yieee eg gaan eases dsaiwtegparss degeesee SSE
120—Faradization of the Uterus..........0.cceeeeeceeeeee gists eave erates se «. 588
121—Uterine Electrode............. iit weod a sin ees sivaerlasa dak Gis ema 8474 589
122—Beard’s Intra-uterine Electrode.......... was See Nene ceawls sf evaesee 589
123—Double Intra-uterine Electrode...............- os wraliatareiaetn di Se Rte vee. 589
124—Duchenne’ s Double-uterine Electrode, open..... ae LOe CER EWA O ed 8S BAS 590
125— ss ss a ee closéds 25 wecsces ieee 845084 590
126—Vaginal Electrode..... wieudneid Siang Bea evesaian ous Sisvaussate wistarwiaver sie geese case «+ 591
127—Intra-uterine Galvanic Pessary............ ibiaeidicaosmarsaa tiated ieee uae . 608
128—Duchenne’s Trocar.........e000+- ise es ineeeee Si ov iviain Wao ote sini ees soe 610
129—Noeggerath’s Trocar........eeeeer ee eee ee ee eeeee apa teiire tie @saanaaces 610
130-131-132—Normal Fibre, first degree... .......50:-+ ee eres ow neler ay 611
133-134—Normal Fibre, second degree......... siidlogwlee eRe da tele Seeey eke 611
135-136— * «© third degree.........000 ieee eee errs ees wea vgs (OI2
137-138-139—Normal Fibre, fourth degree.... ........ dk 6 ee Trrerr re exe B12
140—Insulated Catheter Electrode. ...... es sce eee teen ee eeaee §.seaebagete 621
141-142—Double Vesical Electrode, closed and Open. .......e ees eee cence . 625
143—Laryngeal Electrode and Necklet.............e0200+ siGibe-etbia .aueaalatonna sess 632
144—Internal Electrization of Ear..........2..4. efide ee ate eess Savidve ody aunave 649
145—Murray’s Galvanic Nipple-shield.............. dae IeA Ode Melee DRT 663
146—Nasal Electrode ..........-+e-eeeeee  aisleraeveGureue ate ees we Meielg ee pees . 634
147—Conductor for Electrolysis... ......-0 ces ce cece teen ence en ee ee en ees 702
148—Bayonet-pointed Needles for Electrolysis. .........0ssceeeseeeeener ees 703
149—Rockwell’s Long Needle for Electrolysis of Uterus............ aa ga wince 703
150—Rockwell’s Needle Holders with Needles for Electrolysis..........0--.55 704
151—Beard’s Long-cutting Needles for Electrolysis of the DASE. cece a eceeee ae 704,
152—Electrolysis of Base in scirrhus OF breast. saicsiweiegie aaa wee tse aes ee . 706
153— “s ce 6a ee ‘6 6 after removal of tumor........ 707
‘154—Byrnes’ Multiple-element Battery. ......-.0. sess rreee ener ecees of ab ahi 712
155—Zinc-carbon Galvano-cautery Battery (Drescher & CO} wi ssaper ceca gees 713
156— “ os (© (Kidder).......cseswseseee eee eeen et 713

157— “ ss «¢  (Galvano-Faradic Manuf’ing Co.). 714
XXVili LIST OF ILLUSTRATIONS,

PAGE
158—Galvano-cautery Battery (Meyer & Meltzer, London).... ......+.. seem, FUG
159~-189—Accompanying Appliances, Handles, Burners, or Cauterizers, Loops,

Knives, etc., for Galvano-cautery..... oisasesiapece shi sopavdiorenaudusig nse 716-718
190— Galvano- -cautery Operating Case and Loop (Galvano-Faradic Manufac-
a PMT ITS (COL) svcat k seneea Natehecier Soh erekcigg weve a ate epladtg ealwoseenetolghonele -- 718
192—Benign Cystic treated by ordinary Hlecttolysis eeaeats iui ween aes seyieiatencis 732
193—Electrolysis of base of malignant cystic tumor............00.. sewsereoee 735
194—Removal of Epithelioma by Electrolysis of base...........0e00e005 sees 740
195— ) Epithelioma of Vagina and Vulva before and after operations by Elec-
os trOlysISs 6a cee vesiese ee eo ie keetaw seamen 743
197—Scirrhus of Breast treated by ordinary electrolysis...... Scayaearacbie wine Dietetins TAY.

198—Trouve’s Electric Explorer......... ceeccees ccccccccsescsevsesvens 773
ELECTRO-PHYSICS.
ELECTRO-PHYSICS.

CHAPTER I.

A KNOWLEDGE OF THE PRINCIPLES OF ELECTRO-PHYSICS NECESSARY
TO THE ELECTRO-THERAPEUTIST—DEFINITION OF ELECTRICITY—.
MAGNETISM.

Electro-physics is the science which treats of electricity in its physical
relations.

No one can be a master in electro-therapeutics without also being a
master in electro-physics. Hence it becomes necessary, in a systema-
tic treatise on electro-therapeutics, t6 present the leading principles of
electro-physics, and to point out their practical bearings both on
electro-physiology and electro-therapeutics. This necessity is all the
greater because electro-physics is the branch of electrology that electro-
therapeutists are most of all disposed to neglect ; and ignorance of this
department has retarded, and still retards, the scientific advance of
electro-therapeutics both medical and surgical. It is possible to make
happy hits in electro-therapeutics without knowing anything of electro-
physics or electro-physiology ; but on the average, and in the long run,
the best results will be obtained by those who to purely practical know-
ledge add a thorough mastery of the scientific relations of the subject.

Why discussed in a Practical Treatise like this.—The necessity of pre-
senting the leading principles of electro-physics in a practical treatise
like this is the more imperative from the fact that, until quite recently
at least, all, or nearly all, the text-books on physics in use in schools
and colleges have failed to represent the advanced researches and
generalizations of modern scientists in the department of electricity.
The old hypotheses, that electricity is a single or double fluid, still linger
in our centres of education, or yield the ground but slowly ; and even in
those works that are fully up to the times on this subject, the special

I
2 ELECTRO-PHYSICS.

and practical bearings of electro-physical principles on electro-phys-
iology and electro-therapeutics are of course not considered.

To this should be added the consideration that any science, however
well acquired, if it be not kept before the mind by teaching or writing,
or by practical application, soon fades from the memory, or becomes a
mass of half-truths and uncertainties. We are therefore justified in
assuming that not one in a hundred of those who will consult this book
as a guide in electro-therapeutics will be so thoroughly and accurately
informed on the principles of electro-physics as not to need, on this
subject, some compact treatise which shall serve as a guide and reminder
of the leading facts and principles of the science. To supply this need
is the object of this division of our treatise.

‘ NATURE AND DEFINITION OF ELECTRICITY.

Electricity is now regarded as a FORCE correlated to the other great
forces of nature—heat, light, etc.—and, like them, is simply a mode of
motion,—a form of vibration.

Although the precise nature of these vibrations have not yet been
‘mathematically demonstrated, as in the case of light and heat, yet the
theory that the phenomena of electricity are the result of vibrations has
much in its favor, and it is by no means impossible that in the future the
nature of these vibrations will be well understood.

In the present treatise, as in all works on physics, various terms, as
“current,” “flows,” “runs,” etc., that took their origin when the fluid
theory prevailed, are retained for the sake of convenience of description.
With this understanding there is no objection to their use.

Electricity is manifested in three general forms: Magnetism ; Stati-
cal or Frictional or Franklinic Electricity ; and Galvanism, or Voltaic
or Dynamical Electricity.

MAGNETISM.

Magnetism.—In order to understand electricity in general it is neces-
sary to understand magnetism, which is one of its manifestations.
Magnetism, defined by its phenomena, is the power which certain bodies
possess of attracting iron. The bodies which are observed to have this
power are called magvets, and are divided into two classes—zatural and
artificial. Natural magnets consist of iron ore or loadstone. Joad-
MAGNETISM—POLARITY OF MAGNETS. 3

stone was first discovered in Magnesia, in Asia Minor, and hence the
name magnet was derived. The compass was introduced into Europe in
the twelfth century; but the Chinese are said to have been acquainted
with it in the fourth century.

Artificial magnets are usually made of steel that has been magnetized
by the galvanic current or by other magnets. Steel bars that have
been thus magnetized may be either straight or bent. For convenience’
sake, they are usually bent in the form of a horseshoe.

All substances are more or less susceptible to magnetic influence, but
iron is more affected by it than others. Experiments illustrative of the
effects and power of artificial magnets are so familiar that they need not
be cited.

Polarity of Magnets.—The polarity of a magnet is that peculiar pro-
perty by which it manifests two opposite kinds of magnetism, that are
termed, relatively to each other, the north and the south pole. When a
magnetic needle is so suspended that it can move unimpeded in any
direction, one end points to the north, and the other to the south. If
the magnét be disturbed in any way, and forced temporarily out of
position, it at once and uniformly returns.

Polarity is a quality that belongs not only to magnetism, but also to
other forms of electricity, and to light and the other great forces,

The poles of a magnet are always at its ends, for here the attractive
power is greatest. This can be demonstrated by a very simple experi-
ment. If a magnetic bar be rolled in a pile of iron-filings, it will be
found that these adhere to the bar most firmly and in the greatest
quantity at and near its poles. The quantity that adheres is less as we
approach the middle of the bar.

Neutral Line.—In long bars there is always a place at the middle,
or near to it, where no filings are attracted. This space is variously
termed the neutral or magnetic zone, or magnetic equator, or point of
indifference.

NE

Fic, 1

 

Another familiar experiment is to pass an iron ball, suspended by a
string or thread, near to a magnet from end to end. It is observed
that the ball is attracted very little, or not at all, in the middle, but
4 ELECTRO-PHYSICS.

that the attractive power is increased as we bring it towards either end.

"If any substance be placed between the ball and the magnet, the at-
traction is just as marked, unless the interposed substance itself con-
tains iron. Nearly all substances that are not themselves magnetic
are capable of transmitting the magnetic influence,

Another feature of magnetic polarity is, that like poles repel, and
*unlike poles attract, each other. If one magnetic bar be suspended
freely in the air, and another be brought near to it; it will be found
that the north pole of one is attracted by the south pole of the other,
and vice vers@—in short, that the like poles repel, while the unlike
attract,

 

Fic, 2.

Magnetism of Broken Magnets.—If a bar that has been magnetized
be broken in the middle, each half will have two poles and a neutral
point in the centre. If one of these halves is broken in the middle,
each half will be found to have two poles and a neutral line. If one
of these parts in turn be broken, each half will again be found to be a
complete magnet, with two poles and a neutral line, and so on as long
as we can carry the division.

Coulomb's Theory of Magnetism.—A theory of magnetism ad-
vanced by Coulomb is, that magnetic substances consist of particles,
each one of whichis a magnet. These particles have their poles turned
in different directions, so as to neutralize each other.

Magnetization brings these particles round so that éhey lie in the same
direction. This theory brings magnetism very close to statical electri-
city, and would naturally be adopted by those who believe all mag-
netic phenomena result from electricity in magnetic bodies.
MAGNETIC INDUCTION. 5

’

Between the behavior of electricity in animal bodies (animal electri-
city), electricity in general (statical and dynamical electricity), to be
subsequently explained, and magnetism as here explained, there are
analogies so close and so consistent as to warrant the view that all are
but different manifestations of one force.

Magnetic Induction.—lf a bar of soft iron is brought in contact
with or near to one of the poles of a magnet, it is attracted, and for
the time being becomes itself magnetic; and if it is brought near
enough to the magnet, it firmly adheres to it. A bar of soft iron thus
obtains by zzduction all the properties of an ordinary magnet. It has
a north and south pole. It attracts iron-filings around these poles, just
like the regular magnet. If another piece of soft iron is brought in
contact with, or near to its poles, it is attracted and made to adhere,
just as it would do if applied to an ordinary magnet. Quite a number
of bars of soft iron may be made to adhere in the same way. But
when this bar, thus made magnetic, is forcibly removed from the per-
manent magnet to which it adheres, it instantaneously loses all its mag-
netic power, and the iron-filings or pieces of soft iron that have been
attracted by it at once drop off. Such a magnet is therefore styled
“temporary,” in contradistinction to the permanent magnets of steel.

If a bar of s¢eel is brought near to, or in contact with a magnet, it
also becomes magnetic, and exhibits very different phenomena from
the bar of soft iron. In the first place, it becomes magnetic much
more slowly than the bar of soft iron, and displays less miagnetic
power. On the other hand, it does not, like the soft iron bar, lose its
attractive power as soon as it is removed: from the magnet, but perma-
nently retains it.

The quality of steel by which it at first resists the attractive power
of magnets, and resists the dispersion of the magnetism which it has
once acquired, is called coercitive force.

The same phenomena are observed in regard to heat. Some bodies
that are quick to acquire heat, are quick to part with it; and vice versd,
those bodies which, like iron, steel, and so forth, acquire heat gradually,
also part with it slowly.

It is by virtue of its coercitive force that doadstone permanently re
tains its magnetism.

The harder any steel is, the greater its coercitive force. Steel that
is soft has comparatively little coercitiveness, and when brought near
to, or in contact with a magnet, it behaves very much like soft iron.
Very hard steel, on the contrary, has so great coercitiveness that it is
only attracted by very powerful magnets.
6 ELECTRO-PHYSICS.

. Soft iron, when adulterated with sulphur, phosphorus, arsenic, or
charcoal, or if it is even twisted or bent, may exhibit a slight degree
of coercitive force. Soft iron that is perfectly pure possesses no coer-
citive force whatever.

The law of the distribution of magnetism in a bar of iron, and the
law of magnetic attraction and repulsion were discovered by Coulomb
in 1789.

Shape of Magnets—Magnetic Armatures.—Artificial magnets are
either composed of straight bars, or are bent in the shape of a horse-
shoe. The horseshoe form is used mainly for the sake of conveni-
ence. It enables us to apply both poles simultaneously and uniformly
to the object that is to be magnetized. Very powerful magnets may
be made of a number of thin steel bars placed side by side, their poles
being situated homonymously, that is, lying in the same direction, A :
number of bundles of bars of steel arranged in this way is called a
“magnetic magazine, or battery.”

Magnetic armatures are pieces of soft iron that are placed at the ends
of magnets, to keep their magnetic power. This bar, or armature, not
only receives magnetism from the magnet, but acts upon it in return,
and thus helps to preserve its magnetic power. Magnets that are not
provided with an armature gradually lose their attractive power by the
disturbing influence of the magnetism of the earth. The magnetic
power of magnets is apt to be impaired by letting them fall on a hard
surface, or by suddenly striking them with a solid body.

 

Fic. 3.

Magnetization.—It is possible to communicate magnetism to bodies
that can retain it in several different ways:

1. By single Touch.—The bar which we wish to magnetize is laid
on a table, and the pole of a magnet is rubbed along its surface from
end to end for a number of times.

2. By double Touch.—The bar that is to be magnetized is placed on
a piece of wood, the ends of which are placed against two strong mag-
nets. Two magnets for rubbing are placed on the bar to be magnet-
ized, making an angle with the bar of from 15° to 20°. A small piece
of wood is placed between the extremities of these two magnets, to
prevent their touching. They are then rubbed along the bar that is to
be magnetized, from the middle towards the end, and back again, and
MAGNETIC INDUCTION. 7

raised from the magnetized bar again at the middle. This method
communicates a strong, though sometimes irregular magnetism; it was
invented by Mitchell, and perfected by Epinus in 1758.

3. By separate Touch.—This method consists in putting two opposite
poles of two magnets of the same force in the middle of the bar that is
to be magnetized, and moving each of them at the same time toward
the opposite end of the bar. This operation is repeated several times
on both sides until the bar is magnetized.

The magnets may be held vertically or may be inclined.

The vertical method was first used by Knight in 1745.

4. By the Galvanic Current.—The bar to be magnetized is placed |
inside a coil of insulated wire through which a galvanic current is run-
ning, and is then moved backward and forward, as in the method by
the double touch.

5. By the Earth.—It is clear that the earth is itself a magnet, for it
manifests strong inductive power. A steel rod becomes permanently
magnetic when it is held parallel to a dipping-needle. If a bar of soft
iron is held in the same position it also becomes magnetic, and much
more rapidly than the steel bar, but does not so long retain its magnet-
ism. Ifa soft iron bar, held in this position, is struck a few times by a
hammer, its magnetism, which was before temporary, becomes per-
manent. The blows of the hammer seem to impart in some mys-
terious way a coercitive force to the temporary magnet.

Large masses .of iron, when kept in a stationary position for any
length of time, always give proofs of having been magnetized by the
earth. Tools in workshops are apt to become permanently magnetic
from the repeated hammering to which they are subjected. The mag-
netism of the loadstone is due to the silent but continuous inductive
action of the earth.*

Saturation Point of Magnetism.—The limit of the amount of mag-
netism that a magnet can permanently retain is called the point of satu-
ration. Mf any magnet receives more of magnetism than it can perma-
nently retain, it gradually loses it or throws it off until it falls to the
point of saturation, when it ceases to lose any more. The saturative
point of any magnet depends on its temper and coercitive force. Mag-
nets will retain their magnetism at the point of saturation for years if
they are not seriously disturbed.

Magnetism is very markedly influenced by temperature. -When a

* On this subject we may refer to the able pamphlet of Prof. Mayer on The Earth
a great Magnet.
8 ELECTRO-PHYSICS.

magnet is heated it loses its magnetic power in proportion as its tem
perature rises ; when it is cooled, it regains more or less of what it has
lost. But if any magnet is subjected to a heating process for a numbe1
of times, it becomes less sensitive to the changes of temperature. All
evidence of magnetism is driven out of a magnet at white heat, but it
regains its capacity of magnetization after it has been tempered and
fhagnetized.

Paramagnetism and Diamagnetism.—When a rod of iron or a needle
is suspended between the poles of a magnet, it is attracted by these
poles, and keeps a position of rest between them, in a line joining the
two poles.

Substances which behave in this way are called paramagnetic, and
they are said to place themselves axiadly between the poles. When a
rod of some other substance, as bismuth, is suspended between the poles
of a magnet, it is repelled by them, and keeps a position of rest in a line
of right angles to the two poles. Substances which behave in this way
are called diamagnetic, and they are said to place themselves equatori-
ally between the poles. The representative of paramagnetic bodies is
iron. The representative of diamagnetic bodies is bismuth. The para-
“ magnetism of iron, nickel, and cobalt is manifested before magnets of
average strength; but the majority of substances exhibit diamagnetic
traits only in the presence of the strongest magnets.

Experiments in this department are usually conducted with electro.
magnets, since they are much stronger than permanent magnets.

Paramagnetism and Diamagnetism of Liquids, Flames, and Gases.—
To study the magnetic properties of liquids, they are placed in long
tubes of thin glass and hung like rods of solid substances between the
poles of a magnet. It is found that some arrange themselves axially
and others equatorially.

A paramagnetic liquid becomes heaped up at the poles and depress-
ed between them. A diamagnetic liquid is depressed at the poles and
heaped up in the centre. The flame of a candle is repelled by the
poles of a magnet and brought into an equatorial position ; it is there-
fore a diamagnetic. The magnetism of gases is studied by sending
them through glass tubes between the poles, or by inflating soap bub-
bles with them. The nature and degree of the magnetism which bodies
exhibit is modified by the nature of the medium in which they are
examined. A glass tube filled with a solution of proto-sulphate of
iron is paramagnetic when suspended in air, in pure water, or in a
more dilute solution of proto-sulphate of iron; in a solution of the
same strength it is indifferent ; in a stronger solution it is diamagnetic.
PHYSICAL EFFECTS OF MAGNETIZATION. 9

Then, according to the medium, a substance may be paramagnetic,
diamagnetic, or indifferent. The general law is, that a substance is in-
different toward a substance of equal magnetism, paramagnetic toward

one of less magnetism, and diamagnetic toward one of greater mag
netism than itself.

PARAMAGNETIC SUBSTANCES, DIAMAGNETIC SUBSTANCES,

Iron, Bismuth,
Nickel, Antimony,
Cobalt, Zinc,
Manganese, Tin,
Chromium, Cadmium,
Titanium, Sodium,
Palladium, Mercury,
Paper, Lead,
Sealing-wax, Silver,
Peroxide of Lead, Copper,
Plumbago, Gold,
Red Lead, Arsenic,
Sulphate of Zinc, Alum,
Shellac, Glass,
Vermilion, Sulphur,
Charcoal, Sugar,
Oxygen, Alcohol,
Au, Water,
Salts of Manganese, Caoutchouc,
Proto and per Salts of Iron. Hydrogen,
Nitrogen,

Carbonic acid.

Brugman discovered in 1778 that bismuth was repelled and cobalt
was attracted by the poles of a magnet. Diamagnetism was discov-
ered and worked up by Faraday in 1845. In 1855 and subsequently the
subject has been variously investigated by Tyndall.

Physical Effects of Magnetization.—Magnetization produces two
remarkable effects—sound and elongation. When a good ear is placed
near an iron core, just as the current is being established around it, a
click is heard. The same sound is heard when the current is broken.
Place a rod of soft iron in an electro-magnetic helix, with its ends rest-
ing on two trays, and musical sounds may be produced. Elongation of
a bar when magnetized is thus explained. The bar may be supposed
10 ELECTRO-PHYSICS.

to be made up of particles united by cohesion but capable of re-
moval.

When the bar is magnetized these particles put their longest
diameters lengthwise to the bar, or tend in that direction. That sound
is an effect of magnetization was discovered by Page. The elongation
of a bar by magnetization was discovered by Joule, of Manchester, one

of the pioneers of the doctrine of the correlation and conservation of
forces. Grove has also shown that iron filings, suspended in a cylinder
around which the current runs, attach themselves end to end.

Terrestrial Magnetism.—When a needle is so placed that it can
move freely in a horizontal direction, it always assumes a north and
south position. When a needle is so placed that it can move freely in
a vertical plane, it inclines more or less toward the earth. ‘

These positions of a suspended needle are directed by the magnetism
of the earth,—/errestrial magnetism,—and are respectively termed its.
declination and inclination.

Terrestrial magnetism is composed of three elements—declination,
inclination, and intensity.

Declination.—The declination of the magnetic needle does not
always coincide with the north and south points of the horizon, but as
a rule only approximates to them.

The magnetic meridian is a vertical plane passing through the
horizon at the points indicated by the needle.

The astronomical meridian is a vertical plane passing through the
horizon at the north and south points. The angle between these merid-
ians is called the vardation of the needle.

Inclination or Dip.—When the magnetic needle is free to move in
a vertical direction, it inclines from the horizontal position. The angle
between the needle thus inclined and the horizon is called the dig or
inclination. ‘The dip is greatest in the polar regions, and diminishes
toward the equator, where at certain points it is zero. This discovery

_ was made by Robert Norman, an instrument-maker, of London, in
1576.

Magnetic Poles.—Those places where the dipping-needle is vertical,
that is, where the inclination is 90°, are called magnetic poles.

In 1830 Sir James Ross found that the north magnetic pole was 96°
43' west longitude, and 70° north latitude. The probability is that the
south magnetic pole is about 154° east longitude and 7 54° south
latitude.

Jntensity.—The magnetic force of the earth which brings the sus-
pended needle to the magnetic position, after it has been driven from
.

VARIATIONS OF THE NEEDLE, II

it, is called intensity. The needle may be regarded as a magnetic
pendulum, with magnetism instead of gravity acting on it.

Halley, the astronomer royal, published the first magnetic charts in
1701.

Variations of the Needle.—The magnetic elements—inclination, de-
clination, and intensity—vary at different places. These variations
are called secular, annual, and diurnal.

Secular Variations are those which take place in the lapse of
centuries. In every place the magnetic elements vary with exceeding
slowness from year to year, completing cycles of change in the course
of ages.

Annual Variations are observed from month to month. The west-
ern declination, for instance, decreases between April and July, and
increases during the remainder of the year.

Diurnal Variations.—The needle has a mean daily position, from
which it regularly deflects eastward or westward at certain hours of the
day. At midnight the needle is 14’ east of this mean daily position.
It reaches its furthest east point at eight o ’clock in the morning. At one
o'clock in the afternoon it reaches to 10’ west. It remains west of the
mean until midnight. The needle is at the mean position a little after
ten in the morning and a little before seven in the evening. But the
daily range of the needle varies in the different seasons of the year. In
the month of May the average daily range between the eastern and
western extremes is 12’. This is its maximum range for the year. In
December the average daily range is 5’ 28”, which is the minimum for
the year. Diurnal variations were discovered by Graham, an instru-
ment-maker, of London, in 1722.

The diurnal variations of the range are not uniform in all parts of the
world. Near the magnetic equator it amounts to very little or to noth-
ing at all, but increases toward the north.

Occasional Variations.—The daily course of the needle is liable to
be quite materially altered by the various changes and disturbances of
the earth and atmosphere. Sometimes these changes thus produced
amount to one or two degrees.

It is very well known that the phenomena of the “northern lights ne
are accompanied by greater or less magnetic variations. Earthquakes,
volcanoes, thunder.storms, whirlwinds, and indeed all forms of disturb-
ances and warring of the elements, are liable to be associated with
greater or less variations of the terrestrial magnetism. These disturb.
ances have been termed by Humboldt ‘magnetic storms,” and are
known as such among telegraph operators and mariners.
12 ELECTRO-PHYSICS.

The magnetism of the earth is indeed in a state of constant fluctua-
tion, like the waves of the ocean. It has been found by the observa-
tions of Sabine and others that there is a certain periodicity to these
storms, and Schwabe and others have shown that the spots on the sun
vary continually and teach their maximum every ten years, and at a
corresponding time. Hanstien published a work on the magnetism of

,the earth, in 1817, and in 1826 published the first iso-dynamic charts.
Magnetic stations were first established in Europe in 1835, and in 1836
observations were published by Gauss and Weber. Between 1840 and
1854 observations were made by British officers throughout the empire
under the directions of Colonel Sabine.

Theory of Terrestrial Magnetism.—The theory of magnetism, which
we hold in common with many philosophers, is, that magnetism is gene-
rated in the earth by the heat of the sun, and that the currents thus
produced are continually traversing the surface.

Prof. Chas. Young, the distinguished spectroscopic astronomer, in-
forms us that while making observations at Sherman, on the Rocky
Mountains, the magnetic needle was disturbed very sensibly a¢ the very
moment that disturbances were taking place on the sun. If these
observations should be confirmed, it would seem to suggest the theory
that magnetism travels from the sun through the ether with the rapidity
of light.

Still further, it has been shown by a powerful array of comparative
observations, extending through many years, that the appearances of
the aurora borealis, the magzefic storms, and variations in the solar
spots, correspond both in their maxima and their minima. This corre-
spondence is so complete as to give convincing probability to the the-
ory that our sun is the grand source of magnetism, and that the aurora
and all other magnetic disturbances are direct resultants of a solar
influence.* °

'The acceptance of the theory that there is one mighty and widely
pervading force in nature, that in some substances and under certain
conditions manifests itself as magnetism, and in other substances and
under different conditions manifests itself as statical or dynamical or
animal electricity, and that the differences of rapidity with which these
forces travel, and the various and distinctive peculiarities by which they
manifest themselves, depend on the medium through which they are
propagated and the circumstances under which they are developed,

* This subject is discussed in a valuable paper in the American Fournal of Sciences,
April, 1873, by Prof. Elias Loomis, of Yale College. :
SOLAR ORIGIN OF MAGNETISM. 13

has the advantage of simplicity, and may perhaps help us to compre-
hend the action of magnetism and electricity on the human body in
health and disease. In this view a proper understanding of the laws
of magnetism becomes essential to the electro-physiologist and the elec-
tro-therapeutist.
CHAPTER II. °-
FRICTIONAL, OR STATICAL, OR FRANKLINIC ELECTRICITY.

WHEN glass is rubbed with silk it acquires the power of attracting
any light substance, such as a pith-ball. By’a short contact this prop-
erty is also communicated to the pith-ball, and it then vepeds the glass
instead of being attracted.

These phenomena are explained by the existence of a force which is
termed LZiectricity. That which exists in the glass is called vitreous, or
positive, or + electricity. If a piece of sealing-wax be rubbed with
flannel it will a¢/¢vact the pith-ball, which is repelled by the glass. This
phenomenon is due to the existence of resinous, or negative, or — elec-
tricity in the sealing-wax. _

The name electricity is derived from the Greek word jAexrpov, mean-
ing amber, because, as the story goes, Thales of Miletus, one of the
seven sages of Greece, first discovered the manifestations of this myste-
tious force by rubbing a piece of amber with a dry cloth.

The science of electricity dates from 1600, when Dr. Gilbert, of Col-
chester, physician to Queen Elizabeth, published a work on magnetism,
entitled 7ractatus de Magnete. He first used the word electricity. He
showed that not only amber, but other bodies, as sulphur, wax, etc.,
develop electricity. He first used the term poles in magnetism, and
announced the first theory of terrestrial magnetism. Not only sealing-
wax and glass, but all bodies contain more or less of electricity that may
be thus developed by some kind of friction.

Conductors and Non-conductors.—All bodies are electrically divided
into three classes: Conductors, semi-conductors, and non-conductors.
Under the first class—conductors—are included water and all saline
solutions, the metals, the earths and stones, the structures of plants and
animals, etc., etc. Under the second class—semi-conductors—are in-
cluded ether, alcohol, dry wood, marble, paper, straw, etc., at 32° F.
Under the third class—non-conductors, or insulators—are included glass,
sealing-wax, porcelain, resins, sulphur, wax, dry metallic oxides, fatty
oils, etc., at — 13° F.; phosphorus, india-rubber, gutta-percha, col-

a
FRICTIONAL OR FRANKLINIC ELECTRICITY. 15

lodion, wool, dry, hair, silk, shellac, ebonite, amber, feathers, chalk,
lime, dry gases, and aqueous vapor in a dry state.

The conducting power of metals may be lessened by heating them.
In nearly all other substances heat increases the conducting power.
Certain substances, such as feathers, wool, hair, and the atmosphere,
which in a dry state are non-conductors, become, when thoroughly
moistened, the best of conductors.

In this classification of all substances into conductors, semi-conduc-
tors, and non-conductors, reference is had only to frictional electricity.
Substances that are semi-conductors for frictional electricity are non-
conductors for galvanic electricity.

Frictional electricity may be obtained not only by rubbing, but also
by cleavage and pressure. When a piece of mica is cleaved, the two
plates which are separated exhibit opposite electricities, and a faint
light is observed when the cleavage is made in the dark. The light
that is seen when sugar-candy or loaf-sugar is broken, is accounted for
by the development of electricity through cleavage.

When a thin piece of cork is pressed against a slice of orange,
by insulating handles, one assumes a positive and the other a negative
electricity. The same phenomena may be obtained by cleavage and
pressure of very many other substances, and under diverse condi-
tions.

A conductor is said to be insulated when it is placed on some non-
conducting substance, so that the electricity communicated to it is pre-
vented from passing into the ground. Glass is one of the best non-
conductors, and is the insulating material usually employed in the con-
struction of electrical apparatus. It is hard, durable, and easily ob-
tained, and, could its surface be kept always dry, would be surpassed as

»an insulator byno material. In frosty and dry weather it acts very well ;
but when the atmosphere is at all damp, it becomes coated with a layer
of moisture, which very much impairs its insulating power.

A much superior insulator to glass is ebonite, a preparation of vulcan-
ized india-rubber, that of late has been much used.

Discovery of Electric Conduction.—Electric conduction was discov-
ered by Stephen Grey in 1729. He found that when a wire 700 feet
long, and hung on loops of silk, was connected at one end with a glass
tube, and the tube was rubbed, the other end of the wire was electri-
fied and attracted light bodies. When wire-loops were substituted for
the silk-loops, the electricity passed off through the wire. Hence origi-
nated the distinction between insulators and conductors.

Loss of Electricity.—All electrified bodies lose electricity more or less,
16 ELECTRO-PHYSICS.

however carefully they may be insulated. There are two reasons for
this :-—

First. No insulators are perfect. The best insulators, as glass and
rubber, conduct somewhat.

Secondly. The air is a conductor ; its conductive capacity depends
upon the amount of moisture in it.

In vacuo, also, electrified bodies lose their electricity more rapidly
than in air, on account of the diminution of the pressure on the insulat-
ing surface.

The human body, as will be shown under Electro-physiology, is
charged with electricity, which is conducted away by the air, and not
unlikely by other conductors.

Statical Induction.—An insulated conductor, when charged with either

positive or negative electricity, acts on bodies placed near to it just as the
magnet acts on soft iron ; tt attracts the opposite

and repels the same kind of electricity. This may
be shown in the following manner : A brass cylin-
der (Fig. 4), rounded at either extremity, is
insulated by means of a glass rod. Two pith-
balls are suspended by cotton thread from each
end. If an insulated ball charged with positive
Fie. 4. electricity be brought in close proximity to the
brass cylinder, the pith-balls will diverge, show-
ing a disturbance of the electrical equilibrium in the cylinder. So soon
as the charged ball is withdrawn, the pith-balls hang down as before,
showing that the electrical disturbance in the cylinder depended on the
presence of the charged ball, and was merely temporary.

If a small disk of insulated gilt paper be brought in contact with
the end of the cylinder next the charged ball, and then approached ©
toward an electrometer, the needle will indicate that the disk has re-
ceived — electricity.

If the experiment be tried with the opposite end, 4 electricity will
be transmitted to the gilt disk.

It is thus seen that + electricity of the charged ball causes the near
end of the cylinder to assume a — condition ; while, according to a
universal law, that no — electricity can be excited without an equal
amount of positive electricity, the opposite extremity becomes +. The -
phenomenon thus described is called induction, or influence ; and while
in this peculiar electrical condition the cylinder is said to be folar-
ized.

Induction and Conduction compared.—We have seen that a body may

se — +

t
DISTRIBUTION OF ELECTRICITY. 17

be charged with electricity both by conduction—actual contact—and
by induction at a distance. In conduction, the first body loses a part
of its electricity; in induction it does not. In conduction, the elec-
tricity given to the body is the same as that which gives it; in induc-
tion, it is of the opposite kind. In order to impart electricity by con-
duction, the body must be insulated ; to impart electricity by induction,
the body must be for the time in connection with the earth. Bad con-
ductors are acted on by induction s/ow/y, but retain their electricity
longer ; just as steel which is slowly magnetized becomes a permanent
magnet, while soft iron, which is rapidly magnetized, soon loses its
magnetism. ‘There is a limit to the conductive capacity of every elec-
trified body ; when this limit is reached, it ceases to have any effect on
the second body,

Distribution of Electricity.—It is evident that the greater the surface
over which electricity is diffused, the less is its power or intensity at any
given point.

Llectricity does not penetrate to the interior of metallic conductors, but
diffuses itself over the surface.

Experiment proves this. Leta brass ball be charged with electricity,

 

Fic, 5:

and suspended by a silk thread, and then covered with two hemispheri-
cal surfaces of brass, which exactly fit it. When the hemispheres are
withdrawn, it will be found that they are charged with electricity, which
‘thas been entirely taken from the brass ball.

Faraday illustrated this truth by a beautiful and original experiment
with a conical bag of cotton gauze, around the opening of which an in-
sulated ring was attached. The bag was held distended by means of a
silk thread attached to the apex, and then charged. By the proof-plane,
he found that the charge was wholly on the outside. The bag was
then turned inside out by pulling the thread the other way, when it was

2
18 ELECTRO-PHYSICS.

found that the electricity had changed sides, and lay wholly on the
outside.

Density.—The quantity of electricity on a given surface at any moment
is called electric density, or thickness.

The shape of a body has an influence in the distribution of electricity
over it. 7

In an ellipsoid, for example, the density is greatest at the small end
and least at the middle space.

 

Fra. 6.

On an insulated cylinder, with the two hemispheres at the ends, the
density of the electricity is greatest at the ends. On a circular disk,
the density is greatest at the edges. Zhe tendency is for electricity to
accumulate at points. Ona sphere the density is uniform; the further
removed a body is from a sphere.the more irregular the distribution.

In all pointed rods the electricity accumulates at the pointed ex-
tremities ; hence lightning-rods are made to terminate at sharp points.
In electro-physiology and electro-therapeutics it is found that small,
pointed electrodes cause much more pain, the strength of the current
being the same, than large, broad electrodes. Hence, except in those
cases where it is desired to confine the action of the current to a very
limited surface, electrodes of pretty good surface are desirable.

Electric Machines.—This term is exceedingly vague. It is applied
to any and all forms of electrical apparatus. The first electric machine
was made in 1672, by Otto von Guericke, of Magdeburg.* It consisted
of a globe of sulphur, turned on its axis by one hand and pressed against

, * Experimenta Nova, Magdeburgica,
HOLTZ’S MACHINE. 1g

the other hand. Afterward a glass cylinder was used instead of
sulphur.

In 1740 Winckler substituted cushions of horse-hair as rubbers. In
1760 Ramsden substituted a circular glass plate for the glass cylinder.
The forms of electric machines now used are modifications of Rams-
den’s. ‘This is one of the forms of apparatus from which we obtain
statical electricity. Fig. 7 represents the common cylinder electrical
machine, for developing electricity by friction.

.

 

Fie. 7.

Holts Electrophorus Machine.—The best and most recent form of
apparatus for statical electricity is the electrophorus machine that was
invented by Holtz,* of Berlin, in 1865. In this machine the electricity
is generated not by friction, but, as in the electrophorus, by zzductive
action. The machine consists of two glass disks and paper coatings,
with a number of conductors. One of the disks revolves on its axis;
the other remains immovable. The disks and paper coatings are cov-
ered with ¢ealing-wax. :

The metallic conductors are made ina comb-shape. An incision in
the immovable disk, with the paper coating and metallic conductor, is
called an element. The machine may have two, four, six, or eight of
these elements. When rotated, the paper coating becomes charged with
negative electricity: the corresponding part of the movable disk be-
comes charged with positive electricity. The conductor corresponds
to the finger of the experimenter. The length of the spark produced

™ A similar machine was constructed about the same time by Topler.
20 ELECTRO-PHYSICS.

by the machine depends on the size of the disk, which may be 12, 21,
or 30 inches in diameter. These machines are also called rotation
multipliers, because by their rotary motion they multiply by successive
transmissions the charge of electricity that they communicate.

ee

 

Fia, 8.

Electric Spark.—An interesting phenomenon connected with the
electrical machine is the electric spar which is drawn from the con-
ductor when the finger is presented to it.

The positive electricity of the conductor decomposes the electricity
of the body, attracting the negative and repelling the positive, and, when
the tension is great enough, these opposite electricities overcome the
resistance of the air and recombine, with a spark and crackling sound.
The spark is accompanied by a prickly sensation. When the spark is
short it is straight; beyond two or three inches in length it becomes
curved or zigzag, like the lightning in the sky.
ELECTROSCOPE, 21

The human body may be charged with electricity by sitting on an
insulating stool and touching the conductor of an electrical machine.

When the body is thus charged, the hair diverges, a peculiar sensa-
tion is felt in the face, and if any other person standing on the ground
touches one so charged, he receives a spark, with a crackling sound
and a pricking sensation.

Electrophorus.—The electrophorus, invented by Volta, in 1775, con-
sists of a metallic mould, filled with a mixture of shellac and turpentine,
and a movable metallic cover that is provided with a glass handle.
The surface of the shellac is negatively electrified by beating it with a
cat’s fur or fox-tail, The cover is then put on, and by contact be-
comes negatively electrified, and gives to the finger a slight spark of
negative electricity. If the cover be now removed by its insulating
handle, it gives positive electricity to whatever touches it. This posi-
tive electricity it acquires not directly from the shellac, but by zaductive
action through the air.

_Gold-Leaf Electroscope.—By this instrument we are enabled not
only to detect the presence, but to determine the kind, of electricity
that may exist in any body.

Fig. 9 represents Bennett's electroscope. B is a tubulated glass

 

Fic. 9.

shade, enclosed at its lower end by a metallic cover, by means of which
it communicates with the ground. A metal rod. fitting in the tubule of
the shade, terminates at its upper extremity in a knob, C, ard at its
lower extremity it holds two narrow strips of gold leaf. On the inside
of the shade are two strips of gold leaf reaching to the metal cover.
22 ELECTRO-PHYSICS.

If a body charged with eithér kind of electricity is brought in contact
with the knob, the goid leaves diverge.

Thomson's Quadrant Electrometer.—A far superior instrument for
all delicate researches is the guadrant electrometer of Sir William
Thomson. This instrument is quite complex, and only in a general
way shall we attempt to describe it. A delicate aluminum needle,
.two inchés long, is hung by two cocoon threads in a glass jar, which is
one-sixth filled with sulphuric acid. From the needle a delicate thread
of platinum drops into the acid. The needle is thus free to swing hori-
zontally a little distance, or until the torsion of one of the threads by
which it is hung forces it back to its original, position. Above the
needle a very delicate mirror is suspended. When the aluminum needle
is charged with electricity, which is conducted through the sulphuric
acid and carried up the platinum wire, the needle is repelled or at-
tracted according as the electricity is positive or negative. Behind a
screen, at some little distance, is placed a lamp, the light of which
reaches the needle through a slit in the screen. On the screen is a
scale; a very slight movement of the needle is reflected by the mirror
above it on the scale. An exceedingly slight displacement of the needle.

 

Fic. 10.

will cause a very large displacement of the image reflected on the
scale. Thus this instrument is of great value in very delicate researches.
Leyden Jar —The Leyden jar is made of glass, with a coating of tin-
foil pasted carefully inside and out, extending to within a few inches of
the mouth. ‘Through a varnished wooden cover a wire, having a knob
at top, is passed, and extends to the inside coating. Now, when either
positive or negative electricity is. communicated to the knob at the
top, it is immediately diffused over the whole inside coating ; and by its
inductive influence the outside coating takes on the opposite kind.
LEYDEN JAR. 33

When in this state,—the two coatings being oppositely electrified,—
the jar is said to be charged; and a discharge takes place when a com-
munication is established between the knob and the outside coating,
the equilibrium being restored with a bright flash of light and. a sharp
report.

As the human system is a good conductor, this discharge may take
place through it, by grasping the outside coating with one hand, and
touching the knob at the top with the other; or several persons may
form a line by grasping hands, the one at one extreme touching the
outside coating, while the one at the other extreme touches the knob.
All will feel the shock, as it is called, at the same instant. While the
jar is receiving the charge, it must not be insulated ; that is, the outside
must communicate with the earth. As the positive fluid collects on
the inside, the outside becomes negative by the expulsion of the posi-
tive fluid naturally in it, and the accumulation of the negative fluid in
its stead, drawn from the earth. But if the outside is insulated, these
transfers to and from it cannot take place, and therefore the jar cannot |
become charged.

A submarine cable is really a vast Leyden jar. The wire constitutes
the izterior coating, the water the exterior coating, and the gutta-
percha the insulator between them. On this account the passage of
an electric current through a submarine cable is greatly retarded.

History of the Leyden Jar.—In October, 1745, a bishop of Cammin,
in Pomerania, Von Kleist by name, passed through a cork in the neck
of a flask an iron nail connected with an electrical machine. The flask
contained mercury or alcohol. On touching the nail, Von Kleist re-
ceived a severe shock. In January, 1746, Cuneus, Allamand, and
Musschenbroek passed a wire from an electrical machine into a flask
filled with water. Musschenbroek held the flask in his right hand, and
when a turn was given to the machine, he received a spark from the
conductor with his left hand.

The spark was so terrible that he declared he would not receive
another like it for the French crown. He observed what Kleist did
‘not, that only the person who /eld the jar received the shock. In this
experiment the Zand of the observer corresponded to the outer coating
of the ordinary Leyden jar. He was the most scientific of the three
Leyden philosophers who have given the name to the Leyden jar.

The theory of the Leyden jar, and apparatus similar to it, was given
by Franklin in 1747. In the same year Watson, Bishop of Llandaff,
sent a discharge from a Leyden jar through 2,800 feet, and subsequently
through 10,600 feet of wire.
24 ELECTRO-PHYSICS.

Experiments like these were also made by Franklin across the Schuyl-
kill.

For a long time Franklinic electricity was the only form used in electro-
therapeutics. At present it is but little used except in certain hos.
pitals and public institutions. Its value as a therapeutic agent is,
however, unquestioned, and now that some of the inconveniences
attending its use have been removed by Holtz’s machine, it is just that
it should have a fair and careful trial at the hands of modern electro.
therapeutists,
CHAPTER III.
GALVANISM, OR VOLTAIC ELECTRICITY.

Unper the general term Dynamical Electricity is included the elec-
tricity which arises, firs¢, from chemical action—especially from that
attending the dissolution of metals—called galvanism or voltaic elec-
tricity ; secondly, from induction .by currents or magnets, called
induced electricity, electro-magnetism, or magneto-electricity ; thirdly,
from heat, called ¢hermo-electricity. These varieties. are called dynam-
ical electricity, signifying electricity in motion as distinguished from
frictional or statical electricity, which denotes the electrical condition
of bodies in which electricity remains insulated or stationary. Strictly
speaking, these terms—dyzamical and statical—are applicable to both
branches of the science ; for if the poles of a series of galvanic batteries
are insulated, they manifest, before the current begins, the electric
tension of a friction machine. Again, the characteristics of the gal-
vanic current are manifested slightly in the series of discharges which
are transmitted in a wire connecting the prime conductor of a machine
in action with the ground or other negative conductor.

Nature and Definition of Force and its Relation to Matter.— Force is
that which produces motion. It is itself a primary motion and cannot
be defined. Matter is a collection of centres of force called atoms.
Molecules are collections of atoms. A molecule is the smallest particle
into which a body can be divided without losing its identity.

The molecules of a gas are in rapid and continuous motion, and the
relative velocities in different gases has easily been determined. These
motions and velocities are the result of the forces of which matter con-
sists. It must be similarly true of liquids and solids : force and motion
are the bases of their constitution. Indeed, without force matter would
not exist at all, for matter is simply an aggregation of centres of force.

Ponderable Matter is a form of force which our senses recognize.
Ether pervades all matter and all space, but it is not recognized by
sense, and yet it is none the less a manifestation of centres of force.

Electricity compared with other Forces.—If force be added to matter
26 ELECTRO-PHYSICS.

the equilibrium of that point is disturbed, and the disturbance is propa
gated from molecule to molecule, through matter, or ether, or both.
Heat by conduction and mass-motion are of matter only. Heat by
radiation and light are of the ether only. Electricity is now regarded
as a movement of the ether, and of the body in which it circulates.
Chemical action is a rearrangement of atoms. After this action the
sum of the activities of the molecules of the resulting product is dif-
ferent from that which its factors previously had. ‘This difference is
force, and. appears sometimes as light, and under certain conditions as
electricity, but it is rarely or never confined to one mode of manifes-
tation. Zhe condition for the generation of electricity by chemical action
appears to be that this action takes place at the surface of a conductor
through which a current (so called) can circulate. Since the current is
made of motion of the molecules of the conductor through which it
passes, and of the ether, the nature of the conductor must modify the
current itself It is known that the current through a telegraph-wire
500 miles long meets the greater part of its resistance in the first 100
miles. The current is modified by the material and length and size of
the. wire. ,

The differential physiological effects of induction-coils of different
lengths and fineness may thus be in part explained. These differential
effects will be spoken of in the electro-therapeutical portion of this
work.

The Chemistry of the Battery not yet Exact.—Chemistry can never
be an exact science until temperature, specific heat, and matter are all
considered, and justly-estimated in all reactions. This has not yet been
accomplished.

Weare unable to state @ prior? what must be the electro-motive force
of the different batteries in use, since that, as we have seen, depends
on data hereafter to be determined. F requently, however, we are able
to state which of two reactions must evolve the greater force, and so,
under like circumstances, the stronger electric current. Thisis done by
inspection of the electro-chemical series of elements. That series, how-
ever, must vary with the temperature, so that it is no sure guide.

Office of the Water in the Battery.—The water used in all common
batteries serves as a solvent of the salt formed in the reaction. When
the water used becomes saturated by this salt the current stops, and it
declines in power as the solution approaches saturation.

Opice of the Metals in the Battery.—Of the two metals in any
battery one only enters into the reaction. Zinc has generally filled that
place in all the best-known batteries, because it is neurer the negative
CHEMISTRY OF THE BATTERY. 27

end of the electro-chemical series than any other common and conve-
nient metal. Potassium or sodium would he the deau ideal of the neyative
metal, but they are not convenient or practicable. Any metal or con-
ductor which is not acted on by the fluid in which it is immersed may
occupy the other place in the couple.

-All modern research tends toward the’ conclusion that the different
forms of electricity which we variously distinguish as magnetism, LFrank-
linism, galvanism, electro-magnetism, are but expressions of one force,
which force is, as we have seen, but a mode of motion of the universal
ether. Very recently a European physicist has estimated the electro-
motive force of Holtz’s machine, and has expressed it in a mathematical
form, so that it may be compared with the ordinary galvanic batteries.

In the present chapter we shall speak of the form of electricity that
is generated by chemical action—ga/vanism or voltaism. Analogy and
experience make it more than probable that a// chemical action whatso-
ever is attended with the evolution of electricity; and reasoning still
further we may believe that all molecular disturbance, however excited,
must give rise to electrical disturbance. ‘The play and interplay of
electrical phenomena are incessant and infinite; electrical force, like
light and gravity, is everywhere being generated and everywhere acting.
‘If we are unable to detect the electricity generated by chemical action
only under certain conditions, or when generated in comparatively
large quantities, it is because of the imperfections of our knowledge and
the want of sufficient refinement in our apparatus for collecting and
measuring electricity.

As a matter of experience it is found that chemical electricity is most
conveniently generated by the reactions that take place between two
metals and some acid solution, and as a matter of convenience and
economy zinc is the metal at the expense of which the electrical force
is evolved, the other metals acting merely as conductors; but the
combinations that are actually employed by physicists are but a fraction
of those that are possible and conceivable.

Every year new batteries and modifications of old batteries are de
vised, but all of them are based on the general principle that chemica]
action of any sort whatsoever is attended by the evolution of electri-
city.

We present below brief descriptions of some of the principal batteries
that are now in use. All, or nearly all of them, in their original shape,
or under various modifications, are used in electro-therapeutics. We
shall not attempt to exhaust the list, but to illustrate those that are best
known, most useful, and are most thoroughly representative. ‘Those
28 ELECTRO-PHYSICS.

who understand the principle on which these batteries are constructed

will not find it difficult to understand any new modification of them that

may arise.

Here let us interpose the remark, that the time and energy that are
devoted to the study of the chemistry of batteries will not be wasted
time—will indeed be spent most wisely—for half the annoyances of

* young and old electro-therapeutists comes from the difficulty of keeping
their batteries in order. This difficulty will be diminished one-half and
more when we really understand the mechanism of batteries and the
laws that govern their action.

Simple Galvanic Circles.—In the formation of a simple galvanic
circle there are usually metals and a liquid.

Fig. 11 constitutes such a circle.

Let C and Z represent respectively plates
of copper and zinc introduced into dilute
acid, and connected by a wire. An electri-
cal disturbance takes place over all the
surface of the zinc covered by the liquid.
Positive electricity is generated at the zinc
element, and flows through the liquid to the
copper, and thus a constant current is es-
tablished over the wires, as shown by the

Fic. 11. arrows. .

So far as the galvanic action is concerned,
it matters not whether the plates touch each other or are connected by
wires, as in the figure. A current is formed, whether contact is made
between the plates either above or below the liquid. In every instance,
however, a circuit must be formed, around which the electricity may flow.

The electricity may traverse the circuit either in a single current or
in a number of partial currents, into which it may divide itself when
the plates are brought in contact along their whole surfaces. When
the plates, or the wires which connect them, are in contact, the circuit
is said to be closed ; when they are separated, it is said to be dvoken, or
open. ‘The electricity is generated wholly by the chemical action of
the acid upon the zinc, and, other things being equal, the quantity of
electricity set in motion will be proportional to the extent of zinc sur- >
face exposed to the acid.

The terms LElectro-positive and Electro-negative.—Both in simple
and compound circles the electricity always moves zz the liquid of the
battery from the zinc to the copper; and of of the liquid, from the
copper to the zinc. This should be remembered, since the zinc is

 
POLARITY OF THE CIRCUIT. 29

called the electro-positive element, although out of the liquid it is nega-
tive ; and, consequently, in the decomposition that occurs in the
battery, that element which goes to the zinc pole is called the electro-
positive element, being attracted by its opposite force; while the
element going to the copper is called, for the same reason, the electro-
negative—a current from two liquids and one metal.

Two liquids and one metal can also produce a circuit as well as one
liquid and two metals. Becquerel’s oxygen battery (pile a oxygéne) is
one of the best arrangements of this kind. The current is produced by
the action of caustic potash on nitric acid, platinum forming the con-
ducting arc.

Homogeneity of the Galvanic Circuit.—In frictional electricity there
are points which form the seat of + or — electricity. On the con-
trary, in a wire where a galvanic current is circulating, there are no
such points. It has no power, like frictional electricity, to attract or
repel objects. The wire feels and behaves no differently when the
current is passing than when it is not. The wire conducts so much
better than the air that the current follows it. Its force is the same at
every point, in the battery or in the circuit. Making interruptions in
it at different points, and sending currents through solutions of sulphate
of copper, the same amount of copper is deposited at each of the
places where the interruption is made. If we connect the several
breaks by pieces of platinum wire, each wire will be heated to the
same temperature.

In short, the magnetic-heating and chemical and other effects of the
current are the same at every point in the circuit.

Polarity of the Circuit.—lf the wire in which the current runs be
cut or broken at any point in the circuit, the current ceases to flow—
that is, ceases to be dynamic, but at the two cut ends there is statical
electricity. One end of the cut wire will be charged with + and the
“other with — electricity. The amount of this statical electricity will
depend on the original strength of the current before the interruption
was made.

By the condensing electroscope it can be shown that each end of
the cut wire is charged with an opposite electricity, and the amount of
this can be estimated. If we take away any part of the wire entirely
from the circuit, the piece of wire taken away is out of the circuit en-
tirely ; but if the ends of the wires at each point of interruption be
dipped in a fluid that is decomposed by the current, the circuit will be
again completed, and it will be found that the part of the wire that is
taken away has opposite electricities at the ends.
30 ELECTRO-PHYSICS.

Similarly, also, the solution in the battery and the metals themselves,
like the connecting wire, are + at one end and — at the other. The
circuit throughout consists of + following — and — following +. It
appears to be electrically the same throughout.

Electrical Relations of the Elements.—In the galvanic cell, by the
decomposition of the water, oxygen arises at the positive pole and
hydrogen at the negative.

The metals assume opposite electricities, the zinc being positive and
the copper negative.

Since electricities that attract each other are opposite to each other,
the substances that are liberated at the positive pole are called electro-
negative, and the substances liberated at the negative pole are called
electro-positive. ‘Vhus, in the decomposition of the battery, oxygen
which is liberated at the zinc is electro-negative, while hydrogen which
is liberated at the copper or platinum is electro-positive.

The elements have heen arranged as to their electro-chemical re-
lations when associated in pairs in the galvanic cell. According to
recent chemistry, ato ns are arranged in two classes, according to their
combining power. ositive atoms are those which are attracted to the
negative electrode in electrolysis, and whose hydrates are bases.
Negative atoms are those that are attracted to the positive pole in
electrolysis, and whose hydrates are acids. The electro-chemical series
are presented below :

Llectro-Chemical Series.

Negative end —. Silicon. Zinc.
Oxygen. Hydrogen. Manganese.
Sulphur. sold. Lanthanum.
Nitrogen. - Osmium. Didymium.
Fluorine. Iridium. Cerium.
Chlorine. Platinum, Thorium.
Bromine. Rhodium. Zirconium.
Todine. Ruthenium. Aluminum.
Selenium. Palladium. Erbium.
Phosphorus. Mercury. Yttrium.
Arsenic. Silver. Glucinum.
Chromium. Copper. Magnesium.
Vanadium. Uranium. Calcium.

Molybdenum. Bismuth, Strontium.
ELECTRO-CHEMICAL SERIES—AMALGAMATION, 31

Tungsten. Tin. Barium.
Boron. Indium. Lithium.
Carbon. Lead. Sodium.
Antimony. Cadmium. Potassium.
Tellurium. Thallium. Rubidium.
Tantalum. Cobalt. Caesium.
Columbium. Nickel. Positive end +.
Titanium. Iron.

Each atom of any of the substances in this list is positive to any
atom of any substance above it, and negative to any one L-low it.
These distinctions are therefore purely relative.

Thus, for example, copper, when associated in a galvanic pair in the
proper fluid with any one of the elements below it, generates positive
electricity and becomes electro-positive, but when associated with any
one of the elements above it, becomes electro-negative.

The more electro-negative any one of the elements in this series is
to a given element, the more intense will be the current generated
when they are united in a galvanic pair. For example, the current
generated by zinc and copper is feebler than that obtained from zinc
and platinum, and the current is less when carbon is substituted for
the platinum. The order in the above arrangement is, however, by no
means absolute. The relative position of the metals depends fre-
quently on the liquid in which they are immersed. Thus silver is —
toward lead in a solution of dilute sulphuric acid, while in a solution
of cyanide of potassium it is + toward it.

Amalgamation.—If pure zinc is immersed in dilute sulphuric acid
no change is manifest, while ordinary commercial zinc is quickly dis-
solved by it. The action of the dilute acid or zinc is due to the im-
purities of iron or lead which it contains. ‘These impurities are electro-
negative toward zinc, and they cause local currents of electricity.
When the battery is closed, these local currents interfere with the
action that produces the main current; when the current is open, they
may still keep up their action, as is evidenced by the bubbling up of
the gases, and thus the zinc may be in time destroyed.

Now, local action in a single battery cell, arising from the above
cause, not only consumes the power of that member, but reduces the
energy of the whole series. In order to avoid this evil, resulting from
local action, it is necessary that the zinc plates be amalgamated with
mercury. The amalgamated surfaces are reduced to one uniform
electrical condition, like pure zinc, and will remain in the fluid for any
32 ELECTRO-PHYSICS.

length of time unacted on, until connected with the electro-negative
element.

At the present time all improved batteries are constructed with amal.
gamated zinc.

How to amalgamate Zinc.—To amalgamate zinc, first immerse it in a

solution of dilute sulphuric acid of almost any strength, so as to clean

the surface ; then dip it in mercury, or pour mercury over it, and rub
it on with a brush or sponge or cloth. The mercury will spread very
rapidly over the surface of the zinc, and give it a bright, mercury-like
appearance.

The art of amalgamating zinc is of great practical importance to the
electro-therapeutist, since nearly all the batteries in common use have
zinc for one of the metals. Amalgamated zinc was first used for gal-
vanic batteries ‘by Kemp, in 1826.

Chemical Action the Origin of the Current.—When the electrically
opposite metals—zinc and platinum, for example—are dipped in acidu-
lated water and united at their ends, either directly or by a wire, the
zinc has so strong an attraction for the oxygen of the water that it unites
with it and forms the oxide of zinc. This oxide of zinc combines with
the sulphuric acid and forms sulphate of zinc. The hydrogen of the
water escapes in the form of gas at the platinum. Zhe result of this
chemical action is a current of electricity. The zine (the electro-
negative element) dissolves, and the quantity of electricity generated
is proportioned exactly to the quantity of zinc dissolved. .

It had been supposed by Volta and his followers that simple contact
of the metals was all that was necessary to excite the current; but
Faraday showed, by two very beautiful experiments, that mere contact
was not sufficient—that there must be chemical action in the cell in
order to obtain a current. It is possible that all chemical actions are
attended with the generation of electricity ; but only under certain con-
ditions, or when the amount is considerable, are we able to detect it.

Ln what way does Chemical Action generate the Current ?—In science
it often happens that the simplest and easiest questions are the hardest
to answer. Just how the current is excited by chemicdl action we do
not fully know. We know that when the different metals touch each
other, the positive electricity will go to one metal and the negative to
the other. This disturbance, however, is only momentary, and equili-
brium is at once restored, and no current continues.

Now we may regard the atoms of oxygen and hydrogen that make
up a molecule of water as charged with opposite electricities, like two
different metals, When ‘zinc and platinum are dipped in water, the
a

ELECTRICITY AS RELATED TO OTHER FORCES. 33

positively charged atom will turn toward one metal and the negative
toward the other; but as long as the metals do not touch each other
the equilibrium is at once restored, and there is no current. ‘The free
ends of the metals are in a state of electric tension, and are capable
of discharging themselves into a condenser or Leyden jar. When the
metals are made to touch each other, or are connected by wires, they are
relieved of their charge, and again become charged ; then again relieve
themselves, and so on indefinitely. There is no equilibrium established,
but a constant effort to establish it, which never succeeds. This con-
stant effort to establish an equilibrium keeps up the current.

Electricity a Mode of Motion.—Although, for the sake of conve-
nience, we speak of electricity as a current flowing in certain direc-
tions, after the manner of a river, yet, as we have already said, we
should not thereby be led into the error of supposing that the elec-
tricity is a real fluid flowing through different substances, or from one
substance to another.

Electricity is a disturbance propagated in the Molecules of a body,
and at the same time in the Ether pervading that body.—The theory that
light was caused by the emission of particles from the sun was aban-
doned long ago; and now the theory that light consists of wsdulations
of ether is considered to be as impregnable as the theory of gravitation.
Similarly we may believe that electricity consists of movements of a
different. kind from those of light, but which is variously modified in its

“manifestations by the substances through which it circulates.

The impulse or movement that constitutes what we call the current
may be regarded as simply a mode of motion.

Polarity of Electricity.— Polarity, or properties in opposite directions,
is not peculiar to electricity. Light and heat may also be polarized,
and chemical attractions and repulsions are likewise manifestations of
the polar qualities of atoms. We may gather a definite idea of the
nature of electricity and the character of the so-called “current” by the
following illustration: Let a tube be filled with balls, all of which are
attracted to each other. If the first ball is turned round on its centre,
it will turn in a similar way the next ball, and so on through the whole
series. There is here no progress of a material current, but simply a
motion.

If the motion is rapidly repeated through the attempt of electricity to
find an equilibrium, we have what we call an electrical current.

Electricity convertible into the other Great Forces.—We see in this
section on electro-physics many illustrations of the transformation of
one force into another. If we start with heat, we find that it pro-

3
34 ELECTRO-PHYSICS.

duces electricity, and through electricity produces chemical action,
magnetism, and light. If we start with magnetism, we find that it
produces electricity, and through electricity heat, chemical action, and
light. If we start with chemical action, we find that it produces heat,
light, and electricity. If we start with electricity, we find that it pro-
duces magnetism, heat, light, chemical action, and motion.

* Conversion of Electricity into Heat. The Electric Light.—By the
law of the correlation of forces the electricity generated in a battery
may be converted into heat. This heat may remain in the battery or
be transferred to any part of the circuit. In order to convert the elec-,
tricity into heat it must pass through some poor conductor that resists
its passage, and thus compels it to appear as heat. With ordinary
thick copper wire there is but little sensible heat in the passage of a
current, because copper wire is a good conductor; but when platinum
wire, which is a poor conductor, is used, it is raised under a strong
current, to white-heat. This has been utilized in galvano-cautery.

In the electric light the heat is transferred to carbon points interposed
in the circuit. Particles of carbon become incandescent, and are volatil-
ized and transported from the positive to the negative pole. A metal
or other substance may give an electric light, but carbon, on account of
its friability, gives a better and stronger light than any other substance.
The electric light was invented by Sir Humphry Davy in 1813.

Compound Galvanic Circles.—The compound galvanic circle, or gal-

 

Fic. 32,

vanic battery, is composed of two or more simple galvanic circles. They
are so connected together that the copper of one battery is joined to
the zinc of the next, and so on throughout the series. By combining
together a number of cups, such as are represented in Fig. 12, we form
DERIVED OR BRANCH CURRENTS. 35

an excellent compound circuit. Each cup contains a zinc and a copper
plate, which are connected together as described above. By examining
this arrangement, it will be seen that one extreme of the series is cop-
per and the other zinc. If these two extremes or poles are connected
by a copper wire, the current will flow in the direction of the arrows,
both through the series and éver the wires.

Derived, or Partial, or Branch Currents.—When a current in its
passage through any conductor meets with different qualities of resist-
ance, it subdivides into various branch currents. In Fig. 13 the cur-
rent goes from the elements through the wire 7, g, p, 2, m; but if a

 

Fig. 13.

,second wire, ”, «, g be interposed, the current will divide at g, x,
part going by way of g and part around through x, 7. The divided
currents which go through the wires are called derived or partial cur-
rents. ' If, instead of one or two wires, a large number were interposed,
the current would subdivide itself as many times as there were wires,
part going through each wire.

In thus dividing into derived or partial currents, two laws are
obeyed : ¥

ist. Zhe sum of the strength of the divided current is equal to the
strength of the principal current. If (in the figure) the strength of the
current g, ~, 2 is 40, and g, x, 7 is 60, then the strength of the prin-
cipal current in 7, g, before division, is 100.

2d. The strength of the currents in the divided parts is inversely
as the resistance in those, parts. This law supplements the first. Re-
sistance is directly as the length and inversely as the diameter.

If the derived wires are of the same length and diameter as the prin-
cipal wire, then the current will divide into equal parts between them.
If the derived wires are of the same length as the principal wire, but
of unequal diameters, the current will divide unequally, according to
the diameter of each wire. The law may be illustrated by thinking of
the course that rivers pursue when they are subdivided or split up inte
36 ELECTRO-PHYSICS.

deltas. The quantity of water that flows through all the subdivisions
or deltas would be equal to the quantity that flowed through the main
stream before the divisions took place. If the subdivisions are of dif-
ferent sizes, the deepest and widest will convey
the most water.

When electricity ‘passes through the human
body it encounters tissues that differ considerably
in their conductivity, and hence it subdivides into
an infinite number of derived or partial currents,
the strength of which varies with the nature and
length of the tissues. This point will be further
illustrated in electro-physiology and electro-thera-
peutics.

Description of Galvanic Batteries.—Under this
head may properly be included, first, a description
of the voltaic pile, which was constructed by Volta
in 1799, and became known in England in 1800.
The apparatus consists of a number of disks piled

   
   

 
  

ima
PT F
ne
MeN ay

ml

    
    

    

 

 
 

oe one above the other! The arrangement is in the
ug following order: A disk of copper is placed on a

mre Le

  

frame of wood; a disk of cloth, moistened by
acidulated water, is then placed on the copper,
and then a disk of zinc on the cloth completes
=& what is called the voltaic couple. A series of
such couples constitutes a voltaic pile—the ter-
minal copper being the positive and the terminal
zinc the negative pole.

This apparatus is inconstant and unreliable, easily corrodes, has
many inconveniences, and is now but little used. Various modifications
of the voltaic pile have been devised, but all of them are too inconstant
for electro-therapeutical purposes, or indeed for any sustained use
whatsoever. :

Polarization in Batteries.-When two metals, as zinc and platinum,
are placed in acidulated water, the platinum plate becomes covered
with a film of hydrogen. This hydrogen is electro-positive, like zinc,
and so when the platinum becomes well covered we have electro-posi-
tive zinc opposed to electro-positive hydrogen, and thus the current be-
comes enfeebled, if not destroyed. This polarization in batteries is pre-
vented in two ways:

ist. By keeping the liquids in constant agitation. Blowing into the
liquid with a bellows, or stirring the liquid by any mechanical arrange-

 

 
POLARIZATION OF ELECTRODES. 37

ment, keeps the surface of the platinum or carbon free from hydrogen,
and thus prevents the weakening of the current.

Dr. Byrne, in his galvano-cautery battery (to be described in the sec-
tion on Electro-surgery), has availed himself of this depolarizing power
of mechanical agitation, and has thus succeeded in obtaining a great and
enduring quantity of electricity from a comparatively small surface.

On the same principle we explain the fact that lifting the metals out
of the liquid for a moment or two at once increases the strength of the
current. While in action, the hydrogen accumulates on the platinum ;
by removing the metals from the liquid an instant, the hydrogen escapes
and the battery is as good as ever.

2d. By the use of ¢wo liquids. The cells of Grove, Daniells, and
Bunsen, to be hereafter explained, are constructed so as to avoid polari-
zation of the metals.

Polarization of Electrodes and Currents of Polarization.—The elec-
trodes that convey the current through acidulated water also become
polarized.

Oxygen covers the positive and hydrogen the negative electrode.
Hydrogen being electro-positive, and oxygen electro-negative, these
two gases act like two metals, and if the current of the battery be bro-
ken and the two films of oxygen and hydrogen are connected metalli-
cally, an electric current is obtained, just as a current is obtained
between zinc and platinum. In the liquid the current flows from the
film of hydrogen to the film of oxygen. Two electrodes covered in
this way with films of gas are called polarized, and the currents gene-
rated by these are called the currents of polarization. ‘These currents
of polarization are always in a direction opposite to the main current,
and tend to interfere with and weaken it. This polarization of the
electrodes takes place more or less in all applications of the galvanic
current. One evidence of this is the discoloration of the electrodes
that are employed in electrization after long use. To meet this difficulty
‘ unpolarizable electrodes have been devised. These will be described
under Electro-therapeutics.

Secondary Piles and Gas-Batteries.—lf a series of plates of plati-
num, with moistened cloths between them, be connected with the poles
of a battery, the gases (oxygen and hydrogen) resulting from the decom-
position of the water-accumulate in films on the platinum. If now the
series be separated from the battery, it will itself, through the action
between these films of gases, generate acurrent. A pile thus formed
is called a secondary pile. It was discovered by Ritter. The .gas-
battery of Grove is constructed on the same principle. The gases are
38 ELECTRO-PHYSICS.

collected in glass tubes, oxygen in one and hydrogen in the other, and
in each tube is fastened a platinum electrode. The tubes are inverted
over sulphuric acid.’ When the electrodes are connected with a gal-
‘ vanometer a current is indicated, the direction of which is from oxygen
to hydrogen.

There are two general varieties of batteries, doudle and single cell.

* Double-cell Constant Batteries.—The current produced by elements
with a single liquid becomes rapidly enfeebled, because of the polariza-
tion. This polarization is prevented in the double-cell batteries
of Daniell, Grove, and Bunsen, by placing the electro-negative ele-
ment in a liquid that is acted upon chemically
by the deposited hydrogen. Currents from
these two-cell batteries are called constant,
because they do not weaken: so rapidly as
currents from single-cell batteries, and the
metals can be allowed to stand all the time
in the solution.

The term constant is now applied to the
galvanic current, however generated, as
distinguished from the induced or faradic
current.

Daniells Battery.—Fig. 15 represents a
single’cell. V is a glass or porcelain vessel

Fighas nearly filled with a saturated solution of

sulphate of copper. C is a cylinder of cop-

per, open at both ends and perforated by a number of holes. G,
which is also perforated by holes, is an annular shelf at the upper por-
tion of the zinc cylinder, upon which crystals of sulphate of copper may
be placed to supply the waste in the cell caused by the electrical action.
P is a thin porous vessel of unglazed earthenware, containing the
amalgamated cylinder of zinc Z, and a solution either of common salt
or dilute sulphuric acid. The elements are connected in series by
strips of copper, # and 2, which are fixed to the copper. and zinc by
means of binding-screws. When the circuit in the battery just de-
scribed is closed, an atom of zinc replaces and liberates from the nitric
acid two atoms of hydrogen, thus producing sulphate of zinc. The
liberated hydrogen replaces one atom of copper in the sulphate of
copper, which by electrolytic action is deposited on the copper element,
or sometimes on the porous cup. Polarization is the resistance to the
passage of the current produced by a deposit (such as hydrogen) on

 
DANIELL’S AND GROVE’S BATTERIES. 39

either of the elements. No such deposit occurs in this battery, hence
the current is constant. j

Order of the parts in Daniell’s sulphate of copper battery: rst, zinc;
2d, sulphuric acid; 3d, porous cup; 4th, sulphate of copper; sth,
copper. s

4

Reaction.

Zn + H,S0O,-+ CuSO, = Zn SO, + H, SO, + Cu

The current obtained from this battery will flow with undiminished
strength for hours, and, in fact, is superior to all its fellows in con-
stancy. Daniell’s battery was invented in 1836. The modifications
of Daniell’s battery are quite numerous; among them we may men-
tion those of Hill, Siemens-Halske, and Muirhead. :

Grove's Battery.—This battery differs from Daniell’s mainly in the
substitution of a nitric-acid for a sulphate-of-copper solution, and pla-
tinum for copper, by which increased electro-motive force is obtained.
In Fig. 16, A represents a glass vessel containing dilute sulphuric acid,
Z a cylinder of zinc. open at both ends, and V a porous pipe-clay vessel
partially filled with nitric acid. P is a plate of platinum, with a cover,
C, which rests on the porous vessel when the platinum is immersed in
the nitric-acid solution ; 4 and @ are binding-screws, which connect re-
spectively with the platinum and zine:

In this arrangement a double reaction occurs between the zinc, sul-
phuric acid and nitric acid, giving as a result, sulphate of zinc, water and
nitrogen dioxide, which is disengaged, and by contact with the air be-
comes nitrogen tetroxide. The reaction in Grove’s nitric-acid battery
is as follows: 1st, zinc; 2d, sulphuric acid; 3d, porous cup; 4th, nitric
acid ; 5th, platinum.

Zn, + (H,SO,), + (HNO,), = (Zn SO,), + N.O, + (H, 0),

also N,O, + O, = N,O, by contact with the atmosphere. Force
must be lost by the evolution of these nitrous fumes. ~-Prof. Wolcott
Gibbs, of Cambridge, has discovered that a small quantity of bichromate
of potash in the nitric-acid cup of Grove’s battery acts as a deodorizer
by taking up the disagreeable nitrous acid fumes. Thus one of the
most serious objections to the use of this battery is removed.
Grove’s battery was invented in 1839. It is very powerful, and is
‘40 ELECTRO-PHYSICS.

much used in telegraphy. It has also been employed in galvano-
cautery.

  

Fic. 16.

Bunsen's Double-cell Nitric Acid Battery.—This battery is very.
similar to Grove’s. It differs from it only in the substitution of carbon
for platinum. The letter P in Fig. 17 represents a single element, as
it appears when ready for use. ,

 

F is a vessel of glass containing dilute sulphuric acid. Z, a cylinder
of amalgamated zinc. V, a porous vessel partly filled with ordinary
nitric acid ; and C, a bar of carbon or coke. The zinc is first placed
in the vessel F, after which the porous vessel V, into the nitric-acid
solution of which the carbon C has been immersed, is inserted into the
zinc cylinder. The binding-screws m and x are respectively the posi-
tive and negative poles. The elements are arranged in the form of a
BUNSEN’S AND WALKER’S ZINC-CARBON BATTERIES. 4I

compound battery, by means of the clamp m m, and a rod connecting
the carbon of one cell with the zinc of the following.

Bunsen's Bichromate Battery.—In this battery a solution of dichro-
. mate of potash—one part to twelve parts of water—is placed in the
porous cup.

The order of the parts in Bunsen’s Bichromate Battery is as follows :

ist, zinc; 2d, sulphuric acid; 3d, porous cup; 4th, sulph. acid and
bichromate of potash; sth, carbon.

Reaction.
Zn, + (H, 5O,), + K, Cr, O, + (H, SO,),
= (Zn 8O,), + K, Cr, (SO,), + (Hz O),

Chrome-alum, sulphate of zinc, and water, are the products. The office
of the porous cup is to keep the bichromate of potash from the surface
of the zinc, and thus inore uniformity and constancy of action is attained.

While the action of Bunsen’s battery is the most energetic of all the
constant batteries, and while the first cost is less than Grove’s, it is yet
more expensive to work and more inconvenient to manipulate. Bun-
sen’s battery was invented in 1843.

Walkers Single-cell Zinc-carbon Battery.—In this battery carbon
is substituted for the platinum of the Smee battery, and the solution
used is composed of bichromate of potash, sulphuric acid, and water,
the same as in Bunsen’s battery. The carbon is usually the pressed
and baked graphite of the gas-works. There is considerable differ-
ence in the quality of the carbon as sold in the market; the more
thoroughly it is pressed and baked, the better it will be. Carbons that
are poorly prepared, or that contain impurities, easily become soaked
with fluid and the salts of the solutions, and also generate local currents
that interfere with the main current. Sometimes: the carbons are
platinized, that is, covered with finely-divided platinum, as is the silver
in the Smee battery. The proportion of the solution used in Walker's
battery is as follows :

Sulphuric acid,
Bichromate of potash, 4.......... Ed.
Water aa. cite Aa: cea sciom are ne guns & xij.

The reaction is the same as in Bunsen’s Bichromate Battery just de-
scribed.

To prepare this mixture, add the sulphuric acid to the water, and
when this ts cool, add the bichromate of potash well pulverized. Do
not immerse the elements in the fluid until it is perfectly coo/, for when
42 ELECTRO-PHYSICS.

hot the fluid saturates the carbons and removes the amalgam from the
zinc, and thus injures very seriously the working power of the battery.*
The proportions of sulphuric acid and bichromate of potash above given
may be varied more or less as may be desired. Mathematical accu-,
racy is not required. If, however, the solution is excessively strong,
if the proportion of bichroraate of potash and sulphuric acid is too
great, say two or three times what is here given, the battery will wear
away very tapidly and a greenish-black deposit will be found in the
bottom of the cells. This deposit, which sometimes forms very hard,
and is difficult to remove without breaking the glasses, is the chrome-
alum, and is a result of the decomposition of the salts and acids that
takes place while the battery isin action. Like the Smee battery, the
zinc-carbon battery will need to be occasionally amalgamated, but, un-
like the Smee battery, it does not require any mercury in each cell, and
the presence of mercury will give rise to local action. We speak thus
particularly of the simple zinc-carbon battery, because it is one very
widely used in electro-therapeutics, and it is important that its manage-
ment should be well understood. The galvanic batteries of Stéhrer, of
the Galvano-faradic Manufacturing Company, and of Kidder, are mostly
of single-cell zinc-carbon elements. The zinc-carbon battery, like
Smee’s, to be hereafter described, is not constant. If the metals are kept
long immersed in the solution, the power rapidly goes down. It is
necessary, therefore, to keep the metals out of the solution, except when
the battery isin use. In this respect the battery differs very much from
the batteries of Grove, Bunsen, and Lechanché, where the metals are
never removed from the solution except to be cleaned and repaired.

Smee's Battery.—This battery, invented in 1840, is very economical,
convenient, and easy to manage, and on that account has been con-
siderably employed in electro-magnetic apparatus. It consists of a
plate of corrugated platinum, or silver covered with finely-divided plati-
num, between the two plates of zinc, in a solution of sulphuric acid and
water (one part to ten or twelve).

The order of the parts in Smee’s Sulphuric Acid Battery is as follows :

1st, zinc; 2d, sulphuric acid ; 3d, platinum.

Reaction.
Zn + H,SO, = Zn SO, + H,

* It is well known that when sulphuric acid and water are mixed, the solution be-
comes very hot, The explanation of this is, that in mixing, the atoms of the water are
attracted to the atoms of the sulphuric acid ; in other words, work is done, ‘The vol-
ume is diminished 8 per cent., and the heat that appears is a result of the work thus
performed.
SMEE’S AND LECHANCHE’S BATTERIES. 43

The chemical action of this battery is more rapid than that of the sul-
phate of copper battery, because platinum is more positive than copper,
whose place it occupies in the sulphate of copper battery. The dis-
engagement of the hydrogen is effected by mechanical means, but there
must be a large loss of force in changing hydrogen to a gaseous state,
precisely as force is lost in changing water to steam.

The object of corrugating the platinum plate, or making it into folds
or furrows, is to give greater surface. The object in covering it with
finely-divided platinum is to roughen the surface so that the hydrogen
will not adhere. It is customary in using the battery to keep about
half a tablespoonful of mercury in the bottom of the cup, in order that
the zincs may be all the time wellamalgamated. Care should be taken,
in the preparation of this battery, to prevent
the mercury from collecting on the platinum
plate. If by any carelessness it does gét
on the platinum plate, it will turn it to the
color of mercury, and will weaken or destroy
the force of the battery. In this battery
more or less action goes on even when the.
connections are not made ; this is evidenced
by the formation of sulphate of zinc at the top
of the metals after they have been long im-
mersed. It is therefore an advantage in using
the battery to keep the elements out of the so-
lution when not needed. If kept constantly
immersed, like Daniell’s battery, it very soon
loses its power and becomes thoroughly incrusted with sulphate of zinc.

Lechanché's Battery.—During the past few years, this battery has
attracted great attention in Europe, both among telegraphists and elec-
tro-therapeutists. The great advantage that is claimed for it, where it
is not used too long at a time, is that it is far more constant than any
other battery yet invented. The battery was devised by Lechanché, a
Frenchman, in 1868, and bears his name. A Lechanché cell consists
of, 1st, a cylinder of zinc in a concentrated solution of chloride of am-
monium ; 2d, a rod of carbon, packed with powdered carbon and na-
tive peroxide of manganese in a porous cell. The whole is closed with
a cover. The chemical changes that take place in a Lechanché bat-
tery are these: Chloride of ammonium is decomposed, chlorine com-
pining with the zinc, hydrogen being absorbed by the oxygen of the
peroxide of manganese, and ammonia being liberated. The ammonia
is absorbed by the water, but in process of time the water becomes

 
44 ELECTRO-PHYSICS.

saturated, then the ammonia escapes through the opening in the
cover,
The chemical formula is as follows :

Zn + (Cl NH,), + (Mn O,), = Zn Cl, + H, O + (NH,), + Mn, O,

» Lechanché’s battery was first arranged for electro-therapeutics by
Gaiffé, an instrument-maker of Paris. It has been modified by Tripier,
the well-known French electro-therapeutist, by Keyser and Schmidt,
of Berlin, and a portable form has been devised by Beetz, of Munich.
Lechanché’s battery has one great advantage and some disadvantages,
Its advantage lies in its power of endurance. If not overworked it
will stand for months and years, and yet retain sufficient power to be
quite useful in electro-therapeutics. This is not true of any other
battery; even Daniell’s, the most constant of all, and as variously
modified, requires replenishing or cleaning every few months, else it
goes down to nothing.

Its disadvantages are these :

ist. It rapidly polarizes, and so generates a secondary current that
weakens the main current. This polarization only takes place when
the battery is in action; if, therefore, the battery is but little used, or
only occasionally, this disadvantage does not appear.

2d. The free ammonia that escapes after the water becomes satu-
rated is annoying.

On account of these disadvantages, vechanché’s battery has not been
as popular among telegraphers as was at one time expected it would be.
Among European electro-therapeutists, however, it is considerably used.
It is sometimes employed in electro-magnetic or induction machines.

Callan's Tron-zine Battery.—In this battery the positive plate is
zinc in dilute sulphuric acid; the negative plate is iron in strong
nitric acid. The great practical difficulty with this battery is, that
under certain conditions it may suddenly and rapidly evolve nitrous
fumes. This complaint has been made even by those who have adopted
this form of battery in electro-surgical practice. The common explana-
tion that the phenomena displayed by this battery are due to the pas-
sivity of iron, is not in accordance with the more recent doctrines of
physics. This fact is a serious objection to the use of these batteries,
in electro-therapeutics. They have been employed, however, for the
purpose of galvano-cautery. ,

Wollaston's Zinc-copper Battery—This form of battery, devised by
Wollaston in 1801, is now pretty well displaced by modern improve .

4
ZINC-COPPER BATTERY—WATER BATTERY. 45

ments. It consists of a copper vessel, enclosing a solution of sulphate
of copper, a zinc plate, or a sheet of copper folded over a piece of
zinc, so as to have both faces of the zinc exposed to chemical action,
and so increase the quantity of electricity. The two objections to the
battery are, that it is not constant, and the metals must be kept out of
the solution except when in actual use, and that the zinc becomes
rapidly corroded with a deposition that weakens the force of the bat-
tery. This deposition must be constantly cleared and scraped off, if
we would keep up the strength of the current.

The order of the parts in the sulphate of copper battery, single’ cell,
is as follows: ist, zinc; 2d, sulphate of copper; 3d, copper.

Heaction.
Zn + Cu SO, = Zn So, + Cu

In this battery any local action on the zinc will deposit metallic
copper in the form of a black powder upon the zinc, or an oxide of
copper, which forms a covering on the surface of the zinc.

For this reason the zinc must be amalgamated or else frequently
cleaned. Sulphate of copper must be frequently added, so that the
battery shall be charged with a saturated solution of that salt ; but care
must be taken that the solution of sulphate of zinc does not approach
saturation.

The necessity of frequently cleaning and scraping the zinc in this
battery is a most serious disadvantage, and on that account mainly it is
not to be recommended to the electro-therapeutist.

Water Battery.—lf a large number of cylinders of zinc and copper
be immersed in water in glass jars, and are properly protected from
light and dust, a current of electricity will be produced. A battery
of 130 pairs causes the gold leaves of the electroscope to diverge, and
1,200 pairs gives a strong shock. A battery of 2,000 or 3,000 pairs is
very powerful. Batteries of this kind have been constructed by Crosse,
Noad, and Gassiot.

These water batteries will keep their power for years, provided water
is supplied to them to make up for the loss from evaporation. They
take up a large space, and, on account of the great resistance of the
water, give but a small quantity of electricity. Yor these two reasons
they offer no advantage for medical ‘use.

Marine Battery.—A sea-water or marine battery has been constructed
by Duchemin, of France. A cylinder of carbon and sinc, attached
to acork, is put into the sea, and connected with the shore by con-
46 ELECTRO-PHYSICS.

ducting wires. As the ocean furnishes the exciting fluid, it needs no
replenishirg. It was hoped that a battery of this kind might be of
sufficient strength to furnish an electric light for light-houses. This
hope, so far as we know, has not been realized.

Dry Pile.—Dry piles have, instead of liquids, some solid hygrometric
substances, as paper or leather. There are many varieties of dry
piles. Those of Zamboni, which are best known, are composed of
tin or silver and binoxide of manganese. A piece of paper is tinned
or silvered on one side, and the other side is covered with powdered
binoxide of manganese. These sheets are cut into disks, about one
inch in diameter, and arranged so that the tin or silver of each disk is
in contact with the manganese of the next in the series. A Zamboni
pile of 200 couples is very feeble arid slow in its action, but it can
charge a Leyden jar, and it is quite permanent.

Instruments for Measuring Electricity—The instruments for mea-
suring electricity are quite numerous, and some of them are very
delicate. It is necessary here to describe only a sufficient number to
illustrate the principles involved.

The Voltameter.—The voltameter is an instrument devised by Fara-
day to measure the strength of the galvanic current. It is a graduated
tube that receives and accurately measures the quantity of gas that is
generated by the decomposition of water by the current in a given
time.

In Fig. 19 the platinum needles connected with the poles of the bat-
tery are inserted through the cork, at the end of the tube. The gases
that result from the electrolysis rise to the top, as the tube is held up-
right, and repel the water through a hole in the cork.

 

that fautudiaduaiudantuntuntiekantealad todiotiadaads

 

Fic. x9.

This is a very trustworthy method of measuring currents and of
comparing batteries. If we wish to ascertain how one battery com-
pares with another in strength, or whether a battery has weakened by
use or long standing, or whether the strength is sufficient for a power-
ful electrolytic: operation, the voltameter will give us precisely the infor-
mation we seek.

Galvanometers.—A galvanometer is an instrument for indicating the
presence and direction of a current, and for measuring its strength.
There are several varieties of galvanometers, but all are constructed on
u GALVANOMETERS, 47

the same general principle—a magnet Sreely hung so as to be deflected by
the passage of a current through a coil of insulated wire. Galvanom
eters with a long coil—sometimes called “¢ension” galvanometers—
are used to measure circuits of large resistance. Galvanometers with a
short coil—sometimes called ‘quantity ” galvanometers—are used to
measure circuits of small resistance. The explanation of this difference
will appear in the chapter on Ohm’s Law.

 

Fic. 20.

Astatic Galvanometer.—This form of galvanometer is used either to
detect the simple presence of a current, or to measure the strength of a
weak current. Let A and B, Fig. 20, represent two needles of about
equal strength, having the same axis, and having their poles reversed
in reference to each other. The needles will settle a very little in the
meridian, from the fact that one of them is very slightly more highly
magnetized than the other.

C is an insulated wire, bent around the lower needle several times.
When a current is passed through this wire, the needles will be influ-
enced to turn in the same direction. In this way the passage of the
most feeble current may be detected. In connection with a thermo-
electric pile, this instrument is capable of indicating a change of tem-
perature of only a very small fraction of a degree. Galvanometers
which have a long resistance coil, and in which a branch resistance coil,
or “shunt,” as it is called, is interposed, may be used to measure
strong currents (see chapter on Ohm’s Law), and are therefore con-
venient in comparing batteries. A galvanometer of this kind that we
employ will be described under electro-therapeutics.

Thomson's Reflecting Galvanometer.—Sir William Thomson has done
much to advance the science of electrology by the construction of
his reflecting or mirror galvanometer, which will indicate the presence
of very slight currents. This instrument consists of the coils of a gal-
vanometer, between which are suspended, by a single silk fibre, a
mirror and magnet, which, when it moves under the influence of a cur-
48 ELECTRO-PHYSICS.

rent, is reflected through a lens on a graduated scale placed at a little
distance in front of it. A lamp is placed behind the screen, which
contains a slit, through which the light passes to the mirror, from
which it is reflected back-on the graduated scale. When the magnet
is deflected by the passage of a current through the coil, the image
moves to the right or left along the scale, the angle made by the re-
flected image being twice the angle through which the mirror and
magnet are deflected. A very small deflection of the magnet pro-
duces a very great displacement of the refiected image on the screen, and
thus a very slight current can be detected.

This instrument, as that of Wiedmann, of Germany, is much used
in delicate electro-physiological researches.

Rheostates: Instruments for Measuring Resistance.—The rheostat,
an instrument invented by Wheatstone, was originally designed to
ascertain the relative amount of resistance of different conductors. In
electro-therapeutics it is employed to interpose resistances in the circuit,
etc., so as to delicately modify the strength of the current within’ small
fractions of the strength of an element.

In electro-physiological investigations, as also in certain branches of
electro-therapeutics—particularly in applications to the ear—rheostates
have been used. The form employed by Brenner and others, and also
the water-rheostat, will be described in electro-therapeutics.

Early History of Galvanism.—In the year 1786, while Galvani, Pro-
fessor at Bologna, was experimenting with an old-fashioned electrical
machine that lay near a dish of frogs that had been prepared, it is
stated, for his sick wife, he noticed that the frogs jumped whenever a
spark was drawn from the conductor of the machine. On observing
this, it occurred to him that perhaps he had found a means of detect-
ing atmospheric electricity more delicate than he had previously em-
ployed. In order to test this, Galvani took the dish of frogs, and, with
his neighbor Camillo, went out on the terrace of his house.* It was
a clear evening in the early part of September, and no marked elec-
tric phenomena were apparent in the air. Fixing an iron hook in the
spine of each frog, he suspended it from the iron railing.

Behold spontaneous movements appeared in the frogs, various in
their character and quite frequent !

That moment was the birth of the science of Galvanism. At once
there flashed on the mind of Galvani the query, What causes these con-

* At No. 96, in Strado S. Felice, Bologna, the house where Galvani lived, with
terrace and railings, is still shown to travellers.
EARLY HISTORY OF GALVANISM. 49

tractions? There were no electric disturbances in the air ; the electric
machine was far away inside the house. Could there be electricity in the
frogs themselves? In the history of science it often happens that a
theory partly false guides us into facts that are wholly true. Thus it
happened to Galvani.

From that moment until he died, he lived in an atmosphere of ex-
periment. Frogs without number were slaughtered, and all for the
purpose of proving to himself and others that it was animal electricity
that caused these contractions.

Galvani’s researches, as soon as they were made public, in 1791, ex-

 

Fic. 21.

cited great interest among scientific men, and inspired him to make
another attempt to master the mysteries of electricity. At the time
when Galvani made his discovery, the interest excited by the discovery
of the Leyden jar and Franklin’s kite, about forty years previously,
had died out. Philosophers had followed the vein thus opened, about
as far as it seemed to lead. They supposed that the battles of elec-
tricity were all fought out, and so they were laying aside their armor.
On the announcement of Galvani’s discovery, his experiments were re-
peated all over Europe, and the theory that the contractions of the mus-
cles of the frog were due to animal electricity was universally adopted.
Volta's Researches.: The Theory of Contact and Chemical Action.—
Among those who were stimulated by the discovery of Galvani, was
4
50 ELECTRO-PHYSICS.

Volta, Professor of Physics in Pavia, Italy, who had already been long
distinguished as an electrical experimenter, and who, in the knowledge
of this special branch, was far superior to Galvani.

At first Volta accepted Galvani’s theory of animal electricity, but
subsequent research caused him to doubt its truth. He observed that
it was only by means of heterogeneous metals that muscular contractions
could izvariably be produced, and hence he denied the existence of
animal electricity, explaining the phenomenon of muscular contractions
through the influence of the artificial electricity excited by a heteroge-
neous metallic combination.*

Galvani then not only demonstrated that contractions could readily
be caused by exactly homogeneous metals, but that the phenomenon
was produced by the simple contact of nerve and muscle. His manner
of experimenting was as follows: The leg of a frog, denuded of its skin,
had its sciatic nerves cut at their exit from the vertebral column. The
nerves thus denuded were taken gently up by some non-conductor and
made to touch one of the muscles, when the leg would immediately
become convulsed. Volta endeavored to prove that the concussion
caused by the contact of nerve and muscle was the cause of the electric
current thus produced ; but Galvani conclusively demonstrated that such
could not be the case, by placing a non-conductor between the two tis-
sues, wlien no action could be excited in the leg. He went further,
and at last succeeded in producing muscular contractions when only the
nerves of non-prepared legs were brought in contact.

The discovery of the Voltaic pile, which excited great interest in
men of science, seemed to decide the battle for Volta, and all the
efforts of Galvani to convince philosophers of the existence of animal
electricity were in vain. Galvani’s first observations on frogs dates back
as far is 1780. He’'first published his researches in 1791.

Volta did not undertake the investigation of the subject until 1792,
the year following the publication of the researches of Galvani. And
yet Volta has almost equal claim to be the founder of the science of
galvanism ; for while Galvani discovered the new manifestation of
electricity, he failed to comprehend its true value, while Volta, by the
discovery of the pile which bears his name, demonstrated what Galvani
would never believe, but which Prof. Fabroni, of Florence, had in 1792
suggested, that chemical action was the source of the electricity in Gal-
vani’s experiments.

* The theory that the experiment of Galvani could be explained by chemical action
was first suggested by Prof. Fabroni, of Florence, in 1792.
COMPARATIVE MERITS OF GALVANI AND VOLTA. 51

Thus Volta made the science of Galvanism or Voltaism a possi:
bility.
Terminology of Dynamical Electricity. _The tenig galvanism and
voltaism are both employed to define electricity generated by chemical
action. Among physicists of recent times the preference is given to
Volta, and the terms voltaism, voltaic electricity, electro-voltaic battery,
are taking the place of galvanism, galvanic electricity, and electro-gal-
vanic battery that were formerly employed, and which among the people
are yet the most familiar. The grounds for thus giving the preference
to Volta are these:

First. He was a more profound and philosophical observer than
Galvani, although he did not make the experiments with the frog until
his attention had been called to the experiments of Galvani. Yet for
thirty years, from the age of eighteen, he had been studying the phe-
nomena of electricity. He was an excellent physicist, and had invented
the electrophorus and electrical condenser. +

Secondly. He came nearer than Galvani to the true interpretation
of the phenomenon of the convulsions in the frog. His contact theory,
which so long guided the scientific world, though now known to be
only a partial truth, was yet a great step in advance of Galvani. It is
now known that both contact between dissimilar substances and chemi-
cal action are necessary to generate the current.

Thirdly. He invented the pile which bears his name, and thus pre-
pared the way for the numerous electro-chemical batteries now in use,
and in fact for the whole science of Voltaism or Galvanism, with all its
many practical applications. But for Volta the science of galvanism
might never have existed. Volta during his lifetime was far more hon-
ored than Galvani. He was called to Paris by Napoleon, invited to
perform his experiments, and’ was invested with titles and emolu-
ments; while Galvani died unhonored, neglected, and comparatively .
obscure.

Although for these three reasons physicists have consciously or un-
consciously been led to give Volta the preference over Galvani in their
nomenclature, there are yet two opposing reasons that will probably
make it impossible to carry this preference into the domain of electro-
therapeutics. ,

rst. Galvani’s experiments really gave the impulse to those investi-
gations that led to the discovery of animal electricity, the study of which
has become so important a feature of electro-physiology.

2d. The terms galvanize and galvanization have become permanently
incorporated into the nomenclature of electro-physiology and thera.
52 ELECTRO-PHYSICS.

peutics. No physiologist or electro-therapeutist thinks of using the terms
voltaize, voltaization, and it. would be useless to attempt to compel
them to adopt them.

For the sake, therefore, of clearness and consistency we shall,
throughout this work, in all the departments, rigidly adhere to the
nomenclature derived from Galvani.
CHAPTER IV.
ELECTROLYSIS (ELECTRO-CHEMISTRY).

ELEcTROLYsIs, derived from #Aexrpoy and Avw, through Avors, disen-
gaging, is the act or process of decomposing a compound substance by
electricity.

Electro-chemical decomposition takes place at both poles, but with
different products and manifestations, according to the strength of the
current, the nature of the substances acted upon, and the material of
which the electrodes are composed.

Liistory of Electrolysis.—The chemical effects of statical electricity
were first investigated by Drs. Priestley and Cavendish, in 1784. The
decomposition of water by passing through it a succession of discharges
of statical electricity was first discovered, in 1789, by Messrs. Dieman,
Paetz, Van Troostwyck, and Cuthbertson. The power of the galvanic
current to decompose water was discovered and first described by
Messrs. Nicholson and Carlisle, in 1800. They experimented with the
voltaic pile, which had then just been discovered. These experiments
ers also decomposed other substances by the galvanic current. On
Nov. 20, 1806, Sir Humphry Davy presented to the Royal Society a
lecture ‘On’ some Chemical Agencies of Electricity,” and in the fol-
lowing year he announced his discovery of the decomposition of the
fixed alkalies. Between 1831 and 1840 Faraday published his “ Zx-
perimental Researches in Electricity,’ in one of the most renrarkable
series of scientific essays that ever proceeded from the pen of man.

Terminology of Electrolysis.—With the aid of two friends, Faraday
prepared the following terminology of electrolysis, which is now gener-
ally adopted. The poles where the electricity passes in and out of the
body that is undergoing decomposition are called electrodes (jAexrpov,
and.63és, way). The surface where the current enters the decompos-
ing body is called the anode (dva, upward, and 68ds, way) ; the surface
where the current leaves the decomposing body is called the cathode
(xard, downward, and é8ds, way). The anode is in contact with the
positive pole and the cathode with the negative.
*

54 ELECTRO-PHYSICS,

Practically, anode is used as synonymous with positive pole, and
cathode with negative, although, strictly speaking, anode and cathode
refer to the points of the decomposing body, and positive and negative
to the goles of the battery that are in contact with these.

Compound substances that are directly decomposable by the current
are called electrolytes (jhextpov, and Avw, decompose). To edectrolyze
a body is to chemically decompose it by the current. The act of pro-
ducing electrolysis is called electrolyzation.

The elements of an electrolyte are termed 7éus, (cidv, participle of
the verb «wu, to go). Those ions that appear at the avode are termed
anions, those which appear at the cathode are termed cations. For-
inerly anions were termed electro-negative, and cations the electro-posi-
tive elements of the compound. Water, for example, is an. electrolyte
that evolves two ions—oxygen and hydrogen; oxygen goes to the
anode and is the anion; hydrogen goes to the cathode and is the
cation.

No substance can be an electrolyte which is not a conductor ; but
in the readiness with which they are decomposed substances widely
vary. Every electrolyte must contain more or less of water. ‘Pure
water, though an electrolyte, is yet decomposed only with great diffi-
culty ; but by adding to it a little sulphuric acid, or certain salts, it very
easily undergoes electrolysis. It is furthermore believed that no fluid
can be a conductor without also being an electrolyte; that is, more or
less electro-chemical decomposition must take place when the galvanic
current passes.throughany fluid. Substances that are found to be ready
electrolytes are chloride of sodium, muriatic acid, and iodide of potas-
sium.

Laws of Electrolysis.—-Although electrolysis, like all other phe-
nomena connected with atomic changes, is but imperfectly understood,
yet some of the general laws of its operation have been already well
ascertained. i

Among the more important of these laws the following may be enu-
merated :

1. Definite Electro-chemical Action.—It has been found that when
several substances are simultaneously decomposed by the current, the
elements that are evolved are definite in quantity and are electro-
chemical equivalents of each other. This law, which was discovered by
Faraday, may be thus illustrated. Let the current be sent successively
through a series of cells filled with oxide of lead, chloride of lead, and
chloride of silver. The different substances would combine in the fol-
lowing proportions :
LAWS OF ELECTROLYSIS. 55

At the Positive Pole, At the Negative Pole.
Water...... istoaaes 8 grs. oxygen. 1 gr. hydrogen.
Oxide of lead..... 8 a 113.5 grs. lead.
Chloride of lead... 35.5 grs. chlorine. 103.5“
Iodide of lead..... 127 grs. iodine. 103.5 “
Chloride of silver.. 35.5 grs. chlorine. 108 grs. silver.

These numbers, it will be seen, represent the combining proportions
of these substances.

Substances combine in equivalent proportions ; they ate decomposed
in the same equivalent proportions.

2. Primary and Secondary Results.—The results of electrolytic action
are distinguished as primary and secondary. The results are called pri-
mary when the elements that are decomposed appear at the electrodes
unchanged and uncombined; the results are called secondary when
the elements that are decomposed are changed or recombined when they
appear at the electrodes. The secondary results are favored by the
nascent condition of the elements that are decomposed. The secondary
results are caused by the action of the decomposed elements on the sub-
stance of the electrode, or on the substance itself that is undergoing
decomposition. Even the decomposition of water, when diluted with sul-
phuric acid, is really a secondary result. Perfectly pure distilled water
does not perceptibly decompose even under quite a strong current. Ifa
few drops of sulphuric gases are added, the acids are freely disengaged.
The sulphuric acid H,SO, is disengaged by the current into H, at the
negative and SO, at the positive pole ; the former H, is liberated,
and the latter SO, at the positive pole acts on the water and forms
sulphuric acid again. Secondary decomposition is modified by the
material of which each electrode is composed. Thus in decomposing
sulphuric acid, when the positive electrode is made of carbon, the oxy-
gen decomposed acts on the carbon, forming carbonic acid and carbonic
oxide. Electro-chemical action continued for weeks, months, and years,
as was done by that very laborious experimenter, Mr. Crosse, of Broom-
field, may produce as secondary results interesting minerals, such as
quartz, arragonite, malachite. During these experiments in electro-
crystallization Mr. Crosse discovered that remarkable insect, the
acarus, which appeared in electrized solutions of sulphate of iron,
sulphate of zinc, and nitrate and sulphate of copper. It was supposed
that the acari arose from ova deposited by insects floating in the at-
mosphere, and that they might possibly be hatched by electric action.
As a reward for this discovery, which now seems to be almost forgotten,
56 ELECTRO-PHYSICS.

Mr. Crosse was subjected to absurd and outrageous abuse, as though
he were infringing on the prerogatives of the Creator. Mr. Weekes, of
Sandwich, in Kent, subsequently repeated the experiments of Crosse by
passing electrical currents through silicate of potash in glass receivers
over mercury. All possible care was taken to keep out foreign matter.
After a constant action of a year, insects appeared, entirely similar to
those obtained by Mr. Crosse. The metallic deposits in electro-metal-
lizing are the secondary results of the electro-chemical decomposition.
Water is electrolyzed, hydrogen is disengaged at the cathode, and oxy-
gen at the anode; but the hydrogen reacts on the metallic solution,
combines with its oxygen, and frees the metal. The oxygen also com-
bines with an element at the anode. In the section on Electro-Surgery
it will be found that the secondary decomposition is utilized in the selec-
tion of the material used for needles in galvano-puncture.

3. The Differential Action of the Poles.—Different elements go to the
anode and the cathode, according to the nature of the substance de-
composed and the material of which the electrode is made.

Platinum-wire makes the best electrode for electrolytic experiments
on various substances, because platinum is not acted on. Copper and
silver wire may be used, but the secondary action which they cause
greatly complicates the experiment.

To distinguish the precise character of the changes that take place in
the electrolysis of many substances is‘frequently difficult, and sometimes

“impossible. It is difficult to decide whether any of the elements of the
electrolyte, besides water, undergo decomposition ; and whether the
changes are of a primary or secondary: character.

Aniong the substances that are most readily decomposed by the elec-
tric current are the following :

Todide of Potassium.—This decomposes under a very feeble current,
the iodide and oxygen going to the positive and the hydrogen and al-
kali to the negative. Thus the decomposition of iodide of potassium
by electricity affords a very good means of distinguishing the poles.
The brown color of the iodine always appears at the positive pole. The
whole solution soon presents the color of iodine,

Chloride of Sodium.—A solution of common salt decomposes quite
readily, chlorine appearing at the positive and hydrogen and oxide of
sodium at,the negative pole. If the positive needle is platinum, the
odor of chlorine is at once detected; if it is of copper, the chlorine
unites with the copper, making the solution turbid. ;

Acetate of Lead.—This salt in solution decomposes with comparative
slowne:s by secondary action, peroxide of lead appearing at the posi-
THEORY OF ELECTROLYSIS. 57

tive pole, and hanging from it in light threads or masses. The water
frequently decomposes before the lead yields at all.

Nobilis Ivis-Rings.—It is by the electrolysis of lead that the beau-
tiful iris-rings are produced. A polished steel plate is put in a dilute
solution of acetate of lead. The steel plate is connected with the
positive pole of a galvanic battery, while a wire, connected with the
negative pole, is put in the solution. Peroxide of lead is at once libe-
rated on the steel beneath the wire, and a film extends outward, but
growing thinner and thinner. Thus a series of concentric circles is
formed exhibiting bright iris colors.

Nitric Acid.—Strong nitric acid conducts well and decomposes, oxy-
gen appearing at the positive pole, nitrous acid and nitric oxyd at the
negative pole. Dissolution takes place, and the water becomes yellow.

LVitrate of Potash.—This is a good conductor, and yields secondary
results.

Sulphurous Acid.—This, when diluted, yields oxygen at the positive
pole, and hydrogen and sulphur at the negative.

Sulphuric Acid.—-This yields sulphur at the negative pole, and pio-
duces secondary results.

Muriatic Acid.—A strong solution of this yields hydrogen at the
negative pole, and chlorine at the positive pole.

Electyo-metallur gy.—Electro-metallurgy, or the art of precipitating
metals from their solutions by the galvanic current, is a result of the
discovery of electrolysis—is indeed itself simply an electrolytic pro-
cess. There are two divisions of this- art—electrotyping and electro-
plating. ‘The art of electro-metallurgy was discovered, independently,
by Spencer, in England, and Jacobi, in Petersburg, in 1837. Electro-
gilding was discovered by Brugnatelli, a pupil of Volta, but was first
used by M. de la Rive.

Theory of Electrolysis.—The theory of electrolysis at present accepted
is the following: In every compound one of the elements is electro-
positive, the other, electro-negative. Under the influence of the
opposing electricities from the electrodes, decomposition and recompo-
sition go on from one pole to the other. But these decompositions and
recompositions are seen only at the electrodes.

This may be illustrated by the electrolysis of water. Water is com-
posed of one atom of oxygen and two atoms of hydrogen. Oxygen is
electro-negative and hydrogen is electro-positive.

When, now, the electrodes are dipped in water, the electro-negative
oxygen of the molecule a (Fig. 22) is attracted to the positive pole, and
the electro-negative hydrogen is repelled.
58 ELECTRO-PHYSICS.

The oxygen is then given off at the positive pole, while the liberated
hydrogen unites itself with the next atom of oxygen of the molecule
6, while the original atom of hy-
drogen is expelled.

This atom of hydrogen unites
te with the oxygen of the molecule

5 ¢, drives out the hydrogen with

Fic. 22. which that atom had ‘been pre-
viously combined, and so on through the whole series of molecules
until the negative pole is reached. Here the hydrogen has no more
oxygen to combine with, so it is liberated as gas.

The electrolysis of all other electrolytes is similarly explained. This
simple and ingenious theory was devised by Grotthiiss.

. Decomposed Elements appear only at the Electrodes.—In electrolysis
the elements decomposed appear only at the electrodes; the interme-
diate region presents no change, although, of course, it must be trav-
ersed by the decompositions that occur. This is illustrated by the
following experiment of Davy: Three vessels are connected by a cot-
ton wick thoroughly moistened. In one vessel is placed an alkaline salt,
and in the other two, water. The liquid of all three vessels is colored
with syrup of violets. When the galvanic current is made to pass through
the vessels. the liquid at the negative pole becomes green, and the
liquid at the positive becomes red, demonstrating that the acid goes to
the positive and the alkaline base to the negative pole. The fluid in
the middle vessel suffered no change of color, although it must have
been traversed by the acid in the solution.

Electrolysis compared with the Reactions in the Batteries.—It will be
observed that the chemical action that takes place in the fluids of any
battery is similar to electrolysis. ‘The two are, indeed, facts of pre-
cisely the same nature. The action in the battery is accompanied by
an electric current; the action in electrolysis occurs as a result of the
passage of a current.

In the section on Electro-Surgery it will be shown that all these phy-
sical laws of electrolysis have a direct and necessary bearing on the use
of electrolysis in surgery.

  

 
CHAPTER V.

INDUCED ELECTRICITY—CURRENT AND MAGNETO-INDUCTION—ELECTRO-
MAGNETISM.

Induced Electricity, or Electro-Magnetism : Electro-dynamical Induc-
tion.—We have seen that zzduction means the action that electrified
bodies exert on other bodies at a distance. Electro-statical induction
has already been treated of. We have now to speak of the induction
of current-electricity.

Prof. Oersted, of Copenhagen, first observed that the electric cur-
rent, brought near a magnetic needle, caused it to deflect. This was
the earliest observation in electro-magnetism.

Philosophers at once set themselves at work to explain this phenome-
non. The discovery was not an accidental one on the part of Oersted.
For years he had been occupied with the study of electro-physics, and
as early as 1807 he had published a work in which he stated that he
purposed to ascertain whether electricity in its most latent state had
any effect on the magnet. His first discovery that the needle had a
tendency to place itself at right angles to the wire in which a current was
passing, was a natural sequence and confirmation of his early researches.
This discovery by Oersted formed another era in the science of elec-
tricity ; for in 1820 the enthusiasm caused by the discoveries of Galvani
and Volta, had subsided, just as the enthusiasm caused by the Leyden
jar and Franklin’s pile had died away when Galvani made his renowned
experiment.

Ampérés Theory of Magnetism.—Among the many scientists who
sought to explain and unfold the phenomena of electro-magnetism as
discovered by Oersted, it was reserved for Ampére to achieve the
highest success. This theory, which was developed by rigid mathemat-
ical demonstrations, was, that each molecule of a magnetic body ts trav-
ersed by closed electric currents. These currents are free to move
about their centres of gravity, but the coercitive force, which is weak in
soft iron but great in steel, tends to keep them in position.
60 ELECTRO-PHYSICS.

Before a magnetic body is magnetized these molecular currents, or
rings of electricity, by their mutual attraction neutralize each other,
so that their combined action on any other substance is nothing.

When a body is magnetized, these molecular currents assume a paral-
lel direction. The more complete the magnetization, the more nearly
parallel they become. When they are completely parallel, the limit of
magnetization is reached. Ampére further supposes that all these mo-
lecular currents are equivalent to a single current circulating round the
magnet. Still further, and in consonance with his theory, Ampére sup-
posed that terrestrial magnetic effects were due to magnetic currents -
that circulate round the earth from east to west, perpendicular to the
magnetic meridian. The resultant of these currents is a single cur-
rent going from east to west. These currents, which are supposed
to be due to the action of the sun, deflect magnetic needles, magne-
tize iron, etc.

The Electric Current acts as a Magnet: Solenoids.—In confirma-
tion of Ampére’s theory of magnetism, it is found that when a helix, or
spirals of covered wire, coated in such a way that one of the wires passes
through the axis (solenoid, as it is called), is suspended into cups of
mercury, and traversed by a current, it will act like a magnetic needle
and point from north to south, Ampére gave the following rule.by
which the directions of the needle under the current can be under-
stood: Let the observer imagine himself placed in the wire, so that a
current enters at his feet and leaves at his head, while his face is turned
toward the needle; the pole will a be deflected toward the left
of the observer.

ffelix.—In a helix of a copper wire through which a current circu-
lates, each convolution of the spiral may be regarded as one of the little
‘magnets of Ampére’s theory. The ends of the spiral, when the current
passes through it, act on a magnetic needle like the poles of a magnet.
Ampeére’s theory explains two important magnetic phenomena.

1st. Why like poles repel and unlike attract.

Two north poles of a magnet side by side have opposite cur-
rents and repel each other. Similarly with two south poles. Buta
north and south have currents in the same direction and attract each
other. ‘"

2d. Why a magnetic needle places itself north and south. A
magnet can come to rest only when the current below it, nearest the
earth, is parallel to the earth-current. The magnetic needle turns to
the north to allow the currents below it to become parallel to the earth’s
current.
ELECTRO-MAGNETIC HELIX. 61

Electro-magnetic Helix.—Magnetism is induced in a bar of soft iron
by the simple passage of a current near it, in a direction at right angles
to the bar. If, however, the wire (Fig. 23) encircles the iron many
times, this efféct will be much in-
creased. Let a current be passed P
over the wire in the direction of the
arrows, and the iron within will be-
come strongly magnetic, with its
poles as shown by the letters S and
.N. If the enclosed iron be not too
heavy, it will be drawn to the centre.
’ and held suspended there.

When the current is broken, the iron ceases to be magnetic; while,
if a bar of hardened steel be substituted for the. iron, it will retain its
magnetism permanently. Such a coil of wire is called a helix, from
tig, a winding, and a magnet formed in the manner described is termed
an electro-magnet.

Fig. 24 represents the general form of an electro-magriet. It is com-
posed of a bar of soft iron, bent into the
form of a horseshoe. An insulated wire is
coiled round its extremities. When a cur-
rent of electricity is passed through the coil,
the horseshoe-bar becomes magnetic, and
attracts the armature. If the current is
broken, the bar becomes demagnetized and
the armature falls to the ground. , Perma-
nent magnets possess much less power than
electro-magnets.

If the iron bar within the helix be more
than a third of an inch in thickness, and the
current be of moderate strength, the mag- Fie. 24.
netism induced is in proportion to the
strength of the current, and of the number of turns in the coil. Ad-
ditional coils of the wire give no increased magnetism, if the bar is
thinner than one-third of an inch. In this case maximum is soon
reached. ‘Again, if the circuit is made very long, thus reducing the
strength of the current, the advantage usually gained by the thick bar,
and by increasing the number of coils, may be lost. The iron bar
should be perfectly. pure and well annealed, in order that the electro-
magnet may quickly acquire and as quickly lose its magnetism on
closing and breaking the circuit.

 

 
62 ELECTRO-PHYSICS.

Direction of the Induced Current.—If a current of electricity is passed
through any conductor, it will in-
duce a current in the opposite direc.
tion in a sécond conductor situated
ree ~SCéppaaile'di to the first. Let A B, Fig.

avae 25, be a wire connected: at either
* extremity with the poles of a gal-
vanic battery, and M N a second wire parallel and near to the first.
As soon as the circuit is formed and a current passes from + to —, a
secondary current is induced in the second wire, but in an opposite
direction.

This current is, however, but for an instant. As soon as the circuit
is broken, an instantaneous current, with its direction reversed, is again
established in the second wire. :

Different Orders of Induced Currents.—Induced or secondary cur-
rents have themselves the power of producing induced currents in other
adjacent circuits. Currents thus induced from secondary induced
currents are called tertiary induced currents. ‘These tertiary induced
currents have also the power of producing induced currents in an ad-
_jacent circuit, and so for a long series. —

Currents produced in this way are in opposite directions alternately,
and their strength diminishes the higher they ascend. ;

As a secondary current flows in a direction opposite to that of the
battery current, so the fertiary flows in a direction opposité to the
secondary. This law holds good throughout the whole series,—the
strength of the current diminishing as the distance from the battery
increases.

The manifestation of electrical action in the secondary coil, upon
closing and breaking the circuit, is called the electric throb, while the
passive condition of the wire while under induction has been described
by Faraday as electro-tonic.

If the primary coil be movable, so that it can be brought in closer
proximity to the secondary coil while the current is passing, an inverse
current is produced at the moment of its approach, the same as when.
the circuit is closed. If now the primary coil be withdrawn, a direct
current is produced, the same as when the circuit is broken. As long
as the primary coil remains in one position, all evidence ‘of electricity
in the secondary wire disappears. If, however, while in this position,
the strength of the primary current be increased or diminished, mo-
mentary currents are established in the secondary coil; the inverse
following the increase, and the direct current following the decrease in

 

 

4
DIFFERENT ORDERS OF INDUCED CURRENTS. 63

the strength of the primary current. In thus experimenting, it is much
more convenient to wind the wires on separate bobbins, so that one
may be placed within the other, as represented in Fig. 26.

 

Let A represent the primary coil, which is composed of wool-covered
wire, #, of an inch in diameter; and.B the secondary coil, of silk-
covered wire, much longer than the other, and about 5 of an inch in
diameter. Now let the secondary coil be connected with the galvan-
ometer, G, by means of the two binding-screws, while the primary coil,
by two loose and flexible wires, is placed in the circuit of a galvanic
cell. As soon as A is inserted into B, a momentary inverse current is
indicated. If it be withdrawn, the galvanometer indicates a momen-
tary direct current. While the primary coil remains in the secondary,
the needle announces the induction of currents according to the prin-
ciples stated above, whenever the strength of the primary current is
increased or diminished.

The Conditions under which Induction takes place.—To sum up in
brief. Induction takes place from one circuit: into an adjacent circuit,
ist. At the moment when the current is closed. 2d. The moment
when the current is opened. 3d. While the current is increasing or
diminishing in strength. 4th..While the current is brought near to or
removed fromthe adjacent circuit. A current that closes or increases
64 ELECTRO-PHYSICS,. -

in strength, or is brought near to an adjacent circuit, induces an inxverse
momentary current in that circuit. A current that opens or diminishes
in strength, or is removed from an adjacent circuit, induces a direct
momentary current in that circuit. It will be seen, therefore, that in-
duction takes place only when there is some change in the condition of
the inducing current. It must be closed or opened, increased or dimin-
,ished in strength, brought near to or removed from the adjacent circuit.

In the ordinary electro-magnetic machines these changes are made
by a rheotome, or current-interrupter, and the strength of the current
is modified by withdrawing or removing a metallic cylinder enclosing
the coils, or by withdrawing or removing the core of iron needles.

Induction of a Current on Itself: Extra Current.—The extra cur-
rent is that which is induced by the current in each coil, or winding of
the primary coil on the other adjacent windings.

The windings act inductively on each other both at the opening and
closing of the circuit. Thus we have a direct and an inverse extra cur-
rent. The direct extra current gives shocks and sparks, decomposes
water, magnetizes steel, and melts platinum-wire. The electro-motive
force of the extra current bears a uniform relation to the intensity of
the primary or inducing current. When the secondary coil is closed,
the extra current does not appear in the primary coil, but by what is
called reaction it is formed in the secondary coil itself, and becomes
an ordinary induced current.

It is called the extra current only so long as it remains in the pri-
mary coil ;, it so remains only when the secondary coil is open.

Leheotome, or Current-interrupter.—Among
the different contrivances for producing these
changes in the primary current that are neces-
2 sary for induction, the most convenient is the
Rheotome, or Current-interrupter.

This, when placed in the circuit of the pri-
mary coil, alternately closes and opens the cur-
rent, and thus causes induced.currents in the
secondary coil.

Fig. 27 represents a current-interrupter.

Into the iron covering A are fastened the
ends of the iron wires of the core within the

Fic. 27. coil.
The hammer H is attached to a spring D,
which is in the primary circuit; f is a projection tipped with plati-
num, because that metal does not corrode; pf’, connected with the

 
‘INDUCTION COILS. 65

screw, is also tipped with platinum. When-the circuit is closed, the
core of iron-wire A becomes magnetic, and draws H away from 9’,
against which it naturally rests. This breaks the current, for the circuit
is completed through the connection of g and g’. As the current is
broken, A of course loses its magnetism, and no longer has power to
attract H ; therefore the spring D brings H back to #’, where it natur-
ally rests. This completes the circuit, and again A becomes magnetic,
and again it attracts H, and thus H is kept rapidly vibrating with a
buzzing sound between A-and '. These constant interruptions keep
up an induced current in the secondary coil. The screw J gives the
necessary stiffness to D.

Object of the Iron Core in the Primary Coil.—The inductive power
of the primary current is very greatly increased by putting a bar of soft
iron or a bundle of iron wires in the heart of the primary coil. The
iron core strengthens the current in this way. It becomes magnetic by
the action of the current, and this magnetism disappears when the cur-
rent opens. The disappearance of the magnetism induces a current in
the same direction as the disappearing primary current, and thus
strengthens it. In electro-magnetic machines, as used for ¢lectro-
therapeutics, this iron core is a very convenient means for modifying
the current. Pushing it in the coil increases the current, withdrawing
it diminishes the current.

A bundle of wires is preferable to a single bar of soft iron, for in the
latter, currents are formed which impede the sudden cessation of the
primary current, while in the former these cannot be formed.

Thickness and Length of the Outer and Inner Wires.—It is a law of
electro-physics that wires of a large diameter conduct electricity better
than wires of a small diameter. It is necessary that the primary cur-
rent should be strong, since its principal object is to excite magnetism
in the core ; consequently the coil is made of thick wire and of moderate
length. The secondary coil, however, is made of very thin wire, and
of great length, so that as many turns as possible may be brought
within the influence of the core and of the primary coil, and thus pro-
duce a secondary current. As with the galvanic or inducing current,
the electro-motive force of the battery is proportionate to the num-
ber of cells; so with the induced or secondary current, the electro-
motive force of the coil is proportionate to the number of turns or coils
in it.

Induction Coils and Electro-magnetic Machines.—An induction coil
for philosophical or electro-therapeutical purposes consists usually of
two helices or coils of wire enclosing a bar of soft iron or a bundle of

5 ‘
66 ELECTRO-PHYSICS.

iron wires.* The inner coil is connected with the poles of a battery,
and there is some arrangement for breaking the current. The inner
coil is composed of tolerably coarse wire, and is comparatively short.
The current that runs through it is called the primary, or sometimes
the inducing, current. The outer coil is in no way connected with
the inner coil, but receives by induction a current from the current of
ethe inner coil as it is alternately broken and closed. The outer
coil is composed of jime wire, and it is very much longer than the
inner coil.

The finer and longer the wire, the greater the tension of the current.
The current that comes through the outer coil is called the secondary.
current, in distinction from that which comes from the inner coil, which

+ is called the primary. In both coils the iron is insulated with silk cover-
ing.

Ruhmkorff’s Coil.—The most powerful of all coils, and the one best
adapted for philosophical experiments, is that of Ruhmkorff, of Paris.
It is about 14 inches in length. The. inner coil is of copper, is about
2mm. in diameter, and 4 or 5 yards long. It is coiled on a cylinder
of card-board, and is enclosed in an insulating cylinder of glass or
rubber.

 

The wire of the outer coil is of copper, from 4 to 4 mm. in diameter,
and from thirty to sixty miles in length. The distinctive features of
this coil are these : :

1st. It is coiled in sections so as to avoid the induction of the outer
coil on itself, which is liable to take place when it is very long and the
tension is high, however thorough the insulation.

* In the machine of Kidder, to be described under Electro-Therapeutics, the helix
is composed of three or more coils of wire, not distinct, buf connected.
RUHMKORFF § COIL. 67

2d. The insulation is very complete. The wire is covered with silk,
and each winding is separated from the others by a layer of shellac.
In the larger coils of Ruhmkorff the induced currents are thousands of
times stronger than the primary current that excites them.

The Condenser of Ruhmkorff’s Coil.—The intensity of the current of
the secondary coil is increased by interposing a condenser in the circuit.
In Ruhmkorff’s coil the condenser consists of 150 sheets of tin-foil 18
inches square, and with a surface of about 75 square yards. These
sheets are coiled around insulating oiled silk, and around each other, so
as to form two armatures, and the whole is placed below the helix in
the base of the apparatus.

Being introduced into the circuit, it receives the extra current and
increases its tension. It stores up and utilizes force that would other-
wise be wasted in the form of sparks at the interrupter.

Lffects produced by Ruhmkorff's Coil.—The tension of Ruhmkorff’s
coil is enormous, and for the reasons above given—the length and fine-
ness of the secondary wire and the power of the condenser. It possésses
all the properties of statical as well as dynamical electricity. It is
capable of giving a shock so violent’ as to prostrate a man, and'ifa
sufficient number of elements are connected with it, it could kill as by
a stroke of lightning. When two couples are connected with it, it will
kill a rabbit. It causes fine iron wire to melt and burn with a bright
light. It can rapidly decompose water, or produce luminous effects in
the water without decomposition.

It decomposes and combines gases. Passed through a hermetically
sealed tube containing air, it forms nitrous acid from the nitrogen and
oxygen. It can produce a spark eighteen inches in length in the air.

In vacuo it produces most remarkable effects. In the so-called
electric egg, a luminous trail is observed between the poles. At the
positive pole the light is red and brilliant; at the negative, feeble and
violet. If vapor of alcohol, or turpentine, or bisulphide of carbon, be
introduced into the vessel, it appears in the form of alternate light and
dark zones or strata. The tints vary with the nature of the vapor.
The same phenomena are obtained by the ordinary galvanic current
from a large number of cells. The luminous effects of the coil are as
great from a single cell as from a large number.

In electro-therapeutics a wide variety of electro-magnetic machines
have been devised. Most of them are run by one or two cells, like
Smee’s or Walker's, and the current generated is just sufficient for ap-
plication to the human body, and are but little adapted for the philo-
sophical room.
68 ELECTRO-PHYSICS.

The largest induction coil of which we have any knowledge is that of
Apps, in London. It is nine feet ten inches long, and its diameter is
two feet. The soft-iron core is five feet long, four inches in diameter,
and weighs 125 pounds. The length of the primary coil is 3,770 yards,
while that of the secondary coil is ove hundred and fifty miles. This
battery is excited by 48 large Bunsen cells. It gives a flash twenty-

eNine inches long that will perforate five inches of solid plate-glass. At
the Stevens Institute of Technology, Hoboken, there is also an induc-
tion coil of great power.

Properties of Induced Currents.—Induced currents have in different
degrees all the properties of the ordinary galvanic current. They pro-

- duce chemical, thermic, luminous, and physiological effects. They
deflect the magnetic needle, magnetize steel, and are capable of them-

* selves exciting induced currents. There is a difference, however, be-

‘tween the effects of the direct induced and inverse induced. The
direct gives a powerful shock, the inverse a mild shock.

The direct magnetizes to the point of saturation, the inverse does
not magnetize.

In their action on the galvanometer they are about equal In quan-
tity, the direct and inverse induced currents are about the same; but
the tension of the direct induced is greater than that of the inverse
induced.

’ Comparative Chemical Effects of the Galvanic and Induced Currents.
—That the chemical character of currents of induction is distinctive from
the galvanic is proved by the following experiment: When the platinum
poles connected with an induced current are placed in water, water is
decomposed and oxygen produces oxidation of platinum, which is re-
duced to metallic platinum by the recombination of the hydrogen with
the oxygen. This process takes place at both poles, so that both
become covered with a powder of platinum.

If a solution of iodide of potassium and starch is brought into the
circuit, the d/ue color appears at doth poles. When the galvanic cur-
rent is used, the blue color appears only at the positive pole. When
the induced current is sent through water it decomposes it, just as the
galvanic current does the oxygen and hydrogen, both appearing at
both poles; but they recombine, and thus the water does not appear
to be decomposed at all.

It is of the first importance to the electro-therapeutist to understand
electro-magnetism, for it is the form of electricity most used in electro-
therapeutics.

Magneto-electricity.—Magneto-electric induction is the induction of
°

MAGNETO-ELECTRIC MACHINES, 6g

electric currents by magnetism. It is, as the term implies, the reverse
of electro-magnetic induction. There are two forms of magneto-elec-
tric induction.

The first and most familiar form is when a current is induced in a
coil of insulated wire. The second form is when a current is induced in
conducting plates.

Under electro-magnetic induction we have seen that the coil of
wire in which a current circulates produces a contrary induced cur-
rent in an adjacent coil whenever a change is made in the current by
opening, closing, withdrawing, or approaching it. The strength of the
induced current is proportioned to the amount and suddenness of these
changes. If now we substitute for the primary or inducing coil a per-
manent dar magnet, and cause it to approach or withdraw from the ad- ,
jacent coil, it induces ‘a current in that coil. This principle is the
basis of all the magneto-electric machines that are so familiar to stu-
dents of philosophy, and that were once so much used in electro-thera-
peutics.

The development of magneto- electricity is shown in a very simple
manner by the conimon horseshoe magnet, its armature,
and a copper wire. Let the armature A B be encircled
by the wire C, one end of which is flattened and amal-
gamated with nitrate of mercury, and the other filed to
a point. When the armature is placed upon the magfit,
the moment of contact, when it is withdrawn, and the
act of withdrawal, will each be marked by a spark of
electricity at C, where the two extremities of the wire
meet.

The electric current flows in one direction at the in-
stant magnetism is induced in the soft iron which is
enclosed by the coil of wire, and in the opposite direc-
tion when its magnetism is destroyed.

In the electro-magnetic machines in ordinary use a soft-iron arma-
ture covered with wire is made to rotate in front of the poles of a per-
manent horseshoe magnet. As the armature rotates, its two ends are,
of course,.alternately brought near to and removed from the bars of the
magnet, and thus two currents are induced in the wires that cover the
armature. Each current lasts half of a revolution, and ifthe rotation
be rapidly kept up, a current is produced which may be perceived when
the ends of the wires are joined.

A Continuous Current from Magneto- electric Machines.—When the
armatures of the magneto- -electric machine are made to revolve with

 
70 ELECTRO-PHYSICS.

sufficient rapidity, a continuous current is produced which has all the
properties of the galvanic current. Magneto-electric currents are,
therefore, extensively used in electrolytic experiments and in electro-
plating. It is possible that some of these may be utilized in electro-
therapeutics.
Currents induced by Magnetism in Conducting-plates: Magnetism.
of Rotation.—In 1824-5 Arago discovered that when a copper disk re-
volved with great rapidity under a needle resting on a disk above the
disk, the needle deflected in the direction of the motion of the disk.
After a time, if the movement be sufficiently rapid, the needle refuses
to remain fixed, and turns around after the disk. The explanation of
this phenomenon was given by Faraday in 1831. He showed that it
arose from the reaction of the currents induced in the plate by the mag-
net. The magnetism of rotation is only one of the many phenomena
connected with induction. All these phenomena—induction by currents
of magnetism and by rotation—are explained by the theory of Ampére
before cited. They are at once in harmony with that theory and con-
' firmatory of it.

History of Induction.—The discovery that electric currents of mag-

netism can induce currents in neighboring circuits was made by Faraday
in 1830. His researches on the subject were published in the Philo-
sophical Transactions in 1831 and 1832.
' This discovery’of Faraday, like that of Oersted, was the result, not
of accident, but of long and laborious experimentation. As early as
1825 Faraday had sought to make a wire, through which the galvanic
current was passing, induce a current in a neighboring wire, just asa
conductor charged with Franklinic electricity would have done. Not
until 1831 did he find out that the current must be broken or closed,
or approached or withdrawn, before it could induce a current in a
neighboring wire.

In 1832 Prof. Henry, then of New Jersey, now of the Smithsonian
Institute, Washington, observed phenomena which, in 1834, Faraday
showed were due to the extra current. In 1837 Bachhoffmer and
Sturgeon showed that a bundle of wire was better in an induction appa-
ratus than a rod of soft iron.

In 1841 Prof. Henry studied the inductive action of currents on
currents. In 1850 or 1851 Rubmkorff constructed the induction-coil,
and in 1853 Fizeau greatly increased its power by adding to it a con-
denser. The discovery that discharges of the Leyden jar made a
primary spiral induce a current in a secondary spiral, and that currents
‘of the third, fourth, and fifth order can be thus produced, and of suffi-
HISTORY OF INDUCTION. 71

cient strength to give shocks, burn, etc., was made simultaneously by,
Profs. Henry, of Washington, and Riess, of Berlin.
The first magneto-electric machine was made by Faraday in 1831.
The first machine of the style now used was made by Pixii in 1832.
Improvements have been since made by Saxton (1833), Clarke (1836),

Petrine (1844), Stéhrer (1844), Siemens, Halske, Duchenne, and
others,

 
CHAPTER VI.

THERMO-ELEFCTRICITY.

Thermo-electricity ts that form of electricity that arises from the heat.
ing of two heterogeneous conductors at their junction. The two most
important methods of generating thermal currents are, rst, with two
portions of the same metal; and 2d, with two different kinds of metal.

Thermo-electricity generated by One Metal.—lf a copper wire be
cut into two pieces, and one of the ends be heated to redness and
pressed against the end of the other piece, a current of electricity is
produced. This is demonstrated by the galvanometer.

When different portions of the same metal have different structures,
a current is obtained when the point where both structures come
together is heated.

If, for example, a platinum-wire be twisted or bent on itself, this
twisting so changes the structure of the wire that a current is generated
by heating the point of union between the’ twisted and non-twisted
portion.

Thermo-electricity generated by Two Metals.—Let A and B (Fig. 30)
be respectively bars of antimony and bismuth, soldered to-
gether, while G represents a galvanometer connected by two
wires with the free extremities of the metals,

When the junction S of the metals is heated, a current of.
electricity is generated, which flows from the bismuth to the
BAI}, antimony, as shown by the arrow. If the junction S is chilled

by applying ice, a current is also produced, but in the oppo-
site direction. This combination constitutes a shermo-electric

~ul Sy pair.
HEAT The following is the thermo-electric classification of the
FIG. 30.

metals. The arrows show the direction of the current, accord-
ing as the junction is influenced by heat or cold. The relative elec-
tro-motive force of the metals is indicated by the numbers.
THERMO-ELECTRICITY. 73

 

 

Bisiiutlies. dss oa enes ebagcaus +25
Cobalt scare aucieteien eis pole eqa tah 9
Potassium...... ea rtreshn a hihicains 5.5
German Silver............... 5.2
Nickel...... asta eis wine io 5
A Sodium .........cce cece eee 3
MEnCUry: cs cursceeemanganeeus 2.5
Aluminume........ eee eevee 1.3
Magnesium..........0-e.00: 1.2
Lead....... Sd dey ooo eana 1.03
A Till wit veeeee tales aac ete I 1
5 COpper . siwdwiees bea oanareates I a
ov Platinum. ..... Coreen ceed 0.7 a
SilVERs bon eatassenes amet aee °
Gas-COKG..eieiaxes paneee ees 0.05
ZINGs de desig ete Gehan eta 0.2
AYSENIC, gate Adenine are) he ee 0.38
TTOM Ga noes wieid sale ee ieee eee 5 Vv
~ Red Phosphorus...........4. 9.6
ADUMONY ‘wie cee we he ee bee ee 10
Tellanum 22 a.asasniwsnve css 179
SSlENIU IN shecaiswa guk lene leh oa ae 290

As in the electro-chemical classification, so here, the greater the differ-
ence between two, elements, the greater is the electro-motive force.
For example, the electro-motive force of a bismuth and antimony pair
is greater than that of a bismuth and copper pair.

Among these substances the strongest current is produced by
bismuth and selenium, but as selenium is expensive, antimony is
generally substituted for it. The antimony is the negative metal
but the positive pole, and thus corresponds to the platinum or cop-
per in the galvanic battery. The bismuth is the positive metal but
the negative pole, and thus corresponds to the ziuc of the galvanic
, battery.

The current goes across the point of union from bismuth to anti-

“mony.

When the temrperature is raised beyond a certain point the direction
of the current is sometimes reversed. Thus, for example, in a circuit
of copper and iron the current goes from the copper to the iron so
long as the temperature does not exceed 300°. When the temperature
74 . ELECTRO-PHYSICS.

exceeds 300°, the direction of the current is changed and it goes from
iron to copper.

Thermo-electric Force influenced by Crystallization.—It is a fact of
interest that the thermo-electric force is influenced by crystallization.

Metals which have a crystalline structure are best suited for a thermo-
electric pair.

» Ithas been noticed, also, that when the cleavage of bismuth is par-
allel to the face of junction, the electro-motive force is greater than
when both are at right angles ; with antimony the reverse is true. The
difference is so great that it is possible to construct a thermo-electric
element of two pieces of bismuth by making the cleavage in one parallel
to the face of the junction, and the other at right angles to it. The
same can be done with antimony.

General Properties of Thermo-electric Currents —Thermo-electric
currents have to a less degree all the properties of the galvanic battery.
They can be kept very constant, for by the use of ice and boiling
water the junction of the metals that give rise to them can easily be
kept at a definite temperature.

For this reason (their constancy) Ohm used them in the experimental
establishment of his great law.

Electro-motive Force of Thermo-electric Currents.—As compared
with the currents generated by chemical action—hydro-electric currents
—the thermo-electric currents have a very feeble electro-motive force.
According to Wheatstone, the electro-motive force of a bismuth-copper
element, with a difference of 100 C. in the temperature of their junctions,
is zg that of a Daniell element. Other observers have estimated the

electro-motive force of thermo-electric currents still less. According —

to Kohlrausch, the electro-motive force of an iron-silver couple with
to° or 15° difference of temperature at their junction is sess that of a
Daniell element.

Origin of the Current in a Thermo-electric Battery.—We have
shown that in the galvanic battery the origin of the current is chemical
action. In the thermo-electric battery chemical action will not explain
the existence of the currents, for they are formed in hydrogen and in
vacuo. They are not caused by contact, for they can arise from 4,
single metal.

It has been supposed that thermo-electric currents are due to the
unequal propagation of heat. In a homogeneous circuit no current is
produced, for the heat extends equally in all directions.

Thermo-multiplier.—The chief use of thermo-electricity is to measure
exceedingly feeble changes of temperature. The thermo-electric pile
THERMO-MULTIPLIER. 75

connected with the galvanometer is incomparably more delicate than
any thermometer. The arrangement used by Melloni is represented in
the cut.

 

Fic. 31.

On a wooden base a graduated copper tube, about a yard long, is
placed. On this are placed a lamp, a, the screws F and E, a sup-
port for the bodies to be experimented on, and the thermo-electric
pile m. Near by is the galvanometer D, which has only a few turns
of thick wire. Such a galvanometer is called a thermo-multiplier.
It is so very delicate that the heat of the hand, at a distance of three
feet, will generate electricity in the pile sufficient to deflect the needle.
If the face of the pile be breathed upon, the needle will swing around
to go®. The thermo-multiplier is a powerful illustration of the great
law of the correlation and conservation of forces. As electricity pro-
duces heat, so in the thermo-electric pile heat produces electricity.

In the thermo-multiplier heat produces electricity ; this electricity
produces magnetism, is converted into mechanical motion, and not
until it has gone through all these transformations can a very delicate
amount of heat be detected. The thermo-multiplier is used in physio-
logical researches.

Thermo-electric Batteries—A number of thermo-electric couples
soldered together so that the copper or antimony of one is soldered
to the bismuth of the other, and so on, is called a ¢hermo-electric bat-
tery. The current is generated by heating one row of the soldered
faces, or, as the current depends on the difference of temperature of
the two sides, by applying ice to one side and heat to the other.

The accompanying cut represents Farmer's thermo-electric battery,
76 ELECTRO-PHYSICS.

constructed on the principles above indicated. The heat is supplied by
a gas-burner or alcohol-lamp.
Thermo-electric batteries of any form are not as yet much used in.
electro-therapeutics. The hopes at one time entertained of them have
been disappointed. In practice they have been found to be inconve-

 

Fic. 32.

Farmer’s Thermo-Electric Battery.

nient, bulky, expensive, and untrustworthy. It is not impossible, how-
ever, that future researches may so develop the department of thermo-
electricity that thermo-electric batteries may be constructed that shall
be more convenient for practical use than the ordinary galvanic batteries.
This is a realm in which there is room for experiment.
CHAPTER VII.

OHM’S LAW AND ITS PRACTICAL APPLICATION TO ELECTRO-THERAPEUTICS.

THE basis of all electrical measurement is Ohm’s law, which is, that
the guantity of electricity passing through any point in a circuit
varies directly as the electro-motive force, and inversely as the resistance.

Putting Q for quantity, E for electro-motive force, and R for resistance,
the law is thus expressed: Q = =.

This law was discovered by Prof. Ohm, of Nuremberg, in 1827, and
for a long time was neglected. It is the north-star of dynamical elec-
tricity. Those who can keep this always in sight need never lose their
way, however long or intricate the explorations they may make in this
important and fascinating realm. Although originally nothing but a
theory, yet it has been powerfully confirmed by the mathematical calcu-
lations of Fechner, Pouillet, Kohlrausch, Daniell, De la Rive, and
Wheatstone, and has proved itself competent to explain all the phe-
nomena with which it has to do. Just as the strength of the theory of
gravitation consists in its power to account for the movements of the
solar system, just as the strength of the undulatory theory consists in
its power to explain the complex phenomena of light, so the strength
of Ohm’s law consists in its power to account for the phenomena of dy-
namical electricity. As no one can be master in astronomy without
understanding gravitation, or in optics without understanding the undu-
latory theory, so no one can be master in electricity without under-
standing Ohms law.

We shall endeavor to make this law and its application as clear as
the nature of the subject will allow. It is necessary to define certain
terms that are not very familiar ; first of all, units of measurement.

A unit is an abstract term to express any determined quantity, by the
repetition of which any other quantity of the same kind can be measured.

An ohm is a unit of resistance; one million ohms = one megohm;
one millionth of an ohm = one microhm. —

A number of units of resistance have been proposed—among others,
78 ELECTRO-PHYSICS.

definite lengths of wires of a definite thickness; but wire is rarely pure,
and the different specimens widely vary.

In 1864 the British Association, acting on the suggestion of Weber,
decided that electrical resistance could be expressed as an absolute ve-
locity, without any reference to the substance that conducts. This unit,
which expresses a velocity of 10,000,000 metres of a second, is called a
B. A., or British Association, unit.

Previous to this action of the Association the best known units were
those of Siemen and Varley. Siemen’s unit is a column of pure
mercury, one metre long and one square millimetre in sections at 0° C.
Varley's unit was one mile of ordinary copper-wire, No. 16, 7g of an
inch in diameter at 60°F. The &. A. unit of the British Association is’
embodied in an alloy of platinum and silver. This alloy has the ad-
vantage of German silver, that its conducting power does not change
with long use.

The unit of edectro-motive force is called a volt. A volt is equal to
about the force of a Daniell cell, or the decimal -9268.

The unit of quantity is a farad. In other words, a farad is the
quantity of electricity which, with a certain electro-motive force, flows
through a certain resistance.

The terminology of electricity in general has been atrociously diffi-
cult and obscure, but nowhere has there been deeper obscurity and
grosser misunderstanding and inconsistency than in the application of
the terms resistance, quantity, tension, and electro-motive force.

Llectro-motive Force.—The electro-motive force ts the force that urges
forward the current.

It is the origin of tension, to be hereafter defined. This force is
modified—

st. By the nature of the plates of which the element is composed.

2d. By the nature and strength of the acid solution.

3d. By the number of elements in the solution.

Substances that stand at or near the ‘two extremes of the electro-
positive and electro-negative series, generate a stronger electro-motive
force than substances that stand near each other.

Zine and platinum or zinc and carbon give more electro-motive
force than zinc and copper, because the difference in their oxidability
is greater, and they stand farther apart in the electro-positive and
electro-negative series.

Plates that are imperfect in their structure, or which contain impuri-
ties that generate currents in opposition to the main current, or plates
that are worn out, or are encrusted with the products of chemical
OHM’S LAW—ELECTRO-MOTIVE FORCE. 79

decomposition, give less electro-motive force than plates that are per-
fect, fresh, and clean.

Similarly also the electro-motive force is diminished by the polarizing
action of the current in the cell. Thus, in the Smee cell, the hydrogen
that gathers on the platinum-plate and the oxygen that gathers on the
zinc, generaté a current that is opposite in direction to the main cur-
rent, and enfeebles it ; and for this reason, lifting the plates out of the
liquid a moment to allow the gases that form on them to escape, or
vigorously agitating the liquid, at once increases the electro-motive
force. Strong acids which excite vigorous chemical action give more
electro-motive force than weak acids, and therefore it is that sulphuric
and nitric and chromic acids are so much used in batteries,

When the proportion of acid in the solution 1s large, electro-motive
force is greater than when it is small. Strong solutions, however, con-
sume the plates faster, and the electromotive force will be reduced
thereby sooner, other conditions being the same, than when weak soln-
tions are used.

The electro-motive force is exactly proportioned to the number of
elements, without regard to their size. Two elements give twice as
much electro-motive force as one element, and one hundred elements
give one hundred times as much as one element of a similar character.
This can be proved by a galvanometer, with a long resistance-coil,
where the deflection of the needle will be in pretty exact proportion to
the number of cells brought into the circuit. The exactness of this
proportion is of course modified by the imperfections of individual ele-
ments, or by variation in the quantity and strength of solution in each
cell; but the law always holds good.

As with the long-coil galvanometer, so with the human body, or any
other powerful resistance whatsoever, the electro-motive force that passes
through it will be—all other conditions being the same—proportioned
to the zumber of elements and without regard to their size. If a series
of very Jarge elements are opposed to an equal series of very smadi
elements of similar construction, no current will pass; they will neu-
tralize each other. If both be tested by the galvanometer with a long
resistance, they will cause similar deflections of the needle.

The quantity of electricity that passes through a circuit ts directly pro-
portioned to the electro-motive force. li there were no resistance in the
circuit, quantity and electro-motive force would be the same: Q = E.
But there can be no circuit without some resistance, therefore Q never
equals E. :

Electro-motive force of different batteries, approximately :
80 ELECTRO-PHYSICS.

GlOve,.... crevasse ew ore aimiste Gabe drarareane tater 100
Bunsen)....0 2s ens aan re tiie Gahanna Gedo uve 9S

Daniell ssiencc a icaswi nents anisole w eciaed eens 56

Smee (when not in action)...........0+++e eee 57

“ (when in action). ....... sete eee ewes 25

Wollaston (copper and zinc)..........0e00ee: 46

Marié Davy (sulphate of mercury and graphite). 76

: Chloride of silver... .... ccc cece eee er eee eee 62
Chloride of lead........cee eee e eee coree seus BO

These estimates are the mean of a very large number of observa-
tions by Latimer Clark, taken on a sine galvanometer. The electro-
motive force is somewhat modified by various undetermined causes.

Tension, or Potential.—Tension is that quality of electricity by which
it overcomes resistance. This definition is practical rather than strictly
scientific, and can only be understood by explanation.

Tension is a resu/t of the electro-motive force, and is dependent on it,
and by mistake the two are often confounded. The sum and the diffe-
rences of electro-motive force are always equal to the sum and diffe-
rences of tension, but they are differently distributed in the circuit.
By mathematicians the term otential, suggested by Green, is preferred
to tension. The term is a re/ative one, and no body or part of a body:
can be said to have an adsolufe tension or potential. The potential of
a body is really the difference between its potential and that of the
earth, which is assumed to be zero. Electricity flows from a body or
part of a body at a higher potential, to a body or part of a body at a
lower potential, and the work which it does measures its amount.
Differences of potential may be compared to differences of level for
water. As water tends to flow from a higher level to a lower level un-
til all is of a uniform height, so electricity tends to flow from a higher
to a lower potential until the potential of all parts of the conductor is
the same, and ceases to flow. An instance of extreme tension is found
in lightning, where it is caused by the differences in the electro-motive
forces between two clouds, or between the clouds and the earth.

The tension of the frictional machine is very great, for the reason
that it is not at all influenced by the resistance of the circuit, which
in the galvanic battery is very great. If the current of the galvanic
battery encountered no resistance in the circuit, or was not affected by
resistance, its tension would be enormous,

The term zz¢ensity has long been used as synonymous with tension ,
but, strictly speaking, intensity is derived from the French intensité,
OHM’S LAW—TENSION, OR POTENTIAL. 81

which has been translated intensity, but which really means guantity.
It is better to dispense entirely with the term intensity, and we have
' done so in the present work.

Our definition of tension may be thus illustrated: Leta battery of 100
cells be joined in the ordinary tension arrangement, zinc united with
carbon and soon. Place the battery on an insulated stand, and connect
the zinc or negative pole with the earth, leaving the other free. Regard-
ing the earth, for convenience’ sake, as zero, the copper pole will have
a tension of 0, while the free end will have a tension of 100 fositive.
If a wire be connected with the free end, a current would flow from it
to the earth. If now we reverse the position of the poles, connecting
the carbon pole with the earth, and leaving the other free, the carbon
end will be o, and the zinc end will be 100 negative, and if it be con-
nected with the earth a current will flow from the earth to it. In both
of these cases the tension is the same; in one case it is positive, in the
other negative. Take the same battery, with the zinc pole connected
with the earth, and join the carbon and zinc ends by a short, thick wire,
and a strong current will flow through the wire. But here comes in the
difference between tension and electro-motive force, for it can be ascer-
tained by proper tests that the electro-motive force of the battery is the
same as it was before the ends were joined, but the tension has changed.
Before, it was 100 positive at the carbon end, now it is almost o.

If, instead of a short, thick wire, a long, fine wire that offers greater
resistance be used to connect the poles, the tension at the carbon end
will rise with the increase in resistance in the wire. When the resist-
ance becomes infinitely great, the tension becomes roo again, but it
can never exceed too, for the tension can never exceed the electro-
motive force at any point, although it may fall very much below it.

These two general laws in regard to tension should be remem-
bered :

rst. It rises with the distance from the zero end of the circuit.

2d. The quantity of electricity passing between any two points is
always proportioned to the difference of tension between these points..
The actual tension may be high or low, positive or negative, but there
can be no current without differences of tension.*

The arrangement in series (or, as it is erroneously called, “intensity
arrangement”’), is when the electro-positive element of one cell is united
to the electro-negative element of the next cell,and soon. The “ quan-
tty arrangement,” or “muitiple arc,” is when all the electro-positive ele-

* On Electrical Measurement, By Latimer Clark. London, 1868, p. 17.
6
82 ELECTRO-PHYSICS,

ments are united to all the electro-negative elements so as to make one
large element. The arrangement in series, or a ‘‘ tension arrangement,”
is used for all ordinary galvanization and electrolyzation. The-multiple
arc, or “‘ quantity arrangement,” is used in galvano-cautery. The phrases
“joined for tension,” or “intensity,” and “joined for quantity,” are
relics of old and exploded theories of electricity. For convenience’
sake they are still used; but those who understand Ohm’s law need
not be deceived by them.

Resistance.—Resistance is that quality of a conductor that impedes.
the passage of a circutt.

There are two kinds of resistance in any circuit :

ist. That of the battery itself (Ztermal Resistance).

2d. That of the connecting wires (circuit outside of the battery), the
galvanometer, the human body, or other substance introduced into the
circuit (Zxternal Resistance).

How Resistance is Modified.—Resistance is modified in three ways:

1st. By the nature of the substance, whether liquid or solid, or by its

- specjal chemical composition.

2d. By the form of the substance, whether long or short, of small or

-large diameter.

3d. Ry the temperature.

It is proved by experiment that che resistances of wires of the same
material and of the same thickness are directly proportioned to their
length, and inversely proportioned to the squares of their diameters.

A wire one mile in length gives twice the resistance of a wire half a
mile long, and four times the resistance of a wire one-fourth of a mile
long. On the other hand, wires of the same metal, but of diameters
which stand to each other in the relation 1, 2, 3, offer a resistance which
stand to each other as 1, }, 4. In other words, the longer the wire the
greater the resistance, the thicker the wire the /ess the resistance: The.
same law, but less exactly, applies to liquids, and for this reason /arge
elements give less resistance than small elements. ‘The relative specific
resistances of a number of metals at a temperature of 54° F. are as
follows : :

COPPCtsis woe s6ceae aw are I ATOM, sc wrerdscesvgeiareaetae TS

GOldeeisieeweiwneceeadoe WA Wed owconacs cibsaacatieers . Il

LATA Coes ido) ae iden'asnc v-acryeatos 3.7 + Platinum......... saan 11.3
Mercury (at 57°).......5. eisiaray BOTs

The converse of resistance is conduction.
The following table of the relative conductibility of metals at 32° F
OHM’S LAW—RESISTANCE, 83

is taken from Latimer Clark. It will be perceived that it varies some-
what from the above table of relative resistances :

DIVER sckeeieweraneelae KMCacepaevesunneauned
Copper (pure)... 6.60.04 .99-9 Steel nadeacdemsonmench
is selected (commer-  Iron......... ania tele carta 15
cial)....85 tog5 | German silver..... 12to15
Copper, ordinary (commer-  Tin.............. iesawT2id
CIAL) scsrceresere ages ...40to 70 + Lead........ Leeee aeO3
DBIASS a aie sie citar +eeee20 = Platinum...... Rea ie OO.
GON siete disse rmeawT® MEICUry. cece eee ee L6

It will be seen that both estimates agree in making copper and silver
the best conductors, and for that reason copper-wire is so much used
in making battery connections. In both tables platinum stands low in
conductibility, and for that reason platinum-wire is used ‘when, as in
galvano-cautery, it is required to generate heat by passing the cutrent
through a resisting medium. If mercury could be made in the forni
of a wire it would of course be better than platinum, since its resist-
ance is somewhat greater. Bismuth, graphite, and coke rank still lower
in conducting power than mercury. The resistance of liquids is enor-
mous. Thus, taking copper-wire at 32° F. as 1, the resistance of a
saturated solution of sulphate of copper at 48° F. is 16.885.520; ditto
of chloride of sodium at 56° F., 2.903.538; ditto of sulphate of zinc,
15.861.267; sulphuric acid diluted to 74 at 68° F., 1.032.020; nitric
acid at 55° F., 976.000; distilled water at 59° F., 6.734.208.000.

It has been estimated that the human body, by virtue of the salts
which it contains, conducts 15 or 20 times better than water, provided
the skin be fully moistened; and that copper conducts from three to
four hundred million times better than the human body.

Liffects of Temperature on Resistance.—Resistance is more or less
modified by temperature.

Between 1° and 100° C. the relative conducting power of the metals
remains the same; at 100° metals lose about 30 per cent. of their
conductibility as compared with o° C.; but this varies with different
metals. Conductivity is increased by annealing. Non-metallic sub-
stances increase in conductivity as they rise in temperature. Water,
for example, when heated conducts better than water cold. When a
current passes from a liquid to a solid, or vice versa, the resistance is

very great.
84 ELECTRO-PHYSICS. ,

All Resistance reiative.—-No substances absolutely resist the passage
of electricity; even resin, glass, and sulphur, the worst conductors, do
conduct a slight current, as can be proved by a very delicate galvano-
meter. ™

NVo perfect Conductor.—Even the best conductors, as copper and
silver and gold, are imperfectly so; they all resist the current more or
less.

This can be shown with the galvanometer, which, when brought d-
rectly into the circuit, shows a deflection of the needle. .When short
wires of copper or silver are interposed the deflection is lessened.

If we now comprehend the terms édectro-motive force and resistance,
we shall have no difficulty in comprehending the term quantity, for,
according to Ohm’s law, the quantity varies directly as the electyo-mo-
tive force and inversely as the resistance.

The quantity of electricity is the amount which passes through the
circuit in any given time.

This depends, according to Ohm’s law, on two factors—the electro-
motive force and the resistance. The quantity varies directly as the
electro-motive force; and if there were no resistance, quantity would
be precisely the same as electro-motive force. But the guantity varies
inversely as the resistance, and therefore, to find out what the quantity
of any current is, we divide the electro-motive force by the resistance.
The fraction thus formed is the quantity or the strength of the current,
as we commonly call it. There are, as we have seen, two kinds of
resistance, that in the battery and that in the circuit outside of the bat-
tery ; doth of these must be taken into account in estimating the relation
of the different kinds of batteries, and in selecting batteries for special
kinds of work. Let E be the electro-motive force, R the resistance
of the circuit outside of the battery, r the resistance in the battery;

= Q, the quantity or strength of the current—the number of

 

E
then
R+r

farads or measures of electricity that flow through the circuit in a given
time. The correctness of this mathematical conclusion may be demon-
strated on a galvanometer that has only a short resisting wire ; one cell
will deflect the needle nearly as much as one hundred cells. Again,
when any number of cells are joined together with great external resist-
ance, such as is offered by a long, fine wire, or by the whole human body,
for example, the quantity of electricity that flows through the circuit
will increase with the increase in the number of cells.

There is no inconsistency between these phenomena. It is indeed a
part of and a conclusion from Ohm’s law. Everything depends on the
OHM’S LAW—QUANTITY OR STRENGTH OF CURRENT. 85

external resistance. Although in this case, asin the other, each added
cell brings in its own internal resistance that counterbalances the elec-
tro-motive force, yet the internal resistance dears so small a proportion
to the large external resistance that the quantity of electricity flowing
through the circuit will be pretty directly proportioned to the number
of cells.

Still keeping Ohm’s law before us, we can demonstrate this mathe-
matically,

Let the electro-motive force of any cell be 10 volts, and the internal
resistance be 20 ohms, and the external resistance afforded by the
human body 10,000 ohms. The quantity of a single cell could be thus
represented :

* ro electro-motive force 10 I

 

zo internal resistance, and 10,000 external resistance 10,020 1002

Again, we may illustrate this as follows:

One hundred cells are joined together and the ends are connected
by a short wire. Let the electro-motive force of one cell be 10 volts
or units of electro-motive force, then the electro-motive force of 100
cells will be 1,000 volts. Let the resistance in each cell be 5 ohms, or
units of resistance, then the resistance in the 100 cells will be 500
ohms. Let the resistance of the short connecting wires be 10,000
ohms: now, in order to find the number of farads of electricity—that
is, the quantity or strength of the current that flows through the con.
necting wire—divide the electro-motive force by the resistance, and we
have this fraction :

1,000 electro-motive force _ 3,000
10,000 resistance of wire, and 500 resistance of battery 10,500

This fraction reduced = 3%, alittle more than jy, which fraction rep-
resents the quantity of electricity that flows through the wire.

We may illustrate this law by supposing a current of water passed
through an ordinary syringe. The quantity of water that flows through
the tube will be directly proportioned to the force with which it is
urged forward by the piston ; this force would correspond to electro-
motive force. The friction will correspond to the internal and ex-
ternal resistance of the battery. Now if we divide the one by the
other, we have the quantity of water which in a given time flows
through the tube, or the strength of the current. In this way we can
find the number of cubic inches of water that flow through the tube in
a second of time, just as we can find the nuniber of farads, or units of
86 ELECTRO-PHYSICS.

quantity of electricity, that flow through a circuit. It follows from all
this, of course, that if the electro-motive force be very greatly in-
creased, the resistance being the same, the quantity must be increased ;
but if the resistance be increased in proportion to the increase of the
electro-motive force, the quantity will not be any greater.

Absolute Quantity and Actual Quantity.—It also follows that the
absolute quantity of any battery—the amount that it is capable of
generating—may be very much greater than the actual quantity that
it sends through a circuit. Everything depends upon the resistance,
whether it be small or great.

Relation of Quantity to Electro-therapeutics.—It is important to know
how to ascertain the guantity of electricity, for nearly all of the lead-
ing actions of electricity depend on quantity. It is quantity that
deflects the needle of the galvanometer, and quite accurately mea-
sures the current that passes through the wires that. surround the
needle. It is quantity that decomposes chemical substances, as water,
salts, the human body, etc. Hence, electrolytic operations largely
depend on the quantity of electricity that flows through the tissues
acted on. It is quantity that accomplishes much of the therapeutical
effect of the different forms of electrization—although tension alone,
with very small quantity, may, as in the. case of frictional or frank-
linic electricity, be capable of therapeutical effects. Franklinic elec-
tricity, however, relieves and cures disease by changing the electrical
condition of the patient, by giving a positive or a negative charge,
more than by the passage of the current through the body, and the
consequent electro-tonic and chemical changes. Ordinary faradic or
galvanic electricity, on the other hand, does not, as many suppose,
charge the patient with electricity, and does not, by its direct action,
leave any more electricity in the body than it finds there. If they
increase or diminish the natural electricity of the body, it is indirectly
through the effect of quantity of electricity passing through the tissues
and improving nutrition.

Under this head come these important practical conclusions:

First. If any large number of cells every way similar are joined in
@ SHORT ciRcuIT by large connecting wires, and without any other ex-
ternal resistance, there will be no more quantity of electricity flowing
than if a small number of similar cells were so joined.

Although each additional cell increases the electro-motive force, yet
it also increases the resistance, as we have already seen, and this in-
crease of resistance will counterbalance the increase of electro-motive
force, so that the quantity of electricity that flows through the circuit
OHM’S LAW—LARGE CELLS vs. SMALL CELLS. 87

will be about the same. Ohm’s law will demonstrate this mathemati-
cally. Let the electro-motive force of any cell be 1o volts, or units of
electro-motive force, and the resistance’of each cell be 20 ohms, or
units of resistance, and the resistance of the short wire 2 ohms.
Dividing the electro-motive force by the resistance, we have for a single
cell $2 + . = $$ = 4, = the quantity that one cell sends through
the circuit. .

Now let there be 50 similar cells, and our fraction will be $9 x £8

= F's + 2 = fifty = $49 = fraction that varies very slightly in
value from 38. Let there be 1,000 cells, and we have this fraction:
2G X 4090 = 50000 4+, = $0000. The result still differs but slightly
from those previously obtained.

Secondly. Large cells connected by great external resistance, as the
human body, or a galvanometer with a long resistance-coil, do not send
more quantity of electricity through that external resistance than similar
small cells.

The electro-motive force of large cells is no greater than that of simi-
lar small cells, as we have already seen. The resistance is less because
the surface of the plates is greater, and the greater the section the less
the resistance, as has already been shown. But the little advantage
thus gained from large cells by a diminution of resistance bears so
small a proportion to the great external resistance of the human body,
or of a very long wire, that the quantity of electricity actually sent
through the circuit will not be materially increased—at least by any
reasonable number of cells.

Here again Ohm’s law comes to our assistance, and fortifies our
statement by a rigid mathematical demonstration. Let us suppose a
battery of 100 smad/ cells. Let the electro-motive force of each cell
be ro volts. Let the izternal resistance of each cell be 20 ohms.
Let the external resistance of the human body, through which the cur-
rent is to be made to pass, be 10,000 ohms. Now, by Ohm’s law, to
find the quantity of electricity that flows through the human body when
enclosed in the circuit, we divide the electro-motive force by the inter-
nal and external resistance, as follows:

Ioo,_X 10 = 1000 1000, » 10 I

10,000 (external resistance), x 100 x 20 = 2000 (internalresistance) ~ 12000 120 12

Let us now suppose too similar very /arge cells. ‘The electro
motive force would be the same, the external resistance would be the
same. But the internal resistance of the battery would be less be.

cause the surface is greater.
88 ELECTRO-PHYSICS.

By a law previously explained, the resistance varies inversely as the
square of the section. Yor convenience sake, we will suppose the re.
sistance of the large cell to be 7, that of the small ones—that is 2—-
and Ohm’s law will give us the following fraction :

100 X 10 = 1000 (electro-motive force) ___ 1000 10

“zo,000 (external resistance) 100 x 2= 200 10200 102
* —a fraction that is, it is true, a little larger than 3!,, but not enough to
be worth considering.

The same truth may be shown by a galvanometer that has a long
resistance-coil. If the fluid be raised just'a little, so that elements are
just immersed and the poles are connected with such a galvanometer,
a certain deflection of the needles will take place, according to the
number of cells; if now we raise the fluid still higher, so that all the
elements are immersed, and four or five times as much surface is
brought into action in each cell, the needles will not be much more
deflected, but will remain at nearly the same point where it was when
the elements were first immersed. This is an experiment that we
-have made repeatedly.’

For the galvanometer substitute the human body from the hand to
the legs, and we can understand the great fact that large cells do mot
send more guantity of electricity through the body than small cells of
_ similar character.

From all these demonstrations we see that it is with electricity as
with money—the adsoluce quantity that any man may give may be a
‘very small fraction of the actual quantity that he can be made to give.
A millionaire has a far greater quantity of money than one who has
only a thousand dollars, but the one may not givé a dollar any: easier
than the other. Under great pressure the millionaire may give a
thousand times more than the poor man, just as a battery of large cells
may, before small resistance, send a very much larger quantity of elec-
tricity than a similar battery of small cells; but when there is great
resistance it may send very little, if any, more.

In electro-therapeutics, as in telegraphy, electro-metallurgy, and,
other uses, large cells have this advantage, that ¢hey last longer and
do not require so frequent cleaning and filling.

Although they cannot in a given time send through the human body,
or long lines of wires, any more quantity of electricity than small cells,
yet their reserve quantity is much greater, and in proportion to their
size they will hold out longer and keep up a more uniform current.
The poor man may give five dollars as easily as the millionaire, but
OHM’S LAW—LARGE CELLS vs. SMALL CELLS. 89

under great pressure the millionaire can keep on giving out five dollars
long after the resources of the puor man are exhausted.

Large cells may, for electro-therapeutical purposes, have the advan-
tage of steadiness of current ; there would appear to be less fluctuation
in the strength of the current from moment to moment than when the
cells are small.

In small cells the degree of the internal resistance and the extent of
the chemical action may vary more or less from moment to moment,
owing to the polarization of the elements and the deposition of the
salts in the solution. This fluctuation is most marked in batteries
where the action is very energetic. Small single cells, especially the
zinc-carbon batteries, lose much of their power during a long opera-
tion. Zhe popular notion that large cells have a therapeutic advan-
tage over small cells by sending a larger guantity of electricity through
the body is, in the light of Ohm's law, as well as in the light of expe-
rience, erroneous.

Thirdly. For the electro-chemical decomposition of water, salts, and
the human body (electrolysis), a considerable number of cells of medium
size, neither very large nor very small, and in which the chemical action
is powerful, are required.

‘The resistance of the “imited portion of the human body usually
submitted to electrolytic operation is great, though not so great as that
of the whole body; and as we have seen, before a great resistance,
very large cells give no greater quantity in a given time than cells of
moderate size. If the cells are too small, however, they will soon
become exhausted. For electrolytic operations, the ordinary zinc-car-
bon or Walker’s batteries, as manufactured in this country by the Gal-
vano-faradic Manufacturing Co., Kidder and others, answer very ex-
cellently most of the purposes of electrolysis. They have more electro-
motive force than Smee’s elements, and although not as enduring, they
yet give a greater quantity of electricity for a short time, which is of
course the great requisite in electrolytic operations. The resistance
of the skin is very great, but in electrolysis the needles go beneath the
skin, and are placed near each other. The resistance is very much
less than in external applications when the electrodes are far apart;
hence it is an advantage in electrolysis to have cells of good size,
though not of the largest.

Fourthly. When a short platinum-wire in a short circuit is to be
heated, as in galvano-cautery operations, a very few large cells or a
single very large cell is preferable to a large number of small cells.

This fact has long been practically recognized, ahd all the batteries
go ELECTRO-PHYSICS.

for galvano-cautery operations are constructed on this principle. The
reason for this is not so well understood; Ohm's law gives us the ex-
planation.

Platinum-wire, though it resists the current very powerfully as com.
pared with silver or copper wire, yet offers a very small resistance as
compared with water or the human body, or very dong wire of any kind.
Hence, in the galvano-cautery instruments, the external resistance is

* small, being not very much greater than the internal resistance of the
batteries, perhaps not so great. Now, before a large external resist-
ance—the human body, or very long coils of wires—the surface of the
elements is used at the best advantage when cut up into small cells;
before a small resistance, the surface of the elements is used at the
best advantage when cut up into a few large cells, or, if the external
resistance be very slight indeed, a single large cell will be better; for
we have previously shown that, in a short circuit, one cell gives as
much quantity of electricity as one hundred, or, indeed, any number of
cells.

Let us suppose 100 small cells; let each cell have an electro-motive
force of 10 volts and a resistance of 20 ohms. Let there be enclosed
in a circuit the human body, or a very long coil of fine wire, that gives
a resistance of 10,000 ohms. ‘Then, according to Ohm’s law, we have
the following fraction :

roo x 10 = 1000 electro-motive force ae.
10,000 external resistance roo x 20 = 2000 internal resistance 12

 

which represents the quantity of electricity that flows through the
circuit. Suppose now one ce// of the same character, but very much
larger, sends a current in a short circuit—through a short platinum-
wire, such as is used in the galvano-cautery for cauterizing surfaces.
Suppose the external resistance of this short circuit be 9g ohms. The
electro-motive force of the large cell is no more than that of the small
cell; the internal resistance of the battery is very much less, for, as we
have seen, the resistance diminishes as the surface increases. For
convenience sake, we will suppose the internal resistance of the large
to be sy that of the small cell—that is, 1. Now, dividing the electro-
motive force by the resistance, according to Ohm’s law we have this
result ;

to electro-motive force 10

+ = = =—=>=1
g external resistance + 1 internal resistance 10

the quantity of electricity that flows through the circuit, or twelve times
as much as with roo small cells.
OHM’S LAW—APPLIED TO GALVANO-CAUTERY. gl

Suppose now this one large cell be connected by a long and fine
platinum-wire, such. as is used in the removal of tumors by galvano-
cautery operations. The resistance will of course be greater, for two
reasons, because the wire is longer and because it is finer; for the law
is, the less the surface or section the less the resistance.

Suppose the resistance be 19 ohms. Dividing the electro-motive
force by the resistance, we have—

10 electro-motive force 10
xg external resistance + 1 internal resistance 20

 

that is, one-half the quantity of electricity that there was when a short
platinum-wire was in the circuit. Very likely this would not be
enough to heat the wire and keep it hot during a long operation.
This law comes to our rescue, and helps us out of this as of so many
other difficulties. Cut up the one large cell into two cells, and inter-
pose the long fine platinum-wire in the circuit. The electro-motive
force will be doubled, the external resistance will be the same; but
the internal resistance will be greater because the surface is diminished.

Dividing the electro-motive force by the resistance, our fraction
stands thus;

20 electro-motive force 20
1g external resistance + 4 internal resistance 23

 

which is nearly double the quantity of electricity sent through the long
wire by a single cell. Thus is explained the fact that the best galvano-
cautery batteries are arranged so as to be thrown into one large cell,
or cut up into several cells, according as a short or long wire is to be
heated.

It has been found byexperiment that the heat developed by the current
in any wire is proportioned to the squares of the quantity of electricity
that flows through i.

This is demonstrated by passing a current through platinum-wires in
a bottle of alcohol. The heat is communicated to the alcohol, and the
thermometer shows the temperature. It is found if a current of a cer-
tain quantity raises the temperature ro, a current of twice that strength
will raise it 40.

Again, it is found by experiment that ile heat developed by the cur-
rent in any wire is proportioned to the resistance of the wire.

This is demonstrated with the arrangement just described, by insert-
ing a rheostat whose resistances are known, so as to keep the quantity
Q2 ELECTRO-PHYSICS.

of electricity constant at a fixed point, and then inserting platinum.
wires of different lengths into the bottle.

From all this it follows that batteries for galvano-cautery should
have large surfaces and a small number of cells, and that they should
be arranged so that the surface may be used as one or two cells, or
cut up into four or six, according as short or long wires are to be
heated.

Fifthly. It follows that the dose of an electrical application cannot
be accurately described by stating the number of cells and the length of
the sitting.

This conclusion is an important one, and for want of a knowledge of
it electro-therapeutists continually blunder.

Supposing now that we are treating a patient locally or centrally by
the galvanic current, and we desire to transfer the patient to another
physician. We inform the physician to whom the transfer is made, that
we are treating the patient with ten cells for ten minutes, and we desire
that he should continue to give the same dose. In the light of Ohm’s
law, let us see what such instructions are really worth. The quantity
of electricity that passes through the patient in a. minute is equivalent
to the electro-motive force divided by the resistance ; multiply the quo-
tient thus obtained by ten, and we have the dose of electricity that the
patient receives in ten minutes. If, now, all the factors that determine
the electro-motive force and the external and internal resistance were
constant and were accurately known, and if they were the same for all
batteries and all modes of application, then the dose thus ordered
would be a mathematical one, and could be mathematically followed.
No forms of error are so erroneous or so illusory as those that approach
us under cover of facts and figures. In our very attempt to be accurate
we stumble into gross inaccuracy. Had we left the whole matter to the
judgment of the physician, with some general suggestions as to the sus-
ceptibility of the patient, we should have come far nearer the truth, as
will be apparent by the following considerations.

The electro-motive force varies in different batteries, and in theysame
battery at different times. Grove’s battery, for example, has four times
the electro-motive force of Smee’s battery in action, and twice the elec-
tro-motive force of zinc and copper, or Daniell’s battery. Then, again,
the electro-motive force will, in some batteries, as Smee’s or Walker's,
fall off during an application ; and in all batteries, however constructed,
the electro-motive force varies at different times, from causes not yet
determined.

But the electro-motive force is constancy itself in comparison with
OHM’S LAW—APPLIED TO ELECTRO-THERAPEUTICS. 93.

the variations of the internal and external resistances. Beginning with
the internal resistance, we find that for a Grove’s cell, containing one
pint of liquid, it is very small, less than one ohm; for a Daniell’s cell,
5 to 15 ohms, and for a Smee’s cell, less than one ohm. The internal
resistance varies with the size and shape of the cell, the distance of the
plates from each other, and with the length of time that the battery is
in action. Even if the electro-motive force and external resistance
were accurate and constant, the variations in the internal resistance
would be sufficient to vitiate all attempts at prescribing electricity by
the number of cells.

But it is in the external resistance that we find the greatest variation,
uncertainty, and inconstancy in applications of electricity to the human
body. The external resistance depends on the following factors:

1st. The size and construction of the wires that connect the battery
with the electrodes, The larger the section the less the resistance,
and, therefore, large wires will conduct more than small ones. A cer-
tain conventional size is manufactured by each instrument-maker, but
the sizes vary with different makers.

2d. The size and shape of the electrode. Up to a certain point,
varying with the number of cells, a large, broad electrode will conduct
more than a small and narrow one. A metallic electrode conducts
very much better than a sponge; flannel conducts much better than
sponge, but worse than metal. The difference in the conducting power
of metal, sponge, and flannel, is great. A current which is painful when
applied by a metal, and is quite perceptible when applied by a flannel
or chamois, is not felt at all when applied by a sponge. The painful-
ness of an application, it is true, does not depend on the amount of
electricity that passes, but is also modified by the extent to which the
current is diffused. This would depend on the action of the electrode.
With the same current passing, the hand of the operator would proba-
bly be less irritating than a sponge or flannel.

3d. The quantity and quality of the liquid used to moisten the elec-
trodes. Electrodes that are perfectly dry conduct but little, at least
with currents of the tension used in electro-therapeutics. Electrodes
that are wet with warm water conduct better than those that are wet
with cold water ; and those that are wet with warm salt-water conduct
best of all. The difference in the conductivity of a sponge wet with
simple cold water and one wet with warm salt-water is so great that a
current which is not felt when applied by the former, becomes unbearable
when applied by the latter.

4th. The amount of pressure that is used on the electrodes. If the
94 ELECTRO-PHYSICS.

wet sponge is lightly pressed it conducts but little, and its conductivity
increases with the pressure. Firm pressure moistens the skin more
thoroughly, and-thus increases its conductivity, and at the same time it
brings into coaptation all parts of the sponge, so that it becomes well
saturated.
5th. The position and extent of the body included between the elec-

trodes. This factor is a most important one, and it has been unac-
countably overlooked in all discussions on this subject. The difference
in the conductivity of the bones and soft tissues is all the difference
between twenty and one, and in all parts the conductivity is modified.
by age, by temperament, and by disease. The resistance of the whole

body, from one hand to the other through the shoulders, is about seven
or eight times the resistance of the Atlantic cable, and the resistance of

the whole length of the body, from the head and shoulders to the feet.

is probably greater than that. But the resistance of any limited portion:
of the body, as the head, or spine, or cervical sympathetic and pneu-

mogastric, or individual muscles or nerves, must be only a fractional

part of the resistance of the whole body. Other conditions being the

same, the nearer the electrodes are to each other the less the resistance.

This may be illustrated by an experiment that we have frequently tried.

If one electrode be put in the vagina and the other in the rectum, a cur-
rent of but two or four cells may be painfully felt; but if one of the
electrodes is placed externally on the back or hypogastrium, a current
of a dozen or more cells may be scarcely perceived. The same experi-
ment may be tried on the back; placing one pole on the nape of the
neck and the other at the lower end of the spine, a current that is just
perceptible at first, as the electrodes approach each other becomes
positively unbearable.

6th. The length of the application. When the galvanic current is

first applied to the body by wet sponges, but little sensation is experi-
enced on the skin; but in the course of a few seconds a burning pain is
felt, that increases with the length of the application. This is explained
in part by the chemical changes that take place, and in part by the fact
that as the skin becomes more and more moistened by the pressure of
the wet sponge, and the skin under the electrode becomes more and
more congested, the resistance is diminished. Consequently, toward
the close of even a very short application, more electricity passes, all
other conditions being the same, than at the beginning. On this
account it frequently becomes necessary to reduce the number of cells
during the sitting, especially when the electrodes are kept all the time
on one spot. Thus it becomes clear that any attempt to prescribe the
OHM’S LAW—APPLIED TO ELECTRO-THERAPEUTICS, 95

dose of electricity by the number of cells, in ordinary external applica-
tions to the body, must fail of its object. In electrolysis, where the
needles are always united, near to each other and under the skin, the
chances for error are not so great, since there is much less variation in
the resistance. If, in describing an electrolytic operation, we specify
the 4imd and number of cells used, and the mode and length of opera-
tion, we convey a tolerably correct idea of what was really done. The
time may come in the advance of science, after physiology shall have
found its Newton to reduce its present chaos to order and law, when
it shall be possible to prescribe so many farads of electricity, repeated
three times a week, as we now prescribe so many grains of bromide of
potassium, or so many drops of laudanum, repeated three times a day ;
but for the present we can rest assured that when we describe the cur-
rent that we employ as m/d, or medium, or strong, and have stated the
method and length and frequency of application, we have attained all
the accuracy that science will allow.

Although the above statements have reference only to the galvanic
current, they just as truly apply to the faradic ; for induced as well as
galvanic electricity is subject to the law of Ohm. One difference, how-
ever, should be noted, that on account of the slighter chemical action
of the faradic current the resistance of the skin beneath the electrodes
does not diminish with the length of the application. For the above
reasons the graduated scales that accompany some of the faradic
machines for electro-therapeutics are of but little practical value.

Finally, Ohm’s law explains the fact of observation, that when the
poles of a galvanic battery are metallically connected, the chemical
action in the battery is greatly increased and the plates rapidly de-
stroyed. The metals being better conductors than the body, conduct
a much greater quantity of electricity ; and as the potential quantity of
electricity that any battery is capable of generating is limited, then
when the resistance between the poles is least, the action must be
strongest, and the metals the most rapidly consumed. Neglect in this
regard causes the premature destruction of many batteries.
ELECTRO-PHYSIOLOGY,
CHAPTER I.

RELATION OF ELECTRO-PHYSIOLOGY TO ELECTRO-THERAPEUTICS—
ANIMAL ELECTRICITY.

Llectro-physiology is the science which treats both of the laws of
animal electricity, and also of the phenomena produced by the action of
electricity on the body in health. We propose to present this subject
as compactly as possible, and consequently shall speak only of those
facts that are necessary for a true appreciation of the science, and
chiefly of those that, directly or indirectly, have a practical aa on
electro-therapeutics.

Importance of a Knowledge of Electro-physiology to the ee
peutist.—It is of course possible to use electricity successfully in thera-
peutics without any thought of its physiological action, and thousands
have so used it. It is possible to relieve pain of almost ¢ very variety,
and to cure any of the curable forms of paralysis, without u.derstanding
anything of the action of electricity on nutrition or on the normal mus-
cle. Any old country granny, the stupidest of nurses, an infant even,
can hold two sponges on a part of the surface of the body, and let the
‘current run. Those who aim no higher than this—the indiscriminate
holding of electrodes on patients—need give no thought to electro-
physiology ; need, indeed, waste no time on this or on any other work of
electro-therapeutics : they do not even need to trouble themselves with
the details of the applications, but have simply to delegate them, with-
out reserve, to the nearest nurse or clodhopper. Those, we assert, who
aim no higher than this will fall short of even that: their success im
relieving symptoms by electrization will be so capricious and illusory,
that, in time, they will abandon the attempt, allow their battery to grow
rusty in the garret, and thenceforth they will condemn and despise sci-
entific and successful electro-therapeutists. :

The electro-therapeutist, above all others, should start out under the
inspiration of the motto of the late President Dwight: ‘Aim high, for
you will be sure to come short of your aim.” To apply electricity after
the manner of nurses and “‘rubbing doctors,” is not using it, but abus-

ing it.
100 ELECTRO-PHYSIOLOGY.

Those who aspire to mastership in electro-therapeutics will not be con
tent with the mere attempt to relieve symptoms ; they will seek to study
those most complex and subtle diseases for the treatment of which elec-
tricty is indicated ; they will resort to this force for diagnostic as well as
therapeutic aid ; they will strive to know not only how to use it, but, what
is more difficult, how not to use it. He only can reap the full and rich
harvest of electro-therapeutical science and art who sows beside all
waters ; he must become more or less proficient in neurology, in electro-
physics, and in electro-physiology. He who has a knowledge of the
laws of animal electricity, and the actions and reactions of franklinic,
galvanic, and faradic electricity on the brain, spinal cord, and sympa-
thetic ; on the nerves of motion and of common and special sense; on
voluntary and involuntary muscles; on the skin, and on all the various
passages and organs of the body in health, and also of the electro-con-
ductivity of the body, will find the paths of electro-diagnosis and of elec-
tro-therapeutics illumined at every step by such knowledge, and will, in
the end; make more correct interpretations of disease than he who

_ merely holds electrodes on patients without any higher aim; and more

than that, he will be introduced into a field of thought and experiment—
a field surpassingly rich and fruitful, and lying in close relation to all
departments of physiology, of pathology, and of biology, where he can
study science for its own sake, without regard to its immediate practical
value.

-In the above remarks we do not wish,to be understood as subscrib-
ing to the notion, quite popular among some, that electro-therapeutics
must be based on electro-physiology ; very far from it: the two sciences
are closely related and are of reciprocal assistance, but one is not built
up on the other. Neither are exact sciences, and may never become
such. Pathology, though it is but “the shady side of physiology,” yet
so complicates therapeutics that electro-physiology cannot become a
reliable basis for electro-therapeutics. The two sciences are pursued
neainly by different methods: electro-physiology is a science of experi-
ment; electro-therapeutics is a science of experience.

Electro-physiology largely Studied by Experiments on the Living Hu-
man Subject.—An advantage of great import to electro-physiology, and
one that especially commends it to the electro-therapeutist, is that it is
largely based on experiments made on the living human subject. True
enough, thousands of frogs have given up their lives in the electro-physi-
ological laboratory, and dogs and cats, rabbits and guinea-pigs, rats, and
monkeys even, have been subjected to electric tests while living, in health
and uninjured, while dying, and when dead; but some of the most
ANIMAL ELECTRICITY. IOI

interesting and suggestive phenomena of this science, those which have
the nearest practical relation to electro-therapeutics, can be best studied
on the living human subject, and without injuring the subject experi-
mented on. This is the supreme advantage of the study of the
physiological action of electricity over the study of the physiological
action of the majority of drugs. The objection so often made against
experiments made with medicines on inferior animals, that they do not
teach the action of such medicines on the human body in disease,
cannot, therefore, apply to electro-physiology, except to a limited
degree.

Not a few of the physiological reactions of the human body to elec-
tricity can be studied while making therapeutical applications. The
reaction of voluntary muscles, of the motor and sensory nerves, of
some of the nerves of special sense, to electricity, and the general effects
of electricity on nutrition, are taught. us every time we electrize a patient
by any of the familiar methods of application. Electro-physiology and
electro-therapeutics thus go hand in hand.

The Localization of Electricity in the Body an Advantage in Studying
its Physiological Effect—The drugs with which we experiment on ani-
mals, in order to learn their physiological action, are usually absorbed
cand carried through the whole system; to confine their action to any
part or member is impossible. If they select any organ on which to
expend their force in preference to other parts, it is by virtue of their in-
herent affinity for such organ, and not from any powerin the experimenter
to confine them there. But electricity can, to a certain extent, be local-
ized in a muscle or nerve, or in some special organ ; thus its effects can
be studied with greater precision and certainty than the effects of drugs
internally administered. Thus the physiological action of electricity has
a specially practical bearing on its therapeutical action.

Animal Electricity is the Electricity that exists in Animal Bodies.
Electric Fishes.—The most remarkable display of animal electricity
appears in certain varieties of fishes. At a very early period it was
known that a certain flat fish had not only the power, when touched, to
give forth shocks, but could impart to other bodies, for some distance
through the water, a benumbing influence. This phenomenon was first
proved by actual experiment to be of an electrical nature as early as
1773; and soon after, by means of a number of Leyden jars, connect-
ing with a disk of leather or wood, either side of which was covered by
tinfoil, an artificial torpedo was constructed. The subject of animal
electricity is one of great scientific interest, and may in time become
of direct practical value to electro-therapeutics. This peculiar power
102 ELECTRO-PHYSIOLOGY.

is possessed only by a small number of fishes, the best known of which
are the forpedo or electric ray, the gymnotus ox electric eel, and the
electric shad.

This development of electricity does not take place in all parts of
the fish, but is confined to a peculiar expansion of the nervous system,
called the electrical organ. The nerves constituting the electrical or-
gans of the torpedo and gymnotus are of great size. Those of the for-
mer consist of three principal trunks, and arise from the cerebro-spinal
system ; while the nerves composing the electrical organs of the latter
are derived from the spinal cord alone. As stated above, the phenom-
ena produced by these fishes are similar to those which are obtained
from electricity that is artificially generated.

If electric fishes are touched with the hand, a shock is perceived, while
if glass, resin, or any other non-conductor is intervened, no effect is
produced.

Sparks may be drawn from them in the same way that they are drawn
from other bodies that are artificially charged with electricity. The
current obtained from them will magnetize steel needles, decompose
water, and if the needle of a galvanometer be brought into the circuit it
will immediately suffer deflection, so that the direction of the current

‘ may be readily determined.

The electric force of the fish is much weakened after it has exerted
its power a number of times in quick succession, and it requires rest
and nourishment to enable it to recover its normal vigor.

Liistory of the Discovery of Electricity in the Body of Man and other
Animals.—We have already seen (Electro-Physics, p. 48) that Galvani
discovered in 1786 that muscular contraction follows the contact of the
nerves and muscles of a frog with a heterogeneous metallic arc. From
this observation, and from subsequent study of the subject, Galvani was
inclined to believe and to declare that in the tissues of animals there
exists a special independent electricity, which he called animal elec-
tricity. Although Galvani’s conclusions were, as we now know, not en-
tirely logical, yet he stumbled on an important discovery that was des-
tined to be demonstrated and confirmed by other and Jater observers.

There zs such a force as animal electricity, but the experiments of
Galvani are explained by contact of dissimilar substances and by the
chemical action of the fluids of the body on the metals, and not by the
electricity of the body.

Volta’s Researches have already been given in Electro-Physics (p. 50).

flumboldt’'s Researches.—In 1799 Humboldt published a work contain-
ing the result of many and curious experiments, the object of which was
ANIMAL ELECTRICITY. 103

to show that both Volta and Galvani were right and both wrong ; that
there was such a thing as animal electricity ; that Galvani was in error
in regarding it as the only form of electricity that appeared in his ex-
periments ; and that Volta was in error in refusing to admit its exist-
ence.

Aldin?’s and Nobili’s Researches.—In 1803 a nephew of Galvani,
Aldini, published experiments that went to demonstrate the existence
of animal electricity. The voltaic pile, however, was a stronger argu-
ment against the existence of animal electricity than any experiments
could be in its favor, and for these reasons animal electricity was for-
gotten.

. In 1827 M. Nobili, having constructed a very sensitive galvanome-
ter, was enabled, as he supposed, to detect, without doubt, the exist-
ence of an electric current in the frog. He observed that when the
needle was placed in the circuit it deviated some 30°.

Researches of Matteucci and Du Bois-Reymond.—aA few years subse-
quently, Matteucci turned his attention to this subject; but it was re-
served for Du Bois-Reymond to investigate most clearly and most
fully, if not most conclusively, the electric properties of the nerves and
muscles. ,

By these two observers it is believed to have been shown, rst. That
currents in every respect like the frog-current of Nobili, are not peculiar
to the frog, but are inherent in all animals, warm and cold-blooded—
in toads, salamanders, fresh-water crabs, adders, lizards, glow-worms,
and tortoises, as well as rabbits, guinea-pigs, mice, pigeons, and spar-
rows. (Du Bois-Reymond.)

2d. That currents are found in nerves as well as muscles, and that
both are subject to the same laws. *(Du Bois-Reymond.)

3d. That the current usually observed is a muscular current that is
produced by the muscles, the nerves acting only as inactive conduc-
tors. (Du Bois-Reymond.)

4th. That this muscular current may be upward or downward, and
that the current of the whole limb is the resultant of the partial cur-
rents of each muscle. (Du Bois-Reymond.)

5th. That these currents do not depend on the contact of hete-
rogeneous tissues, as Volta had believed, for the nerves, muscles, and
tendons in their electrical relations are homogeneous. (Du Bois-Rey-
mond.)

6th. That electricity is found not only in the muscles and nerves,
but also in the brain, spinal cord, and sympathetic—in motor, sensory, and ,
mixed nerves—in a minute section as well as in a large mass of nervous!
104 ELECTRO-PHYSIOLOGY.

substances—in a small fibril as well as in a large muscle—in the skin,
spleen, testicles, kidneys, liver, lungs, and tendons; but not in fasciz,
sheaths of nerves, and sinews.

7th. That animal electricity is capable of decomposing iodide of
potassium, and of deflecting the needle of the galvanometer, (Mat-
teucci.)

8th. In the muscles and nerves electricity is in the condition of a
closed circuit.

oth. That contraction of muscle is accompanied by an electric dis-
charge resembling that of a torpedo. (Matteucci.)

It was the perusal of the essay of Matteucci that inspired Du Bois-
Reymond to undertake those magnificent researches that have given
him a name and a fame in the realm of electrology.

He devised special apparatuses for his researches, and handled them
with great skill and patience.

Even if many of the conclusions presented are erroneous, they are
none the less interesting suggestions, and have prepared the way for
those who are now earnestly seeking to discredit his experiments and
disprove his statements.

The above conclusions of Du Bois-Reymond were derived from ex-
periments on the nerves of frogs, but electricity is not confined to the
lower forms of life, either dead or dying.

Electricity in the Living Man.—In the living man it is believed
that cutaneous currents are found. The hand is negative to the elbow,
and the palm of the hand is negative to the back. The foot is negative
to the chest, and the sole of the foot is negative to the back. The elbow
is slightly positive to the chest, and the hand is sometimes negative to
the foot, and sometimes the reverse.

These cutaneous currents are quite strong and uniform. They are
to be distinguished from the thermo-electric currents that are observed
when two symmetrical parts are heated.

A finger at the temperature of 32° is positive to one at 90°, and a
finger at 60° is feebly positive to one at 80°, and strongly positive to
one at 180°. The cutaneous currents are also to be distinguished from
currents that arise from dissimilar immersion, dissimilar sweating and
shielding of the body.

Currents of electricity have been found in the urethra and bladder
of the rabbit, the intestines, the spleen, the testicles, the tendons, and
the oviduct of the frog, and the iris of birds.

All these currents resemble the ordinary muscular currents, in that
the outer and inner surfaces have opposite electricities.
ANIMAL ELECTRICITY. 105

The currents of the nerves and muscles are very much stronger than
those of other tissues.*

_ Dr. C. B. Radcliffe takes a radically different view of animal elec-
tricity. His conclusions, briefly summarized, are as follows:

1. The sheaths of the fibres of nerve and muscle during rest are
charged with electricity like Leyden jars. He believes it probable,
though not entirely demonstrable, that the sheaths of the fibres con-
duct electricity so feebly that they are practically non-conductors and
are di-electric.

This charge is brought about by the development of electricity, either
positive or negative, through oxidation, or some form of chemical action,
on the outside of the sheaths of the fibres, which electricity induces
through the di-electric sheath, an opposite electricity from the inside of
the sheaths, after the manner of the Leyden jar. Electricity which exists
in the nerves and muscles during rest is in a statical condition, and not
in dynamic or current state.

The nerve-current and muscle-current are purely incidental phenom-
ena, resulting from applying the electrodes to points of unequal elec-
tric tension.

2. That the passage of a nerve or muscle from a state of rest toa state
of action is accompanied by a discharge similar to that of a torpedo.
The arguments in favor of this view are, that the anatomical and physio-
logical apparatus of the torpedo closely resembles the muscular appara-
tus of all animals; that the nerve-current nearly disappears from the
nerve, and the muscle-current from the muscle, when nerve and muscle
pass from rest into action ; and, finally, that the phenomena of induced
or secondary contraction cannot otherwise be explained.

This discharge takes place between the sheaths of the fibres, which are
very elastic, and are capable of being elongated during rest by the mu-
tual attraction of the opposite electricities with which they are charged.

3. That when a nerve or muscle passes from action to rest it resumes
its condition of charge. Elongation, therefore, is the result of charge,
and contraction of discharge.

This point is illustrated by the following experiment :

A narrow band of rubber is wound on both surfaces very near the edge
with gold-leaf, so that it can be charged or discharged with electricity
like a Leyden jar. By a simple arrangement of a grooved wheel and an
apparatus that multiplies and records the movements, it can be shown
that when the band is charged by a few turns of a frictional machine, it

* Dynamics of Nerves aud Muscles. London, 1871.
106 ELECTRO-PHYSIOLOGY.

elongates, and when the charge is discharged it contracts. It is believed
that the muscle behaves in precisely this manner. If nerves are not
affected in the same way, it is because their fibres are not sufficiently
elastic.

4. That the blood keeps up the natural charge of electricity in nerve
and muscle.

The acceptance of this view explains many interesting facts in
pathology. It explains the fact that diseases that are accompanied by
a deficiency in the nerve-currents, as neuralgia, spinal irritation, hysteria,
tetanus, epilepsy, usually manifest themselves by morbid activity, by
increased and unnatural movements of muscles and nerves.

Active inflammations, when there is increase of blood, are not usually
accompanied by excessive muscular or nervous action.

Apparatus for Studying Animal Electricity.—In a practical work of
this kind it is not necessary nor proper to enter into elaborate detail
of all the experimental premises by which Matteucci, Du Bois-Rey-
mond, Pfliiger, and others have made their discoveries. A very brief
description of the apparatus of Du Bois-Reymond may possibly be of
interest.

He employed a very delicate galvanometer, the distinctive fea-
tures of which were, jirsé, the astatic needles were constructed and
arranged with great care ; and, secondly, the wire around them was very
long, and of from 4,000 to 24,000 convolutions. A multiplier of this
sort will indicate the presence of exceedingly feeble currents. The
wires of the multiplier are connected with carefully cleaned and pre-
pared flat new plates dipped in vessels of zinc, containing sulphate of
zinc to prevent polarization. Two cushions, as they are called,
made of layers of blotting-paper soaked in.a solution of sulphate of
zinc, are laid in the edge of edch vessel, with their ends in the liquid.
The whole is enclosed in a moist chamber. In order to protect any
tissue, it is placed in connection with the two cushions in various posi-
tions ; then, if there be any current, the deflection is seen in the needle
of the multiplier.

When two symmetrical parts of the longitudinal or transverse section
of a nerve are applied to the cushions, no deflection is seen ; when two
dissymmetrical parts of the longitudinal section are placed on the
cushions, the needle deflects 6° or 7°. When the longitudinal section
of the nerve on one side touches one cushion, and the transverse sec-
tion touches the other side, the needle deflects 15° to 30°.

Instead of the galvanometer multiplier we may use the rheoscopic
frog, which may give some results ; but it has the disadvantage that it
EXPERIMENTS OF TROWBRIDGE. 107

loses its irritability, and that it contracts only when the current is
closed or broken.

Experiments of Trowbridge.—We have given a full and varied pre-
sentation of the leading conclusions of Du Bois-Reymond and others,
and have described, in a very general way, the best method of perform-
ing the experiments on which his conclusions are based.

We have done this in justice to a name that is greatly honored in
science, in justice to the name that has made an era in physiology, and
to prepare the student for an intelligent understanding of the experi-
ments that seem to overthrow these views of Du Bois-Reymond that
have been so widely accepted.

It has always appeared to us that in the experiments of all electro-
physiologists, the later as well as the earlier school, there were chances
for great error, and have been surprised that their conclusions have
been accepted with so little reservation.

Bearing in mind that all chemical action, however slight, is probably
accompanied by the generation of electricity, it is surely not irrational
to suspect that the conclusions from careful experiments of Du Bois-
Reymond and others might be in some, if not in all cases, modified by
chemical action between the animal tissues and the cushions of the gal-
vanometer, however skilfully these were protected.

Among the physicists at least, the theories of Du Bois-Reymond have
been, on the whole, losing ground during the past ten years, and pro-
bably on account of the considerations that are above presented.

Prof. John Trowbridge, of Harvard College, has recently made a
series of researches that seem to cast grave doubts on the interesting
and hitherto accepted conclusions of Du Bois-Reymond in regard to
animal electricity.

This physicist, starting out on the face of the accepted fact that
two liquids of dissimilar chemical character, separated by a porous
partition, give rise to a current of electricity, has made experiments
with an apparatus similar to that employed by Du Bois-Reymond in
his researches on animal electricity. Instead, however, of placing a
piece of muscle or nerve on the cushions, he used a series of artificial
muscles. These artificial muscles were made of glass-tubes covered by
porous partitions, and filled with the different liquids, such as—

Undistilled water,

Weak solution of salt in distilled water,
Solution of different salts of iron,
Blood,

Acidulated water.
108 ELECTRO-PHYSIOLOGY.

Placing the artificial muscle thus prepared in the position where the
natural muscle is placed in Du Bois-Reymond’s experiments, he found
that each liquid caused a deflection of the needle of the galvanometer.

There is no question, in the opinion of Prof. Trowbridge, that the
currents that caused these deflections of the needle arose from the
actions of the fluids in the tubes on the saline solution of the cushion and’
the protecting guard. This view is confirmed by the fact that when
the artificial muscles were, filled with distilled water, there was no de-
flection of the needle observéd; but when undistilled water or the
other fluids mentioned were used, the needle of the galvanometer de-
flected so far as in some cases to throw the spot of light off the scale.*
Prof. Trowbridge exercised the same precautions as are found necessary
by electro-physiologists in obtaining the so-called muscular currents.
He argues that the behavior of the artificial muscle must be similar to
that of a natural muscle placed on the cushions ; and he states further,
that when we use the natural muscle, containing fresh and chemically
active blood, separated by its sheath from the clay guards of the cushions,
an electrical action must take place between the fluids of the muscle and
the saline solutions in the connecting apparatus, which action cannot
well be distinguished from the so-called muscular current.t

In order to avoid every possible source of error in these experi-
ments, Prof. Trowbridge not only tried distilled water in the artificial
muscles, instead of undistilled water and the different solutions, but also
tried the mere contact of the bladder membrane-partition without any
fluid, and in neither case was any current produced. He employed a
vessel shaped like the letter U, opened at the bend, and covered at the
ends bya membrane. Into the two limbs of the tube he injected
fluids of different kinds. When the vessel was filled with a fluid that
was homogeneous, and the ends of the tube brought in contact with
the cushions, the needle of the galvanometer was deflected. When the
points of contact were reversed, the direction of the needle was re-
versed. That mere contact of the tube with the cushions did not cause
the deflection of the needle, was shown by the fact that when no fluids
were in the tube there was no deflection. That the direction of the
current was ¢hrough the U-shaped tube, and not from its extremities to
the galvanometer and back, was proved by the fact that when the
section of one of the limbs of the U-shaped tube was constricted, the

* Thomson’s reflecting galvanometer and new quadrant-electrometer were used in
these experiments.

+ On the Electro-motive Action of Liquids separated by Membranes, American
Fournal of Science and Arts, vol, iii., May, 1872.
EXPERIMENTS OF TROWBRIDGE. 109

deflection of the needle was reduced, and when the constriction was
complete there was no deflection.

The conclusion to which Prof. Trowbridge arrives from these ex-
periments, which have been repeated at various times, is, “‘ ¢hat when the
cushions of the galvanometer are connected by a membranous sac con-
taining fluids, or animal tissue saturated with fluid, an endosmotic action
takes place, accompanied by galvanic action ; and that this galvanic
action is determined by the difference of endosmotic action at various
points of the enclosing membrane.” *

When, therefore, a muscle is placed on the cushions of the galvanom-
eter, its transverse section on one pad and its longitudinal section
on the other, endosmose takes place, which is different at different
points, and the galvanic current that appears is probably caused by
this difference of endosmotic action and not by the so-called muscular
current. Then granting that a muscular current exists, it must suffer
important modifications in strength and direction through this endos-
motic action. Jf the muscular current does not exist, this endosmotic
action, with the accompanying galvanic action, will account for the de-
fiection of the needle of the galvanometer that had been supposed to be
aue to the muscular current.

In a letter received by Dr. Beard from Prof. Trowbridge, under date
March 28, 1873, nearly one year later than the date of the publication of
the researches of which the above is an abstract, he says that “later
experiments have convinced me that there are no such currents as mus-
cular currents, properly so called. I think that the phenomena noticed
by Du Bois-Reymond arise from differences in the chemical nature of
different portions of the muscle. Du Bois-Reymond contends that
such chemical difference does not exist, and that the tissue is homo-
geneous from a chemical point of view. It must be remembered,
however, that a delicate galvanometer can detect differences in chemi-
cal composition which cannot be detected except by the most refined
analysis. I should therefore make my assertions stronger than I have
done, in the accompanying papers, in view of subsequent experiment.”

Prof. Trowbridge has also made experiments that seem to cast grave
doubts on the conclusions of Du Bois-Reymond in regard to electrical
currents in the arms. Du Bois-Reymond in his experiment connects
the terminals of a galvanometer in separate vessels by a siphon-tube
containing the same liquid as the vessel. The ends of the tube are
covered with a porous preparation.

* Proceedings of the American Academy of Arts and Sciences, January 9, 1872.
110 ELECTRO-PHYSIOLOGY.

Placing a forefinger in each vessel and violently contracting the
arm, he observed that the needle of the galvanometer was deflected ; on
contracting the other arm, the needle deflected in the opposite direc-
tion. Du Bois-Reymond explained this phenomena by the theory
that electrical currents circulate in the arm distinct from and co-exist-
ing with the muscular and nerve-currents. It is not difficult to con-
ceive that in an experiment of this kind there would be chances for
error sufficient to make us very cautious in accepting any immediate
conclusions in regard to it. In order to test the validity of this con-
clusion, Prof. Trowbridge prepared a vessel with two limbs, which he
substituted for the human finger. Du Bois-Reymond’s experiment-
vessel was filled with a solution of salt, and the end of the limbs was
covered with prepared membrane. The resistance of the circuit
through both limbs and the vessel was about that of the human body
from the forefinger of one hand to the forefinger of the other—that is,
about seven or eight times the resistance of the Atlantic cable. The
ends of the limbs or tubes were immersed in the fluid of the vessel con-
nected with the galvanometer. As soon as they touched the liquid,
the needle of the galvanometer was deflected, and on reversing the
limbs the needle was deflected in the opposite direction.

When the flexible portion of one of the limbs was pinched so as to
diminish the diameter, the deflection was also diminished. When a
trifling change was made in the chemical character of the fluids in the
two limbs, and one of the limbs was slightly contracted, the direction af
the needle was reversed.

Prof. Trowbridge is disposed to believe that the deflection of the
needle caused by the contraction of the muscles of the arm, “is pro-
duced either by the temperature or ‘by the change in the flow of the
blood.” It has been established, that the electro-motive force between
venous and arterial blood is about one-thirtieth that of a Daniell’s
cell; and as muscular contractions change the chemical character of
the blood, and as by very slight chemical difference between two fluids
separated by a membrane, like the skin, is sufficient to create a gal-
vanic current, it is not improbable that the conclusion of Du Bois-
Reymond in regard to the existence of a separate electrical current
in the arm is erroneous.
CHAPTER II.
ELECTROTONOS, ANELECTROTONOS, AND CATELECTROTONOS.

Lilectrotonos is the peculiar modification of irritability that nerves
and muscles undergo when acted upon by a galvanic current.

While the nerve is in the electrotonic state, that part of it not in-
cluded between the poles will deflect the needle of a delicate galvano-
meter; and that the deflection then caused is not due to the natural
nerve-current, is proved by the fact that it appears when only the sur-
face of the nerve is connected with the galvanometer. It is therefore
the electric condition of the nerve caused by the passage of the current
through it that deflects the needle. The electrotonic condition not only
remains so long as the galvanic current continues to pass, but, if the
current be sufficiently powerful, it remains for a limited time after the
current ceases to pass.

The electrotonos is more noticed the larger the extent of nerve
acted upon, provided the current be sufficiently increased to overcome
the increased resistance.

In nerves that are dead, or have lost their irritability, electrotonos
cannot be excited at all, or only feebly, and the same is true when the
nerve is cut across or tightly bound with a ligature.

The change in the nerve-current depends on the direction of the
galvanic current. When the galvanic current flows in the same direc-
tion with the nerve-current, the strength of the nerve-current is in-
creased ; when the galvanic current flows in a contrary direction, the
strength of the nerve-current is diminished.

Electrotonos is greater when the galvanic current flows lengthwise
than when it flows across the nerve. It increases, within certain limits,
with the increase in the intensity of the current.

Molecular Liueory of Anelectrotonos—Du Bois-Reyniond has sug-
gested a theory to account for the phenomena of electrotonos, which
has been generally accepted. It is analogous to the theory of mag-
netism suggested by Coulomb. He supposes that muscles and nerves
consist of electric molecules, which have one positive equatorial zone
*

112 ELECTRO-PHYSIOLOGY.

and two negative polar zones, whose axes are parallel to each other;
that is, two molecules make one molecule. This is called the peri-polar
arrangement. In a magnet, each individual molecule manifests the
same phenomena as the entire magnet: each molecule is indeed a
magnet in miniature. In like manner, each molecule of the nerve or
muscle manifests the same phenomena as the entire nerve or muscle.
These peri-polar molecules are enclosed by a moist covering.

Du Bois-Reymond further supposes that each peri-polar molecule
may be divided into a group of dipolar molecules—where the positive

 

Fic. 33.

Peri-polar Arrangement of Electro-motor Molecules.
L S—Longitudinal Section. T S—tTransverse Section.
P—Parelectronomic Layer.

hemispheres are turned toward each other—without changing their
electrical properties. This is called the di-golar arrangement. If a
number of such molecules are brought under the influence of a galvanic
current, their positive zones will turn toward the negative pole, and the
negative toward the positive ; one of the molecules (3) turning 180°
on its axis. The arrangement will be as above. From its resemblance
to the voltaic pile it is called the pile-like arrangement.

This pile-like arrangement of the molecules not only takes place
between the electrodes, but also beyond them into the extra-polar
region.

Du Bois-Reymond has illustrated these phenomena on molecules
made of zinc and copper. ,

From these experiments Du Bois-Reymond concluded, first, that the
nerve is always in the condition of a closed circuit, since electric cur-
rents are produced by the connection of layers surrounding the mole-
cules with their molecules; and secondly, that the current obtained
from an animal, as indicated by the galvanometer, is only a small por-
tion of the entire current.
ANELECTROTONOS AND CATELECTROTONOS. 113

The galvanic current that produces the electrotonic condition is called
the polarizing current. The portion between the poles is called intra-
polar ; beyond and outside of the poles, extra-polar. Electrotonos is
ascending when it proceeds from the muscle to the nerve ; descending
when it proceeds from the nerve to the muscle.

Anelectrotonos and Catelectrotonos.—Anelectrotonos is a condition of
diminiched irritability which takes place at the positive electrode. Cate-
lectrotonos is a condition of increased irritability which takes place at the

 

 

Fic. 34.
L S—Longitudinal Section. T S—Transverse Section.
1. Peri-polar arrangement of electro-motor molecules.
2. Di-polar arrangement of electro-motor molecules.
3. Pile-like arrangement of electro-motor molecules, caused by the action of
the galvanic current.

negative electrode. At some point between the electrodes the irritability
of the nerve is unchanged. The conditions of anelectrotonos and
catelectrotonos are found not only between the poles, but also in the
other portions of the nerve, in the extra-golar portion.

The portion between the poles and near the negative pole, together
with the portion beyond the negative pole, is in a state of catelectro-
tonos, with increased irritability. The portion between the poles and
near the positive pole, together with the portion beyond the positive
pole, is in a state of anelectrotonos, with diminished irritability.

The extra-polar catelectrotonos depends on the length of the nerve be-
tween the poles, and the strength of the current, up to a certain limit.
The strength of the extra-polar anelectrotonos is proportioned to. its
Il4 ELECTRO-PHYSIOLOGY,

distance from the poles, being greatest near the intra-polar portion.
The extra-polar catelectrotonos, both ascending and descending, is in
a state of increased irritability. The extra-polar anelectrotonos, both
ascending and descending, is in a state of diminished irritability.

Neutral Point.—Between the poles there is a point where the irrita-
bility is not changed ; there anelectrotonos meets catelectrotonos. This
is called the neutral point. The relative position of this depends on

+ the strength of the polarizing current. Where the strength of the cur-
rent is medium, the neutral point is about midway between the poles.
Where the current is weak, the neutral point is nearer the positive
pole. Where it is strong, it is near the negative pole.

Negative Variation—When a current frequently interrupted is
applied to an irritable nerve, it causes the nerve-current to diminish in
strength, and finally utterly destroys it. This fact is demonstrated by
the galvanometer.

The same phenomena is caused to a less degree by chemical or
mechanical stimulation of nerve. Negative variation has been explained
by the theory that the peri-polar molecules in the nerve chanze their
arrangement, so that their electro-motor power is diminished. ‘The neg-
ative variation of the current has been studied by Bernstein. He re-
gards all the electric phenomena of the nerve as undulatory movements,
and has mathematically estimated the length of the waves in nerve and
muscle. Cyon, in confirmation, has shown that the degree of the
variation is directly proportioned to the number of interruptions in the
exciting current.

Lffects of Electrotonos in Diminished Conductivity.—The power of a
nerve to conduct irritability 7s more or less modified by the condition of
electrotonos. The portion of the nerve near the positive pole, which is
‘in a condition of anelectrotonos, has its conductibility diminished ; the
portion of the nerve near the negative pole, which is in a condition of
catelectrotonos, has its conductibility increased. If the current be suf-
ficiently strong, the power of the nerve to conduct impressions may be
nearly or entirely destroyed.

Effects of Electrotonos after the breaking of the Galvanic (polarizing)
Current.—One of the effects of the electrotonos is the zrritation which is
caused by the passing away of the anelectrotonos. This. irritation,
which appears at the positive pole, is shown either by a contraction or
by a tetanic condition. ,

Positive Modification and Negative Modification.—The nerve which is
in a condition of catelectrotonos at the negative pole is greatly
modified by the breaking of the polarizing current. Its irritability is
ANELECTROTONOS AND CATELECTROTONOS. II5

thereby diminished. This diminution of irritability is called the “nega-
tive modification.” At the positive pole in the catelectrotonic region, an
increase of irritability, or positive modification, appears on breaking the
current. This increase and diminution of irritability continue for some
time after the polarizing current is broken.

Liffect of a Change in the Direction of the Current.—Another effect of
electrotonos is the change of irritability which is caused by a change in
the direction of the current. Ifa nerve is subjected for some time to
the influence of a galvanic current in a certain direction, it loses some
of its irritability, which it regains when the current is reversed.

Restoration of Irritability.—A very important effect of electrotonos
is a restoration of irritability in a nerve. It has been proved, both by
experience and by experiments, that nerves, which from any cause have
lost their irritability to the faradic current, sometimes regain it after an
application of the galvanic. It has been shown by the experience of
several writers on electro-therapeutics, and of ourselves, that, in cases
of paralysis, when the faradic current at first fails to produce contrac-
tions, the application of the galvanic may not only readily produce con-
tractions, but may also produce such a change in the irritability of the
paralyzed parts as to cause them to regain their lost irritability to the
Jaradic current. (See Electro-Therapeutics.)

LElectrotonos of Muscle.—A muscle, like a nerve, may be put in the
condition of electrotonos ; the changes of irritability that accompany
this condition are confined to the portion of muscle through which
the current flows. The subsequent effects, after the polarizing current is
broken, are also limited to the portion through which the current passes.

It is logically probable, also, that not only the motor-nerves, but also
all parts of the nervous system—central and peripheral—are capable of
exhibiting the phenomena of modified irritability under the galvanic
current.

Theory of Anelectrotonos and Catelectrotonos.—That the galvanic
current in its passage through the nerve diminishes the irritability of that
nerve in the region of the positive pole, and increases its irritability in
the region of the negative pole, may be explained by the purely physical
effects of the currents in the tissue.

We have seen that in electrolysis acids go to the positive and
alkalies to the negative pole ; now it is a fact of physiology that acids
diminish the irritability of nerves, while alkalies increase it. Anelec-
trotonos and catelectrotunos may therefore be caused by acids at the
positive and alkalies at the negative pole.

This explanation is rendered probable by two facts: first, that
116 ELECTRO-PHYSIOLOGY.

anelectrotonos and catelectrotonos are not produced by the secondary
faradic current, which has no marked chemical action ; and secondly,
that very feeble and instantaneous passages of the galvanic current pro-
duce electrolytic effects.

Phliiger's Contraction-Law.—The law of contraction, as derived by
Pfliiger from experiments on the frog, is thus formulated: Zhe nerve is

excited by the appearance of catelectrotonos, and the disappearance of
anelectrotonos, but not by the appearance of anelectrotonos or the dis-
appearance of catelectrotonos. This law is considered of great scientific
as well as practical value.

Electrotonos in the Living Man.—The subject of electrotonos in the
living man has been studied by Eulenburg, Samt, Von Bezold, Brenner,
Erb, Briickner, Runge, and Filehne, but most successfully by Cyon.

Cvon,* by a series of elaborate and careful experiments, has shown
that the contraction-law of Pfltiger, as established on the frog prepara-
tion, applies also to the living human subject.

He has shown that, after closing the circuit, the irritability is in-
creased near the negative pole; tuat this condition of catelectrotonos
increases as the current runs up to a certain point; that on breaking
the current the zegative modification, or condition of diminished irrita-
bility, appears for a moment, and then disappears.

Near the positive pole, on the other hand, the irritability is.diminished
at and after closing the current. On breaking the current there is
an increase of irritability, or positive modification, which appears to be
greater when the current has been allowed to run a long time.

The experiments from which Cyon derived these conclusions were
made on the ulnar nerve, and with great care to avoid error. It will
be seen that the results correspond with the results of Pfltiger’s experi-
ments on the frog, and confirm them. Cyon found, however, that these
results were not uniform in all persons, but were modified more or less
by temperament and disease.

Practical Bearings of the Laws of Electrotonos.—The laws of electro-
tonos do not by any means explain all the therapeutical action of the
galvanic current on the body; but so far as they go they are of great
value, and should be considered by those who stndy the therapeutics of
galvanism. ‘The calming effects of the positive pole, and the irritating
effects of the negative pole, as well as the exact effects of strong and
interrupted currents, may in these laws find their partial if not complete
explanation.

“ Principes d’ Electrothérapie. Paris, 1873, p. 130 ef seg.
CHAPTER III.
ACTION OF ELECTRICITY ON THE SKIN,

In regard to the study of the action of electricity on the body in
health, it is necessary to make the preliminary remark that many of
the experiments that have been made and published, and widely quoted
in this department, have but little scientific value, and cannot be re-
garded as in any sense authoritative. The reason for the uncertainty
pertaining to the reported experiments aré manifold :

1. The distinction between the currents has not been observed. Not
only have the faradic and the galvanic currents been constantly con-
founded, but the subdivisions of the faradic current—the electro-mag-
netic and magneto-electric—have been vaguely commingled. Many
observers speak of galvanization when they mean faradization, and vice
versé, and not a few apply both terms to the use of the same current.

2. Allowance has not been made for the differential action of strong,
medium, and feeble currents, or of long and short applications. The
difference in the physiological effect of a large and small dose of opium,
strychnine, belladonna, or ergot, or any other powerful remedy whatso-
ever, is enormous. When a small dose has no perceptible effect, a large
dose may throw into profound sleep, or into violent convulsions, that lead
to death. In speaking of the physiological action of drugs of any kind,
the dose is always mentioned, and any experiment with drugs, on man
or animals, when the dose is not known or mentioned, has little value in
science. Similarly also in electro-therapeutics, we find in every-day
experience that the difference in the effects of a mild and short, and a
severe and” long, application, is only the difference between making a
patient infinitely better or infinitely worse.

- When, therefore, we read that galvanization of the sympathetic or
pneumogastric produces such and such effects, we really get no precise
knowledge whatsoever.

3. The differential susceptibility of man and animals has not been duly
considered. Experiments with electricity performed on the lower ani-
mals, as frogs, dogs, cats, horses, rabbits, cows, guinea-pigs, etc., do not
118 ELECTRO-PHYSIOLOGY.

always afford a safe basis for generalization in regard to the effects of
electricity on man, and especially on man in a state of civilization. In
their susceptibility to the electrical stimulus, and in the length of time
that they retain their irritability’ after death, there is a great difference
in animals; between animals and civilized man this difference must be
very great.

“In proportion as the organization of man is more complex than that
of the lower animals, in that proportion will the physiological reactions
of the human body to the electric current, or indeed to any other in-
fluence, be more complex and uncertain, and more liable to deviations
and modifications than the physiological reactions of the inferior forms
of life to which we are supposed to be related. Conclusions in electro-
physiology, derived solely from experiments on animals, have the great
merit of simplicity; but when applied to the far higher and more com-
plex organization of man, and especially of civilized man, with his ex-
cessively sensitive system of nerves, they are apt to lead into serious
error.

4. Individual idiosyncrasies have not been properly considered. The
action of medicines varies with the temperament to such a degree as to
make necessary great caution in rushing to generalizations from expe-.
riments on one or two persons. Applications of electricity, faradic
or galvanic, to the cervical sympathetic, similar in length and strength,
may cause in one individual symptoms of cerebral congestion, in another
symptoms of cerebral anzemia, and in another its effects may be purely
negative. In one individual the effects of such application may be felt
at once, in another an hour or two after the application, in another not
until the following day. .

There is a great difference in the average susceptibility of different
nationalities and of the higher and lower orders of society, with occa-
sional exceptions both ways; the tough, coarse-fibred laboring classes
are much less susceptible to electricity, just as they are much less sus-
ceptible to drugs, than the delicate, finely organized, brain-working
classes.

5. Zhe action of electricity on the body in health may be learned, in
part at least, by studying its action in disease. ,

“Pathology,” Allbutt well says, “is but the shady side of physiology.”
To draw the line precisely where health ends and disease. begins, is
oftentimes beyond the power of mortal man. Of the deep darkness of
the midnight-hour any child is conscious, and even the birds discern the
approach of evening ; but what physicist so keen as to tell the precise
moment when the late afternoon begins to fade into the early twilight ?
ACTION OF FARADIC CURRENT ON THE SKIN. Ily

It is because physiology and pathology thus run into each other, that
observations on pathological states may be of great service to physiology.
Experiments made with electricity on patients more or less diseased
have helped, as we shall see, to solve some of the problems of electro-
physiology. Certain pathological states render the nerves unusually
unpressible to electricity in degree, though in the same way as in
health, and thus are of great value to the electro-physiological experi-
menter.

The above considerations explain in part the opposite and inconsistent
as well as fragmentary character of electro-physiological researches, and
they should be borne constantly in mind by those who study this and
the following chapters, devoted to the action of electricity on the human
body in health.

Action of Franklinic Electricity.—When the sparks of frictional
electricity are applied to the skin they produce a sensation of pricking,
and if the sparks are large the skin becomes red and a papular eruption
appears. Applied to the scalp, it causes the hair to stand on end.

Action of the Faradic Current.—lf any dry artificial electrode is
pressed against the dry skin while a faradic current is passing, the elec-
tricity will penetrate but slightly to the deeper tissues, unless the current
is very intense, because of the great resistance offered by the skin.

One effect of the faradic current on the skin in this way is to cause a
change in the circulation. The change may be eithér anzemia or hyper-
zemia. At first there is anzeemia. The calibre of the blood-vessels is
narrowed, through the action of the current on the vaso-motor nerves.
This contraction with anzmia is spasmodic in its character; it lasts
but for a time, and in the course of two or three minutes it gives way
to hyperemia. The skin becomes red, and remains so for a short or
long time, from several minutes to several hours, according to the
strength of the current, the length of the application, and the tempera-
ment of the individual.

Another effect of faradizing the skin in this way is pain. This pain is
caused by the irritation of the extremities of the sensory nerves.

When the dry hand is substituted for the dry artificial electrode, the
surface can be faradized without producing pain. During the latter
operation the electricity, acting upon the dry surface of the skin, pro-
duces a peculiar cracking or humming sound that may be heard several
feet.

An application of a faradic current of ordinary strength is followed
by the most marked effects on the skin when it is dry, from the fact
that the electricity is mostly confined to the surface of the tissue. A
120 ELECTRO-PHYSIOLOGY.

very fine, or, in other words, a rapidly interrupted, faradic current, has
a more marked effect on the sensory nerves than a coarse, or slowly in-
terrupted, current, and in the treatment of the more common forms of
anzesthesia and neuralgia this fact must be considered. Zhe negative
pole has a much stronger effect both on the sensory and motor nerves
than the positive. Any one can readily distinguish the poles, when held
in the hand, by the stronger sensation and more violent muscular con-
traction which is felt at the negative.

Some parts of the skin are more sensitive to the’current than others,
from the fact that they are more richly supplied with nerves. The face
is especially sensitive at the points where the various branches of
the trigeminus issue, and at the line of demarcation of the skin and
mucous membrane of the nose and mouth. The relative sensitiveness
of different parts of the surface of the body to the faradic current will
be discussed in detail in a chapter devoted to that subject in the section
on Electro-Therapeutics. A faradic current’of moderate strength, when
applied to bones that lie very near the surface, produces considerable
pain of a peculiar character. This pain is caused on account of the
irritation of the sentient nerves of the periosteum. ‘The forehead and
the region of the scapula and tibia are especially sensitive to electriza-
tion.

It is not supposed that the bone is specifically affected by the electric
current. Both the ‘periosteum and the bone, however, may have an
increased amount of blood attracted to them by the electric current.
Acting in this manner, electrization has been known to reunite an old
fracture. (See Electro-Surgery.)

The great and peculiar sensitiveness of the skin to electricity is ex-
plained in part by the fact that the epidermis as a whole is so poor a con-
ductor, and the electricity enters it dy points through the sudoriferous and
sebaceous glands, and the smaller the diameter of the point at which the
electricity enters a body the greater the density, the strength of the
current being constant. When now an electrode is applied to the body,
the entire current, instead of diffusing itself over the whole surface,
enters at the glands, where there is best conduction, and consequently
excites pain. For the same reason, to a greater degree, electricity
applied by means of a metallic brush is far more painful than when
applied with a broad metal or sponge.

For the same reason a wet sponge electrode, when lightly touched to
the surface of the body, causes more pain than when firmly pressed on
the skin.

One effect of faradizing the skin is the phenomenon of “ goose-flesh,”
ACTION OF GALVANIC CURRENT ON THE SKIN, 121

popularly so called. This is noticed not only where the electrodes are
applied, and between them, but atadistance. Itis more observed in the
nervous and feeble than in the hardy and strong. It may be excited by
weak currents of momentary duration. In some persons it cannot be
excited at all. ‘

Action of the Galvanic Current.—The effects of the galvanic current
on the skin differ somewhat from those of the faradic. At both poles
there is a burning sensation, which increases in intensity with the strength
of the current and the length of the application. ‘The sensation, when
the current is closed, is like that of a mustard-plaster, or, with a very
strong current, that of a hot iron pressed on the skin. The “ goose-
skin” sometimes appears as under the faradic current, but it lasts longer.
It appears only around the poles, and not beneath them, at the points of
contact. At the positive pole, in some cases, there appears under the
electrode, at first, a shallow depression, and the skin is pale, but soon
hyperzemia appears, and many little elevations here and there. When
a strong current is used an ischaemic appearance is presented beneath
the electrode, and a red areola extends for some distance around.

At the xegative pole substantially the same phenomena appear, but
the hypereemia arises more rapidly, and is more intense and extended.

The general sensation caused by the galvanic current is then, 7
character, substantially the same. at both poles. In degree of action
there is a certain difference, since the change at the negative develops
more rapidly and powerfully.

The above phenomena we have repeatedly demonstrated on a variety
of temperaments. We have observed that the rapidity and strength of
the action are considerably modified by the individual. Soft, thin, and
delicate skins appreciate the burning feeling and the various stages of
hypereemia more quickly than skins which are coarse, thick, and hard.

Ziemssen, who has carefully studied this subject, states that zzpo-
larizable electrodes are necessary in order to obtain the complete
results with certainty. The advantage of unpolarizable electrodes is,
thac they are not so painful, and so a current of from thirty to sixty
elements can be borne for a long time, say from ten to thirty minutes.
With ordinary electrodes such a current would for most persons be un-
endurable after the second minute.

Chemical Effects of the Galvanic Current on the Skin.—The chemical
effects of the galvanic current on the skin differ not only in degree but
in kind. Under the zegative pole—when metallic electrodes of moderate
diameter are applied on the skin, slightly moistened—there appear small,
pale vesicles, that are transparent and are not raised much above the
122 ELECTRO-PHYSIOLOGY.

skin. This phenomena is produced by a current that causes a strong
burning sensation. These vesicles contain fluid and layers of epidermis.
The fluid is a/kaline. When the strength of the current is increased the
fluid becomes of a brownish color, and blisters are formed and a red
areola appears. The serum that comes out on the skin is alkaline.
These blisters, and all the other phenomena, as has been often
demonstrated, appear more rapidly on delicate than on thick skins, and
when fully formed they are a long time in healing, and for days and
weeks a yellowish and brownish discoloration may be observed at the
points where the skin was acted on.

If the application be still more protracted little ulcers are formed, that
are also slow to perfectly heal, but are not painful, and cause no an-
noyance.

At the Jositive pole, when a strong current is used for some time, a
blister appears, accompanying the other symptoms of ‘“ goose-flesh,”
ischemia. The blister is colored in its centre a yellowish brown.
The serous fluid that comes from the blisters is acid. The metallic elec-
trode becomes black through oxidation. In order to demonstrate this
action of the positive pole, it is better to have the connection at the
negative pole established by means of a broad, soft, and well-moistened
sponge.

Ziemssen states that by this experiment, made with thermometers,
no elevation of temperature takes place either at the positive or nega-
tive pole.

In all these chemical actions of the galvanic current on the body, it is
probable that more or less ozone is produced, and it is not impossible
that the ozone thus produced may in some way modify the effects.
(See section on Ozone and Ulcers, in Electro-Therapeutics. )

Llectro-anesthesia.—It has for some tine been a matter of dispute
whether a slight anaesthesia can be produced by the electric current.
It is well known that for a number of years some dentists have been
accustomed to connect the forceps for extracting teeth with one pole
of an electro-magnetic apparatus while the patient rested his foot on the
other pole, so that as soon as the forceps seized hold of the tooth a cur-
rent is established. Although this method of producing anzesthesia is not
now received with favor, there is no question that the electric currents
do have a slight benumbing effect. The results of various experiments
that we have from time to time performed in this department seem to
be conclusive. We have had teeth extracted while a strong faradic
current was passing through the jaw, and feel assured from this personal
ELECTRO-ANASTHESIA. 123

“

experience that the electricity caused the pain to be lesg sensitively felt.
That the pain caused by the prick of a pin, for example, is less sensi-
tively felt when a strong faradic current ‘is passing through the part
where the puncture is made, we have practically demonstrated on the
hand and other parts of the body.

Althaus* arrived at the conclusion that the electric current could pro-
duce an anesthetic or slightly paralyzing effect, from experiments on
the nerve-trunks, as the ulnar and sciatic. His method of operating
was to place the positive pole over some point where the nerve was
superficial, and the negative over some one of the terminal branches,
keeping up the action of the current for fifteen minutes, with the result
of producing a feeling of numbness, and less sensitiveness to the cur-
rent. Knorr, of Munich, has availed himself of the anzesthetic effects
of electrization for opening felons and buboes.

We have also experimented on inflamed and irritated mucous mem-
branes. In rhinitis, pharyngitis, and laryngitis, we have for three years
been accustomed continually to make use of the benumbing effects of
electrization.

It has a very slight anesthetic effect on irritated and inflamed mucous
membrane, and those on whom it has been employed desire to have the
applications repeated. Our custom has been, in some cases, to use local
faradization after the application of caustics and other irritants, in order
to relieve the very annoying pain that they so often cause, or in any
irritable condition of the parts.

A French physician, M. Victor Revillout, has obtained similar results
from applications of the faradic current to the uterus after cauteriza-
tion. +

* Medical Electricity, 1860, pp. 166, 167.
+ Archives Générales de Médecine, September, 1868, p. 356.
i CHAPTER IV.
ACTION OF ELECTRICITY ON THE BRAIN AND SPINAL CORD.

Direct Application.—it has been shown by Fritsch and Hitzig that
in the cerebral convolutions there are centres for the production of
voluntary muscular movements in various parts of the body. These
physiologists took off the upper part of the skull of a dog, and by
means of weak galvanic currents excited the exposed brain, locating
the current, as far as possible, in small portions. They found that
when certain definite portions of the anterior convolutions were excited,
movements were caused in certain groups of muscles on the opposite side
of the body. Continuing their researches, they showed that there are
definite nerve-centres for the nerves that preside over the muscles of
the neck, the foot, and the face, for the extensor and adductor muscles
of the forearm, and for the flexor and rotator muscles of the arm.

Prof. Ferrier, of King’s College, London, has made similar researches
with the faradic current, and with it has investigated the brains of fish,
frogs, dogs, cats, rabbits, guinea-pigs, and monkeys. He has studied
not only the cerebrum, but the cerebellum, the corpora quadrigemina,
and other portions of the brain. Electrization of the optic thalami
produced no result. Electrization of the corpora striata caused the
limbs to be flexed. Electrization of the anterior tubercles of the corpora
quadrigemina caused dilatation of the pupils and opisthotonus ; while
electrization of the posterior tubercles caused the animal to make all
sorts of noises. Electrization of the cerebellum caused movements of
the eyeballs. Dr, Beard* has carefully studied this subject on the brains
of dogs, rabbits, cats, and pigeons. He used both currents, mild, me-
dium and strong, and studied also the question of diffusion of currents.
His provisional conclusions were, that the surface of the brain was
electrically excitable ; that the theory advanced by Dupuy and other
French observers, that the excitation was due to the diffusion of the cur-
rents to the central ganglia, was not tenable. Dr. Bartholow+ had made

* Archives of Electrology and Neurology. May, 1874. t Ibid.
GALVANIZATION OF THE BRAIN. 125

similar experiments on the brain of a living woman, exposed by can-
cerous disease. ,

Liffects of External Galvanization of the Brain.—The leading effect
of medium and strong galvanization of the brain by external application
in the living human subject is different. When one electrode is placed
on the forehead and the other on the occiput, or one on the summit of
the head and the other on the stomach, galvanization is followed by
little if any tendency to vertigo. When a current of even feeble tension
is passed from temple to temple, or from one mastoid bone to its fellow,
very decided dizziness is at once perceived, which continues during the
operation of the current, and becomes most decidedly manifested at the
moment the circuit is broken.

During the passage of the current there is a very marked and quite
irresistible tendency to lean toward the positive pole, while objects in
view seem to move in the same.direction. When the circuit is opened
there is a reversal in the direction of the seeming movements, and the
experimenter instantly bends in the opposite direction toward the nega-
tive pole.

For these phenomena an ingenious and plausible explanation is given
by Hitzig. When the current passes from the forehead to the occiput,
the right and left lobes of the brain and all that pertains to them are
equally or symmetrically influenced, and little if any dizziness is per-
ceived. Place, however, the anode upon one temple ahd the cathode
upon the other, and mark the readiness with which dizziness is produced.

In this operation the brain is no longer symmetrically affected. One
hemisphere 1s in a condition of anelectrotonos, or diminished irritability,
while the other is in a condition of catelectrotonos, or increased irrita-
bility, or, as it is expressed, there is a falsification of the muscular sense,
a disturbance of the equilibrium, and the apparently involuntary incli-
nation toward the anode is in reality a voluntary effort to restore the
imaginary loss of balance.

Hitzig indicates several degrees of galvanic giddiness.

1. A mere sense of fulness in the head. This feeling is caused by a
mild current when broken, but not usually when the current is running,
nor so markedly when the current is closed. Certain temperaments,
however, experience this feeling not only when the current is broken,
but also when it is running.

2. Apparent movements. These are produced by stronger currents.
Objects when the current is running appear to go from the positive to.
the negative pole ; when the current is broken the apparent movement
is reversed.
126 ELECTRO-PHYSIOLOGY,

3. Staggering. This is produced by stronger currents. In impress.
ible temperaments very mild currents may produce it.

Movements of the Eyes.—Movements of the eyeballs have also been
observed by Hitzig during the second and third stages of dizziness.
When a strong current goes transversely through the head, and its
direction is changed, movements of the eye, resembling nystagmus,

«appear. There is a jerk, and then a further movement. If the positive
pole be in the right mastoid, and the negative in the left, both eyes are
jerked toward the left, and kept there, provided the current be suffi-
ciently strong.

There are anatomical reasons for supposing that the brain can be
more easily affected in the mastoid and occipital regions than in the
anterior portion. A large vein connects the transverse sinus with the
posterior auricular veins, and with the posterior meningeal artery into
the skull through the mastoid foramen. In the occipital region a vein
connects the transverse sinus with the vena cervicalis profunda through
the posterior condyloid foramen.*

SPINAL CORD.

Rigid cramps of all the muscles of the trunk and extremities follow
electrization of the spinal cord when an electrode is placed at either
extremity of the cord. Cramps ofthe same character are also pro-
duced when one electrode is applied to the anterior and the other to
the posterior column, either at their upper or lower extremities.

If the spinal cord be divided at about its centre and the lower half
electrized, only the muscles of the lower or hinder limbs will contract.
If the upper half be electrized, only the muscles of the fore limbs will
enter into contraction. The results will be the same, whether the cut
extremities are separated or brought in close contact, in which latter
condition no impediment is offered to the passage of the current.
The above researches of Weber have been confirmed by Dr. Beard’s
experiments on dogs and rabbits. The effects are produced by both
currents. :

Inhibitory Effects.At the moment of closing and breaking a gal-
vanic current its action upon the cord is manifest by the contraction of
the muscles of the body and limbs ; but during the passage of the cur

* Quoted from Luschka and Anatomie des Menschen, vol. iii, 2, p. 154, by
Althaus, Third edition, p. 139.
SPINAL CORD. 127

‘

rent no contractions are observed, and a paralyzing effect soon takes
place. The cord remains insensible to any stimulus that may be ap-
plied to it as long as the current is passing, but at its cessation any
mechanical irritation will give rise to the usual tetanic convulsions.
This diminution of excitability is confined alone to the spinal cord, for
if the motor nerves and muscles are traversed by an induced current
(while the cord is under the influence of the galvanic) they contract
vigorously. The galvanic current applied through the spinal cord for a
long time produces paralysis

According to Mayer, if a mild faradic current be applied to the cervi-
cal region of frogs that are in an irritable condition, movements of the
lower extremities occur. Electrization of the posterior columns pro-
duces these movements easier than electrization of the anterior col-
umns. If the posterior columns are removed no movements occur. If
the cord is divided into halves, posteriorly and anteriorly from above
nearly down to the origin of the sciatic nerve, electrization of the pos-
terior half produces movements, but electrization of the anterior does
not. If the posterior roots on the trunk of the brachial nerve are elec-
trized, the movements are produced just as when the cord itself is elec-
trized. Fick, however, declares that the anterior columns respond to
faradization.

Cilio-spinal Centre.—The cervical sympathetic nerve, which animates
the radial fibres of the iris, takes its rise from the spinal cord between
the seventh cervical and the sixth dorsal vertebre.

If this portion of the cord be galvanized, the excitation is transmitted
to the cervical sympathetic nerve, and thence to the iris, producing dila-
tation of the pupil. This point has been termed by Budge and Waller
the centrum cilio-spinale. A ganglion near the fifth lumbar vertebra
which, on being electrized in animals, produces contractions of the rec-
tum and bladder, is called the ganglion genito-spinale.

The first of these points, the centrum cilio-spinale, can be demon-
strated by external applications both of the galvanic and faradic cur-
rents, and is of great importance in general faradization. The ganglion

_genito-spinale also is probably directly, though not so ‘demonstrably,
affected by external electrization of the spine.
CHAPTER V.
ACTION OF ELECTRICITY ON THE SYMPATHETIC AND PNEUMOGASTRIC.

In order to intelligently appreciate the experiments that have been
made to determine the action of electricity on the sympathetic and
pneumogastric, it is necessary to keep constantly before the mind the
following considerations :

rt. The action of electricity on the sympathetic and pneumogastric
must be modified by the kind of electricity employed, by the strength
of the current and length of the applications, and by the condition and
temperament of the subject in which the experiment is made. :

To say that galvanizing the sympathetic produces such and such
effects is really to give no information whatsoever, for at once the
inquiring soul raises the questions, How strong were the currents used?
How long were the applications? Were men or animals subjected to
the experiment? Were they intact or injured? If animals, what kind,
and were the results the same on several animals of the same kind ?

2. These nerves can be affected both by external and internal appli-
cations of electricity.

The fact that external electrization affects these nerves, which has by
some been disputed, is fully apparent from what is known in general
of the electro-conductivity of the body, is confirmed by special experi-
ments, and is demonstrated by observations in physiological and patho-
logical cases. This is true not only of the cervical sympathetic ganglia,
but of all the ganglia of the body. Known facts in regard to the elec-
tro-conductivity of the body show that none of the ganglia of the
sympathetic can escape the electric influence when the current is ap-
plied over the surface of the body.

3. The effects of external application through the skin on these nerves
cinnot be expected to be identical in kind and degree with the effects
of direct application to the nerves themselves. Although the cervical
ganglia of the sympathetic and the pneumogastric nerve are traversed by
the currents of electricity when the electrodes are placed on the skin in
sucha position that the current in passing from one to the other finds these
SYMPATHETIC AND PNEUMOGASTRIC. 129

nerves in their pathway, yet on physical or physiological principles we
cannot expect the same results as when the one or both poles are di-
rectly applied to the nerves. In external applications it is the derived
currents that pass through the nerves, and direct polar effect is not
gained. When we consider that the currents in passing from one pole
to the other diffuse themselves into numberless undulatory, diverse cur-
rents, it is easy to see that only a small part of the electric influence
will be appreciated by such small nerves as the sympathetic ganglia or
the pneumogastric. In the body between the electrodes the currents
act like diffused light ; at the electrodes the currents act like light con-
centrated to a focus. If currents of sufficient power could be borne
externally, it is possible that by single external applications there could
be produced all the effects that are obtained by direét applications to
the nerves themselves ; but this is hardly probable, for the twofold rea-
son that the differential polar effect could not be obtained, and that
the great stimulation of each of the electrodes on the surface would
complicate the experiment. These considerations, as it seems to us,
sufficiently explain what to many has been regarded as a great diffi-
culty—that the ordinary therapeutical measures for electrizing the sym-
pathetic do not produce the same effects as direct applications to the
ganglia.

That the sympathetic and the pneumogastric are traversed by the cur-
rent when the electrodes are placed on the surface of the neck, is suffi-
ciently probable from the known laws of electric conduction. When
one electrode is placed at the nape of the neck, and the other at
the anterior border of the sterno-cleido-mastoid muscle, the current,
whether faradic or galvanic, however widely it may radiate, and however
numerous the branch-currents may be, must by physical necessity trav-
erse the sympathetic and pneumogastric. There is no more prob-
ability that it’ will go out of its way, in violation of physical laws, and
avoid these nerves, than that a storm sweeping between New York and
Brooklyn will take a circuitous march and avoid the East River.

These nerves—the sympathetic and pneumogastric—and the tissues
by which they are surrounded, are good conductors, very much superior
in conductivity to the skin, and of almést the same conductivity as the
muscles; and even if some branch or derived currents pass through
other tissues, as unquestionably is the case, these nerves cannot be
wholly avoided, and when the electrodes are in central positions they
are probably the highway through which nearly the entire charge
passes.

But stronger than the analogies of electro-physics, and more con-

9
130 ELECTRO-PHYSIOLOGY.

vincing than experiments on the dead subject, are the observed effects
of electrization of the neck in physiological and pathological cases.
These effects, which will be detailed further on, harmonize so closely
with all our knowledge of nervo-physiology, and accord so exactly with
pathological observation, as to demonstrate beyond doubt, and with an
emphasis by which those who observe cannot fail to be impressed, that
the sympathetic and pneumogastric can be affected by external faradi-
zation or galvanization of the neck.

4. It is difficult, if not impossible, to affect the cervical sympathetic
or the pneumogastric by external applications, without at the same time
affecting the depressor nerve, the spinal cord, or the brain, and especially
difficult is it to limit the action to the pneumogastric without at the
same time affecting the sympathetic, and vice versa.

This conclusion follows as a logical result from the anatomical rela-
tion of the parts and from what is known of the electro-conductivity of
the body, and is pretty distinctly demonstrated by the physiological and
therapeutical action of the current when externally applied. In what-
ever position we place the electrodes, the derived currents, in passing
from one electrode to the other, must traverse some portion of both of the
great nerves. The base of the brain and the region of the neck constitute
the most important part of the central nervous system. ‘So far as life
can be said to have any centre, it is here, where the pneumogastric, the
phrenic, and the other great nerves take their origin. Directly or indi-
rectly, by the actual passage of the current, or by reflex action, any part
of this important region is liable to be affected in the applications em-
ployed in the so-called galvanization of the cervical sympathetic.

It is partly on account of this difficulty of limiting the action of the
current to one or other of these great nerves that we treated them both
under the same chapter. When operating on these nerves, exposed
and laid bare and isolated, the action of the current can, of course, be
limited pretty exclusively to the nerve operated on. The. cervical
ganglia of the sympathetic receive the chief attention in all these ob-
servations, because they are prominent and accessible and bear a
powerful and recognized influence over the cerebral circulation ; but
_all the ganglia of the sympathetic are accessible to the electrical influ-
ence.

Action of Electricity on the Cranial Portion of the Sympathetic.—In
1727 M. Pourfour du Petit discovered that the following symptoms re-
sulted from division of the cervical filaments of the sympathetic nerve,
viz. : contraction of the pupil, redness and injection of the conjunctiva,
and flattening of the cornea; the eyelids approach each other, the
SYMPATHETIC AND PNEUMOGASTRIC. 131

nictitating membrane becomes more prominent, the secretion from the
mucous surfaces of the eye is increased, and the eyeball is drawn fur-
ther into the orbit. In addition to these symptoms, the ears and
nostrils also become red and injected, and the head hotter and more
sensitive.

Claude Bernard observed that not only did all these phenomena dis-
appear when the cranial portion of the nerve was submitted to electri-
zation, but that quite reverse phenomena appeared. The pupil be-
came larger than natural ; the conjunctiva, the ears, and the nostrils be-
came quite pale; the eyeball protruded from its orbit; the mucous
surfaces became drier, and the head cooler and less sensitive ; but as
soon as electrization was discontinued, all the phenomena caused by
the section of the nerve again appeared.

Electrization of the great sympathetic Jefore it is divided produces
almost precisely the same results as after division. It has been ob-
served by Weber, that if either the inferior cervical ganglia of the
sympathetic nerve or its cardiac branches are submitted to electrization,
the action of the heart ts accelerated.

Action of Electricity on the Cephalic, Thoracic, and Abdominal Gan-
glia.—Section of the sympathetic causes, as we have seen, increase of
heat in the ear.

Now if the cephalic end of the divided sympathetic is electrified, the
increased temperature of the part is lowered ; but if the electric current
be passed through the large diameter of the ear, the temperature is further
increased. On the other hand, if there has been no division of the
sympathetic, and the ear is electrified, the heat in that part is lessened.

Valentin found that the galvanization of the superior thoracic gan-
glia revived the pulsation of the heart after it had ceased, and increased
the frequency of the beats when already in action. Mild galvanization
of the splanchnic nerves that arise from the six lower dorsal ganglia
of the sympathetic increases, while strong galvanization diminishes,
the peristaltic action.

Effect of direct Electrization of the Pneumogastric and on the Respi-
ration.—MM. Arloing and ‘Tripier have shown that section of the
pneumogastric below the medulla oblongata so far modifies its irrita-
bility that the action of the heart is not arrested, or but for a short time,
by the faradization of the distal end of the cut pneumogastric.

The same authors believe that weak faradic currents cause a slight
increase in the rapidity of the beats of the heart and elevation of the
blood-pressure in the arteries.

They found that the right pneumogastric has a more powerful influ
132 ELECTRO-PHYSIOLOGY.

ence over the heart than the left. Faradization of the peripheral end
of the divided pneumogastric causes arrest of the action of the heart.
sudden irregularities of its rhythm, and some diminution of pressure.
Faradization of the central end causes retarded and diminished pres-
sure.

According to MM. Arloing and Tripier, faradization of the intact
pneumogastric with feeble currents does not accelerate respiration ; fara-
dization with medium currents causes sudden inspiration and forced
expiration ; faradization with strong and powerful currents causes re-
flex coughing and vomiting. The same observers found that the left
pneumogastric has a more powerful influence over respiration than the
right.

The discovery that the right pneumogastric has a greater power over
the heart than the left, was made by Masoin, of Belgium, about the same
time as it was made by Arloing and Tripier. Masoin found the move-
ments of the heart were stopped by the galvanization of the left pneumo-
gastric. It was possible to restore the movements by a mechanical ex-
citation, such as striking the heart with the finger ; but after the move-
ments were stopped by galvanization of the right pneumogastric, it was
not possible to restore them in that way.

Dr. Brown-Séquard * states that he has found the same differences to
exist in men as in animals, judging from experiments made not by electri-
city, but by pressing on the nerves near the angle of the jaw.

Arrest of Respiration by Galvanization of the Laryngeal and other
Branches of the Pneumogastric.—It has been shown by Brown-Séquardt
that electrization of the upper or the lower laryngeal nerves causes
arrest of the respiration, and Bidder has shown that a reflex spasm of
the glottis may be caused in the same way. Electrization of the
cesophagus and pharynx may sometimes produce the same effect. If
the upper laryngeal nerve is electrized after the chest is opened, the
arrest of the respiration does not take place as easily as when the
chest is not open. The respiration, when thus arrested, usually re-
turns in the course of a quarter or half a minute, whether the electriza-
tion is continued or not.

The effect of electrizing the pneumogastric on the respiration is
modified by two factors—the portion of the nerve that is electrized
and the strength of the current. Mild galvanization of the pneumogas-
tric in the lower part of the neck may increase the respiratory move-

* Archives of Scientific and Practical Medicine January, 1873, p. 92..
+ Loc. cit., p. 96.
SYMPATHETIC AND PNEUMOGASTRIC. 133

ments ; weak electrization in the upper part of the neck, near the origin
of the nerve, may arrest respiration.

A mild current may increase the respiration or diminish it, or it may
have no effect whatever.

A medium current may arrest respiration and cause spasm of the
glottis and of the muscles of inspiration.

A powerful current may paralyze the diaphragm, and may produce
death without the accompanying symptoms of agony.*

Coughing.—A prominent effect of electrizing the pneumogastric is
coughing. This symptom may be excited by external as well as by
internal applications, and by the faradic as well as by the galvanic
current.

We made our first experiments in this direction in 1867. Dr. Rock-
well then observed that the application of either pole of a strong faradic
current to the nape of the neck—the other pole being at the feet, or in
either hand, or at the pit of the stomach—excited in sensitive patients
quite severe attacks of coughing, that lasted so long as the pole remained
in position. Most clearly this effect was seen in thin and sensitive pa-
tients. It was not necessary to be particular in regard to the position
of the pole on the neck in order to excite this symptom ; not only in the
cilio-spinal centre, but even when the pole is as low down as the
first and second dorsal vertebre, the laryngeal branches of the pneu-
mogastric may be so irritated as to induce coughing.

This phenomenon we daily observed in the operation of general
faradization. The same effect follows the use of strong interrupted gal-
vanic currents.

According to Donders, the pneumogastric, when acted upon by the
galvanic current, conforms to (Pfliiger’s law of contraction; in the
region of anelectrotonos its irritability is lessened; in the region of
catelectrotonos its irritability is sometimes increased.

Action of External Applications of Electricity on the Pneumogastric
and Cervical Sympathetic of living uninjured Men.—The experiments
above recorded were made chiefly on the exposed nerves of animals, and
the applications were made directly to the nerves by one or both poles.
Keeping in mind the considerations previously adduced, we proceed to
examine into the effect of external applications of electricity on the
cervical sympathetic and the pneumogastric of living men in health.

In our attempts to solve the problem, we have experimented on a

* Archives of Scientifie and Practicrl Medicine, No. 1, 1873, p. 96. Whether
these experiments were performed with the faradic or galvanic current is not dis.
tinctly stated,
*

134 ELECTRO-PHYSIOLOGY.

large variety of individuals of different ages and by different methods of
application. One of the electrodes is placed in the mastoid fossa, and
the other over the seventh cervical vertebra, or at the top of the clavicle.
Both directions of the current are used. We used in these experiments
a zinc carbon, or the Smee’s battery, of from 5 to 30 cells, from 1 to 5
or Io minutes.

The general results of our researches may be thus summed up:

1. A slight feeling of drowsiness. This sometimes began to be per-
ceptible shortly after the electrodes were applied, increased up to a
certain point, and continued for some little time after the séance was
over. In many cases it is not observed until the lapse of five or ten
minutes after the séance. The feeling, which was by no means con-
stant, was usually so slight that it might not have been observed, had
we not in our experiments kept closely on the watch for every sensa-
tion experienced during or just after the application.

Some individuals are amazingly susceptible to this soporific effect of
galvanization of the neck. A young lady whom we were treating for
facial acne by central galvanization, was frequently put right to sleep
within one minute after the application began. Her eyes would close
and her head would droop and nod; and when the electrodes were
removed she would awake but slowly, and with a vacant look and
drowsy feeling, such as we all experience when we are suddenly roused
from a nap. This effect followed any surt of application around the
neck with either pole and in any direction.

On the accepted theory that a state of cerebral anzemia predisposes
to sleep, we should reason, @ griori, that electrization of the sympa-
thetic ought to induce a feeling of drowsiness, since on some individ-
uals it unquestionably diminishes the current of blood in the brain, and
experimentally we have found that it does thus induce a slight and
temporary disposition to sleep, although this result is probably far less
marked than it would be if, without injury to the living subject, the
application could be made directly to the ganglia, and this effect is by
no means uniform, but varies with the strength of the currents and
with the temperament of the individual.

2. A feeling of warmth through the system with sensible perspiration.
This was not a constant symptom, though it was oftentimes very
decided. To produce sensible perspiration usually requires a strong
current and a long application. The extent to which this was felt was
manifestly dependent on the strength of the current and the length of
the application. It was usually felt but a short time after the séance
was completed. We have observed this effect more frequently and
SYMPATHETIC AND PNEUMOGASTRIC. 135

more markedly in the susceptible and nervous than in the cold and
phlegmatic, and most frequently in more or less pathological cases.

3. A marked effect on the pulse. The pulse was sometimes accele-
rated, but more frequently lowered, two, three, four, or more beats.

In order to determine the effects of electrization of the sympathetic
on the pulse, we made the examinations imniediately before and imme-
diately after the applications. Every prec:tution was taken to avoid
error, by allowing an interval of rest before the sitting, in order to give
time for the subsidence of the pulse to its natural condition from any
excitement that it may have received from the exertion of walking or
the labor of partially disrobing. In cases of doubt the whole minute
was counted, in some instances several times in succession. A patient
unaccustomed to the sensation produced by the electric current, or to
the modus operandi of its employment, might experience an accelera-
tion of the pulse from simple mental excitement, not only prior to or
at the commencement of the sitting, but also during or after the appli-
cation. Error from this cause was in our cases manifestly impossible,
and all the others on whom we experimented with a view to obtain
physiological results were so well’ familiarized to the medical employ
ment of electricity that they would receive any treatment proposed
with cool indifference. In order still further to guard against error, and
at the same time to observe the continuance or permanency of the
effect of the experiments, we repeated, in some instances, our exami-
nations of the pulse at intervals of fifteen minutes or half an hour after
the sitting was over.

A corroborative evidence that these changes in the pulse were due
to the action of the current, and not to mental excitement, is found in
the fact that, after an interval of five, ten, or fifteen minutes, the pulse
returned to its original condition.

These changes in the time of the pulse were also accompanied by
perceptible changes in its character, which, if careful sphygmographic
observations had been made, might perhaps have been reduced to some
general law.

Eulenburg and Schmidt found that when the positive pole of
from twenty to forty of Daniell’s elements was placed at the manu-
brium sterni, and the negative pole in the auriculo-maxillary fossa,
the pupil of that side was at first slightly dilated and afterwards con-
tracted. These changes in the pupil are by no means uniform in their
appearance. In some cases they appear at once after closing the
circuit, and in others after the lapse of half a minute or minute,
and ‘in others after interruptions. These phenomena are liable to
136 ELECTRO-PHYSIOLOGY.

many variations, according to the strength, length, and locality of the
applications. If an electrode is placed in the auriculo-maxillary fossa
of each side, the changes in the pupil occur on both sides, but are more
marked on the side on which is the negative pole. The same applica-
tion, continued for some time with a strong current, reduced the normal
pulse from 4 to 16 beats a minute and the pathological pulse even
more, diminished the tension in the carotid and vertebral arteries, and
markedly altered their sphygmographic tracings. The.same observers
found that galvanization of the spine also diminished the beats of the
pulse.

Liffect of External Electrization through the neck on the Retinal
Circulation.—In order to determine the effect of external applica-
tions of electricity through the neck on the retinal circulation, we have
made many experiments with the aid of a number of leading ophthal-
mologists.

These experiments, which have been frequently repeated with dif-
ferent individuals, with different strengths of current, and with different
batteries, seem to us to demonstrate the following propositions : *

1. Galvanizing or faradizing the region of the cervical sympathetic
has a marked temporary influence over the retinal circulation. It may
cause contraction of the arteries or dilatation of the veins.

2. The faradic current produces precisely the same effects on the
retinal circulation as the galvanic, only more slowly. The physiological
difference between the currents in this respect is therefore a difference
of degree and not of kind.

3. Mild currents and short applications caused contraction of the
blood-vessel of the retina, while strong currents and long applications
caused dilatation. Much seemed to depend on the temperament and
condition of the individual. What would cause contraction in one
would in the other cause dilatation.+ ‘These varying effects correspond
with clinical experience.

4. When the patient on whom the experiment is made is in an
excited or irritable condition from any cause, or from previous electri-
zation, even a mild current will sometimes cause dilatation at once,
without any early contraction.

* The ophthalmologists who observed the retina in these experiments were Drs,
Roosa, Hackley, Loring, _Matthewson, Prout, and Newton, to all of whom we desire
to return our acknowledgments.

+ The opposite and contradictory results obtained by different observers who have
studied the effects of chloral, bromide of potassium, etc., on the retinal circulation,
may be similarly explained,
EXPERIMENTS WITH THE SPHYGMOGRAPH. 137

5. The contraction which takes place is sometimes followed, a few
minutes after the close of the séazce, by dilatation which is greater than
normal.

6. The dilatation which takes place is sometimes followed by con-
traction after the close of the séance.

In some of the experiments no effect on the retina could be detected.
Impressible and nervous temperaments seem to exhibit changes in the
vascular condition of the retina much more readily than cold and phleg- -
matic temperaments.

The question now arises, Whether these changes in the retinal circu-
lation were due to the effect of the current on the sympathetic or on
the pneumogastric, or did they take place through the spinal cord or
by reflex action ?

This question is answered by comparing the results of these experi-
ments with the result of experiments made by Duchenne and Prof.
Léigeois, of Paris. These gentlemen laid bare the cervical sympathetic
in a rabbit, and electrized it with both currents in the same manner
that we electrized the necks of the individuals on whom we experimented.
The results on the circulation in the rabbit’s ear were in every distinc-
tive feature identical with the results on the retina when the galvanic
current was passed through the neck of the living human subject.

The other effects of galvanizing the region of the cervical sympathetic
—disposition to sleep, sweating, increased circulation in the extremities,
etc.—seem to confirm these physiological observations.

These experiments have been ‘partially confirmed by Onimus, who
has shown that the circulation of the retina may be influenced by
galvanization of the cervical sympathetic. He observed hyperzemia,
but this, as we have shown, is not a constant effect.

Experiments with the Sphygmograph—We have made experiments
with the sphygmograph, with the assistance of Dr. IL. De Forest Wood-
ruff.

For assistance in the study of sphygmography we are under obligations
to Dr. Roger S. Tracy. A few samples of the observations are repre-
sented in the cuts.

"No. 1.—Normal pulse.

Pe a

No. 2—After five minutes’ galvanization of the sympathetic.

     
138 ELECTRO-PHYSIOLOGY.

ta:

No. 3.—After ten minutes’ galvanization of the sympathetic,

 

No. 5.—After five minutes’ faradization of sympathetic
Sef SS ce =~

No. 6.—After nine minutes’ faradization of sympathetic.

 

No. 7.—After twenty minutes’ faradization of sympathetic

No. 8.—After fifteen minutes’ general faradization,

No. 9.—Five minutes after close of séance of general faradization.

From these experiments we derive the following conclusions :

1. Both currents—faradic and galvanic—when applied in such a
way as to traverse the region of the neck in which the pneumogastric
and cervical ganglia of the sympathetic are situated, markedly affect
the pulse.

2. The effect is chiefly shown in abruptness of the systole, and in
abruptness of the diastole, and in shortening of the interval between
the cardiac impulse and the arterial impulse. In general it may be
said that the force of the pulse is increased. Its rapidity may be
either increased or diminished, according to the length of the appli-
cation and the strength of the current, and analogy would lead us
EXPERIMENTS WITH THE SPHYGMOGRAPH. 139

to believe that the effect must widely vary with the individual. The
arterial impulse increased probably from the effect on the vaso-motor
nerves.

3. The effect of general faradization was to prolong the systole and
the interval between the cardiac and the arterial impulse. The ab-
ruptness, and the systole that is so marked during and after faradi-
zation through the neck, was not observed after general faradization.
A calming, soporific influence is very frequently produced by general
faradization, and the effect on the pulse harmonizes with this obser-
vation.

4. These effects on the pulse gradually pass away, but are distinctly
traceable for a number of minutes after the electrodes are removed.

The effect of the current thus applied on the circulation is pro-
bably a complex resultant of the effect of the electricity on the
pnheumogastric, the sympathetic, the depressor and the spinal cord.
To differentiate these effects is manifestly impossible.
CHAPTER VI.
ACTION OF ELECTRICITY ON THE NERVES OF SPECIAL SENSE.

Action of the Galvanic Current on the Optic Nerve.—The galvanic
current, when applied to the eye, causes both flashes of light and per-
ception of color.

If one electrode is placed on the tongue, or on any part of the
mucous surface of the mouth or nose, and the other on any part of
the surface of the body, the flash is readily perceived.

The character of these flashes is variously modified by the strength
of the current and the suddenness of the interruption. The tempera-
ment of the patient also modifies the reaction, and the effect of the two
poles is usually quite different.

We have studied this subject with various strengths of current, and on
subjects of both sexes differing widely in age and temperament.

In one subject—a young man of nervous temperament—the positive
pole placed over the eye, with a medium ‘current from ten zinc-carbon
cells, caused a white central spot, with a light areola. ‘The white
central spot varied in shape between that of a quarter or half toa full
moon. When the negative pole was placed over the eye, the central
spot appeared of a bluish or purplish color, and the areola was the same
as under the positive pole. In both cases the areola seemed to consist
of waves of light radiating from the centre toward the periphery.

In making these experiments, the pole that is placed over the eye is
armed with a soft sponge, and is pressed firmly on the closed lid, while
the other is applied at the back of the neck, or is held in the hand of
the subject.

In another subject, a young physician of good health, and nervo-
sanguine temperament, the positive pole from a current of six cells caused
a central disk of a pink color, and from this spot violet waves radiated
through the areola. The pink disk appeared when the current was
closed, the violet areola flashed out when the current was broken. The
negative pole produced reactions every way similar. This subject
could not bear very strong currents,
EXPERIMENTS ON THE EYE. 141

Several other physicians on whom we experimented could not dis-
tinguish any central disk, but all could readily see the light areola.

The conclusions from the above, and numerous similar experiments
made in different individuals, are as follows :

1. A mild as well as a strong galvanic current applied to the eye, and
interrupted, causes a flash or glimmer of light to appear.

2. A medium or strong galvanic current causes, in addition to the
flash of light, a distinct central spot of varying shape, and both the
central spot and the areola may be of various colors, as pink, purple,
yellowish, and violet.

3. With some individuals, though not with all, the colors of the central
spot and of the areola, and their relative arrangement, appear dif-
ferently under the two poles, and also differently at the closing and
opening of the circuit.

4. All those reactions, like all other electro-physiological reactions,
are variously modified by the temperament of the individual operated on
and by the strength of the current.

The above conclusions, as will be seen, differ somewhat from those
of Helmholtz and others who have studied this subject. The differ-
ential action of the ascending and descending currents we have not
been able to demonstrate, and see no way of demonstrating. We be-
lieve that here, as in so many other electro-physiological and electro-
therapeutical procedures, the differential polar action has been con-
founded with the differential action of the ascending and descending
currents. :

Although the above reactions in their full degree can be most con-
veniently obtained by placing one electrode over the closed eye, and
the other in the hand or at the back of the neck, yet the general re-
action of the glimmering flash of light can be obtained by placing one
electrode in the vicinity of the eye, or on any part of the face or beard,
or in the mouth. In susceptible persons the flash comes from inter-
rupted galvanization of the neck or spine.

Faradic Current.—The current from the primary or secondary coil
of the ordinary faradic machines has little or no perceptible effect on
the retina, as we have demonstrated by various experiments. We
have found, however, by repeated observations, that the current from
the Jong coils of the electro-magnetic machine manufactured by Kidder
has a most decided action on the retina. The peculiar construction of
the coil of this machine will be described in the chapter devoted to
apparatus for electro-therapeutics. It is sufficient here to say that it is
composed of three or four or more coils of insulated copper-wire, the
142 ELECTRO-PHYSIOLOGY.

inward coil being short and thick, and the others gradually increasing
in the length of the wires. These coils are not separate’and distinct, as
in ordinary machines, but connected, and are, so to speak, sapped at the
points of union, so as to obtain a number of currents varying in
quantity, tension, and physiological power. It is from the fourth and
fifth coils, which are not furnished to the majority of his smaller machines,
that we obtain the reaction of the retina that we are now to describe.
‘The reaction is best obtained by placing a medium-sized sponge:
electrode, well moistened, over the closed eye, or very near to the eye,
while the other electrode is held in the hand or applied to some
indifferent point, as the back of the neck, or arms, or feet. With a
current of moderate strength thus applied, a circle filled with wavy,
undulating light, or whitish spots or figures, appears. It is difficult to
convey in language a precise description of this appearance. If snow-
flakes could be elongated somewhat, and made to coil about in various
directions, they would give a good idea of this reaction. If we look
through a window at a thick, driving snow-storm, with large flakes, we
can get a not very incorrect notion of the reacticn, as we have over
and over again demonstrated on ourselves and others. So far as we
have been able to see, bright or variegated colors do not appear, except
from the current of the 7th coil. The negative pole gives a stronger
reaction than the positive; but not appreciably different in character.
This reaction of the fourth coil of this machine is utterly unlike that
which is obtained from either pole of the galvanic current. This effect
has long been shown by the inventor of this machine, and has been
illustrated by him. We were induced to question his assertions until
we had first made experiments of our own with the different coils of
the machine.

The Effect of Electrical Irritation compared with Mechanical Irrita-
tion of the Eye.—It is interesting to compare the reaction produced
by the galvanic and faradic currents on the retina to the effects of
mechanical irritation. We have found by experiment on ourselves
that rubbing the eyes when closed, or partially closed, causes various
and oftentimes beautiful appearances. Very frequently a central spot.
will appear, varying in shape and color, and changing in shape and
color during the irritation. All conceivable shapes, and every grade
of color, we have seen in this way over and over repeated ; sometimes
a mere circle of light shading off into darkness, and again a definite and
well-formed object, brilliant in color, standing forth clear and beautiful
against the dark background. Forms resembling a bouquet of flowers,
or a cluster of stars, or various shapes of crystals, appear with such
AUDITORY NERVE. 143

vividness that we love to prolong the experiment. Simple pressure on
the side of the eyeball will cause reactions somewhat similar in kind
(though less in degree) to those produced by the faradic current.

These reactions, however, are not constant; they vary greatly with
the individual, and with the same individual at different times. In
order to obtain the most beautiful appearances, it is necessary to first
look for a moment on bright light, or to have the eyes open in the full
sunlight. It would seem that the retina must first become sensitive,
by exposure to strong light, before the reactions can appear in their full
extent.

Action of Electricity on the Auditory Nerve ; Action of the Faradic
Current.—The faradic current, when applied to the ear, or in the
vicinity of the ear, causes a ringing, or humming, or rumbling sourd,
according to the method of application and the strength of the current.
These sounds are due, in part, to the susurri of the muscles.

Action of the Galvanic Current.—To the galvanic current the audi-
tory reacts by certain fixed laws.

This normal formula is as follows :

Ka § KI, distinct accented sound.

Ka D KI >, sound disappearing by degrees.

Ka O —, no sensation of sound.
An S os 73 £6
An D— “6 77

7 >

An O KI, weak and short sound, similar in character to Ka S.

In the above formula, Ka = Kathode (negative pole), An = Anode
(positive pole), S = closing (schliesung), O = opening (oeffnung), D
= duration of current.

Pf = whistling sound.

Kl =ringing “

Z = hissing ae

The sensations with Ka S appear sooner and stronger than with
An O.

This formula, it will be observed, harmonizes with the law of elec-

_trotonos (see p. 111), and Pfliiger’s contraction law—that “a nerve is
stimulated by the appearance of catelectrotonos and the disappearance of
anelectrotonos ; not, however, by the disappearance of catelectrotonos and
the appearance of anelectrotonos. (See p. 116).

Although the character of sounds varies with the strength and contin-
uance of the current and with the individual, yet in the healthy ear the
polar effects never vary.
144 — ELECTRO-PHYSIOLOGY.

There is never any sensation of sound with the closing of the anode
(An S), except in pathological conditions.

The polar effect is therefore the leading effect, and the direction of
the current through the auditory nerve appears to have no demonstra-
ble influence.

The use of the rheostat and the changes in the reactions that are
made by interposing the various grades of resistances in the circuit are
represented in the following experiments of Brenner : *

The experiment was performed on a healthy ear that had been cured
a short time before of a catarrh of the middle ear. The number of
elements is in Roman, the number of resistances in Arabic.

 

 

XX 10-80 gave no reaction. XX 260-400 Ka S—Rumbling of
XX go-120 Ka S—Buzzing of flies cannon.
very short. Ka D—Same >
Ka D —— Ka O ——
Ka O —— Ans
Ans —— An D
An D —— An O—Rumbling of
An O wagons.

XX 130-170 Ka S—Stronger buzz XX 410-550 Ka S—Striking of me-

ing. tallic plate.
Ka D—Same. Ka D—Same >
Ka O —— Ka O ——
Ans — Ans —
An D —. An D ——
An O —— An O—Rumbling.

XX 180-250 Ka S—Distant rum-

XX 560- Ka S—Sharp ring like

bling of wag- a silver table
ons. bell.

Ka D—Same. Ka D—Same >

Ka O —— Ka 0 ——

Ans —— AnS ——

An D — An D —

An O—Buzzing of

flies.

* Op. cit., Bandi., p. 105.

An O-——-Weaker and
shorter ring-
ing.

Erb + gives the following result of experiments on himself:

+ Archiv Ophthalmology und Otolog. Vol. i., No, 1, p. 246. ,
»

BRENNER’S RESEARCHES. 145

to El Ka S K] —~
Ka D KI >
Ka O ——
AnS ——
An D
An O Kl

8 and 6 El KaS Kl

Ka D ——.-
Ka O ——-
An S —
An D ——
An O ae

On another patient,* 50 years of age, he obtained the following 1e-
‘action with accompanying symptoms of pain and facial contortions :

8 El Ka S—Clear whistling, stinging pain and facial contortions.

Ka D—Gradually disappeared.

Ka O—No sensation.
An S—Violent pain.
An D—Pain remains.

An O—Short and weak whistling; slight facial convulsions with
1o E]; the same formula gave still louder sensations
of sound, but the accompanying pain was very severe.

Brenner + gives the following reaction in a healthy man :

Ka 5—Rumbling of cannon.

Ka D— ‘“ ‘
Ka O ——
AS —
AD
AO—Rumbling of wagons.

 

Same patient treated by a stronger current.

Ka S—Sharp ringing.

KaD— “ 6c

Ka O ——

AS —

AD [ing.

 

AO--Weaker and shorter ring-

The variations of the tone with the difference of the current are rep-
resented in the following experiment of Brenner : }

With the Cathode closing.

XX 10 KaS K.
20 KaS K.
30 KaSK.
4o KaS K’.
so KaS K’.
60 KaS K’.
yo Ka S K”.
80 Ka S K”.

With Anode opening. (An O.)
XX 30AO0 K.
40A0OK,
5s0AOK,
6oA OK.
Fo AO K.,
80 AO K’
go AO K’.
100 A K’,

These Reactions produced directly and not by Reflex Action.—We

* Loc. cit., p. 250,
10

+ Op. cit., Band i., p. 106.

$ Loc. cit.,. p, 110,
146 ELECTRO-PHYSIOLOGY.

thoroughly agree with Brenner and Erb that these reactions of the audi-
tory nerve are obtained by the direct action of the current on the nerve,
and not by refex action through the trigeminus. This view is proved
by the general fact of the conductibility of the tissues of the brain (see
chapter on that subject), by the fact that even when the trigeminus is
paralyzed the reaction may yet occur,* and by the fact that when the
, electrode is placed in a condition favorable for the entrance of the
“current into the ear, the reaction is more decided than when the elec-
trode is placed in a condition favorable for the excitement of the trige-
minus, but unfavorable for the direct entrance of the current, as has
been conclusively shown by Erb} and by ourselves.[ We have removed
the pole from the ¢ragus to the malar bone and the cheek, both of which
points are highly favorable for the excitation of the trigeminus, and
have found that with removal the reaction diminished or disappeared.

In order to obtain that normal formula, the following conditions are
necessary :—

1. Convenient galvanic apparatus.

A very powerful galvanic battery is not needed. The range of éle-
ments to which the auditory nerve sensibly reacts is between 2 to 30. In
some cases quite strong currents are necessary. The galvanic batteries
and electrodes described in this work are: adapted for these investiga-
tions. There should bea current reverser ; and a rheostat, though not
exactly indispensable, is yet very convenient.

2. A right method of application, and practice in using it.

On the whole, the best method of application to produce these reac-
tions is the external arrangement, in which one pole is firmly pressed
on the tragus (the ear external auditory canal having been previously
filled with warm salt water), while the other is held in or fastened on
the hand on the opposite side. Any convenient electrodes may be
used for these purposes. So long as the pole whose specific effect we
desire to produce is on the right place in the ear or on the tragus, the
position of the other electrode is not absolutely essential, provided it
is somewhere on the opposite side, so as to allow the current to pass
through the auditory nerve. It is difficult or impossible to get the
reaction while the pole is on the mastoid process of the same side. It

* Vide Moos’ case, above quoted in Archiv Ophth, und Otol., vol. i, No. 2, p.
482.

¢ Archiv Ophth. und Otol., vol. i, No. 1., p. 261 et seq.

} For a detailed discussion of this subject, see Brenner’s work, Band i., 1 Abth.,

P. 94, et seq. ;
ACTION ON AUDITORY NERVE. 147

has been shown that when both poles are placed in the auditory canal,
‘by means of a double electrode, the auditory nerve reacts to the nearer
pole. :

A number of intelligent and practised patients with both healthy ana
diseased ears.

The advantages of intelligence on the part of a patient are obvious ;
just as in investigating electro-muscular sensibility, it is necessary to
depend entirely on the statements of the patient for our information.
Even the strong-minded and intelligent are sometimes so distressed by
the pain produced by the applications, or so distracted by the sensa-
tions of dizziness, and the contractions of the facial muscles, that they
are unable to rightly interpret their subjective sensations in the ear.
It is necessary that the experiments should be made on a number of
patients, in order to obtain the variety of reactions above described.

It is best also to make the first experiment on patients who have
diseased ears, for it is as true of the auditory as of the nasal passages
that they sometimes become less sensitive when diseased. This is to
be explained partly by the manipulations and treatment to which such
patients become accustomed, and partly by the fact that the morbid
process itself produces callousness of the parts.

The operator should proceed calmly and with self-command. After
the patient is in position, with his head inclined on the back of the
chair or lounge, and one of the electrodes fastened to or held in the
hand opposite the ear to be experimented on, a little warm salt water
should be dropped in (which can be very conveniently done by squeez-
ing the small quantity necessary to fill the external auditory canal from
a small sponge or from a teaspoon or funnel-shaped glass *) and the
other electrode firmly pressed on the tragus. It is well to begin with
a small number of elements, and gradually increase until a reaction is
obtained. The reaction will usually appear when the current is strong
enough to produce contractions of the facial muscles. The patient
should all the time be continually and repeatedly questioned in regard
to the sensations experienced, especially if he is unaccustomed to the.
treatment, for at first he may be so distracted dy the flashes of light
before the eyes, the contractions of the facial muscles, the nausea, the
metallic taste, and the noise of the water in the ear, and especially by
the pain, that he may be unable at first to distinguish the true character
of the reaction.

* It is well to place a towel about the neck, just as when syringing the ear, so
as to avoid wetting the collar or other clothing of the patient.
148 ELECTRO-PHYSIOLOGY.

If the battery is provided with a commutator, for increasing and
diminishing the number of elements brought into requisition, a current
reverser tor changing the direction of the current without removing the
poles, and a rheostat for introducing resistances into the circuit, the
labor of the operator will be materially lightened ; dut such appliances .
are not indispensable,

+ The operator should remember that the reactions are modified by the
experiment itself. (@.) Ka.S is most effectual after An.S. Therefore
the use of voltaic alternatives is of service.

(4.) The excitability of the nerve is increased by long closure of cath-
ode (Ka.S.).

(c.) The excitement of An.O. increases with the strength of the cur-
rent and the length of closure. .

It should be remembered also that Ka.S. is stronger and quicker
than An.O. a

Judging from our own researches in this department these three lead-
ing statements of Brenner—that the auditory nerve reacts to the wearest
electrode in a regular manner, that in health sounds of some kind are
produced at the closing and in the duration of the cathode, and that in
pathological cases a part of the normal formula is more or less changed
—are capable of sufficient and easy demonstration to those who are
thoroughly familiar with electro-therapeutical experimentation.

On the other hand, some of the special features of Brenner's system
offer difficulties in the way of their successful and uniform demonstra-
tion that can only be overcome by careful practice in this special de-
partment. . To catch the sounds which in health are heard at the open- ,
ing of the anode ; to distinguish between the noise caused by the agita-
tion of the water in the ear, and the subjective sounds that are so fre-
quently the symptoms of disease of the auditory apparatus and the genu-
ine reaction of the auditory nerve; to obtain the complete normal
formula in health, and to satisfactorily discriminate between the various
abnormal reactions of disease—the first attempt to fully corroborate all

‘the assertions in these particulars will usually result in complete or par-
tial failure, especially to those who are unfamiliar with the use of gal-
vanic apparatus.

Degrees of SIrritability.—Brenner distinguishes three different de-
grees of irritability of the auditory nerve, according to the number of
elements that it takes to excite the reaction. The degrees of irritability
may be changed during the sitting by the effect of the current on the
nerve, and especially by the voltaic alternatives.

Thus, if at the beginning of the sitting the nerve reacted to 16 ele-
OBJECTIONS ANSWERED. "149

ments, but to no number less than that, these 16 elements would repre
sent the primary irritability of that nerve.

If by various alternations of the current the nerve is brought into a
condition that it reacts to 12 elements, these 12 elements represent-the
secondary irritability of that nerve.

If, by still further excitation, the nerve is made to react to ro ele-
ments, these 10 elements represent the ¢ertiary excitability of that nerve.

In opposition to the above conclusions Dr. Wreden, of' St. Peters-
burg, has made a number of experiments which seem to him to establish
that the sounds heard during galvanization of the ear are due not to
the reaction of the auditory nerve, but to the contraction of the small
muscles of the middle ear. In his experiments he electrized the Eusta-
chian tube, through the catheter, and also the middle ear, by means of
small, delicate, and finely graduated sounds insulated to their points.
He believes that by this method he causes contraction of the ¢ensor
tympani and of the stapedius, through irritation of the fifth and seventh
nerves.*

Wreden asserts that during electrization by these methods the mem-
brana tympani is retracted, and believes that this retraction is caused
by the contraction of the muscles. This, however, has been denied by
. Poorten. To settle this question, Léwenberg devised a manometer,
which consists in a bit of cork or rubber fitted into the external meatus
hermetically, and receiving hermetically a capillary glass tube which
contains a drop of colored liquid. The external meatus is filled with
water, which is connected with one of the poles of a faradic machine,
while the other is applied to the skin by a sponge or through the Eusta-
chian tube. When the membrana tympani is retracted by the action
of the current, the drop of colored water indicates this retraction by
falling, when it is pushed outward, by rising.

Admitting to the full all that has been claimed by Wreden and Low-
enberg, we do not see that it proves that the supposed complex reac-
tions of the auditory nerve to electricity are nothing more than muscu-
lar contractions. Admitting that in some cases where the membrana
tympani is gone, the reactions are not obtained, still the following con-
siderations are, to our mind, convincing :

1. The reactions of the galvanic current, when applied to the ear, are
frequently similar to some of the sounds of tinnitus aurium. They are
sometimes so much alike that they cannot be distinguished.

* A résumé of this subject is presented in Dr. Roosa’s work on Diseases of the
Ear, pp. 493-495-
150 ELECTRO-PHYSIOLOGY.

2 The differential polar effects of the galvanic current on the ear,
wnich are very easy of demonstration, cannot be explained by any
theory of muscular contraction.

3: Some of the reactions are produced by the steady action of the
galvanic current, without any interruption, and with a strength not suffi-
cient to produce muscular contraction; while it is true that certain

.Teactions in some cases require strong and interrupted currents, it is not
true of all of them. .

4. A reaction of the auditory nerve similar to some forms of tinnitus
can be obtained in some sensitive cases, not only by galvanization of
the ear, but of the other parts of the head, and even the trunk.

We have had a patient who complained every. time we galvanized
the spine that buzzing, hissing sounds were excited in his ear. Simi-
lar sounds are produced by galvanization of the ear. The effect in
this case was probably reflex.

All these considerations convince us that the variety of sounds pro-
duced by galvanization of the. ear is due to the excitation of the au-
ditory nerve, and that this excitation may be both direct and reflex.
We are fully aware, however, that for the present this fact has a greater
interest for the electro-physiologist than for the electro-therapeutist.

Olfactory Nerve.—We have observed in frequent experimenting on .
ourselves that the negative pole of a strong galvanic current applied to
the Schneiderian membrane caused, in certain sensitive localities, an odor
muchresembling sulphurettedhydrogen. The odor observed in the neigh-
borhood of docks will perhaps suggest the peculiar character of this re-
action more than any formal description. This reaction is obtained only
when a powerful current is used. It is obtained at the opening of the
circuit, while the circuit is closed and for some little time after the circuit
is opened. We have found that this peculiar reaction varies much with
the individual, and with the same individual at different times. A sen-
sitive, or even an ulcerated condition of the mucous membrane would
seem to form it. Although we are frequently treating cases of rhinitis
(nasal catarrh) by internal galvanization with metallic electrodes, yet our
patients never speak of this peculiar odor. The mucous membrane
of the nasal passages is very sensitive, and in: ordinary therapeutical
applications only gentle currents will be borne, whereas this reaction of
the olfactory nerves demands powerful and painful currents.

The differential reaction of the positive and the negative pole of the
ascending and descending currents that were long ago claimed by Rit-
ter, we have not been able toconfirm. ‘Ihe phenomenon of sneezing, or

3 disposition to sneeze, of which Ritter spoke, is due, not to any reac-
ACTION ON THE GUSTATORY NERVE, ISI

tion of the olfactory nerve, but to the mechanical irritation of the sen-
sory nerves by the electrode. Sneezing, as all aurists know, is called
forth by a single introduction of the Eustachian catheter, and we observe
it continually in introducing the nasal electrode. It is observed most,
however, just as the electrode is being inserted ; and when the current is
running, the symptom does not usually annoy us. The action of a gentle
current on the sensory nerves of the nasal passages seems rather to have
a sedative effect, and in a measure counteracts the tendency to sneeze
that is excited by the mechanical irritation of the electrode.

Schénbein suggests that the peculiar smell experienced from the pas-
sage of the electric current through the olfactory nerve is caused by
ozone that is generated.

This peculiar odor, observed in powerful galvanization of the nasal
passage, is unquestionably due to the reaction of the nerve to the elec-
trical stimulus, and corresponds to the effects produced by the same
agent on the nerves of seeing, hearing, and tasting.

Franklinic electricity, electro-magnetism, magneto-electricity, are
unable, in any-strength that can be endured by a person in health, to
excite the peculiar reaction of the olfactory nerve. ‘

Action of Electricity on the Gustatory Nerve—Action of the Galvanic
Current.—In 1754, long before the discovery of galvanism, it was
noticed by M. Sulzer that lead and silver, when connected and then
brought in contact with the tongue, gave rise to a peculiar taste similar
to that produced by vitriol of iron. If we apply a piece of zinc to the
upper, and one of silver to the lower part of the tongue, a powerful acid
taste will be experienced under the zinc plate, and a slight alkaline
taste under the silver plate. These sensations are perceived as long
as the circuit is closed; but if the plate or the tongue be warmer or
colder than natural, or very much benumbed by acids or other irritating
substances, very little, if any, sensation is produced. If the tension of
the current be much increased, by using several pairs, the tongue be-
comes convulsed and a flash of light is perceived. When neither of the
electrodes touches the tongue, a metallic instead ‘of an acid or alkaline
taste is produced. .

The peculiar reaction of the gustatory nerve to the current is gen-
erally described by those on whom we have experimented as “ cop-
pery,” or “sour,” or ‘‘metallic,” or “ bitter.” Sour or coppery are, we
believe, the designations most frequently employed by those persons
who experience the sensation for the first time, and who have no
theories in the matter to prove or disprove, and who therefore are
likely to give their real impressions. If we ask them whether they have

x
152 ELECTRO-PHYSIOLOGY.

a taste in the mouth while the current is passing, they usually reply that
the taste is sour or ‘‘ coppery,” and sometimes they may call it “ bitter.”
If we ask them whether the taste is ‘‘ metallic,” they usually reply in the
affirmative. Our observations on this subject have been very numer-
ous, and they have been made with both currents. It is not necessary
to send the galvanic current through the tongue or through the chorda
tympani nerve, or through the face even; for galvanization of the neck

“in the anterior and posterior regions, and of the head in almost any
direction, and of the spine—the lower as well as the upper region—will
be felt in the gustatory nerve.

This metallic taste is felt almost as soon as the galvanic current is
closed, grows stronger while the current runs up to a certain point, and is
sometimes felt for several minutes after the electrodes are removed.
In some temperaments on which we have experimented, the metallic
taste remains on the tongue for several hours, and even all day, and
longer. :

In susceptible temperaments the faradic current produces in a less
degree this metallic, taste, and that, too, not only when applied to the
tongue, but also the head, neck, and spine. In the operations of cen-
tral galvanization this reaction of the gustatory nerve becomes of con-
siderable value in showing us that the current is passing as we wish it,
and that the patient is receiving all that is well for him. The gustatory
reaction thus answers the purpose of a galvanometer, showing that. the
current is passing, and to a certain degree regulating the dose.

There is little doubt that this metallic taste, caused by electrization,
1s due to a peculiar excitation of the properties of the gustatory nerves |
by. the stimulus of the current.

The theory that it might be of an electrolytic character, and therefore
explained by the products of decomposition at the poles—acid at the
positive, and alkalies at the negative—Rosenthal, by a variety of ex-
periments, has shown to be untenable.
CHAPTER VIJ.

ACTION OF ELECTRICITY ON MOTOR AND SENSORY NERVES AND
VOLUNTARY MUSCLES.

Irritability of nerves and muscles is that property by virtue of which
they conduct the natural stimulus of the body, or external apr eNO,
or respond to artificial stimulation.

Nerves and muscles are called irritable so long as they retain this
property. Irritability of the nerves is a property inherent in them.
No other tissue except nerve tissue possesses this property.

During life nerves and muscles manifest their irritability by fulfilling
all the natural functions that belong to them; it is this property that
_ enables them to conduct that mysterious vital agent, which, in lieu of
definite knowledge, we are obliged to call nerve force. This nerve
force, which is peculiar to living beings, may possibly be correlative to
the other forces of nature —light, heat, electricity, magnetism, and
gravitation—but the theory that it is identical with electricity is, as will be
seen, untenable.

Lrritability, how long Retained after Death.—The irritability of nerves
and muscles. begins to diminish after death, and sooner or later disap-
pears. It disappears much sooner in cold-blooded than in warm-
blooded animals.

In warm-blooded animals, as the rabbit and the dog, the muscular
current may disappear in half or three-quarters of an hour. In the
limb of a frog that has been properly protected and under a cool tem-
perature, it may remain for two, three, or even four weeks. It is on
account of this persistence of irritability in frogs that they are so fre-
quently chosen in electro-physiological experiments. Irritability also
varies with the temperature. It lasts longer in cold than in warm
weather, and under extreme heat it remains but a short time.

The local application of poisons and powerful chemical substances,
as extract of opium, acetates of strychnine, morphine, creasote, nitrate
of silver, mineral acids, rapidly destroys the irritability.

How Muscular Contractions are Produced.—There are, then, two
154 ELECTRO-PHYSIOLOGY. ;

ways by which the muscles can be made to contract under electricity :
(x) by acting on the motor nerves, and (2) by acting on the muscles
themselves. There is, however, this interesting and important differ-
ence in the effect of electrizing the motor nerves and the muscles, that
when the fornier are electrized all the muscles supplied by them con-
tract, and when the muscles are electrized, only that muscle to which
the electrodes are applied, or that part of the muscle between the
“electrodes, will contract. When direct applications to the muscle are
made, the best contractions are produced by putting one electrode at
each end. The muscular contractions produced by directly fara-
dizing the muscle are due to the excitation of the muscle, and also of
the intra-muscular nerve-fibres. The most powerful muscular contrac-
tions are produced by placing one electrode on the muscle, and the
other at the point where the motor nerve that supplies it is most super-
‘ficial.

Differential Action of Positive and Negative Pole in Producing Con-
tractions.—Not only is there a difference in the degree in the opening
and closing contractions of the faradic current, but there is also a dif-
ference in the action of the poles in producing contractions. When the
interruptions are rapid, as in the majority of machines, the muscle does
not have time to go through all the process of lengthening and shorten-
ing with each movement of the current to and fro, and consequently
it is kept in the state of tonic contraction above described. If, now,
one pole be placed on some indifferent point, while the other pole
is placed over the nerve to be acted on, it will be found that the zega-
tive pole produces stronger contractions than the positive.

This experiment is easily made, and it is not difficult to demonstrate on
one’s self that this stronger action of the negative pole in producing mus-
cular contraction is entirely independent of the direction of the current
—is, in short, a polar effect. We have already seen that on sensory
nerves the negative pole is more powerfully felt than the positive.

Stmple Fluctuation in Strength of Current sufficient to Produce Con-
traction.—In order to produce muscular contractions, it is not necessary
that the current should be opened or closed. A moderate variation in the
strength of the current—such as is obtained by adding one or more
cells, or by uniting another and independent current in the circuit, or
by taking off some portion of the current from the circuit—will cause
muscular contractions. The contractions produced in this way are,
however, less vigorous than those produced in closing and opening the
circuit. It is to be observed, also, that the vigor of the contractions is
proportioned to the suddenness of the closing or opening the circuit.
MOTOR AND SENSORY NERVES, ETC. 155

This point is frequently forced upon our observation in the treatment of
paralysis. If the electrodes are armed with large sponges, and are
slowly applied over the muscle, with gradually increasing pressure,
scarcely any contraction, or at least only a feeble one, is produced ;
but if the interruption be made in the metallic part of the circuit—in
the electrode by an interrupter, or in the battery—the contraction with
the same current will be very energetic.

By referring to Electro-Physics (p. 63), it will be seen that the law of
muscular contraction under electrization follows the laws of current-
induction. Both contraction and induction occur when a change is
made in the strength of the current by closing, opening, increasing,
or diminishing.

Muscular Contractions more Vigorous when a great length of the
Nerve is Galvanized.—The muscular contraction caused by galvaniza-
tion is greater when a large than when a small extent of the nerve is
included between the electrodes. It is not a difficult matter to demon-
strate this fact.. The experiment can be made on nerves of rabbits,
dogs, frogs, or other animals.

Nerves of Living Man.—Our previous remarks have been applied to
the reaction of the nerves of animals in a condition not purely physio-
logical. When the ga/vanic current is applied to a living and healthy
motor nerve in a healthy man, contraction takes place only on closing
the circuit. This fact is constant with either pole and any direction of
the current. The negative pole applied to the nerve produces stronger
contraction than the positive. At the opening of the current there is no
contraction. When the nerve is separated from the body, or injured, or
fatigued in any way, the phenomena already described appear. The
first symptom of fatigue is contraction both at the opening and closing
of the current. When the nerve becomes more exhausted the contrac-
tions are produced on closing and opening the inverse current; and
when the exhaustion is still greater, contraction is obtained only on
making the direct current.

Action of the Faradic Current.—The faradic current, when rapidly
interrupted, as in most of the faradic machines, and applied to the
motor nerves, keeps up a tonic contraction of the muscle supplied by
these. This contraction is maintained so long as the current runs.

If a contrivance for making s/ow inductions be connected with the
faradic machine, then the contraction ‘of the muscles corresponds to
the opening and closing of the current, and the opening contraction is
stronger than the closing.

When the current of the secondary wire is closed by placing the
156 ELECTRO-PHYSIOLOGY.

electrodes on the skin, the current of the primary cqil (extra-current)
exercises a retarding influence on the secondary current, and then the
closing contraction is rendered more gradual and gentle from nothing
to the maximum.

When the current of the secondary coil is opened, the current of the
primary coil (extra-current) does not exist (see Electro-Physics, p. 64),
, and consequently the current of the secondary coil is not retarded and
goes rapidly from its maximum to nothing.

Differential Action of Primary and Secondary Coils.—Duchenne has
stated with a measure of truth that the current of the primary. coil (ex-
tra-current) of his apparatus has a more powerful effect on the sensi-
bility and contractility of the organs beneath the skin, while the current
of the secondary coil acts more powerfully on the retina and on the
skin. The primary coil is composed of thick, short wire.

The secondary coil is composed of long and thin wire with many
windings.

The differential action of the primary and secondary currents on the
skin, muscles, and optic nerve is due to these two causes :

1. The primary current, circulating through a short thick wire, has
less tension than the secondary current that circulates through a long
thin wire, because tension is developed only in the presence of resist-
ance. Since, now, the skin offers greater resistance than the muscles,
the secondary current, by virtue of its greater tension, is able to pene-
trate it, and also to penetrate the brain and affect the optic nerve.
But the primary current, having less tension, passes through the skin,
circulating in it but slightly, and goes to the muscles beneath, which are
good conductors, and on these it spends its force. In other words, a
current of low tension selects the best conductors, avoiding the poor
conductors so far as is possible, while the current of high tension
traverses also poor conductors.

2. The primary current moves in one direction, and has a mild elec-
trolytic power, while the secondary current moves to and fro so rapidly
that it cannot perform electrolysis.

Action of the Galvanic Current.—The interrupted galvanic current
of moderate strength, if applied to a motor nerve, causes all the mus-
cles supplied by that nerve to contract.

If the current be interrupted slowly, the contractions will be clonic, if
rapidly interrupted, the contractions will be sonic. The violent contrac-
tions that occur at the moment of closing and opening the circuit of
an intense current. may be avoided if we begin with an extremely mild
current and slowly and gradually increase its tension. By this method
. VOLUNTARY MUSCLES. 157

Ritter was enabled to pass through his own person, without experienc-
ing either the closing or opening shock, the enormous current gener-
ated from a battery of two hundred elements.

Galvano-tonic Contractions—When very powerful currents are
applied continuously to the nerves, tonic contractions are produced dur-
ing the whole time that the circuit is closed. Contractions thus pro-
duced were called by Remak galvano-tonic contractions. They are
called galvano-toni¢ contractions to distinguish them from the clonic
contractions produced by the faradic current. When the galvanic cur-
rent is applied continuously to the surface of the body, by means of
moist sponges, the galvano-tonic contractions increase in vigor, up to
a certain point, the longer the electrddes are kept in position. This
phenomenon is explained mainly by the fact that the skin becomes more
moist as well as hypersemic (p.121) by the effect of the current, and
thus becomes a better conductor for the electricity. With the faradic
current this increase of effect is not so observable. The current
required to produce galvano-tonic contractions is quite powerful and
painful. The strength of current required will depend on the position
of the nerve acted on, the length of nerve included between the elec-
trodes, and the individual experimented on.

Tonic Contractions in Antagonistic Muscles.—Remak states that when
galvanic currents of great power are used, certain nervous /onic con-
tractions appear in antagonistic muscles. ‘Thus, for example, when
the median nerve is subjected to the continuous action of a powerful
galvanic current, contractions appear in the common extension of the
same arm, so that the fingers are raised. It is probable that this phe-
nomenon is due to reflex action.

Lifect of the Will in opposing and aiding Contractions produced by
Electricity—The contractions produced by electricity can be materially
aided or opposed by effort of the will of the person operated on. Ifa
person whose muscles are being electrized concentrate his mind on the
muscle that is subjected to the influence of the current, and simultane-
ously with the closing of the circuit, wills to contract the muscle, the
contraction will be more vigorous and complete than when the elec-
tricity is not so aided. The will co-operates with the electricity, and the
two agents reinforce each other, and thus accomplish more than would
be possible for either alone. This can be very conveniently demon-
strated on the communis extensor of the forearm. In electro-therapeu-
tics this co-operation of the force of will and electricity becomes of
great practical value. It has long been known that paralytic patients
of all kinds, even those of a cerebral chronic incurable character, can be
158 ELECTRO-PHYSIOLOGY.

greatly benefited by slightly concentrating the mind on the parts to be
moved, as the fingers or toes, and resolutely willing to move them.

In practice it has been found that such treatment is of positive and
permanent service.

The combination of the force of will with electricity is very much
more efficacious than either when used alone. When a muscle becomes

_so diseased that the will is powerless to remove it, the electricity
may contract it with ease. Where electricity alone causes feeble or
imperfect contraction, electricity, co-operating with the will, may make
the contraction vigorous and complete. In order to make experiments
of this kind fully successful, it is necessary that the will and force should
be concentrated simultaneously with the closing of the circuit; and
yet experience shows that the effect of the electrization, if not too
long continued, isto give tone of the muscle, so that it responds more
readily to the will for several minutes, or even hours, after being sub-
jected to the electrization. This is especially observed in muscles that
are in a condition of paresis.. In all these experiments much depends
on the organic energy and grit of the patient. Cozversely, it is found
that by an effort of wil the contraction of muscles induced by electri-
city can be within a certain limit, successfully opposed. The experi-
ment can be made on the communis extensor of the forearm without
difficulty. A feeble current will cause this muscle to contract so as to
bring up the hand and fingers; by an effort of the will this can be
resisted so that the hand remains on a level, or nearly so. When very
strong currents are used the will is completely overborne, and has no
effect whatever.

Lxtent of Shortening of Muscle during a Contraction.—In the process
of contraction muscles shorten in proportion to their length. The
greatest possible shortening is obtained during tetanic or continuous
contraction, and not during a momentary contraction. The maximum
of shortening is reached, not suddenly, but gradually, and it does not
long remain at the maximum even when the electrization is continued,
but begins to lengthen at first rapidly and then more slowly.

The greatest amount of shortening possible to a muscle is ¢hree-quar-
ters or two-thirds of its length.

In contraction the muscle becomes a little smaller in bulk. The
cause of this is not fully understood.*

Immediate Strengthening or Restorative Effect of Electrization on

* Electro-Physiology and Electro-Therapeutics, By C. E, Morgan, M.D. New
York, 1868, p. 573. ‘
VOLUNTARY MUSCLES. 159

Voluntary Muscles.—One very interesting effect of electrization on
voluntary muscles is to increase their power of doing work. This effect,
which is called by Heidenhain and Remak restorative, can be demon-
strated in various ways. The capacity of walking, in cases of paralysis
of the lower limbs, is sometimes increased at once after electrization ;
the patient steps across the floor easier and-more firmly and rapidly,
and can walk further; or he can raise his leg higher and with less
difficulty. In one case of paralysis of the tibialis anticus muscle there
was no response to the will until a current of medium strength had
been applied, when it contracted without much difficulty. Dr. Poore *
found, on placing a weight of 17 oz. in the hand of a man holding his
arm out at right angles with his body, that in four minutes the pain was
so great that he could not go on; applying now a mild current through
the nerves of the arm, the strength returned. Another man could hold
out his arm 134 minutes when the current was applied, but only 6
minutes without the current.

The dynamometer is a good means of studying this subject. In one
case Dr. Poore found that eight successive squeezes of the dynamome-
ter with electrization gave 477 lbs. ; without electrization, 388 Ibs.; a
difference of 89 lbs. In another experiment made, when the hand was
not tired by previous experimenting, the difference was even more
marked, being a gain of 152 in six squeezes of the dynamometer.

Effect of Fatigue of Muscles on the Contractility. --When a striped
muscle becomes very much weakened or fatigued it behaves under elec-
trization much like the smooth muscle. Dr. Beard has demonstrated this
fact on dying rabbits and dogs. Beginning the electrization just as
they are cut open, the striped muscles react vigorously and normally to
the current; but as the animal dies the character of the contraction
changes, becoming slower and more deliberate. If, now, the current
be rapidly interrupted, no contraction occurs, for there is not time for
the muscle to respond. If, now, weak currents are used, the muscle
contracts very much after the manner of unstriped muscle—that is, with
a slow drawing rather than a rapid and vigorous action.

Effect of Muscular Tension and Relaxation on Muscular Contrac-
tion.—Dr. Wm. R. Fisher, of New York, has called attention to the
fact that muscles contract more easily when somewhat relaxed than
when in a tense condition. This experiment can be tried very easily on
the common extensor of the forearm or on the peronei muscles of the
leg. The fact is of practical importance in the treatment of paralysis.

The Practitioner, Jan., 1873.
160 ELECTRO-PHYSIOLOGY.

Ziemssen,* on experimenting with unpolarizable electrodes, and
gradually increasing the strength by the acid of the rheostat, obtained
the following results:

1. With the weakest current that caused muscular contraction there
was opening contraction at the cathode.

2. With a current a little stronger there was strong closing contrac-
tion at the negative pole, and weak opening contraction at the positive.

3. With still stronger current theré was also weak contraction at the
opening of the positive pole. ,

4. With still stronger currents there was @ tonic contraction at the nega-
tive pole, continuing for some time after the contraction at the closing.

5. With a much stronger current the tonic contraction was more
vigorous; the other contractions are also increased in strength, and there
appeared a contraction at the opening of the negative pole.

6. With the strongest current that can be borne, all the other contrac-
tions were increased in strength, and there appeared, besides, moderate
tonic contractions at the positive pole.

The above results can be verified only when unpolarizable electrodes
are used, for with ordinary electrodes the pain would be far too great
to be endured. The opening and closing of the current must be made
in the metallic part of the connection, in order to give it the greatest
possible suddenness. ‘Ziemssen suggests for these experiments the
median and ulnar nerves at a point a little above the wrist. At this
point the epidermis is quite thin and the nerves superficial. Judging
from our observations, it is impossible to reduce this subject to a rigid
mathematical law. The words “strong” and ‘ weak,” as applied to
currents, are quite indefinite, and the irritability of nerves varies in dif-
ferent individuals at different times. It is for these reasons that observ-
ers differ in the results of their experiments.

Lilectro-muscular Contractility and Electro-muscular Sensibility.—
The susceptibility of the muscle to contract under the influence of the
electric current is called electro-muscular contractility. The sensation
that accompanies this contraction of the muscles under the electric
influence is called electro-muscular sensibility. Electro-muscular con-
tractility and electro-muscular sensibility vary in different individuals,
and in different parts of the body. They are greatly modified by dis-
ease. ‘This fact is of great importance in diagnosis of paralytic affec-
tions.

In using the terms electro-muscular sensibility and electro-muscular
contractility, we do not wish to convey the idea that they represent any

. * Op, cit., p. 80,
ELECTRO-MUSCULAR CONTRACTILITY. 161

special nerve-functions, but rather that the general sensibility of the
nerves, and the general contractile power of the muscles may be excited
by the application of electricity. The question, whether there is any
special sense of muscular contractility, aside from the general sensibility
of the nerves, of the muscle, of the tissues that surround it, and of the
bones and cartilages with which it is connected, is one that we are dis-
posed to answer in the negative. There appear to be hysterical cases,
where the consciousness of muscular contractility under the electric
current remains, while the skin is almost perfectly anesthetic ; and there
are certainly cases where the muscles respond to the will, but do not
respond to electricity. Practically, therefore, the terms electro-muscular
sensibility and contractility, especially the latter, with its subdivisions
into. farado- and galvano-contractility, are of great value in electro-
physiology and therapeutics, and it appears to us are perfectly legitimate.

The manifestations of the electro-muscular contractility and sensibility
of the muscles in the different parts of the body are modified, first, by
the anatomical position of the muscles; secondly, by the quantity and
distribution of the sensitive nerves ; and thirdly, by the thickness of the
skin and adipose tissue.

The muscles of the face, the platysma myoides and sterno-cleido-
mastoid are, in health, very sensitive to the electric influence. Next
in order of sensitiveness to the electric current are the anterior muscles
of the forearm and of the inner side of the thigh. On the other hand,
the muscles of the back possess a much less degree of electro-muscular
contractility and sensibility, and the posterior muscles of the forearm,
and posterior and other muscles of the thigh are much less susceptible
to the electric influence than those of the anterior and inner portions of
these limbs. In corpulent patients it is more difficult to affect the mus-
cles, because adipose tissue is comparatively a poor conductor. In
women and children the adipose tissue is relatively more abundant than
in males and adults.

Increase of Temperature after Muscular Contraction.—It has been
ascertained by careful experiments, that an increase of temperature
results from muscular contractions produced by the electric current.
Increase of temperature in the muscles of paralyzed limbs, after elec-
trization, is frequently perceptible to the touch of the operator, and the
sensations of the patient. We have repeatedly demonstrated the same
results from faradization of the aims, the legs, the face, and, indeed, all
parts of the body. In very many cases this increase of temperature is
so marked as to be powerfully appreciated by the patient, and entirely

perceptible to the hand of the operator. General faradization causes
Ir
162 ELECTRO-PHYSIOLOGY.

more or less elevation of the temperature of the body. This is
demonstrated by the sensations of the patient,* and by the thermom-
eter,

It has been shown by Brown-Séquard and Lombard that excitation
of the nerves of the skin causes an increase of temperature in the
limb. +

The development of heat is not aided by increasing the strength
of the current above the degree necessary to produce a full contrac-
tion. It has been demonstrated that, in patients afflicted with trau-
matic tetanus, there is a great increase of temperature that remains
for some time after death.

Investigations on the effect of muscular contraction on temperature
should be made by delicate surface thermometers. Sume of the super-
ficial muscles of the forearm offer a good surface for this- experiment.
The thermometer must be kept firmly and uniformly pressed on the
skin, and the modifying effect of currents of cold air should be guarded
against. The thermometer should be kept z situ about fifteen minutes
before beginning electrization, so as to get accurately the normal tem-
perature. Then the nerve that supplies the muscle or muscles to be
tested should be faradized.

The following investigation is from Ziemssen.{ The patient was a
strong man, ‘who was suffering from complete paralysis of the extensor
muscles of the hand and finger from nerve injury. This fact accounts
for the low temperature before faradization.

Temperature on the forearm, between the extensor digit. comm.
and exten. carp. radi. brev. :

The skin uncovered...............005 contests 34.7° Cent.
After 4 minutes’ faradization through the radial nerve :
At Opening OF CUITENt i i.icaucinanieaamteairens aoe 34.8
I minute after opening the current............... 35-3
5 minutes ‘ss (C eaeiewanwna eae 35-7
Io es s CO ates eR AROS 35-35
12 es “ saa Gaeaa enews 35:3
In the 13th minute faradization was renewed for 1 minute:
Temperature at opening the current.......... we B47
I minute after opening the current.............. 35-1
4 minutes . EE steheechaisel gua vaise Suara 35°45

* Electricitdt in der Medecin, 1866, p. 29.
} Archives de Physiologie, November and December, 1868. _¢ Op. cit., p. go.
INCREASE OF TEMPERATURE AFTER FARADIZATION, 163

In the 6th minute faradization was renewed for 1 minute:

Temperature at opening the current............. 35.1
1 minute after opening the current....... aretxartata 35-3
5 minutes a BE” oc ceaetaca dea sie aera’ gs 35-6

The general results of all the investigations that have been made in
this department by Becquerel, Breschet, Helmholtz, eee Althaus,
and ourselves are these :

1. When muscles are made to contract under faradization of the mus-
cles that supply them their temperature rises.

2. This elevation of temperature is not necessarily accompanied by
any increase in size of the vessels, although faradization usually increases
the size and appearance of the vessels more or less.

3. The more vigorous the contraction and the longer it is continued,
the higher the temperature rises. :

4. If the faradization be continued long enough the temperature will
be so much increased that it can be detected without difficulty by the
hand, and by the sensations of the person operated on.

5. When all the superficial muscles of the body are faradized, as in the
method of general faradization, the temperature not only of individual
muscles, here and there, but also of the whole body, rises. This fact we
have repeated and demonstrated by observations made on many varie-
ties of temperament.

Amore accurate method of investigating this subject is by means
of the thermo-electric pile (see Electro-Physics, p.75). This instru-
ment is capable of measuring a small variation in temperature, and
also indicates the variations much more quickly than the thermom-
eter. The thermo-electric pile is connected with areflecting galva-
nometer (see Electro-Physics, p. 47). Ziemssen gives the following ob-
servation made on the extensors of the forearm:

TIME OF FARADIZATION. DEFLECTION OF THE NEEDLE
Minutes. Seconds. OF THE GALVANOMETER,.
° TS ek shereyares alacant — 1.5
° 30 Pacituereeuatasers + 2.3
° AS <amsmadeocas < + 5.0
1 — Sei eeeieee — 7.2
2 — sat tne ences +19.0
3 = Aes wae iee +30.1
4 — ea ea eH Ps are +40.2

It will be observed that with the increase in the time of the faradiza-
tion there is greater and greater deflection of the needle, just as there
is a rise of the mercury in the ordinary thermometer.
164 ELECTRO-PHYSIOLOGY.

Source of Heat in Muscular Contraction.—According to Hermann,*
who has specially studied the chemistry of the development of heat
during muscular contraction, muscular work is the result of the decom-
position of nitrogenous substances. Among the products of this de-
composition are a fixed acid, carbonic acid, and myosine. Of these the
carbonic acid leaves the body, while the fixed acid and the myosine re-
“main and are worked over again in the organism. The muscles grow at
the same time that they work and develop heat, and urea and creatine
are found in the residuum. The muscle is restored by the action of
oxygen, an albuminoid, and a non-nitrogenous substance in the blood.

All these complex chemical changes that are excited during muscu-
lar contraction give rise to heat. If the muscle is prevented, by me-
chanical means, from contracting, the heat develops in it more rapidly
than when it is free. This follows from the recognized law of the cor-
relation and conservation of forces. The force that does not appear as
work appears as heat.

Duration of L&lectro-muscular Contractility after Death.—The
muscles retain their contractility under electricity several hours after
death. The length of time that the electro-muscular contractility is
preserved varies with different muscles, with different animals, and
probably, also, with the mode of death. In order to determine this
question, Dr. Beard has made experiments on dogs and rabbits. Dr.
Onimus,}+ of Paris, has experimented on the body of a murderer who
had been guillotined. He found that the muscles of the tongue and dia-
phragm were the first to lose their electro-muscular contractility. Next
came the muscles of the face, among which the masseter retains its ex-
citability the longest. Zwo and a half hours: after death the electro
muscular contractility was lost in all these muscles.

In the limbs the extensor muscles first lose their electro-muscular
contractility, and in about an hour the flexors followed. The muscles
of the trunk responded five or six hours after death, and the abdominal
muscles longer still.

Onimus observed on the criminal what Dr. Beard has observed on dogs
and rabbits, that when the muscle is dying it contracts most noticeably
at the point where the electrodes are placed, and very slowly at a dis-
tance from the electrodes; and that the muscles respond to direct
electrization with needles after they have ceased to respond to the cur-
_rent when applied through the skin.

* Morgan, op. cit., p. 582 et seq.
+ Le Mouvement Médicale, Feb., 1873,
ELECTRO-PHYSIOLOGICAL ANATOMY. 165

Previously, in January and February, 1802, Aldini, a nephew of
Galvani, obtained permission from the government to experiment or
two criminals who were executed at Boulogne. Immediately afte:
death the bodies were submitted to powerful galvanic excitation. ‘The
muscles of the face contracted vigorously in such grimaces as to frighten
the assistants, The limbs were violently convulsed, and the bodies
acted as though they would rise again to life.

At Glasgow, Ure made similar experiments on the body of a crimi-
nal that had been on the gallows one hour. The applications were made
to the spinal marrow, the phrenic nerves, and the intercostal muscles.
According to the position of the electrodes the body was bent forcibly

_ back, the chest rose and fell as in the act of breathing, and the various
emotions of rage, terror, despair, were depicted on the countenance.
One of the spectators fainted, and several were obliged to leave the
room.

Llectro-physiological Anatomy.—E£lectro-physiological anatomy treats
of the physiological action of muscles under the influence of the electric
current applied in such a way as to produce contractions.

The contraction observed in an individual muscle, when submitted to
the influence of the electric current, closely resembles the contraction
of the same muscle when under the influence of the will.

Duchenne was the first to investigate this subject systematically, and
his researches have done much to modify the accepted views concerning
the functions of certain muscles. Those who desire a more complete
idea of his ‘views than is given in the following brief résumé, we refer to
his writings.*

Muscles of the Face—Electro-physiognomy.—This name has been
applied to the study of character and expression, through localized
faradization of the muscles of the face. By means of small electrodes
the current can be localized so as to produce contractions even in the
smallest muscles. For these experiments a recently dead subject has
this advantage over the living man, that in the case of the latter con-
tractions produced by the current would be complicated and interfered
with by involuntary movements.

According to Duchenne, who has chiefly investigated this subject, the

* De lElectrisation Localisée et de son Application 4 la Pathologie et 4 la Théra-.
peutique, Paris, 1861. Also, Méchanisme de la Physionomie Humaine, ou Analyse
Electro-physiologique de 1’Expression des Passions applicable ala Pratique des Arts
Plastiques. Paris, 1862. This work contains photographic representations of the

- yarious appearances of the face under ’electrization of the different muscles. These
photographs are frequently referred to by Darwin in his work on Zxgression,

*
166 ' ELECTRO-PHYSIOLOGY.

Jrontalis muscle, when a little contracted, expresses pleasure ; when
more contracted, astonishment or doubt; when strongly contracted
with other muscles, terror.

Contraction of the pyramidalis nasi expresses sadness ; of the cor-
rugator supercilii, contemplation ; of the orbicularis palbebrarum, con-
tempt. Contraction of these two, united with the pyramidalis nasi,
gives a hateful, malicious expression. Contraction of the ¢riangularis
nasi expresses lust ; of the zygomaticus major, various degrees of mirth;
of the zygomaticus minor, melancholy ; of the platysma myoides, hypo-
critical laughter; of the platysma myoides, pain. Contraction of the
platysma myoides and frontalis gives an expression of terror. Contrac-
tion of the platysma myoides and pyramidalis expresses rage. United |
contraction of the zygomaticus major and frontalis produces an ex-
pression of agreeable surprise. Contraction of the duccinator indicates
age, by making furrows in the cheek.

Contraction of the Jevator ale and /abii superioris causes an un-
pleasant expression, such as a child exhibits when about to cry ; contrac-
tion of the ¢viangularis oris gives an expression of sadness or disgust.

Contraction of the external fibres of the ordicularis oris gives the
lips a position of whistling or kissing ; contraction of the internal fibres
of the same muscle compresses the lips against the teeth.

Muscles of the Upper Extremity——The contractions resulting from
electrization of the extensors of the fingers give to the hand a peculiar
appearance.

The first phalanges not only become extended, but are spread apart,
while the last two phalanges become flexed.

The metacarpus forms an angle with the forearm, and in this condi-
tion the hand resembles, to a certain extent, a bird’s claw.

Electrization of the extensor digiti minimi proprius separates the lit-
tle finger from its neighbor, while contraction of the extensor indicis
proprius brings the index and middle finger together. By the method
of localized electrization the adductors and abductors of the fingers,
and the interossei and lumbricales, are found to act not only in draw-
ing these members together and separating them, but also in extending
the second phalanx of the thumb and the second and third of the other
fingers.

' The flexor pollicis brevis is concerned in extending the second
phalanx of the thumb, as well as in flexing the first.

So long as the arm is in its natural position, the supinator longus has
no function to perform ; it is only when the forearm is prone that its
peculiar action is manifest.
ELECTRO-PHYSIOLOGICAL ANATOMY. 167

In paralysis of any one of the above muscles, it is readily seen that
the observation made concerning their function is correct.

For example : if the adductor longus and extensor brevis pollicis be-
come paralyzed, the metacarpal bone of the thumb is adducted. If the
extensor longus pollicis is paralyzed, the thumb is inclined towards the
metacarpus, although its movements are not markedly impaired if the
extensor brevis and adductor longus are strong.

Electrization of the deltoid not only raises the upper arm, but also
very perceptibly changes the position of the scapula. The external
angle of the shoulder-blade becomes depressed, the internal angle is
elevated, while the distance between its posterior spinal border and the
ribs is slightly increased. In paralysis of the deltoid the arm hangs by
the side almost completely helpless. The muscle is composed of three
distinct groups of fibres, and the degree of paralysis depends upon the
number of groups or special group involved.

The pectoralis major and latissimus dorsi muscles, although situated
for the most part on the trunk of the body, are especially useful in
assisting in the movements of the arm.

Muscles of the Trunk.—When all of the fibres of the trapezius are
submitted to electric excitation, the shoulder-blade becomes elevated,
its posterior border approaches the median line, the shoulders are
drawn backward, and the head is thrown slightly forward and toward
the opposite side. Like the deltoid, the trapezius is made up of three
sets of fibres.

When the superior set is electrized the head turns toward the side
irritated, and the face looks toward the opposite side.

The middle set of fibres elevates the shoulder-blade, while by the
action of the lower set its inner angle is depressed, and its posterior
border is drawn toward the median line. In complete paralysis of the
trapezius the following symptoms are manifest: The back is rendered
broader, on account of the scapula removing slightly from the spinous
processes; the shoulder becomes depressed, and, on account of the
absence of steady support for the arm, its movements are rendered diffi-
cult. Electrization of the rhomboideus major and minor muscles ele-
vates the scapula and slightly turns it on its outer angle.

If the current be sufficiently intense, the lower angle of the scapula
approaches nearer to the spinous processes than the inner.

If the rhomboideus muscles are paralyzed, the scapula removes itself
somewhat from the walls of the thorax, the skin between the shoulder-
blade and the spine appears in folds, and the lower angle of the bone i;
drawn forward and outward, on account of the action of the serratus
168 ELECTRO-PHYSIOLOGY.

anticus major. By excitation of the serratus anticus major the scapula
is drawn forward and outward, so that the space between its posterion
border and the spine is doubled. The posterior border is pressed
against the ribs, while the anterior border is markedly removed from
them.

When the muscle is paralyzed the shoulder-blade sinks but little, so
long as the arm hangs motionless by the side; but as soon as it is
-moved from the body the posterior border and under angle of the
scapula are lifted from the thorax, while the anterior approaches it more
closely. In complete paralysis of the serratus anticus the movements
of the arm are much impaired.

A single external intercostal muscle may be electrized by pressing a
small electrode against the lower border of one of the upper ribs, near
the origin of the serratus magnus muscle.

The individual abdominal muscles are readily influenced by electric
excitation.

Electrization of the rectus muscle so stretches and draws it inward
that the abdominal wall becomes flat. Irritation of the external oblique
expands the abdomen laterally.

If we electrize the transverse abdominal, powerful transverse con-
tractions of the abdomen follow. When both phrenic nerves are sub-
mitted to electric excitation, powerful and frequent contractions of the
diaphragm are produced. An increased amount of air rushes into the
lungs, on account of the capacity of the thorax enlarging through the
descent of the diaphragm, and the moving outward of the false ribs.
Atrophy of the diaphragm causes, during inspiration, a depression of
the epigastrium and abdominal walls, while the thorax expands as
usual.

Muscles of the Lower Extremities.—Electric excitation reveals the
fact that flexion and extension of the foot cannot be produced by the
flexor or extensor muscles alone, since these muscles tend to abduct
and adduct as well as flex and extend. The flexors and extensors
cause direct flexion and extension only when they act in conjunction
with certain other muscles.

The movements of the foot are controlled by four sets of muscles.
These are :

The tibialis anticus, which at the same time flexes and adducts the
foot—the flexor adductor muscle, the extensor digitorum communis
longus and extensor hallucis, which flex and abduct the foot—the
flexor abductor.

The gastrocnemius solius and tibialis posticus, which extend and
ELECTRO-PHYSIOLOGICAL ANATOMY. 16g

adduct the foot—the extensor adductor, and the peroneus longus and
brevis, which extend and abduct the foot—the extensor abductor.

Electrization of the tibialis anticus, or, in other words, the flexor ad-
ductor muscle, not only extends and adducts the foot, but lifts the inner
border of its upper portion as well.

Electrization of that group of muscles called the flexor abductor, be-
sides flexing and abducting the foot, extends the four last toes, lifts the
outer border of the foot, turns the sole outward, and bends the great
toe.

Pes equinus may result from the stronger action of the extensors.

If the flexor abductor group become paralyzed, the movement of the
foot is reversed—the sole turning inward and the anterior portion turn-
ing upward.

Electrization of the extensor adductor group so extends and adducts
the foot that the heel is directed outward and the great toe inward. The
first phalanges of the toes become extended, and the last flexor, giving
to them the form of claws.

Electrization of the extensor abductor so extends and adducts the
foot that the internal malleolus becomes decidedly prominent through
the sinking of the inner border and the elevation of the outer border
of the foot. Paralysis of this last-named group of muscles produces in
the course of time what may be termed a flat foot. This results from
the disappearance of the arching of the foot.

In consequence of paralysis of the extensor adductor the foot natu-
rally becomes abducted, the arch of the dorsal surface is increased, and
instead of the flat foot above mentioned, we have a very decided hollow-
ing out of the plateau side.
CHAPTER VIII.
ACTION OF ELECTRICITY ON INVOLUNTARY MUSCLES..

ConTrRactions are produced in a voluntary muscle the instant the
poles of a galvanic battery, or of an electro-magnetic machine in oper-
ation, are applied to it. The contraction of the muscle continues
during the passage of the faradic current, but when the galvanic current
is used quickly relaxes after the first shock. When, however, the intes-
tines, the stomach, the cesophagus, and other parts which are composed
of involuntary muscular fibre, are subjected to the electric current, move-
ments are not induced in them until a certain time after the tissue has been
acted upon. The movements thus excited continue for a time after the ces-
sation of the current, and do not,as in the case of voluntary muscles, at
once return to their normal condition.

Jris.—¥aradization of the iris, with a very gentle current in a room
that is moderately darkened, causes it to be constricted or dilated, ac-
cording to the position of the electrodes.

Stomach.—Faradization or galvanization of the stomach causes gra-
dual shortening of the transverse and longitudinal fibres in the direc-
tion from the cardiac to the pyloric orifice. Dr. Rockwell, in the treat-
ment of paralysis of the cesophagus associated with a sort of atony of
the stomach, has frequently had occasion to observe the readiness with
which this phenomenon is demonstrated in the living man by applica-
tions directly to the mucous surfaces of the parts.

Intestines.—If finely pointed electrodes or needles, connected either
with a faradic or galvanic apparatus, be applied to the intestine of
a living’or recently killed animal, steady and firm contraction takes
place at the points where the electrodes are applied. Under a
mild current the contraction is slow, steady, and gradual. The intes-
tines are drawn up after the manner of a woman’s work-bag. This
contraction, though most marked just at the point where the needles
touch the intestines, is also observed a little distance between and on
the outer side of the needles. Under strong currents this constriction
takes place very rapidly, and goes on until the calibre of the intestines
INVOLUNTARY MUSCLES, 171

is nearly closed. When the electrodes are removed this constriction
slowly disappears. These phenomena, are seen both in the large and
small intestines and in the rectum. The duodenum responds most read-
ily, the rectum and colon less so. These phenomena are more or less
modified by the condition of the animal, whether living or dead, and
whether recently or long killed. This fact of electro-physiology, which
has been frequently demonstrated on animals, is very suggestive in a
practical point of view. The value of electricity in constipation is, in
view of these observations, partially explained.

Spleen.—When the spleen of certain animals, living or recently killed,
as the dog, is submitted to the action of a tolerably strong current,
either faradic or galvanic, a visible drawing and contraction through-
out the entire extent of the organ, not only where the electrodes are
applied, but between them and beyond them, in every direction, there is
manifest shrinking of the tissues, with change of color. This fact, which
has been disputed by some physiologists, we have demonstrated in a vari-
ety of experiments. The phenomenon is not so noticeable in the
spleen of the rabbit as in that of a dog, and in order that it may
occur rapidly and be easily seen, the current used must be of consider-
able strength. The shortening and discoloration of the spleen under
electrization appears to be more or less permanent. This physio-
logical fact suggests the query, whether the enlarged spleen of inter-
mittent fever might not be treated by electricity.

Bladder.—When the filled or emptied bladder of a living or recently
killed animal is acted on by either current, of moderate strength, a
visible drawing and contraction take place in various directions. The
tissue becomes firmer and harder, the cavity diminishes, and if it con-
tains urine a portion of it is expelled. This electro-physiological fact
is utilized in cases of paresis and paralysis of the bladder.

Uterus.—The uterus of animals and of the human being contracts
after the manner of the intestines, bladder, and other involuntary muscles.
Whatever pole is used, or in whatever direction the current be applied,
contraction takes place whenever the current is applied, whether the
uterus is or is not in a gravid condition. Both faradization and galvani-
zation have this slow contracting influence on the uterus.

In the chapter on Diseases of Women, the very interesting and im-
dortant practical applications of this physiological fact will be pointed
gut in detail. It applies especially to the electrical treatment of me-
tritis and uterine engorgements.

Ureters.—The ureters are constricted and shortened by electrization,
and as-in the case of the uterus, the intestines, and the spleen, the con-
172 ELECTRO-PHYSIOLOGY.

tractions take place, according to the law of their physiological action,
from the kidneys toward the bladder, and the contractions continue aftet
the electrodes are removed. i

Vas Deferens, Epididymus, and Tunica Vaginalis.—When the electric
current is applied to the vas deferens, the epididymus, or the scrotum,
they likewise contract after the manner of the intestines, uterus, and sa
forth. The scrotum contracts rapidly, almost instantaneously, under a
strong current, and remains contracted for some time, as we have
demonstrated on rabbits and dogs, and on the living human being.

Gall-bladder.—When a current of considerable strength is applied to
the gall-bladder by pointed electrodes, constriction takes place at the
points of application, and the whole, bladder tends to contract, and,
like the urinary bladder, to discharge its contents. It is not impossible
that a powerful current sent through the liver of the living subject,
by external applications, may cause contraction of the gall-bladder ;
and in this way we may in part explain the value of electrical treat-
ment in jaundice.

Gsophagus.—Iin rodents the cesophagus consists of striped muscle
only ; in birds it consists of unstriped muscle, and in man of a com-
bination of both striped and unstriped muscle. Both sets of fibres,
longitudinal and circular, contract under the current, not only at the
points where the electrodes are applied, but through the whole length
downward toward the stomach. In the treatment of dysphagia this
fact may well be considered.

Heart.—The effect of electrization of the pneumogastric and other
nerves that supply the heart has already been considered. The effect
of direct electrization of the tissue of the heart itself is not’ without
interest. Galvanization, with currents of moderate strength, of the
heart of an animal that has stopped beating, may cause a return of its
rhythmical action. It has been sometimes observed that the contrac-
tions return more vigorously in the right than in the left side. Accord-
ing to our observation, in the hearts of dogs and rabbits much depends
on the strength of the current used. If a strong current were directed
through pointed electrodes to the substance of a heart of a dying
animal, the pulsations are in part arrested, but they recur as soon as
this current isbroken. These conclusions are based on a large number
of observations. When the heart has fully stopped it may be restored
by a weak current, and again arrested by a strong current.

Blood-vessels.—The small arteries that contain considerable unstriped
muscle contract under the current, after the manner of the intestines ;
that is, the contraction does not appear instantaneously, but a little
INVOLUNTARY MUSCLES—EXPERIMENTS. 173

time after the needles are applied it goes on slowly, and after the
needles are removed they gradually return to their normal condition. In
the larger arteries this contraction is not so marked.

It will be observed that electricity acts on unstriped muscular fibre,
in this respect at least, very much like ergot. The power of ergot to
constringe the blood-vessels is the explanation of its great value as a
remedy in spinal and cerebral congestion. The efficacy of electrization
in the same affections, as well as in sprains and various local inflamma-
tions, may be in part explained by the same theory. This subject will
be discussed in the chapters devoted to the Influence of Electricity on
Nutrition and Spinal Congestion.

The above conclusions are based largely on our own experiments,
although many of the observations had been previously made by various
physiologists.

There were, however, certain queries in regard to the differential
action of the poles, and of the two currents, and of weak and strong,
on involuntary muscle, that had not been answered. These queries
have aimed to solve by a large number of experiments on animals.
The records of one set of these experiments, noted at the time by our
friend Dr. John Van Bibber, of Baltimore, are herewith presented. It
will be observed that the chemical and other effects of the current,
besides the contracting influence, are noted.

Experiment 1.—The abdominal cavity of a good-sized rabbit was
opened, and a medium faradic current, with needle electrodes, was
applied to the upper part of the small intestines. Contraction produced
most vigorous at the positive. A vermicular motion was also observed not
only in the part within the circuit, but extending some distance beyond
each pole. The rabbit was fully under ether, and the only other mus-
cular movements were cardiac and respiratory. The color of intes.
tines was normal and healthy, and was undisturbed during this operation.

Experiment 2.—A galvanic current, sixteen cells, was now applied,
with needle electrodes, a little below point of first experiment. There
was an immediate change in the circulation of the part. It became
darker and venous in its appearance, presenting the appearance of a
clot. The intestines, before so flaccid as to render the insertion of a
needle difficult, became very full and hard. The negative pole was
loose in the tissues, with bubbles of hydrogen generated around it, and,
on the.other hand, the positive pole became very firm in its insertion,
with evident constriction of muscular fibre around it.

The first effect, therefore, seemed to be congestion, and afterward,
coagulation.
174 ELECTRO-PHYSIOLOGY.

Lixperiment 3.—On stomach, with galvanic current, sixteen cells,
In region of positive pole the circular fibres are much contracted, and
the same disintegrating effects of negative pole were observed.

Lixperiment 4.—Faradic current on large intestine. Contraction of
muscular fibres was observed, and thought to be greater at positive
pole.

Lxperiment 5.—Faradic current on spleen. The smooth surface of
that organ was soon corrugated, tending to show that the tissues were
contracting under its influence.

Experiment 6.—Galvanic current on spleen. Generation of hydro-
gen at negative pole, also congested appearance, and after removing
needle very dark spot at negative pole. /

Lixperiment 7.—Faradic current on bladder. The bladder was par-
tially filled with urine, and when the current was applied there was
great and immediate contraction of muscular fibres and expulsion of
urine.

Lixperiment 8.—On left kidney, faradic current. Muscle con-
tracted, and seemed to be permanently so, at least during observation.

Right kidney, galvanic current. Same effect at negative pole, dark
congested spot ; but during passage of current the bladder, which had
been much contracted by faradic current, seemed to fill up.

Experiment 9.—On liver. No action. The rabbit seemed to show
remarkable vitality, and it was necessary to renew ether very frequently.
It was determined then that the electricity seemed to prolong life, even
after it had been so taxed by anatomical mutilation.

The conclusions from a large variety of experiments, of which the
above is a fair illustration, are these:

1. Both currents—faradic and galvanic—cause an unstriped muscle
to contract in accordance with the law of its physiological action. It
remains contracted, and after the breaking of the current gradually
returns to its normal condition.

2. The time when the contraction begins, and the vigor with which
it continues, and the rapidity with which it returns to its normal condi-
tion, after the breaking of the current, varies with the organ acted on,
with the strength of the current, and with the condition of the animal
acted on, whether living, dying, recently or long dead.

3. The positive pole has a more powerful contracting influence on
unstriped muscles than the negative. The differential action of the
poles is seenin both currents, but is more decided with the galvanic.
This fact we were, we believe, the first to discover. This fact of the
more potent action of the positive pole on unstriped muscle is of con-
INVOLUNTARY MUSCLES—-EXPERIMENTS. 175

siderable signification in the treatment of engorgements of the uterus,
etc. It will be discussed in the chapter on Diseases of Women. ‘

4. Unstriped muscles can also be made to contract by faradization
or galvanization of the nerves and nerve-plexuses that supply them—
indirect electrization.

5. The behavior of the different organs that are supplied with un-
striped muscles under electrization depends on the relative amount of
muscle in their tissues. The intestines, the scrotum, contract rapidly
and vigorously ; the spleen and arteries less perceptibly and more slowly.

The liver and lungs do not apparently contract under either current.
The electrolytic action of the current is observed in these organs, as
in all other tissues.

6. The differential reaction of voluntary and involuntary muscle to
the current is mainly a matter of degree. Both kinds of muscle con-
tract in accordance with the law of their physiological action, under
both currents, and both return to their normal condition ; but involun-
tary muscle returns very slowly, while voluntary muscle returns rapidly,
almost instantaneously. When voluntary muscles have become greatly
exhausted through fatigue or death, they behave very much like invol-
untarv muscles.

‘
CHAPTER IX.
ACTION OF ELECTRICITY ON THE BLOOD.

Tue action of the galvanic current on the blood is a subject to
which we have given at different times considerable attention. Blood
coagulates so quickly after leaving the living body, that the action of
electricity upon it can only be studied with satisfaction when the elec-
trodes are placed within an artery or vein, or in a current of blood as
it flows from the wounded blood-vessels before the process of coagula-
tion has set in. We have experimented on blood with the gal-
vanic current in both ways.

When the needles connected with the poles of a galvanic battery are
inserted into the feebly flowing blood of a wounded animal, electroly-
sis at once takes place with differential polar action of a striking char-
acter. At the positive pole a small, firm, and dark clot forms, that
adheres closely to the needle, especially if it be steel that is readily oxi-
dized. At the negative pole a larger, softer, lighter, yellowish clot
forms, with a mixture of foam or froth from the bubbles of hydrogen.

If the current be strong, and the operation protracted, the positive
steel needle will become either destroyed by oxidization or greatly
reduced in size.

From the above it will be seen that the action of electricity on the
blood is mainly, if not entirely, of a chemical character—in a word,
electrolysis, or electro-chemical decomposition. Golubew and Burdon-
Sanderson have studied the effect of faradization on the blood-corpuscles
under the microscope, and Rollet and Neuman have studied the same
under the influence of the galvanic current. It has been shown that
the red corpuscles of the blood are discolored by the alkalies of the
negative pole, and caused to shrink by the acids at the positive pole.
Under the discharges of the Leyden jar the red corpuscles change their
shape and lose their color.

March rath and 24th, 1871, Dr. Beard made, with Dr. E. L. Keyes,
a number of experiments on dogs, in order to determine the differen-
tial action of the poles in producing a clot. One method of ex-
ACTION OF ELECTRICITY ON THE BLOOD. 177

perimenting was to etherize the animal, open the abdomen through
the linea alba, and expose the aorta, into which needles, insulated with
hard rubber up near to their points, and connected with both poles,
were introduced. In some cases the artery was constricted, in others
not. Wecondense the record of the experiments from the published
statements of Dr. Kéyes,* based mainly on notes made at the time
by the physicians who co-operated with us.

EXPERIMENT J.—-March 17th. A small dog was etherized, the
abdomen laid open through the linea alba, and the aorta exposed.
Positive and negative needles, insulated (imperfectly) with hard rubber,
were introduced into the aorta about one inch apart. Both needles
were of steel, gold plated at the points. The negative needle was acci-
dentally run through the artery, and emerged into the muscle beneath.
The current from sixteen cells of a Stéhrer’s battery was passed for ten
minutes. The artery was not compressed. Blood flowed eee it at
great force.

Result.—Bloody foam surrounded the negative needle, the bleed
emerging from the artery. Needle loose. It dropped out, the blood
followed.

Positive needle adherent to artery, requiring a little force to pull it
away. Artery was cut, before the needle was removed, to look for
clot. No clot discovered in the vessel. A little black material was
found adherent to the wall of the artery, and to the positive needle at’
the point of entrance. The lining membrane of the artery was altered
and discolored, wherever either needle had touched it, over a space
about one and a half line in diameter.

EXPERIMENT IV.—Medium-sized dog etherized. Batis needle
(platinum), insulated with hard rubber, was placed in the artery. Nega-
tive needle (platinum), insulated with shellac, in muscles near the spine.
Eighteen cells Stéhrer. Time, ten minutes. Current of blood about
three-fourths, arrested through the artery, by compression with thumb
and fingers, one inch above and below the needle.

Result.—Firm black clot outside of the vessel at- point of the en-
trance of needle, and where the opposite wall was touched by the
needle’s point. Inside—firm, black clot, adherent to the wall, but not
large enough to obliterate the vessel.

Lining membrane of artery blue-black, and coats of vessel adherent
and condensed at point of entrance of needles, and where opposite wall
had been touched. Needle not much acted upon. A little flake of

* Practical Electro-Therapeutics, New York Medical Fournal, December, 1871,
I2
178 ELECTRO-PHYSIOLOGY.

hard rubber came off, and was left attached to the clot. A few bubbles
of oxygen escaped from the vessel alongside the needle.

EXPERIMENT VII.—Positive needle gold, non-insulated. Negative
needle steel, non-insulated. Both in vessel. Sixteen cells. Time,
ten minutes.

Result.—Clot same at the positive pole as in Experiment IV., but
action on lining membrane was much less than in that experiment.

“Gas escaped at negative needle. No clot at negative needle. Artery
compressed only below, circulation arrested.

EXPERIMENT XI.—Renal artery of dog was cut, and blood allowed to
flow into peritoneal cavity. As it flowed, negative and positive steel,
non-insulated needles, connected with eighteen cells, were dipped into
it. Action commenced at once. A dark clot formed about positive
needle, and a light foam around negative. At the end of one minute,
at the positive needle, a black clot had formed, a quarter of an inch in
diameter, dense enough to be lifted out of the fluid on the point of the
needle, and to sustain its own weight. At negative needle there was a
spumous yellow mass, which could be lifted in part from the blood on
the needle’s point, but which had no consistence whatever.

The experiments were continued with Dr. Keyes, at the slaughter-
house, the needles being placed in the warm blood, as it flowed from
the arteries of dying animals. These experiments were performed
under great difficulties, and at some risk of being kicked by the expiring
bullocks, and did not therefore lead to any important results.

Blood coagulates so quickly after it leaves the body that when we
wish to determine the chemical action of the electric current on it, it is
necessary to introduce the needles into the vessels of the living animal,
or into the blood, just as it is flowing from the vessels.

During the winter of 1873 Dr. Beard made, with the assistance of Dr.
J. H. Raymond, similar experiments on dogs and rabbits. The animals
were etherized, cut open, and the needles (platinum) inserted into
different arteries and veins. In some cases also the arteries were rup-
tured, and the needles were introduced into the pool of blood before it
had time to coagulate.

The conclusions in regard to the electro-coagulability of the blood,
to which we have been led by these repeated experiments on animals
and on men are these :

1. Both poles of the galvanic current cause a clot in blood, either
running in an artery or vein, or freshly drawn, and stationary.

2. The positive clot is black, hard, and small; the negative clot
is light, soft, and bulky.
ACTION OF ELECTRICITY ON:THE BLOOD. 179

3. These clots are the result of the electrolytic action of the current,
with the evolution of oxygen and hydrogen, of acids and alkalies, and
their subsequent combinations.

4. The largest clot and most satisfactory observation in an artery is
caused when both goles are placed within the blood-vessel and near to-
gether. The reason of this is, that when the poles are near together in
the blood, the resistance is very much less than when one of the poles,
is on the surface.

5. In order to produce a firm clot of sufficient size to obstruct a
large artery, strong currents—from 20 to 4o cells—are required, and
quite protracted séances. The process of coagulation under the cur-
rent is comparatively a slow one. .

6. Electro-coagulation in a blood-vessel is aided by any compression
that impedes the rapidity of the flow of the blood. The slower the cur-
rent runs, the more rapid and fitm the coagulation. Small and recent
clots, especially those connected with the negative pole, may possibly
be washed off. The practical bearings of these conclusions on the
electrical treatment of aneurisms will appear in the section on Electro-
Surgery
a“ CHAPTER X.

ELECTRO-CONDUCTIVITY OF THE HUMAN BODY.

TuE chief constituent in the human body is water, which is about
three-fourths of its average weight.* The saline constituents which the
water holds in solution vary in quantity and quality in the different
tissues and the different parts and organs of the body.

The conductibility of the body, as a whole, may be best understood
by regarding it as a mass of water and saline ingredients, with solid
tissue interspersed. The degree of resistance to the current that differ-
ent parts of the body offer will therefore depend on their structure.
Those parts which, like the bones and epidermis, contain little water,
will offer a much greater resistance, and be poorer conductors, than
those parts which, like the muscles, nerves and tendons, and carti-
lages, contain a large percentage of water. Soft parts, like the stomach,
intestines, and mucous membranes in general, offer comparatively
little resistance, because they contain so large a percentage of saline
solutions. Saline solutions conduct better than simple water, and
warm saline solutions conduct better than those which are cold.

The human body, as a whole, conducts electricity jifteen to twenty
times better than pure cold water, provided the skin is thoroughly moist-
ened. It owes this superior conductibility to the warm saline solutions
which it contains. According to recent experiments by Richardson,
the blood is the best conducting material of the body.

Percentage of Water in the Tissues.—To ascertain the relative pro-
portion of water in the different tissues of the body is a subject that
has occupied a number of observers. The results of the different inves-
tigations do not agree mathematically, for the reason, partly, that indi-
viduals differ in the water-holding capacity of their tissues, as in all
other respects.

The following table + gives at a glance the results of the different
investigators :

* Pereira, Food and Diet, Am. ed., p. 39.

t+ Ziemssen, Die Electricitét in der Medicin, vierte ganz umgearbeitete Auflage.
Erste Halfte, p. 18. 1872.
ELECTRO-CONDUCTIVITY OF THE HUMAN BODY. 181

PERCENTAGE OF WATER IN THE TISSUES OF THE HUMAN BODY.

Adults. New-born chil-
dren.
Blood......... sigma es Sa leant ams 80.5... av grains 85.0
(E. Bischoff) (Bischoff)
Gray matter of the brain.......... 85.0
e (Lassaig) { 77.2 ........ 88.6
White SS tN Se dst aves, 73.0 { (Ranke) (Bischoft)
(Lassaig)
Gray matter of spinal cord........ 71.0 1
: (Lé Hérit) MOS. bases 81.8
White “ “ « sO en aimisreia 65.0 (Ranke) (Bischoft)
(Von Bibra)
Nerve matter...........0...0.05. 77.0 39.68....... 64.5
(Ranke) (Von Bibra) (Von Bibra)
Muselé.. ns veae sn aces Re aunneirae ST2=84. Bi nisnananies se 87.8
? (Ranke) (Bischoff)
TAVEE sooed aie ak Sele aise ia Wei ste b FOuL sy wiaswiseads sa x eal 82.5
(Von Bibra) (Oidmann)
Elastic tissue ....... 00... cece eee TOA? cersra sities cree cite
(Schultze)
Fatty © AsGsrerdagesvee nos 80:9. s dornisadumueguedes
(Ranke)
(cornea ........ D530. citpetie eas on strate
Connective tissue 4 skin........... (His)
lederhaut...... 57.5- TOE s sax x55 .
(Wienholt) (Ranke)
Bones—os parietal .............. TQ=16 esis vans tas eee ete 18-2

9
(Friedleben) (Friedleben)

An examination of the above table shows'clearly these two facts: .

1. The percentage of water in the different tissues of the human
body, excepting the skin and bones, is almost uniform—ranging be-
tween 70 and go. The percentage of water in the skin is almost two-
thirds as great as in the brain, spinal cord, and nerves. In the bones
the percentage of water is one-fifth that of the soft tissues.

2. There appears to be more water in the tissues of new-born chil-
dren than in adults. The difference, however, is but trifling.

Investigations of a similar character have been made on the tissues of
oxen, dogs, frogs, cats, hares, and rabbits ; the results do not differ mate-
rially from those obtained on the tissués of human beings.

Compared with a number of metallic substances, the human body
is an exceedingly poor conductor. Thus it has been estimated that
copper is several thousand million times a better conductor than the
human body.

Dr. C. B. Radcliffe made three experiments, in which he measured the
resistance of nerve, tendon, and muscle, as nearly of the same shape
and size as possible. The pieces were taken from the sciatic nerve,
the tendo-Achillis, and the adductor longus of a recently killed rabbit.
He found the mean resistance of one inch of the sciatic nerve to be
182 ELECTRO-PHYSIOLOGY,

40,000 units (see p. 77)—that is, about eight times the resistance of the
Atlantic cable; of the tendon, 38,000 units ; and of the muscle, 12,000
units. *

Bones and Skin poor Conductors.—It should never be forgotten that
the epidermis, in a dry state, is a poor conductor. In practice this
resistance of the epidermis is overcome by thoroughly moistening it.

= The hair and nails are also poor conductois. In making applications to
the top of the head it is necessary to thoroughly moisten the hair. The
bones contain less water than the soft parts, and are consequently poorer
conductors. Soft parts which.are thus enclosed in a bony covering are
less powerfully affected than soft parts which are not so enclosed.

The Current tends to take the shortest Way between the Electrodes.—
The electric current always takes the shortest and most. direct course
from one pole to the other, provided the media intervening between the
electrodes is of a uniform conductibility. When, therefore, the positive
electrode is applied to one part of the body, and the negative to the
other, the current would diffuse itself uniformly between the poles,
provided the structures of the body between them were uniform. But,
as has been seen, the different parts of the body vary widely in regard
to their conductibility,—those which contain a large quantity of saline
solutions being good conductors, and, vice versdé, those which contain
a small quantity being poor conductors,—the difference of conductibility
between muscle and bone being nearly twenty to one.

The current does not affect all parts alike. The extent to which any
part is directly reached, when the current is applied over the surface,
will depend both on its structure and its situation.

Soft parts, which contain a large amount of water, like the brain,
spinal cord, and abdominal viscera, are good conductors, and unless
their situation is unfavorable, they are directly and powerfully affected
by the current, when applied to the surface by means of moist conduct-
ors. On the other hand, bone, which contains a much less percentage
of water than the muscles and soft parts, is comparatively a poor con-
ductor. Accordingly, soft parts which are partially or entirely enclosed
by bone are much less readily affected by external applications than
would be the case if they were exposed.

Another legitimate inference from the accepted theories of the nature
of electricity, and from what we know of the relative conductivity of
the different tissues of the body is, that when electrodes are placed on
the surface of the body the current moves between them in a kind of

,

* Dynamics of Nerve and Muscle, p. 19.
ELECTRO-CONDUCTIVITY OF THE HUMAN BODY. 183

undulative or wave-like manner, extending on both sides of the median
line between them for a considerable distance.

That these theories, in regard to the electro-conductivity of the body,
are sound, is proved in three ways:

1. By experiment on the living subject.

2. By direct experiment with the galvanoscopic frog and reflecting
galvanometer on the dead subject.

3. By the evidence of pathological cases.

That the tendency of electricity is to take the shortest road between
the electrodes, is proved by the following experiment: The: two fore-
arms are crossed so that they touch each other a little distance above
the wrist. Placing now one electrode on the outer surface of each arm,
and letting the galvanic current run, a feeling of heat and pricking is
felt, not only beneath the electrodes, but also, to a less degree, at the
polar surfaces of the forearms where they touch each other. On remov-
ing the electrodes it is observed that not only the spots beneath the
electrodes, but also the spots where the arms touched, have become
reddened.

This shows that a portion of the current takes the shortest way from
one electrode to the other, although that road lies through two layers
of epidermis, which is a very bad conductor.

A portion of the current, in this experiment, goes up the arm, across
the body, and down the other arm.

In order to ascertain what proportion of the current took the route
across the arms, Ziemssen* made the following experiment: Putting
one forearm over the other, as in Erb’s experiment, he placed between
them two plates of zinc, connected with a delicate reflecting galvanom-
eter (see Electro-Physics, page 47). The result of the experiment, when
zo elements were directed across the arms, was a deflection of the
needle 36.3°.. The same arrangement made on the dead body gave,
with ro elements, a deflection of 8.5° ; with 15 elements, a deflection of
19.7°; with 20 elements, 28.2°. On separating the forearm, so that -
the whole current must run around through the arms and body, he
found that with ro elements there was a deflection of 15.99; with 15
elements, a deflection of 31.7° ; with 20 elements, a deflection of 48.5°.
The conclusion was that in each experiment ome-half of the current
went across through the forearms, and the. other half up and down the
arms and through the body.

Evidence of Pathological Cases.—When the spinal cord is in a condi-

* Op. cit., p. 22.
184 ELECTRO-PHYSIOLOGY.

tion of health, a powerful current may be applied down the back with-. ,

out discomfort; but in cases of myelitis, spinal congestion, and other
morbid states, very marked and peculiar symptoms are sometimes ob-
served. We have seen a case of myelitis when even a very mild faradic
current over the spine, near the supposed seat of the disease, caused
severe pain in the right leg that continued for several hours. Such a
phenomenon is never observed in health. The fact that it does occur,
especially when the electrodes are not placed near any prominent
nerves, shows very clearly that the current affects the spinal cord in a
more direct way than by mere reflex action.

The sensations of the patient, and the results of treatment, also show
that the stomach, liver, spleen, intestines, and the genital organs in
both sexes, are traversed by the current in external applications of either
current.

Experiments on Dead Subject with a Frog Preparation.—Erb opened
the skull of a dead body, took out the brain, and covered the out-
side of the skull with pieces of muscle about three-quarters of an
inch thick. Over the muscle pieces of skin were placed, and over
the skin the electrodes. The skull was then filled with the brain, in
such a way as to avoid any direct connection with the muscle. The
skull was thoroughly dried, and a prepared frog placed on the cerebral
matter. A very gentle current was then let on, and both on opening

and closing the frog contracted energetically, showing that a portion of.

the electricity at least passed through the brain. Branch currents may
also have gone around through the layer of muscular tissue ; but the
important point, that some of the electricity took the short way direct
through the skull and brain, was in this experiment conclusively shown.

The same experiment with the faradic current showed the same
result.

Similar experiments on the spinal cord showed that the current pene.
trated the vertebrze as readily as through the skull.

Actual Experiment witha Reflecting Galvanometer.—The evidences
already given are sufficient, with corroboration, to establish the fact,
that the electricity, when applied to the surface of the body, goes
through the tissues lying between the electrodes, and that all the in-
ternal organs may be thus acted on by the current. The mathematical
demonstrations of this fact that have been recently made by Burchardt,
and after him by Ziemssen, are, however, none the less interesting.
Ziemssen’s method of investigation was to insert two platinum needles,
insulated to their points, into the organ to be experimented on, as the
brain, spinal cord, sympathetic, lungs, liver, etc., and connect them with
ELECTRO-CONDUCTIVITY OF THE HUMAN BODY. 185

a delicate Wiedmann’s reflecting galvanometer, while the electrodes of
a galvanic battery of from 1 to 50 elements were applied externally, in
such a way that the current, in passing from one to the other, must
pass through the place where the points of the needles were inserted.
These experiments were performed on the dead subject, and on ani-
mals, living and dead. Unpolarizable needles (Electro-Physics, p. 37)
were used. The body, or part to be examined, was isolated on wood
or glass. By these means he easily demonstrated these two facts :

t. That all the internal parts and organs of the body can be traversed
by derived currents (see page 35) when the electrodes connected with
a galvanic battery are properly placed on the skin.

When the electrodes are placed on the head, derived currents pass
through the brain. When the electrodes are placed on the spine, de-
rived currents pass through the cord. In the same way it was demon-
strated that the sympathetic, heart, lungs, liver, spleen, intestines, and
bladder were traversed by derived currents when the electrodes were
applied respectively to the neck, thorax, and abdomen. Similarly also
the nerve-plexuses and great veins were shown to be traversed by cur-
rents when external applications were made.

2. The derived currents were usually most powerful, that is, the
greatest quantity of electricity passed in & direct line, between the elec-
trodes.

‘When the ends of the unpolarizable needles were removed from one
another, near the central line, the needles showed less and less deflec-
tion, proving that the derived currents were weaker. To this general
law there are, however, exceptions. The current which contains a very
large percentage of water conducts electricity better than other neigh-
boring parts, even when out of the axis of the curve. :

3. The derived currents can be sent through the internal parts in any
direction, and increase in strength with increase in the strength of the
principal current.

When the principal current is reversed, the derived currents will be
reversed also. In one experiment, on the dead body of a young
man, the electrodes of the principal current were placed behind the
ears. Two holes were made in the parietal bones, in the track be-
tween the electrodes, and two other holes were made, about six centi-
metres farther forward, and about eight centimetres from each other.
In the holes made through the bones into the brain were placed the
unpolarizable needles connected with the reflecting galvanometer.
Two needles were also in the tubercula quadrigemina. The results of
the observations are contained in the following table :
186 ELECTRO-PHYSIOLOGY.

Needles in posterior Needles in anterior Needles in
No, of elements. poles in direct line poles out of tubercula
of current, direct line, quadrigemina,
5 15° 0.6° 1.6°
Io 7 07° 2.2°
15 ; 2.9° 2.8° 35°
20 6.5° 9.38 4-2°

In the above observation, which may be regarded as a crucial and
convincing one, these three points are distinctly proved :

First, That the current passes from one electrode to the other
through bone and brain.

Second, That most of the derived, currents take the direct route in the
axis between the electrodes, and that the strength of the derived currents,
the conductivity of the parts being the same, diminishes in proportion
to their distances from the axis.

Third, That the tubercula quadrigemina, by virtue of their uid
structure, conduct electricity better than the after parts of the brain.

Fourth, That the strength of the currents sent through the body is
proportioned with considerable exactness to the strength of the current
employed in the application. °

The Jaws of conductivity of the body, as here demonstrated in the
brain, have also been similarly demonstrated in the spinal cord and in
all the organs of the thorax and abdomen.

The grand conclusion from all these experiments, and from clinical
experience, is that the electro-conductivity of the human body is to be
explained, mainly, by the ordinary physical laws of electro-conduction,
and only to a very limited extent by physiology.

Physiology and pathology may come in to modify, to a slight extent,
the conductivity of the body; for, as we have seen, individuals differ in
their conductivity. Increase in the quantity of blood or salts in the body
increases the conductivity, and diminution of blood or of the salts, as
takes place in some diseases, diminishes the conductivity. But all
these varying factors have caused only a very slight perturbation of the
physical laws of electro-conductivity.

There is some difference in the conductivity of the living and dead
body, but this difference can mostly be explained by physical principles.
It may well be questioned whether the principle of life, whatever that
may be, exerts any very important influence on electro-conductivity.
Burchardt found that when more saline solutions were injected into the
dead body the electro-conductivity was increased. This is just what

‘
ELECTRO-CONDUCTIVITY OF THE HUMAN BODY. 187

we should expect on physical principles, because warm saline solutions
are good conductors of electricity in the body or-out of it.

According to Ranke, living muscle conducts much worse than dead
muscle, the proportion being as 100 to 56. Living muscle conducts
115,000,000 times, and dead muscle 64,400,000 times worse than
copper. Dead muscle conducts better than living, on account of the
decomposition and chemical changes that take place after death, and
especially on account of the accumulation of lactic acid.

LElectro-conductivity modified by Ageand Temperament.—Young peo-
ple offer greater resistance than old people, for the probable reason that
the tissues of the old contain more of the salts than those of the young.
The hands of those who labor with muscle, and whose epidermis is
thereby thickened, offer greater resistance than the hands of those who
live by brain alone. The right hand, being more used than the left,
has a thicker epidermis, and therefore presents a greater resistance.

Different individuals of the same age and condition differ in their
conductivity in a manner that cannot be fully explained. When
“shocks” of a battery, or faradic machine, or Leyden jar are sent
through a number of persons in a row, some will feel it slightly, others
strongly, and perhaps one or more may be almost if not quite pros-
trated. This fact may explain some of the freaks of lightning, for it
has long been known that when a number of persons are standing near
together some may be struck down and others unharmed. Some Indians
and negroes, it is said, can take hold of the electric eel without receiving
shocks.

The same individual may conduct differently at different times. As
the body is perpetually changing, as it varies in its intimate constitu-
tion, not only from year to year, but from day to day, and from moment
to moment, it is easy to understand why it should vary in its suscep-
tibility to electricity, just as it varies in its susceptibility to the articles
of ordinary food, to stimulants and narcotics, and to internal medi-
cation.
CHAPTER XI.
THE EFFECT OF ELECTRICITY ON NUTRITION.

It is not a little surprising that electricity should have been used as
a therapeutic agent for more than a century before it began to be
recognized among scientific men as a powerful means of aiding nutri-
tion. In 1867, after a series of preliminary experiments, mainly con-
ducted by Dr. Rockwell, we ascertained that electrization was a tonic
of most remarkable efficacy ; that its permanent tonic effects were, in-
deed, far more wonderful, as well as more valuable, than its primary
stimulating effects. When we announced this discovery to the pro-
fession, in our Treatise on the Medical Use of Electricity, the statement
was received by many, and especially by those accustomed to and
familiar with other electro-physiological and electro-therapeutical re-
searches, with incredulity and surprise.

The attention of observers has been so exclusively directed to the
primary stimulating effects of electricity, that they have neglected to
pursue the subject further, and to study its permanent effects on nutrition.

The effects of the passage of electricity through the body are of a
fourfold character :

1. Mechanical.

2. Physical.

3. Chemical.

4. Phpsiological.

Inasmuch as the effect of electricity on nutrition is a resultant of
all these four orders of effects, it is necessary to speak of each in
some detail.

The mechanical, physical, and chemical effects of electricity on the
body are similar in character to the same effects of electricity on any
substance whatever; the Physiological effects are those which take
place in virtue of the vital properties of the tissues. The mechanical
effects of electricity on the body are most markedly appreciated under
the faradic current. The reason is clear from the nature of the faradic
current. It is a current of alternation, of to-and-fro motion, of con-
stant closing and breaking (see Electro-Physics, p. 64). When it
EFFECT OF ELECTRICITY ON NUTRITION. 189

passes through the body, even when it produces no muscular contrac-
tion, it acts very much in the same way as gentle tapping, or pound.
ing, or rubbing on the tissues; and this gives passive exercises to all
the deeper lying as well as the superficial tissues. We may believe
that the molecules of the tissues are agitated by the passage of the
current, as the particles of a bar of iron are moved by the influence of
magnetization (see p. 9), or as bodies are expanded by heat. ‘The
numerous branch currents going to and fro act as so many shuttlecocks,
keeping every atom in incessant disturbance. That the simple process
of tapping on the surface of the body, by means of the widrations that
it excites, has a positively beneficial effect in certain chronic affec-
tions, has long been recognized. It is reasonable to suppose that this
beneficial effect is in part due to the increase of endosmotic action.

Physical Effects.—The physical effects of the passage of electricity
through the body are heat, and the modification of endosmose and exos-
mose, and the transferrence of substances from one pole to the other.

The heat excited in the body by the simple passage of a weak cur-
rent that causes no muscular contraction, is small; but there is little
question that heat is thus excited, although it is difficult or impossible
to measure it by the thermometer. The main arguments in favor of
this belief are (1), that all conductors of electricity become heated
more or less in proportion to their resistance—the body offers great
resistance, and more or less of the electric force must be converted
into heat; and (2), powerful currents, either galvanic or faradic,
even when not used so as to excite muscular contractions, cause in-
crease of heat in the track of its passage, so marked as to be easily
detected by the touch. No thermometer is necessary to show that in
electrolytic operations, where strong currents are used, the tissues near
the needles, and between them, become intensely heated, so that to
rest the finger on them almost causes pain. This fact we have demon-
strated over and over again in various parts of the body. It is equally
clear that the faradic current, even when not very powerful, raises the
temperature of the parts through which it passes. The sensation of
the patient and palpation by the operator demonstrate this beyond
doubt. Cold extremities are warmed sensibly and quite rapidly by
faradization or galvanization, even when no sensible muscular contrac-
tions are produced by the current. It is logical to infer that very weak
currents, either faradic or galvanic, cause a slight increase of heat by
virtue of the passage of the current, and as a physical effect of such
passage, without reference to the physiological phenomenon that must
accompany the physical phenomena, which must probably also cause
190 ELECTRO-PHYSIOLOGY.

a rise of the temperature. Schiff declares, as a result of his observa-
tions, that a nerve is warmed by an almost momentary passage of the
current.

A second important physical effect of the passage of an electric cur-
rent through the body is the transference of substances from one pole
to the other. This physical effect of the current has long been recog-
nized. In the electric light, for example, the particles of carbon go

*from the positive to the negative pole, and to so marked a degree that
the positive carbon is quite rapidly worn away. A very remarkable
illustration of this transference of matter in the track of electricity some-
times occurs in lightning stroke. Trustworthy cases are reported of
individuals who have been found struck dead by lightning, and bearing
on their bodies distinct images or impressions of some object, as a tree
or house, near which they stood when they fell.

In 1864, at Nibelle, in France, three men who were gathering pears
were struck by lightning. One was killed at once. The others were
thrown to the ground unconscious, and one of these, when taken home,
was found to have on his breast a “distinct daguerreotype of the tree.”

In 1860 a woman of Sisonne, in France, who was struck by lightning,
carried on her back a complete image of a tree—trunk, branches, and
leaves—that was near the place where she fell. A similar case is re-
corded by Franklin.*

The explanation of all these cases is the same. The particles of the
tree, reduced to great fineness by the electricity, are mechanically trans-
ported and burned in the skin. The process is therefore not chemical,
but mechanical and thermic.

Bodies have been literally tattooed in this way. Transference of sub-
stances is a part and result of the electrolysis in organic substances
already described (Electro-Physics, p. 58), and also of the electrolysis
of organic bodies to be hereafter described.

The electric currents also exercise a positive and very interesting in-
fluence over endosmose. By the passage of a galvanic current the endos-
motic phenomena may be both stimulated or reversed. This is shown
in the following experiment of Dutrochet: A tube containing gum-
water is closed at one of its ends by animal membrane and dipped in
a vessel containing common water. By the ordinary operation of the
laws of endosmosis the gum-water rises in the tube on account of the
entrance of some of the ordinary water through the membrane into

“ Death by Lightning, by M. Dr, Fedet (Clermont Ferrand), Gazette des Hépi-
taux, June 8-10, 1872, translated in The Clinic, July 6, 1872.
EFFECT OF ELECTRICITY ON NUTRITION. I9I

the tube. But if the positive pole of a galvanic battery be placed in
the common water, and the negative polé in the gum-water, the endos-
motic action is stimulated to such a marked degree that the level of the
gum-water rises with much greater rapidity ; if we reverse the pole the
level of the gum-water in the tube sinks instead of rises. The faradic cur-
rent from the secondary coil produces no such effect. The current from
the inner coil—the extra current so called—produces these effects to a
less degree. It is pretty clear, therefore, that these phenomena de-
pend on the chemical, and not on the mechanical power of the current.

Lilectrical Endosmosis is influenced by Strength of Current and Resist-
ance of Circuit.—It is found that the quantity which rises is in exact pro-
portion to the strength of the current, and to the extent of the porous
surface. It has been found that the greater the resistance of the liquid
to electrolysis, the more it yields to this endosmotic action.

The above phenomena have been demonstrated at different times, and
by a variety of observers.

Besides the physical effects above described, there may be many
others that we cannot at present recognize or appreciate, but which
may be revealed by the spectroscope and other means of refined re-
search.

After Physical: Effects of the Currents.—-It has been observed that
platinum wires are contracted by the passage of electric currents through
them, and that copper wires that are used for conducting electricity
become brittle thereby. The differential action of the faradic and gal-
vanic currents in this respect is quite interesting, for, according to
Ruhmkorff, the copper wires that conduct faradic currents break more
speedily and more frequently than those which conduct galvanic currents.

This physical fact is very suggestive of what may be facts in physi-
ology and pathology. We have already seen that magnetization has
physical effects of a most decided character. We have seen that it
causes sounds to proceed from the body magnetized; that the body
magnetized also becomes elongated ; and that this elongation is proba-
bly due to the fact that the particles arrange themselves, during mag-
netization, lengthwise in the direction of the bar. It is not improbable
that the human body in health and in disease may also be changed by
the action of the currents in a manner that we do not yet comprehend,
and that such physical or physiological changes may. account for some
of the therapeutic effects of electrization. This probability applies
especially to the after effects of electrical treatment, effects that are
noticed not while the applications are being made, or during the course
of the treatment, but weeks and months after the treatment is discon-
192 ELECTRO-PHYSIOLOGY.

tinued. On this subject we shall speak in more detail in the sectio1 on
Electro-Therapeutics.

Chemical Effects.—The chemical effects of the current are mainly of
an electrolytic character. They consist of an electro-chemical composi-
tion of the fluids of which the body is composed. The general laws
and phenomena of electrolysis in its relation to inorganic substances
have already been set forth in the chapter on that subject in Electro-
*Physics. It remains for us here to speak of electrolysis, in its rela-
tion to organic life. At the outset we may remark that there is no
evidence that organization, as such, seriously modifies electro-chemical
decomposition. The fluids of the body decompose under the influence
of the current, just as the same combination of fluids with tissue would
decompose if not endowed with life. If the results of the electrolysis
of the dead body are different from the results of the electrolysis of
the living body, it is because of the chemical changes that take place in
the body after life has departed.

The human body is composed of fourteen different chemical sub-
stances, many of which are singly capable of decomposing under the
current, and in their various combinations are capable of many decom-
positions and recompositions, with secondary results that cannot well be
estimated. .

The general facts of the electrolysis of inorganic substances, the ap-
pearance of oxygen and acids at the positive pole, and hydrogen and
alkalies at the negative pole, apply also to the electrolysis of the living
body. The great law arrived at by Faraday, that in electrolysis
substances are decomposed in equivalent proportions (see Electro-
Physics, p. 54), also finds no exception or interference in organic
structures.

Some of the Phenomena of Electrolysis of Living and Dead Tissues.—
In order to determine the electrolytic effect of the current on organic sub
stances we have made a wide variety of experiments on both living and
dead tissues, fluid and solid, in a normal as well as pathological condi-
tion, on animals and men. We have tried the galvanic current on the
voluntary and involuntary muscles ; on the mucous and serous mem-
branes ; on brain, spinal, and nerve matter ; on the lungs, the heart, the
liver, spleen, stomach, intestines, bladder, uterus ; on the saliva and the
urine ; on the cartilage and on bones. The general conclusions at
which we have arrived from these experiments are these :

1. All these animal tissues, living or dead, decompose, so far as cat
be seen, like inorganic substances, and by uniform laws.

2. The fact most patent to superficial observation is that the rapidity
EFFECT OF ELECTRICITY ON NUTRITION. 193

of the electrolysis depends more on the amount of fluid in the tissues
than on all other factors combined.

3. The great difference in the effects of electrolysis on organic and
inorganic substances is seen after the current has ceased to act. In
the electrolysis of most inorganic substances—such for example as iodide
of potassium, acetate of lead, chloride of sodium, and so forth—the
effects cease as soon as the current ceases; the substances remain in
the condition that the current left them. The electrolysis of organic
substances starts a process that continues long after the current ceases to
flow.

Electrolysis of the White of an Egg.—When the white of an egg is
electrolyzed by copper needles or wire, white flakes rapidly form around
the needle connected with the negative pole, covering the needle as
cotton covers a bobbin of a loom. This white covering soon becomes
detached from the needle, if the current is tolerably strong, and floats
on the surfacé of the albumen, and then another similar envelope is
formed over the needle. In a little time the surface of the albumen
becomes covered with white, slight masses, resembling what are known
on our tables as “floating islands.” These formations are not coagula,
as might be supposed, but are simply composed of hydrogen gas envel-
oped by very thin layers of albumen, into which it is mechanically driven
by the electrolytic action, after the analogy of soap-bubbles and the froth
of a beaten egg, where the distension is caused by common air envel-
oped by water and albumen.

Besides these changes the albumen becomes discolored, and reddish-
yellow streaks are found at both poles. This discoloration is due partly
to the action of the oxygen or the albumen on the copper of the elec-
trodes.

Although, as has been said, platinum wires at the point of insertion
into the substance are best for these experiments, since they are not
acted on, and exhibit the’ changes in their purity, yet a common sewing
or darning needle, or copper wire, will answer; but it should be borne
in mind that the action of the substances on these will complicate the
observation, and that they will in a short time become destroyed by
oxidation.

Electrolysis of Fresh Milk.—When fresh cow's milk is electrolyzed
with platinum needles an odor of chlorine is distinctly perceived, due to
decomposition of the chloride of sodium, and little islands of foam appear
on the surface. This foam, on being broken up, gives forth an odor of
chlorine, and disappears, showing that it is not coagulated albumen,
but simply chlorine gas and albuminous envelopes.

13
194. EI,ECTRO-PHYSIOLOGY.

Electrolysis of the Aqueous and Vitreous Humors of the Eye.—When
platinum needles connected with a galvanic current are inserted into
the aqueous and vitreous humors of the eye of a dead or dying rabbit,
rapid electrolysis takes place at both poles, with evolution of gases in
albuminous envelopes. A cloud resembling cataract is speedily formed
over the pupil, and in a few moments, if the current be of medium
strength, the covering of the eye will be ruptured, with a violent escape
of albumen-enveloped gases. This process, which Dr. Beard has fre-
quently studied in the eyes of rabbits and dogs, is similar to that which
takes place in the electrolysis of hydrocele and of certain cystic tumors.

Electrolysis of Beef.—It is possible to gain a measurably correct idea
of what changes take place during and after electrolysis of the living
body, in health or disease, by studying the phenomena that appear
during electrolysis of dead tissue. Ifa piece of beefsteak, for example,
be subjected to the action of the galvanic current by needles connected
with the positive and negative poles, a process somewhat resembling
frying can be distinctly seen and heard and felt; more specifically,
bubbles of hydrogen appear at the negative pole, and a kind of hissing
sound is heard, even when the ear is at some little distance, and a posi-
tive sensation of heat is felt when the finger is pressed over the part
that is being electrolyzed. Under the microscope this process can be
more closely studied. Chemical examination shows that oxygen, acids,
and albumen go to the positive pole, while hydrogen, alkalies, and
coloring matter go to the negative, and the action at the negative pole
is much greater than at the positive. Under this process the beef be-
comes gradually dried and: changed in color, owing to the disappearance
of the watery constituents and the other electrolytic action; and, in
proportion as the beef grows drier and the fibres begin to lose their ad-
herence and fall apart, the electrolytic process becomes less and less
active, because there is less fluid on which to act.

For some hours after the needles are removed, the process of drying
and disintegration and decoloration goes on, until the portion that lies
between and near the poles shrivels, contracts, and crumbles, until it
resembles the burnt corners of a piece of roast beef. ‘

Electrolysis of Fruits and Vegetables.—We have experimented on a
variety of fruits and vegetables—as oranges, lemons, apples, pears,
peaches, potatoes, turnips, etc. The effects of the electrolytic action,
as they appear to the eye and the ear, though consistent with the great
general laws of electrolysis of inorganic substances, yet are more or less
modified by the varieties of structure. When a sound apple is electro-
lyzed, the part around the negative needle changes in color and looks
EFFECT OF ELECTRICITY ON NUTRITION. 195

as though it had been bruised’ and was beginning to decay, and the
needle soon becomes loosened and will easily fall out. The process of
drying and decoloration goes on after the operation is discontinued. In
fruits and vegetables the electrolytic changes that take place are largely
due to the electrolyzation of water, which is aided by the acids that
they contain.

When muscles have been separated from the body and submitted for
several days to the action of a strong galvanic current, there have been
found at the positive pole sulphuric, phosphoric, hydrochloric and azo-
tic acids, and at the negative pole alkalies—as soda, potassa, and am-
monia.

Legros arid Onimus have shown that when an alkali, as carbonate of
soda, is placed at the positive pole in electrolysis of the human body,
and an acid—as tartaric acid—at the negative pole, the usual eschars
have not been formed. ‘This would seem to indicate that the cauteriza-
tion in electrolysis is due in part to the acids and alkalies that result
from the decomposition.

This cauterizing action is not solely due to the acids and alkalies, for,
when other acids and alkalie$S are applied to the body, eschars of the
same degree are not obtained. The current penetrates and pervades
the tissues and induces various changes beyond and beneath the eschar,
which changes continue long after the current is broken.

The phenomena above described all occur under the galvanic cur-
rent, and with needles as electrodes.

The current from the primary coil of the faradic machines has some-
electrolytic power, and even the current from the secondary and ter-
tiary coils is not without some chemical effect. It is not necessary to
use needles or pointed electrodes of any kind in order to produce elec-
trolysis ; but with a sufficient strength of current the phenomena may
be produced by large, flat, metallic surfaces. There is more or less
electrolysis in all the ordinary applications of electricity to the body,
whether made with metals or sponges, small or large.

Physiological Effects.—The physiological effects of electricity, pro-
perly so called, are those which take place by virtue of the wéfa/ proper--
ties of the body. The other effects above described—mechanical,
physical, and chemical—are not peculiar to living bodies; they are
observed on the dead as well as the living, on inorganic as well as
organic substances, although they are, as we have seen, more or less
modified by vitality. But the physiological effects of which we are here
to speak are peculiar to organization ; they cease when life ceases, for
they are mainly the modification of the vital processes by electricity.
196 ELECTRO-PHYSIOLOGY:

There are in general four ways in which electricity applied to the tis-
sues modifies their physiological functions :—

1. It may increase them.

2. It may diminish them.

3. It may arrest them.

4. It may modify their quality. ‘

Some of the more important illustrations of their effects have been
already discussed.

We have seen that electricity, according to the kind that is employed,
and according to the method and strength and length of the applica-
tion, causes various phenomena on the skin, contracts voluntary and’
involuntary muscles when applied either to the muscles themselves or
to the nerves that supply them, and increases the process of oxidation,
and raises the temperature, excites the nerves of common and special
sense so as to cause pain, flashes before the eyes, noises in the ears, and
a peculiar taste and odor. When applied to the pneumogastric it
increases, diminishes, or arrests the action of the heart.

It remains here to speak of the following physiological effects of elec-
tricity :—

1. On the circulation.

2. On secretion and excretion.
3. On absorption.

The effect of electricity on the circulation is somewhat complex. It
includes the effect on the heart and on the unstriped muscular fibres of
the arteries, as well as on the central and peripheral nervous system in
general, since the flow of blood in the arteries, veins, and capillaries is
influenced by the quality and quantity of innervation that they receive.
We have to speak merely of the direct effect of electricity on the capil-
lary circulation. It has been shown already that electrization of the
cervical sympathetic may have the directly opposite effect of contracting
or dilating the vessels of the retina. That the same opposite effects
may follow electrization of any part or organ, depending on the tem-
perament of the patient, the quality of current, and the length and
strength of the application, is also demonstrable. One effect is con-
stant under all conditions, and. that is, that the circulation is modified
in one or the other, or in both ways. The average ultimate effect is
to increase the flow of blood, raise the temperature, and dilate the veins.
Dilatation of the veins, after prolonged electrization, is a phenomenon
that can be demonstrated with ease on any part of the body where the
EFFECT OF ELECTRICITY ON NUTRITION. 197

veins are prominent. The back of the hand is the best place to study
this phenomenon, and faradization illustrates it most distinctly.

This enlargement of the veins is accompanied by.a rise in tempera-
ture that is appreciated by the subject, and if the muscles have been
brought into vigorous contraction, by the thermometer, as we have al-
ready seen (p._). Under general faradization the hands and feet be-
come warmer during the sitting, and may remain warmer for hours. Cen-
tral galvanization, or galvanization of the cervical sympathetic, also
warms the periphery.

On Secretion and Excretion.—The secreting power of the secreting
organs of the body is very markedly influenced by electrization. The
usual effect is to increase their activity ; but when very mild currents
are used, such effect is not always observed, and it is probable, from our
experiments, that very strong currents may produce a reverse effect.

On the lachrymal glands the action of the current is not so easily
shown, because strong currents are not well borne on the face or head,
and the glands themselves are not directly accessible. It is difficult to
decide whether the flow of tears that accompanies strong electrization
of the face is the result of the mechanical irritation or the physio-
logical action of the current on the lachrymal glands or the nerves that
supply them.

The secretion in mucous membranes is quickly increased by electriza-
tion, as can be demonstrated most easily on the Schneiderian membrane
by means of metallic electrodes introduced in the nasal passages.
This fact becomes of practical importance in the treatment of the so-
called “dry catarrh,” and also in exhausting diseases, associated with
dryness of the mucous membranes.

On the salivary secretion the effect of the current is very easy of de-
monstration. That application of the current, both galvanic and faradic,
can increase the secretion of the salivary glands, is very easily demon-
strated. We have shown this at various times during the past five years,
galvanizing or faradizing the tragus of the ear, with either pole, or against
the membrana tympani. This effect is due to the excitation of the
chorda tympani nerve, some of the fibres of which go to the submaxillary
ganglia. This increase of saliva is sometimes so great that, while the
current is flowing, continual swallowing is necessary. :

In sensitive persons the same effect follows, by reflex action, electri-
zation in almost any part of the neck or face. In certain pathological
cases, as Addison's disease, Dr. Rockwell * has found the annoying dry-

* These results are alluded to in the recent edition of Dr. Flint’s work on the
Practice of Medicine,

«
198 ELECTRO-PHYSIOLOGY.

‘ness of the mouth greatly relieved by electrization, and in pathological
cases of the severe character, as in diabetes, when the salivary secretion
may be greatly increased, we have found central galvanization to
diminish the secretion quite rapidly.

On the dliary secretion the action of the current is less easy of mathe-
matical demonstration. The results of external electrization in patho-

» logical cases seem to prove that the quantity of the bile may be increased,
Whether this increase is due to the action of the current on the sub-
stance of the liver, or the nerves that supply it, we are not able to
state. *

The secretion of gastric juice, and of the intestinal fluid, is in all prob-
ability increased by external electrization. Analogy would show these
fluids ought to be secreted in greater abundance under the influence of
the current, and the results of treatment in pathological cases give this
probability something of the force of certainty. Appetite is sharpened,
digestion is quickened, and constipation relieved, both by local and by
general electrical treatment, so rapidly ‘and so decidedly as to make it
pretty evident that the gastric and intestinal fluids are made to secrete
more liberally by the action of the current on the nerves that supply
these organs than on the tissues of the organs themselves.

An excellent means of studying the variations in the nutrition is
found in the elimination of the urine. This is believed to be a result
of oxidation processes that may take place either in the kidneys or in
the tissues, or in both.

Legros and Onimus have studied the effects of electrization of the
spine on the elimination of urine.

Their conclusions, derived from more than 250 analyses, made on
the urine of rabbits and of themselves, are these :—

1. Interrupted currents diminish the quantity of urine and of azote.

2. Centrifugal galvanic currents increase the quantity of the urine
and diminish that of the urea. :

3. That continuous centripetal currents increase the quantity of urea
without increasing the quantity of urine.

On the urinary secretion the effect of electrization can be demon-
strated in pathological cases without difficulty. In cases of diabetes
insipidus and mellitus, local and general treatment may cause great di-
minution in the discharge, while in dropsy and in rheumatism we have
known the kidneys to be stimulated as much as by powerful diuretics.

On the average man in health there is considerable difficulty: in esti-
mating a moderate increase of the urinary secretion under electriza-
tion, for the sufficiently apparent reason that the quantity of urine

»
EFFECT OF ELECTRICITY ON NUTRITION. 199

varies with so many conditions of food, drink, and exercise, and so
forth. Unless the effect of electrization on the kidneys were immediate
and decided, it would be difficult to differentiate between its effects
and the effects of the other important and varying factors.

On the menstrual secretion electricity acts with remarkable power.
Both currents, applied externally and internally, centrally or generally,
in physiological as well as pathological cases, affect the quantity of
menstrual secretion rapidly, and sometimes permanently. The effects
are sometimes immediate, taking place during or directly after the
application. The number of days that the menses appear are some-
times increased, and entire suppression is slowly or speedily cured.

In pathological cases, where there is an excess of menstrual flow,
electrization corrects and diminishes it. . These apparent and interesting
effects of electricity on the menstrual secretion may take place through
the direct action of the current on the ovaries and the uterus, or indi-
rectly through the brain, sympathetic, and spinal cord, and the nerves
that supply the pelvic organs. They may take place through reflex
action from electrization of the feet or hands, or other and distant parts
of the body. Franklinic electricity also produces these effects.

The whole subject is of immense practical importance, as will be
seen in the chapter devoted to Diseases of Women.

On the dacteal secretion electricity, especially the faradic current,
acts with decided though varying power. It has never been known to
diminish it, while it sometimes increases it, and it may restore it after
it has been temporarily suppressed. This physiological fact has a
‘practical significance that will appear in the chapter devoted to Mid-
wifery.

Similarly also the secretion of the spermatic fluid is increased by gal-
vanization or faradization. A mathematical test of the power of elec-
trization to increase the secretion of the testicles cannot, for obvious
reasons, be obtained; but the statements of individuals on whom the
experiment was tried seem to establish this point. The applications may
be made not only through the testicles, but through the perineum and
over the spine. The results are not invariable, but are obtained in a
sufficient number of cases to make it fair to regard such effect as a
law of electro-physiology.

The secretion of the sweat glands is also increased by powerful
galvanization of the central nervous system, and especially of the cervi-
cal spine and sympathetic. In very susceptible patients either galvani-
zation or faradization of the head, neck, or spine, and strong electrization
of almost any part of the body. will cause sensible perspitation. We
200 ELECTRO-PHYSIOLOGY.

have seen individuals whom a few minutes of general faradization with
feeble currents brought out large drops of sweat on the forehead, and
made the hands as moist as though they had been dipped in water.

On Absorption.—Yhe action of electricity on the absorbents is best
studied in pathological cases, such as hypertrophies, effusions, and
morbid growths.

In thickening of the skin that appears in some cutaneous affections,
in corneal opacities, in enlarged joints, in pleuritic effusions, in hydro-
cele, in dropsy of various parts, in passive cedema, and in enlarged
glands, in tumors of nearly every variety, can be demonstrated the power
of electricity to produce absorption. Reasoning backward from patho-
logy to physiology, we justly infer that the same effect takes place, more
or less, in all applications of electricity to the body, but that the degree
of it is modified by the condition of the part to which the application
is made. The effect on secretion is apparent at once to the eye or the
sensation ; the effect of absorption is apparent only to the eye, and
then only when there is a visible excess of fluid or solid in the part to
which the application is made. This part of our subject will be prac-
tically illustrated in various chapters both in Medical and Surgical
Electricity.

| Effects of Electricity produced by Reflex as well as by Direct Action.

—The reflex effects of electricity seem not to have been fully recognized
by electro-therapeutists. There is considerable difficulty in ascertaining
the precise reflex effects of electricity on animals. The effects as they
show themselves on man are largely sensory, not motor; the stimula-
tion of the circulation of absorption and of secretion that might and
probably does take place, refléxly as well as directly, is too minute to
be readily observed. We are justified in believing that electricity acts
in absorption, secretion, and exertion by reflex as well as by direct action,
from the fact that in irritable constitutions sensory effects on the sensa-:
tion and on circulation, of a marked character, are produced by electric
irritation. Thus, for example, when the hands or the feet are traversed
by strong currents, either continuously or in sudden shocks, pain or
disagreeable sensations may be felt in the hands and feet, of the oppo-
site side, or in the back, or stomach, or side. These reflex effects are
not constant, and when we look for them we may not find them. They
can be best studied in persons who are susceptible to electricity, and
whose spinal cords are weak and irritable. In some pathological cases
also, such as chronic myelitis of the anterior column (anterior spinal
sclerosis), the reflex action of electricity is illustrated with great dis

tinctness. Localized faradization, or galvanization‘of the lower limbs ’
EFFECT OF ELECTRICITY ON NUTRITION. 201

may be felt not only in the part traversed by the current, but in the
arms, in the opposite limb, in the back, and stomach to such a degree
as to cause pain.

Strong currents acting on irritable constitutions may sometimes by
reflex action shock the whole system, provided the application be
localized in certain localities. Thus in a case of very obstinate con-
stipation that we once treated by internal galvanization of the rectum,
a current of not very great strength, suddenly interrupted, was disagree-
ably felt in the head, left hand, and feet. Very frequently, indeed, in
experimenting on ourselves or other individuals, or on animals, and in
treating patients, we have received shocks through the hands or arms
that seemed to be felt in all parts of the body. In some instances the
pain and disagreeable sensations thus caused by the reflex action of the
current last for several minutes or hours.

On the circulation the reflex effects of electrization are demonstrable ’
by delicate apparatus for testing temperature. It has been shown by
experiments that electrization of one hand affects the circulation in the
hand of the other side, so as ta change its temperature under the thermo-
electric pile.

Powerful electrization of feeble persons may cause a general chilli-
ness of the extremities that may last for hours. A sensation of hav-
ing caught cold has been known to follow strong peripheral faradiza-
tion.

Whether the action of the current on the retina and on the auditory
and gustatory nerve is direct or reflex has been long disputed. Our
researches induced us to the belief that electricity acts on the nerves of
special sense both reflexly and directly. That the gustatory nerve can
be treated by reflex action, we have shown in a variety of experiments
with both currents. Sensitive patients appreciate the sour or metallic
taste when the application is made to the lower part of the spine or to
thearms. Similarly, flashes before the eyes may be produced when the
electrodes are so placed that the current cannot traverse directly the
region of the brain where the optic nerve takes its origin. Excitation of
the auditory nerve by reflex action is not so easily demonstrated, but
tinnitus aurium sometimes follows electrization of the spine and neck,
and it is not unfair to infer that it is the result of reflex excitation.

In thus admitting the possibility of exciting the nerves of special
sense, we do not desire to give the impression that the ordinary physio-
logical excitation of these nerves under electricity is purely of a reflex
character ; on the contrary, we have shown already, in the chapter on
,Electro-Conductivity, that the. current penetrates the brain and goes
202 ELECTRO-PHYSIOLOGY.

through those parts where the optic nerves originate, and also must
pass through the labyrinth and act directly on the auditory nerve.

In reference to the reflex effects of electricity these two considera-
tions are of importance :—

1. The galvanic currents operate much more powerfully by reflex
action than the faradic. The partial explanation of this fact which we
offer is that the greater chemical power of the galvanic current, due to
its acting always in one direction, causes it to operate more distinctly
on the nerves than the faradic current. This fact of the superior reflex
capacity of the galvanic current is one of high practical import in the
treatment of disease, and explains in part, if not entirely, the dangerous,
or at least unpleasant, effects that sometimes follow careless or ignorant
galvanization in cerebral hemorrhages and other irritable conditions of
the central nervous system.

Althaus has recorded a case of anesthesia of the fifth pair of cerebral
nerves of a most profound character, in which there was a complete
absence of cerebral symptonis—dizziness, flashes of light, and galvanic
taste—-whenever a galvanic current of twenty cells was applied to the
face. A current from thirty cells, which on a person in health would
cause powerful flashes, a hissing sound in the ears, feeling of heat, and
perhaps perspiration, caused in this patient only a slight sensation of
giddiness and metallic ‘taste and phosphoric odor.

This remarkable case is a strong argument in favor of the opinion
that the results of electrization of the head and the results of experi-
ments like those of Erb are due in part, if not entirely, to reflex action.

It is possible that in the above case the portion of the brain where
the optic nerve originates was also diseased so as torender it insensible
to electric excitation.

2. These reflex effects occur in all the applications of electricity of
either form, and complicate the direct effects. The physiological and
therapeutical effects of electrization of the brain, the eye, the ear, the
cervical sympathetic, the spine, the trunk, and the periphery, every-
where are a complex resultant of both direct and reflex electrical ac-
tion. Localized electrization, strictly speaking, is an impossibility, how-
ever closely together the electrodes may be placed, and however dis-
tant from the great nerve tracts and nerve centres the spinal cord must
take cognizance of the impression made by the current on the sensory
nerves, and other parts and organs must share in the effects, for bet-
ter or for worse. It is for this reason that caution is requisite even in
faradizing the paralyzed muscles in recent hemiplegias and in active my-
elitis.
EFFECT OF ELECTRICITY ON NUTRITION. 203

The very remarkable results that follow general faradization—a
method to be subsequently described—are to be accounted for in part
by reflex actions, which are continually taking place during all stages of

. the application.

Practical Application of these Physiological Principles to Electro-
Therapeutics.—With the above facts and reasonings before us we are
prepared to intelligently appreciate the effect of elgctricity on nutrition.
We do not profess to have exhausted the rationale of the complex action
of electricity on the tissues, but to have indicated the leading principles
by virtue of which it affects the nutrition of the animal body. Many dis-
coveries may yet bein store for us in this department ; it may e shown
that ozone is generated in the tissues with every passage of the current,
and that this ozone is taken into the circulation; the subtle and intri-
cate chemistry of electrolysis of living tissues in their secondary and
tertiary, as well as their primary changes, may be unfolded to the vision
of the future, and what we now see in a glass darkly posterity may
behold face to face; but sufficient is known to explain in a most in-
teresting way the unrivalled effect of electricity on the nutrition.

An objection sometimes brought against electricity is that we do not
understand its action ; and yet in the whole round of stimulating tonics
there are but few whose action can beso well explained as that
of electricity. Who knows how arsenic feeds the nervous system or
how quinine breaks an attack of chills and fever? Why does oxide of
zinc act with magic force in chronic alcoholism? How does opium
produce sleep and relieve pain; and who has entered into the myste-
ries of anzesthesia ?

Animal nutrition is a process of enormous complications. There is
no single chemical change at which one can point and declare that
this explains the growth and sustenance of the body; but there are
nameless and numberless phenomena every moment going on in the
living tissues, and as a result of all these, in their infinite play and com-
bination, the body lives, moves, and has its being. Electricity in pass-
ing through the body modifies many or all of these processes, and thus
modifies nutrition. As a resultant of the complex physical, chemical,
and physiological action of electricity on the tissues, there is increased
development and growth.

Experimental and Clinical Proofs of the Effect of Electricity on Nutri-
tion.-We have studied the effect of electricity in great detail on animals
and on man. On animals our experiments have been confined to the
effects of general faradization ; on man we have studied the effects of
both localized and general treatment. '
204 ELECTRO-PHYSIOLOGY.

Of a litter of four puppies, Dr. Beard submitted two to general fara.
dization every other day, for eight minutes each, and two were not so
treated, all having an equal chance at their mother’s breast and nothing
besides. All the puppies were carefully weighed at the beginning and
at the end of the treatment, which lasted for four weeks. It was found
that both of the pups that had been electrized weighed more than the
puppies that had not been electrized; all had, of course, increased in
weight, but of those electrized one had increased Jour ounces and the
other zem ounces more than his fellows that had not been electrized.
The difference of size in favor of the puppies that were electrized was
so marked and so easy to see, that without great difficulty one who had.
never seen them succeeded in picking out, from ocular inspection,
those that had been treated, and that too in the evening, and in a bad
gas-light. It was observed during the treatment that the puppies which
were electrized became ravenous, and sucked with greater energy than
their less-favored companions. ‘

The method of treating the pups, we may remark, was to put them
on a sheet of copper, while the hand of the operator or a sponge-
electrode was rubbed all over the surface of the body, previously moist-
ened.

The details of the experiments, prepared by our assistant, Dr. J. W.
Sterling, who made the applications, are as follows -

July 1, 1871.—Weight of 4 pups, 10 days old:

2 black pups (weight each)..... eoeve Tb. 602
2 yellow pups, weight of one........ 1 lb. 34 0z. ; other, 1 Ib, 2} oz.
July, 1, 1871.—Commenced general faradization, each application about 8 minutes,
Applied it to one of the black pups, weight 1 lb. 6 0z., and the lightest of the yel-
low pups, weight 1 lb. 24 oz.
Continued the applications four weeks, making three each week.
July 28, 1871.—Weighed the pups after twelve applications,

1 black pup (general faradization)..... inetd oes sisscsaee 3lbs, 7 02,
1 black pup (no faradization).............04. sesvsende 2 ong. @
1 yellow pup (general faradization),...........48 wae 3 & o &
1 yellow pup (no faradization),....... eS RIM anatase! 2 BS eae ORE

Making a clear gain for the edectrized pup (black) of 10 0z., for the yellow electrized
pup, 4 02.

This we believe, was the first comparative experiment of this kind
made with the faradic current. Subsequently, Dr. Beard repeated the
experiment on a litter of three rabbits. Two were faradized every other
day ; to the other no treatment was given. At the end of six weeks the
EFFECT OF ELECTRICITY ON NUTRITION. 205

<

one not treated was visibly larger than either of those that were treated.
We explained this unexpected result by the theory that the current had
been used too strong and too long for the young and delicate animals.
The experiment was: carried on while we were in the country, and the
details were intrusted to those who were utterly incompetent for their
duties. The directions given were to put the feet of the rabbits in a
basin of tepid water, and after well moistening the back of the neck to
pass the current through for ten minutes; on account of the non-con-
ductivity of the dry hair of the rabbit, general faradization was almost
impossible.

Legros and Onimus electrized with the galvanic current some pup-
pies for a quarter of an hour every day, by placing one of the fore-paws
‘and one of the hinder-paws in tepid water connected with the elec-
trodes. At the end of six weeks those that had been electrized weighed
more than the same lot that had not been electrized ; and this ditfer-
ence was perceptible to simple inspection ; one was galvanized with the
ascending, and the other with the descending current.

The effect of faradization on nutrition is powerfully illustrated by
the experience of those who habitually or frequently apply general fara-
dization through their own persons, taking an electrode in one hand,
and applying the other to the body of the patient. In this method the
current passes through both arms, and vigorously contracts the muscles.

The permanent effects of the current on the person of the operator
are:

1. Zo cause very marked and sometimes rapid growth of the muscles
of the arms.

The explanation of this phenomenon is sufficiently easy. The mus-
cular contractions that are produced by the current in its passage
through the arms cause increase of the local processes of waste and
repair, and accordingly the muscles increase in size, just as they natu-
rally do under the influence of any other form of active or passive exer-
cise. This mechanical explanation would be of itself sufficient, but, in
addition, it is entirely probable that the electric current exercises a
direct and specific influence on the nerve-branches, which effect is ex
pressed by the increased size and vigor of the muscles through which
the nerves ramify.

Dr. Rockwell, during his first experimental attempts in the treatment
of disease by general electrization, observed a decided increase in the
development of the muscles of the arm. It began to force itself on his
attention a few weeks after he commenced to give special attention to
general electrization, and at the present time it is fully as marked as
*

206 ELECTRO-PHYSIOLOGY.

ever. Both arms of each one of us have not only increased much in
size by actual measurement, but also correspondingly in strength and
hardness. This effect is observed in the arm and forearm, but most
decidedly in the muscles which, from their position or nerve supply,
contract most readily and vigorously when the current passes from
hand to -hand, such as the deltoid, brachialis anticus, biceps, and the
flexors and extensors of the forearm. his same effect has been noticed,
to a greater or less degree, by our students, and, so far as we have
been able to ascertain, by others, who have employed electricity through
their own persons for any considerable period. This development of the
arms seems to progress up to a certain limit, at which it remains.

2. A very gradual but decided tonic influence on the system.

This effect is so exceedingly slight, that in a very hardy and vigorous
person it would not be recognized. That the current, in passing from
hand to hand, so frequently and so long, should, in the course .of time,
mildly affect the general system, is entirely probable. Like any other
muscular exercise of the arms—-gymnastics and the use of the clubs—
its influence, so far as it goes, must be positively touing and beneficial
to the constitution.

Sull further, there is no doubt that even the faradic current, widely
diffused and weakened as it must be when it reaches the neck and
shoulders, affects in a very gentle manner, and to a limited extent, that
portion of the sympathethic and central nervous system through which
it must pass.

Oui infants we have used the same treatment that appeared to be so
successful on the puppies, and with satisfactory results. An opportunity
for a comparison of the nutrition of faradized and non-faradized infants
has never been presented to us, and on account of the rarity of triplets
and twins, we fear that it would be difficult to find such an opportunity.
But infants who are in a condition more or less pathological, who are
“ebilitated and marasmic, appreciate the tonic effects of general fara-
dization so markedly as to nurse with greater liveliness and vigor, to
grow apparently with greater rapidity than when electricity is not used.

The practical application of these physiological truths will appear in
the section on Electro-Therapeutics, and especially in the use of general
fax adization, and in diseases of children.
CHAPTER XII.

RELATION OF ELECTRICITY TO LIFE.

EXPERIMENTS in électro-physiology, interesting and suggestive as

they are, and important as they have been shown to be for therapeu-
_tics, have done but little toward solving the mystery of life.

The extravagant hopes at.one time entertained that electricity and
life would be proved to be identical, have not as yet been realized ;
but recent investigations, so far as they go, seem to prove that they are
radically and essentially different. The facts and arguments on which
the theory of the non-identity of electricity and nervous force rests are
mainly these :

1. The nerve-current can be detected in a nerve after it has ceased
to react to the electrical stimulus. The reverse of this law, however,
does not obtain. This consideration will have weight only with those
who accept Du-Bois Reymond’s experiments in animal electricity.

2. The slow rate at which nerve-force travels.

Speed at which the Nervous Force Travels.—It had long been sup-
posed that the rate of passage of the nervous force could never be esti-
mated. It had been the popular belief that the nerve force, like light
and electricity, travelled with great rapidity, and as the field of its
operations was limited to the small area of the human body there seemed
to be no prospect of ever ascertaining its rate of passage.

Long ago Haller estimated the rate of passage of the nervous force
to be aboutsene hundred and fifty feet in a second. He arrived at this
estimate by finding out the number of letters he was able to pronounce
in a minute while reading aloud, and calculated the length of the nerve
tract between the brain and the muscles. It is remarkable that Haller,
with his rough-and-ready method, came near to the estimates made with
the most improved apparatus of recent times.

In 1850 Helmholtz, eminent both in physics and in physiology, by
means of a very delicate chronometric apparatus, estimated that the
nervous force of the frog travelled at the rate of about eighty-five feet in
a second. Marey, with improved apparatus, made the estimate thirty-
six to forty-six feet per second. More recently still, Helmholtz and
208 ELECTRO-PHYSIOLOGY.

Baxt have estimated that in the human subject the rate of the nervous
force, in motor nerves, is one hundred and eleven feet per second.

Hirsh and Schelske have shown that the rate of conduction in sensory
nerves is almost the same as in motor nerves—that is, not far from one
hundred feet per second; and for the present we must accept this as
an approximately correct estimate of the rapidity of nervous conduction
an motor and sensory nerves in the human subject.

Further than this, endeavors have been made by Helmholtz, Marey,
Donders, and others, to ascertain the time required for the nervous force
to generate the operations within the brain and spinal cord; the esti-
mates that have been made in this direction are merely approximate,
and may be radically revised by future investigators. Donders ascer-
tained, by experiments on himself, that the act of volition required
wy of a second, and the act of receiving and appreciating any distinct im-
pression about y4; of a second. The general estimate is that in the reflex
acts of the spinal cord the conduction is /welve times slower than in
the transmission of impressions through the nerves. It has also been
estimated that the brain is about 5 of a second in distinguishing and
signalling the difference between two colors, and about the same time in
distinguishing between the two vowels as they are uttered. As compared
with light and electricity, nervous force is exceedingly slow.

It has been ascertained, furthermore, that the velocity of muscular
contraction is about s{; that of nervous force in the nerves.

The velocity of nerve transmission is considerably modified by temper- .
ature. Observations made in the summer give different results from
observations made in the winter, and show very clearly that high tem-
perature accelerates, and low temperature retards, the velocity of the
nervous-force. By the observations of Helmholtz the temperature of
the frog has a very great influence over the rapidity with which nervous
force is transmitted. At 32° it moves not more than jl; as rapidly as at
a temperature of 60° or 70°.

It has also been established that different parts of the trunk of a
nerve conduct with different degrees of rapidity.

It has also been noticed by Marey that the rate of transmission
is somewhat reduced by fatigue of the muscles.

The velocity of the nervous force is still further lessened by the
action of the curare poison, or by disease,—such, for example, as pos-
terior spinal sclerosis.

This argument from the greater speed of electricity is to be qualified
by the consideration that the velocity is not absolute, but relative, and
RELATION OF ELECTRICITY TO LIFE. 209°

is greatly modified by the nature of the substance through which it cir-
culates.

3. Ligature or division of a nerve impedes the transmission of nervous
force, which would not be the case if the nerves were simply telegraph
wires. Even if the stumps of a divided nerve are made to touch each
other, the nervous force will not pass.

Theory of the Correlation of the Physical and Vital Forces.—The rela-
tion of,electricity and magnetism to life may perhaps be explained by
the theory of the Correlation and Conservation of Forces. May not
the body contain a number of distinct forces—electricity, magnetism,
and vital or nervous force, or life? If light, and heat, and motion, and
electricity are mutually convertible, may not the zervous force also be
convertible with electricity and magnetism? It is certainly probable
that the therapeutic results of electrization are partly due to the increase
of the nerve force by the molecular changes produced by the action of
the current on the tissues.

frree Electricity in the Body.—The subject of free electricity in the
body has at various times attractecl the attention of observers. Hem-
mer, in 1790, Gardini, in 1793, made a large number of experiments
with a view to ascertain the general electrical condition of the human
body. Their conclusions were that there is electricity in the body,
sometimes positive, sometimes negative—that it was variously modified
by conditions of health and disease. In 2,422 trials on himself, Hem-
mer found a positive charge 1,252 times, a negative 771 times, and
none at all 399 times. He concluded that the natural electricity of the
body was positive ; that this was modified by physical or mental exer-
tion. Sfdsten, in 1800, Ahrens and Pfaff, in 1812, and Nasse, in 1834,
investigated the same subject, and concluded that free electricity was
more manifest in the enthusiastic and excitable than the cold and
phlegmatic, that it was greatest in the evening, that it was increased
by stimulants, and diminished by cold. Ahrens and Pfaff stated that
the electricity of the body disappeared during attacks of rheumatism,
and reappeared on recovery. Nasse found positive electricity in every
one, under all circumstances. Although some of these experiments
were performed on naked patients, seated on an insulated stool, yet
Sterrieberg decided that these manifestations of electricity which they
obtzined were the result of the friction of the clothes on the skin.

Animal Magnetism.—Of the familiar and mysterious phenomena of
animal magnetism, so called, our knowledge is at present so unsatis-
factory that any attempt to explain them must be futile. The connec-
tion that is supposed to exist between animal electricity and animal _

14
210 ELECTRO-PHYSIOLOGY.

magnetism is not demonstrated by any known facts. The exceedingly
mysterious and suggestive character of the phenomena, which appear
to be connected with some unknown force in the body, has induced a
spirit of inquiry, which, in lieu of positive knowledge, has been obliged
to content itself with speculations. The most noteworthy treatise on
this subject is that of Reichenbach,* in which the author accounts for
the strange phenomena attributed to animal magnetisin by the exist-
ence of odyllic (all-penetrating) force, which he claims to have first
discovered.

The excitement produced on the first publication of the work has
now died away, and the science is now waiting for more accurate in-
vestigations to provide suitable data before attempting any further
speculations on this dark and difficult question.

Electricity in Plants and Fruits.—Electrical currents have been
found in pears, apples, peaches, and plums. It has been ascertained
by Donné and Du Bois-Reymond that in apples and pears the currents
flow from the peduncle to the bud, but in fruits with stones, as peaches,
apricots, and plums, from the bud to the peduncle. When the fruit is
divided in a line at right angles with the long axis, and the juice is
squeezed out of the two halves in vessels connected with a galvanome-
ter, then, on completing the circuit, the current is observed.

It is claimed that the roots and all parts of the interior of plants
filled with sap are negative, while the humid or moistened interior of
the green twigs, leaves, flowers, and fruit, are positive. Experiments
recently made show that in lemons, turnips, gooseberries, and pears,
and in raw potatoes, the current is from the centre to the skin.

Dr. Burdon-Sanderson has recently made experiments on plants,
which seemed to show that they possess definite currents of electricity,
like animals.

On the validity and value of all these experiments in animal and vege-
table electricity much doubt is thrown by the researches of Trowbridge,
previously recorded.

Leffect of Electricity on the Growth of Plants.—The influence of elec;
tricity on the growth of plants has recently been studied by Mr. H. H.
Bridgeman, of Norwich, England. On a plate of glass three inches
square, two strips of sheet-tin are laid, so as to almost touch in the
centre. On this glass, and over the tin strips, is spread a piece of felt
moistened with rain water. On its dampened surface, cress-seeds are

* Physico-Physiological Researches on the Dynamics of Magnetism, Electricity,
Light, ete.
ELECTRICITY OF PLANTS. 211

thickly strewed. The tin plates are connected with the poles of a weak
galvanic battery ; the result is that one half of the felt is charged with
positive and the. other half with negative electricity. At the side of
this plate is a second plate, which has connection with the battery, and
upon which the seeds grow, subjected to no artificial conditions. After
four days the seeds on the opposite side of the first piece of felting gave
signs of germination, and the hulls were shrivelling up and becoming
black. On the negative side of the felting the seeds were swollen, and
their hulls, which retained their natural color, were beginning to burst.
At the end of six days the first shoots made their appearance. Several
days later the first shoots appeared upon the second plate. A strange
result of this trial was, that while on the negative pole, where there was
every sign of stronger development, the root-sprout sank downward into’
the moist felting, the roots from the positive side rose upward from the
blackened and dried-up seeds.
ELECTRO-THERAPEUTIGCS.
CHAPTER I.
HISTORY OF ELECTRO-THERAPEUTICS.

LElectro-Therapeutics is the science that treats of the study of electri.
city in its relation to disease.

It includes both Electro-Medicine and Electro-Surgery, or as théy
are more commonly termed, Medical and Surgical Electricity. Under
Medical Electricity are included Zvectro-Diagnosis, or Electro-Pathology,
as it is sometimes termed, and Zvectro-Therapeutical Anatomy.

The earliest history of electro-therapeutics, as of many other depart-
ments of medicine, is shrouded in obscurity. It dates back to a mythi-
cal and legendary age, before mankind had been trained to habits of
scientific criticism, while yet history was a mass of traditions, and rumor
was a substitute for truth.

It is said that centuries ago the negresses of West Africa were accus-
tomed to dip their sick children in water where lay the electric fish called
the torpedo. The remedial powers of electricity were also referred to by
Pliny and Dioscorides. Scribonius Largus, a physician of the time of
Tiberius, was accustomed to prescribe the same remedy in the treat-
ment of gout. As long ago as the days of Pliny, necklaces of amber
were worn by women and children for the sake of their supposed reme-
dial powers.

The mysterious power of the magnet was known to the ancient world,
but we have no reason to believe that it was ever extensively resorted
to by them for the cure of disease. In Europe, during the middle ages,
the loadstone was used in the treatment of disease, and although its
successes were trifling it aroused the professional attention and received
extravagant praise from the distinguished Paracelsus. About the mid-
dle of the eighteenth century, Maximilian Hehl, of Vienna, and others,
excited a new and more successful interest in the use of magnetism in
disease by the manufacture and employment of artificial magnets.

The real history of electro-therapeutics may be divided into three
eras: the Era of Franklinic Electricity, including the early and crude
experiments with the frictional machines and the Leyden jar ; the Ara
HISTORY OF ELECTRO-THERAPEUTICS., 215

of Galvanigation, beginning with the publication of the discovery of
Galvani, in 1791, and including the invention and medical employment
of the voltaic pile ; the Era of Faradization, beginning with the discov-
ery of induction, in 1831-32, and including all that has since been ac-
complished in the department of localized and general electrization.

In the first era only franklinic electricity was used, because it was
the only form that was known; in the second era, both franklinic
electricity and galvanism were used, since the latter supplemented, but
not entirely supplanted, the former ; in the third era, all three forms of
electricity—franklinic, galvanic, and faradic—were brought into requisi-
tion, though the use of franklinic is confined to a few, and will proba-
bly soon become historic.

The Era of Franklinic Electricity.—The records of this era, though
not extensive, are yet both interesting and suggestive. It is probable
that in this, as in the second era, very much was attempted and even
accomplished in this department that has never been recorded in per-
manent medical literature, and therefore could never become of value
to science.

In 1730 Etienne Grey first observed divergence of the hairs in an
isolated subject put in communication with static electricity.

The same experiment was repeated by Abbé Nollet and Du Fav.
Du Fay observed the electric sparks drawn from the isolated subject.

Nollet says, ‘I shall never forget the surprise which the first electric
spark ever drawn from the human body, excited both in M. Du Fay
and myself.”

Sparks were then drawn from the body in various shapes—one of
which was called the electrical kiss; other forms were known as the
“electrical star,” ‘electrical rain,’ and so forth. The drawing of the
sparks constituted a great source of amusement in the society of the
period.

In 1743 Kruger d’Helmstadt suggested that these electric sparks
might be made of service in therapeutics.

In 1744 Kratzenstein, a German physician, recorded a case of
cure of paralysis of the fingers by sparks drawn from a frictional ap-
paratus.

In 1746 the discovery of the properties of the Leyden jar by Mus-
chenbroek gave physicians a new means of using electricity in the
treatment of disease.

In 1749 Jallabert,* of Geneva, published a treatise on the medical
use of electricity, in which he reported a cure of long-standing paralysis

* Experiences sur Electricité, Paris, 1747.
216 ERA OF FRANKLINIZATION,

of the right arm, resulting from injury, by electric sparks. The cure
was brought about in two or three months, and may perhaps be re-
garded as the.first decided and unquestioned result of the kind that was
obtained in the early days of electro-therapeutics.

1750 Nebel showed that contraction of the muscular tissue was pro-
duced by electrization.

Bohadtch, of Bohemia, also recommended electricity, especially for
the treatment of hemiplegia.

In 1753 Lindhult, a Swedish physician, reported a cure of epilepsy
by electricity.

In 1754 Sulzer made his famous experimext on the tongue with zinc
and copper plates. (See Electro-Physiology). He did not, however,
pursue his experiments, and it was reserved for Galvani and Volta to
discover galvanism.

In 1755 De Hiden reported a large number of electrical cures of
paraly sis, spasmodic and other nervous affections, and also of suppres
sion of the menses, and St. Guy’s dance. About this time, also,
Schaeffer and Nebel published cures of rheumatism, toothache, hypo-
chondria, paralysis of the optic nerve, and of intermittent fever and
neuralgic pains. Between 1750 and 1757, cures of paralysis were re-
ported by Brydone,-Bertholon, Sauvages of Montpelier, and Spry, the
latter of whom cured a case of lockjaw and paralysis.

The position that electro-therapeutics held at that time, and the
hopes that were entertained of it, is very well represented in a little
treatise by the eminent divine, Rev. John Wesley, entitled, Zhe Desid-
eratum ; or, Electricity Made Plain and Useful, by a Lover of Mankind
and of Common Sense. 1759.*

In this treatise the author anticipates, in a sort of theoretical way,
very much that has since been demonstrated, both in electro-physics and
electro-therapeutics, and with surprising accuracy. In the preface he
acknowledges his indebtedness ‘“‘to Mr. Franklin for the speculative
part, and to Mr. Lovett for the practical.” He also mentions as authori-
ties, Dr. Haadley, Mr. Wilson, Watson, Freke, Martin, Watkins, and
the Monthly Magazine, whence we may conclude that even at that
early day the subject was exciting much interest, but more among the
laity than in the profession.

From the tone of the book it is clear that the Faculty, as Wesley
calls the profession, were disposed to despise electro-therapeutics

* This treatise has been recently republished by Baillitre, Tindall & Cox. Jondon,
1871.
HISTORY OF ELECTRO-THERAPEUTICS. 217

and to reject its claims, as they have been ever since, until sath a few
years, and consequently they suffered what was really valuable in medi-
cine to be monopolized by the laity. ‘

The mind of Mr. Wesley, as the world knows, was of the practical
sort, and in this treatise he does not suffer himself to be carried away
into gross hyperbole or serious untruth. He expressly disclaims any
idea of regarding electricity as a panacea, but says what we now know
to be true, that it is indicated in a wide range of disorders ; but that if
any one agent should ever become a panacea, electricity stood the best
chance of being that agent.

Evidently ignorant of Franklin’s invention of lightning-rods, in 1775,
he suggests that buildings and ships might be saved from the effects of
lightning, by ‘ upright rods of iron, made sharp as needles and gilded to
prevent rusting,” and connected with the earth. He further suggests,
that the northern lights are of electrical origin.

He gives the following list of diseases in which electricity is of service,
with a number of illustrative cases, most of which are very imperfectly
detailed. It will be observed that most of these diseases are still treat-
ed electrically, and with greater or less success. It seems from the list
that the treatment of diseases of the skin by electricity is simply
another attempt to effect what was accomplished with success more
than a century ago.

All these conclusions of Wesley and his contemporaries were, how-
ever, based on experiments made with franklinic electricity. The
world was to wait forty-one years for the Voltaic pile, and seventy-two
years for Faraday to discover induction.

“« Agues, St. Anthony’s Fire; Blindness, even from a Gutta Serena; Blood Extra-
vasated ; Bronchocele; Chlorosis; Coldness in the Feet ; Consumption ; Contraction
of the Limbs; Cramps; Deafness; Dropsy; Epilepsy; Feet violently disordered ;
Felons; Fistula Lacrymalis; Gout; Gravel; Head-ache; Hysterics; Inflamma-
tions; King’s Evil; Knots in the Flesh; Lameness; Leprosy; Mortification ; Pain
in the Back, in the Stomach; Palpitations of the Heart; Palsy; Pleurisy; Rheu-
matism; Ringworms; Sciatica; Shingles; Sprain; Sore Feet; Swellings of all
kinds; Throat sore; Toe hurt ; Tooth-ache; Wen.”

In 1763 Watson cured a case of general tetanus in a young girl of
seven years. Although the fame of the cures wrought by electricity
attracted crowds of invalids, yet by the ignorant and superstitious it
was confounded with witchcraft, and the aid of the priest was invoked

to save them from its baneful influence.*

* A Treatise on Medical Electricity, Theoretical and Practical, By J. Althaus,
M.D. 1870, p. 284.
218 CRUDENESS OF THE EARLY EXPERIMENTS.

Abbé Sans published a work on the medical use of electricity, and
recorded important cures. According to this authority, there were
seven different methods of employing static electricity—“ an electric
bath, drawing sparks, by irroration, friction, insufflation, exhaustion, and
commotion.” Injurious and negative as well as favorable results were
sometimes reported. Thus Dr, Hart brought on paralysis in a girl,
and Abbé Mazras excited epilepsy in one of his patients. Benjamin
Franklin failed to cure the invalids that flocked to him after his great
discovery, and Abbé Nollet, after many years’ experience, was com-
pelled to admit that he had seen but little permanent benefit from
electricity.

Symptoms only treated in these early Experiments.—In these early
and many of the later experiments, not disease, but the results of
disease, were both studied and treated. When electricity was applied, it
was to the symptoms and not to the pathological condition ; hence the
enormous blunders and frequent failures of the early electro-therapeu-
tists. The symptoms most treated, and in the treatment of which the
greatest hopes were entertained, were blindness, deafness, paralysis of
motion, symptoms which are now known to depend, in very many in-
stances, on pathological states, which are in their very nature as incurable
as death itself. Still further, the applications were made to the seat of
the symptoms exclusively, instead of to the seat of the disease, and this
mistake helped to swell the number of the failures.

Physiology and pathology had not yet reached that degree of strength
and breadth of sureness to furnish good foundation on which to erect
the science of electro-therapeutics, and withal the appliances for gene-
rating electricity were bulky and untrustworthy.

Electro-therapeutics was therefore baffled in its first attempts at
growth, through lack of needful support from allied and fundamental
sciences ; it must wait for physics, for physiology, for pathology to come
to its rescue, which in due time they have done and are now doing.

In 1773 and 1778 Maduyt presented memoirs * + on the subject,
in which he affirmed in his report that electricity was a remedy of vast
and varied powers ; that it had a positive and very beneficial influence
over nutrition ; and that it equalized the circulation, materially affected
the pulse, the perspiration, and the secretions; and was surprisingly

* Mem. sur les effets généraux, la nature et Pusage du fluide électrique considéré
comme médicament. Lu en décembre, 1778, 4 la Société royale de médecine,

+ Mem. sur les diffSrentes muniéres d’administrer l’éiectricité, et observations sur
les effets que ces divers moyens ont produits, Lu en décembre, 1783, & la Société
royale de médecine,
t

HISTORY OF ELECTRO-THERAPEUTICS. 219

efficacious in the treatment not only of paralysis, but also of other con-
ditions, such as constipation and oedema. This report aroused con-
siderable interest in electro-therapeutics on the part of the profession,
and for a season the application of franklinic electricity became exten-
sively popular. In 1777, Cavallo published a work * which excited con-
siderable attention. He reported cures of epilepsy, paralysis, chorea,
deafness, blindness, rheumatism, glandular enlargements, and recom-
mended electricity as a means of artificial respiration.

On the theory that medical substances might be combined with
electricity, Pivati, of Venice, placed in his electric machine a glass
cylinder, filled with Peruvian balsam, and Giuseppe Bruni affirmed that,
by the same arrangement, filled with purgatives, he had produced the
same effect on an electrified patient as though the remedy had been ad-
ministered internally.

In 1783 Wilkinson presented the results of some experiments with
electricity in England. Although the fame of the cures wrought by the
new remedy attracted thousands of the people, yet by the ignorant and
superstitious electricity was confounded with the spirit of evil.f

Of the seven methods of employing statical electricity recommended
by these early experimenters, but three were in common use. These
were, the electric bath, electrization by sparks, and shocks from the Ley-
den jar.

The Eva of Galvanization.--Animal electricity was discovered by
Galvani in 1786, and made public in 1791. It was by the experiments
of Galvani that Volta was stimulated to investigate the subject of
electricity. He denied the existence of animal electricity which Gal
vani had discovered. One of the most important fruits of the discus-
sion that arose between them and their respective followers was the
construction of the voltaic pile, which for many years physicians
employed, with various alternations of failure and success, in the treat-
ment of disease.

In the period intervening between the discovery of animal electricity
by Galvani, and the construction of the pile of Volta, electricity was
applied to the body by means of metallic plates, joined together by a
metallic arc. Sometimes these were simply placed against the skin,
and sometimes over spots denuded by a blister.§

* A Complete Treatise on Electricity, in Theory and Practice, with original Ex-
periments. Londres, 1777. Id., Medical Electricity. Londres, 1780.

+ Althaus, op. cit., p. 287.

{ A, Tripier, Manuel d’électro-thérapie, exposé pratique et critique des applications
médicales et chirurgicales de ’électricité. Paris, 1860,  § Tripier, op. cit., p. 262.
220 ERA OF GALVANIZATION,

In 1792, Behrend, Creve, and Klein suggested the use of galvanism
as a means of distinguishing real from apparent death. The first
attempts to make galvanism of practical service in the treatment of
disease were made by Prafessor Loder, of Jena. The results of his
experiments were unsatisfactory.

In 1793 Hufeland and Reil advised the use of galvanism in
paralysis.

In 1796 Pfaff advised the same remedy for amaurosis. None of
these authorities spoke from much personal experience.*

In 1797, Alexander von Humboldt ¢ suggested, on theoretical
grounds, the use of galvanism in paralysis, rheumatic pains, and dis-
eases of the eyes.

Valli actually restored to life, by galvanism, frogs and fowls that had
been nearly suffocated.

The voltaic pile, invented in 1800, marked an era in the medical use
of the galvanic current, because, with all its imperfections, it was vastly
superior, for therapeutic purposes, to the metallic plates that had pre-
viously been employed during the period which had elapsed since the
discovery of Galvani. It was at once employed by Loder, in Jena, by
Grapengiesser,§ Bischoff, and Lichtenstein, in Berlin, and by Haller,
in Paris, chiefly in cases of paralysis.

In 1801, Augustin, of Berlin, published a treatise on galvanism, in
which he reported results of treatment of paralysis by applying the
negative pole to the central end the nerve, and the positive to the
peripheral. Prof. Schwab experimented with the voltaic pile in cases of
deaf-muteism. In 1802 Sigaud de la Fond published a work in which
he recommended franklinic electricity for nearly every form of disease.
In 1804, Aldini, a pupil of Galvani, published a treatise on galvanism,
in which he theoretically recommended it for deafness, insanity, and
amaurosis, and also to produce artificial respiration.||

Even during this era, and for many years after the invention of the
voltaic pile, franklinic electricity was still employed.

In 1817 Dr. Thomas Brown, of Albany, published a work entitled
“ The Ethereal Physician,” in which he recommended franklinic electri-
city for paralysis, tic-douloureux, epilepsy, chorea, and in a large variety
of disorders. ‘

* Tripier, op. cit., p. 263.

+ Versuch iiber die gereizte Muskel und Nervenfaser. Berlin, 1797.

¢ Expérience sur le galvanisme, traduit par Jadelot. Paris, 1799.

8 Versuche den Galvinismus zur Heilung einiger Krankheiten anzuwenden
Berlin, 1801. i Essai théorique et expérimental sur le galvanisme. 1804.
HISTORY OF ELECTRO-THERAPEUTICS, 221

In 1818 Dr. Everett, of New York, published something on the use

of electricity in medicine that was based on experience that he had de-
rived with the apparatus of Dr. Brown.
In spite of all these endeavors on the part of scientific men to give
importance and dignity to the cause of electro-therapeutics, it failed to
fulfil the extravagant expectations that had been formed of it 3 areaction
followed, and it fell into disrepute. Electricity had been tried for a
wide range of diseases, but partly on account of the inconstancy of the
voltaic pile, and partly through the ignorance of the operators, it was
found to be a most uncertain remedy. It was confounded with mes-
merism, which at this period came into notoriety, and for a time it
shared its fate.

Many of the early Experiments made by the Laity.—It will be seen by
a glance at the above-mentioned names that the earliest experiments
in electro-therapeutics were made by the laity. A science that now
commands some of the best brains of civilization was born among the
humble and the lowly. It was cradled in ignorance and reared and
fostered by those who, however eminent in other walks, knew little or
nothing of medicine. Chemists, physicists, priests and paupers, monks
and mountebanks, were in the eighteenth century the leading authorities
in electro-therapeutics. If there were those at this time who had faith
in the coming of a better day, when electro-therapeutics should be a
recognized and permanent part of the medical science, it was their mis-
fortune to die without the sight. Not until the close of the eighteenth
century were the great discoveries of Galvani and Volta revealed to the
world, which was to work and wait for at least half a century before it
should see even the beginning of the fulfilment of its hopes. Some of
the great sciences, like some of the great religions, have had the hum-
blest origin.

Of the early history of electro-physics, Whewell* thus remarks :—
“At such a period a large and popular circle of spectators and ama-
teurs feel themselves nearly upon a level in the value of their trials
and speculations with the more profound thinkers; at a later period,
when the subject is becoming a science, that is, a study in-which all
must be left far behind who do not come to it with disciplined, informed,
and logical minds, the cultivators are far more few, and the share of
applause less tumultuous and less loud. Electricity, to be now studied
rightly, must be reasoned upon mathematically.”

What Whewell here says of electro-physics may just as truly be
applied to electro-therapeutics.

* History of the Inductive Sciences, 2d ed., vol. ii., p. 200,
222 CHARACTER OF THE EARLY EXPERIMENTERS,

.In the earlier experiments, the philosopher and the fool were pretty
nearly on the same level in their knowledge of the application of this
subtle force to the treatment of diseases, with this advantage on the side
of the fool, that through the very excess of his ignorance he dared and
ventured where the philosopher knew just enough to fear to tread.

It was, as we shall see, a long time before electro-therapeutics should
be gradually developed into a science of sufficient positiveness to com-
mand the attention of men of science for its own sake, and to excite the
despair of the ignorant.

Here, as in all other realms of investigation, the development is from
simplicity towards complexity, from generals to specials, and from truths
that are common to all classes, to truths that only a few specialists can
thoroughly master. We are reminded here of the beautiful thought
of Thoreau. When reproached for his exclusiveness and love of solitude,
he replied, ‘It is not so much that I love tobe alone, as that I love to
soar, and the higher I ascend, the company grows thinner and thinner,
until at last I am left almost alone.”

Strikingly this principle has been illustrated even in the most recent
history of electro-therapeutics, both in Europe and America. A field
now occupied by some of the ablest scientists of Germany, England, and
France, was formerly crowded with lawless intruders.

When we began to write on this subject in 1866, a tide of in-
quiries at once set in upon us, from all parts of the country. The
authors of these letters, with some few exceptions, we have never seen ;
but, judging from the style of composition and the character of the in-
quiries, they were as a rule comparatively ignorant, and belonged to
the lower strata of the profession. Letters that we receive more re-
cently during the past three years, evidently come from many of the
best men in the profession. As the science develops, brains and cul-
ture are attracted to it. In our large cities, those who are studying this
subject are among the most promising names in science.

In 1825, Sarlandiére proposed the employment of acupuncture
needles in galvanization, so that the current could be more exclusively
and definitely localized on the desired nerve or organ. This method
of treatment was called electro-puncture.* He used for this purpose
franklinic electricity. Subsequently Magendie successfully experimented
with galvano-puncture in neuralgia, paralysis, and other nervous dis-
eases.

The discovery of electro-puncture was the beginning of the science

* Mém, sur l’électro-puncture, Paris, 1825.
HISTORY OF ELECTRO-THERAPEUTICS. 223

of electro-surgery, a department which at that time commanded a
wider interest than the medical use of electricity, and which has now a
most important position in science.

Gerard and Pravaz suggested, and Pétrequin and Ciniselli succeeded
in curing aneurism by galvano-puncture. Subsequently galvano-cauter-
ization has been investigated by Steinheil, Middeldorpff (1859), Amus-
sat, Althaus, Byrne, ourselves, and many others. (For detailed history
of the surgical uses of electricity, see Electro-Surgery, Chapter I.)

In 1826, Baumé published in London a work on galvanism, which
two years later reappeared in a different form, and was translated into
French by Fabre Palaprat, who was the first to use the ga/vawic current
in electro-puncture.

The Era of Faradization.—The publication of the discovery of in-
ductive electricity by Faraday, in 1831~2, changed the whole course of
electro-therapeutics. On the basis of this discovery electric machines
were constructed that were both more reliable and more convenient
than the ordinary voltaic pile. The first magneto-electric machine was
constructed by Pixii in 1832, and was first employed. in the treatment
of diseases by Neef of Frankfort. Afterwards electro-magnetic (volta-
electric) machines were constructed by Neef, Clarke, Stéhrer, and
others, which from time to time have been variously modified by a
large number of experimenters in different countries.

From this time electricity in the form of faradization began to be ex-
tensively and indiscriminately employed, both in this country and in
Europe. It was used by the laity as well as by the profession, though
at first without any recognized method, and without any very clear
ideas of the indications for which electrization was adapted. Since
that time four distinct methods of medical electrization have been intro-
duced, in which the galvanic as well as the faradic current have been
appropriated, and under one or the other of which may be classed all
the applications of faradic or galvanic electricity that have since been
employed. These methods are localized faradization, localized galvan- '
ization, general faradization, and central galvanization.

History of Localized Faradization.—The history of localized electri-
zation is identified with the name of Duchenne, whose experiments and
discoveries have given such an impetus to this important and growing
department. Duchenne was not, however, the first to employ localized
faradization. Prior to his time, faradization had been used by Masson
in France, and Neef of Frankfort; and in this country it has been em-
ployed by the profession and by the laity from the period of the first
popularization of machines of induction.
224 LOCALIZED FARADIZATION.

Even as early as 1843 localized faradization was used in this country
side by side with general faradization, though, like the latter, it had re.
ceived no distinct nomenclature, and was indiscriminately recommended
and unscientifically applied.* The two methods, localized and general,
were frequently confounded, and both were known under the vague
term, “electrifying.” Duchenne’s earliest attempt to call the attention
of the profession to this subject is thus recorded in his own words :—

“De l'art de limiter l’excitation électrique dans les organes sans
piquer ni inciser la peau, nouvelle méthode d’électrisation appelée élec-
trisation localisée, et dont les principes, résumés dans une note adressée
en 1847 4 1’Académie des Sciences, ont été développés et publiés dans
les archives générales de Médicine en juillet et aodt 1850, et février et
mars 1851.” In 1855 he published his chief work, “ De I’Electrisation
Localisée, et de son Application & la Physiologie, a la Pathologie, et &
la Thérapeutique.”

This work became known to the profession in Germany through the
abridged translation of Dr. Erdmann.

The leading idea of the method’ of localized faradization of Du-
chenne was, that the current can be localized over a fixed point under
the skin if well-moistened conductors are strongly pressed upon the skin.

He observed—what is perfectly familiar to all experimenters in elec-
tro-therapeutics—that when dry electrodes are applied to the dry skin,
sparks with a crackling sound are produced, but no sensation and no
muscular contraction. He observed that when the electrodes are well
moistened, contractions are excited in the muscles, with the phenomena
of sensation. ,

He recommended three forms of electrodes—solid metallic elec-
trodes, metallic brushes, and the hand.

On these observations and experiments Duchenne based a system of
electro-therapeutics and electro-diagnosis which, as since refined, de-
veloped, and modified by himself and by numerous other laborers in
various countries, has now grown into a permanent department of
science.

Localized faradization was appieciated by electro-therapeutists more
rapidly than some of the other methods of using electricity, as electro-
lyzation, general faradization, galvano-cautery, and central galvaniza-
tion, for the reason that it is the easiest learned of all the methods and

* In Pike’s Catalogue of Mathematical, Optical, and Philosophical Instruments,
1848, there is a cut of the faradic apparatus that had been in use for five years by
these early experimenters. The same work also contains a cut illustrating their
method of localized faradization of the leg.
4

HISTORY OF ELECTRO-THERAPEUTICS. 225

requires only the simplest and cheapest form of battery. To be an
expert in it requires a degree of skill and experience and manual facil-
ity, as well as familiarity with the diseases for which it is indicated, and
some knowledge of electro-physics and electro-physiology are of essen-
tial service ; but in none of these respects is this method ‘as exacting
as any one of the others.

Hence it is, that localized faradization is the method with which
novices usually begin their experiments in this branch, and it is the
method which by the mass of the profession is now more used than
any other.

Among specialists, however, of all countries, localized galvanization
is more used than localized faradization, since it meets on the whole,
as experience shows, a larger range of indications.

Listory of Localized Galvanization.—One of the ablest and most
prominent of those whom the writings of Duchenne inspired to enter
upon the study of electro-therapeutics was Professor Remak, of Berlin.
His first work, “ Ueber Methodische Electrisirung Gelihmter Muskein,”
“On the Methodical Electrization of Paralyzed Muscles,” was pub-
lished in 1855. In this work he revived and recalled the attention of
the profession to the galvanic current, and he furthermore announced
that in order to bring a muscle to complete contraction it is better to
excite its motor nerves than to allow the current to operate on the
muscular substance itself. His second work, “ Galvano-Therapie der
Nerven- und Muskel-Krankheiten,” was published in 1858.

Remak became the founder of a school of electro-therapeutists in
Germany, as Duchenne had been in France. Their systems, as has
been said, differed in two important particulars. Both used localized
electrization. Duchenne used the faradic current, making the applica-
tions to the muscles ; Remak used the galvanic current, making the
applications to the motor nerves.

Duchenne declared that the galvanic current was useless for the
treatment of disease, while Remak contended that it was the only cur-
rent that was of any value. Duchenne was unwilling to admit the
reality of the discoveries of Remak, and Remak as emphatically re-
jected the conclusions of Duchenne. Both enforced their statements
by the resus of experiments, and both appealed to experience.

It is now well recognized by all electro-therapeutists that there was
truth on both sides of this interesting controversy—that the galvanic
and fatadic currents are both of service in the diagnosis and treatment
of disease, and that too in more than one mode of application. We
now see that if Duchenne was too dogmatic, Remak was too extrava-

15
226 LOCALIZED GALVANIZATION.

gant, but that both of them, by their experiments and labors, were of
positive service to science, and made the way easier and safer for those
who have since followed them in the department of localized electriza-
tion.

Remak, shortly before his death, published a work entitled ‘* App/i-
cation du Courant constant au Traitement des Néuroses,” Paris, 1865,
Which contained the leading ideas of his system, and has been the means
of stimulating many other experimenters in this difficult department.

Remak did more than merely introduce the galvanic current to the
profession—he discovered and recommended special applications of
the current, and suggested the theory of its catalytic action. He was
the first to scientifically investigate localized galvanization of the cer-
vical sympathetic, of the brain and spinal cord, and thereby greatly
widened the sphere of electro-therapeutics. Although at first his
theories were scouted, and his statements discredited, yet since his
death they have, in the main, been strikingly confirmed, and are now
regarded as accepted facts in science.

Even during this last era, franklinic electricity has been by no
means laid aside. In 1847, Dr. Golding Bird published very
remarkable results obtained in the treatment of amenorrhcea by
static electricity, in Guy's Hospital He made use of a Leyden
jar. Franklinic electricity has been successfully used by Drs. Gull
and Clement. It has, for a number of years, been successfully
employed by Dr. Radcliffe and others, in the London Hospital for the
Paralyzed and Epileptic. Quite recently Prof. Schwanda, of Vienna,
has reported suggestive results from franklinic electricity generated by
Holtz’s electrophorus machine. Dr. Arthius, of Paris, has recently pub-
lished a work on the subject ; this has been translated by Dr. Leveridge,
of Chicago.

Within the past fifteen years localized faradization and galvanization
has been developed and improved in France, in Germany, in England
and America, by a number of able and laborious men of science.
Among the voluminous authors in this department may be mentioned
the names of Meyer,* Becquerel,t Baierlacher,t Althaus,§ ‘Lripier,|

* Die Electricitat in ihrer Anwendung auf praktische Medicin. Berlin, 1854 and
1868. Translated by Dr. Hammond,

+ Traité des applications de Velectricité 4 la Thérapeutique. Paris, 1857.

-f Die Inductions-Electricitaét in physiologisch-therapeutischer Beziehung. WNiirn-
perg, 1857.

§ Treatise on Medical Electricity. London, 1859. Latest edition, 1873. Gal-
vanism in Paralysis, Neuralgia, etc., 1866.

|| Manuel d’Electrothérapie, Paris, 1861.

-
HISTORY OF ELECTRO-THERAPEUTICS, 227

Rosenthal,* Frommhold,} Ziemssen,{ Garratt,§ Benedikt,|| Brenner, {
Cyon.**

History of General Faradization.—In general faradization the aim
is to bring the whole body under the influence of the faradic current, so
far as is possible, by external application.

The origin of general faradization, like that of localized, is somewhat
uncertain, since it is difficult to determine how long it was used by the
laity before we formally introduced it to the profession. It is certain
that both methods have been in popular, and, to a certain extent, in
professional use in America, froms a period not long subsequent to the
popularization of the discovery of induction, certainly a long time be-
fore they were introduced to the profession. One of the first—and
probably the very first--to employ a form of general faradization was
William Miller, of New York, who began the empirical use of this sys-
tem of treatment in 1843. Since that time some form of general far-
-adization has been employed by Sherwood, of New York; Dr. W. Dem.
ming, of Portland; Drs. Garratt, Cross, and Guthrie, of Boston; Dr.
Wells, of Rochester, N. Y.; Drs. Page and Channing, and by a very
large number, both in the profession and out of it, of whose names and
special methods but little is known, since they have taken but little pains
to establish the treatment on a scientific basis, or to introduce it to the
attention of the profession. Many of these practitioners combined
localized with general faradization, and some, perhaps the majority, em
ployed the latter exclusively, though with little definiteness or precision.
Although, as has been said, some of these early experimenters were
educated physicians, the majority were ignorant not only of medicine,
but of every other department, and not a few, unfortunately, were as
unprincipled as they were ignorant.

Although many of these experimenters were laymen, although they
had no part nor lot in the realm of science, and although many of them
weré as devoid of conscience as of intellect, yet we should none the
less eagerly seek for and accept whatever of truth they may have stum

* Die Electrotherapie, ihre Begriindung und Anwendung in der Medizin. Wien,
1865. Latest edition, 1873.

+ Electrotherapie mit besonderer Riicksicht auf Nerven-Krankheiten ; vom prak-
‘tischen Standpunkte skizzirt. Pesth, 1865.

t+ Dic Electricitaét in der Medicin. Berlin, 1866, Latest edition, 1872.

§ Medical Electricity. Philadelphia, 1866.

| Electrothérapie. Wien, 1868. Second edition, 1874.

| Untersuchungen und Beobachtungen auf dem Gebiete der Elektrotherapie
Leipzig, 1868 und 1869.

** Principes d’Electrothérapie, Paris, 1873.
228 GENERAL FARADIZATION.

bled upon or discovered. In the history of therapeutics it has often
been the fortune of the ignorant and the lowly to hit by chance on
some great fact for which the wisdom of the ages has sought in vain,
Says Dr. Stillé, “‘ Nearly every medicine has become a popular remedy
before being adopted or even tried by physicians ;”"* and according to
Pereira, nux vomica is one of the few remedies the discovery of which
is not the effect of mere chance.}

Impartial history must, we think, record that, before Duchenne and
Remak were known on either side of the Atlantic, before our more
recent electro-therapeutists had comménced their professional labors or
studies, there were in this land not a few empirics who, by some form
of general or localized faradization, or both combined, or by methods
various and inconsistent, and in spite of their own ignorance or vice,
were achieving successes in the treatment of disease which, in certain
features, even the most advanced physicians of our day have not yet
surpassed. If they did not belong to the chosen ranks of the profes-
sion, itis none the less true that the results which they secured were
oftentimes such as the ablest leaders in science might well have envied.
If their methods were empirical, their empiricism was often justified by
its success. If their nomenclature was imperfect and confused, and
their diagnosis erroneous, yet their confusion and errors were not a lit-
tle redeemed by the skill with which they met emergencies when the
therapeutist was far more needed than the pathologist or the diagnosti-
cian. Zhe great defect of these empirics was not in their results, which
oftentimes were truly remarkable, but in the fact that their general
ignorance, and especially their ignorance of medicine, rendered it impos-
sible for them to discriminate in their cases or their methods, or to intel-
ligently communicate their experience to others, or in any way to make it
of permanent value to science. They treated all cases about alike,
without reference to the pathological condition, and in spite of all their
successes frequently failed where, with better knowledge, they might
have succeeded.

In Europe, so far as we can ascertain from,the published writings on
the subject, or from our own personal observation, the method of general
faradization, as described in this work, has not been used or recom-
mended, at least by men of science. In 1852, Beckensteiner{

* Therapeutics, vol. i, p. 31. The same author states that ‘by far the
greater number [of medicines] were first employed in countries which were and
are now in a state of scientific ignorance.”

+ Materia Medica, vol. ii, p. 336. Hydrate of Chloral may now be added to
this list. ¢ Etudes sur l’Electricité. Paris, 1859.
HISTORY OF ELECTRO-THERAPEUTICS. 229

suggested the idea of ‘‘animalizing” statical electricity by passing it
through the body of the operator, and making passes over or near the
patient.

In 1857, M. Dropsy* de Cracow published a new method of
faradization, the modus operandi of which consisted in connecting an
electrode by two branches on the top of the head and the epigastrium,
while the other electrode was connected by four branches with the
hands and feet. At each sitting the poles were reversed. In 1858,
Seilert proposed to cure consumption and many other obstinate and
incurable diseases by passing a faradic current through two electrodes
near to but not over the body of he patient.

In 1863, Gubler{ suggested the treatment of conditions of debility
by placing both hands and feet in separate basins containing salt
water, and passing a faradic current through the body.

Our own attention was called to the subject of general faradization
in 1866, and in that and the following year we introduced it to the
profession, describing in a general way its powerful tonic effects and
modus operandi.

(The Medical Use of Electricity, with special reference to general
electrization as a tonic, Gc. Beard and Rockwell, New York, 1867.)

The name general electrization, as descriptive of this method of
treatment, was first employed by us and in the writings to which we
have referred. In the present edition of this treatise we restrict the
terms to general faradization, for the reason that our method of
central galvanization, to be hereafter described, has to a considerable
extent taken the place of general galvanization.

Our own claims in regard to general faradization are :

ist. To have studied the method as practised by the laity, and to
have improved it, reduced it to a system, and given it a scientific
basis, and to have shown its relations to other methods of using
electricity—in short, to have done for this method what Duchenne did
for localized faradization.

2d. To have interpreted its special and general effects, giving it a
name, pointing out the true rationale of the method, and the in-
dications for its use.

3d. To have first called the attention of the profession to this
method, enforcing our views by the results of personal experiments.

* Electrothérapie en application médicale pratique de l’électricité basée sur de
nouveaux procédus. Paris, 1857, in 8vo.

+ Galvanisation par influence. Paris, 1858.

¢ Del’ Electrization générale, Bulletin de Thérapeutique, Dec., 1863,
230 CENTRAL GALVANIZATION.

4th. To have discovered in our experiments with this method, that

electrization was a tonic of great and varied efficacy, and therefore
indicated in a large range of conditions of debility, and to have forced
this fact on the professional mind until it has become widely accepted,
and has become the basis for the use of electricity in the treatment
of medical diseases.
+ The length of time required to make a thorough application of general
faradization, and the amount of practice necessary to acquire skill and
facility in its employment, have interfered somewhat with its populariza-
tion among specialists in electro-therapeutics ; but in spite of these
difficulties the method is now used with the highest success by hundreds
of physicians, specialists and general practitioners, &c., and its popular-
ity is very rapidly increasing.

In Germany the méthod has been from the first received, in part
through the careful résumé of Prof. Erb, of Heidelberg, with greater
interest and appreciation and with more favorable consideration than
in any other country, excepting perhaps the United States. Dr. R.
Vater, of the University of Prague, in his preface to the German
translation of the first edition of this work, has warmly recommended
the method, basing his recommendation on his own personal experience ;
and more recently, Benedict of Vienna, in the latest edition of his work,
-has given the method intelligent and appreciative consideration.

History of Central Galvanization.—The method of central galvan-
ization, as has been described in our published papers (Electricity and
the Sphygmograph, N. Y. Medical Record, December 15, 1871; also,
Recent Researches in Electro-Therapeutics, October, 1872, by Dr.
Beard; Central Galvanization, N. Y. Afed. Journal, May, 1872, by
Dr. Rockwell), consisted in placing the negative pole at the epigast-
rium, while the positive was applied over certain portions of the head,
over the sympathetic and pneumogastric in the neck, and down the
whole length of the spine from the first to the last vertebra. At that
time we had used the method with the highest success, in hysteria, ‘in-
sanity, neurasthenia, gastralgia, dyspepsia, and certain diseases of the
skin, and since that time this method has been extended to a wide
variety of affections. In some diseases it has supplemented, in others it
has supplanted, general faradization and galvanization of the cervical
sympathetic.

The full method of central galvanization, as it will be described in
this edition of the present treatise, was not stumbled upon by accident,
but is the result of a long period of experimenting. When we began to
use the galvanic current, we sometimes treated gastralgia and dyspep-
a

HISTORY OF ELECTRO-THERAPEUTICS, 231

sia by placing one pole, usually the negative, in the epigastric region, |
and the positive on the nape of the neck at about the sixth cervical ver.
tebra. Gradually we extended the domain of the application so as to
include the mastoid fossa and the anterior border of the sterno-cleido-
mastoid muscle, down to the sternum on both sides. Afterwards we
resolved to apply the positive electrode to the forehead, still keeping
the negative on the epigastrium.

Influenced by the fact of observation, that the top of the head be-
tween the ears was frequently tender and painful in hysteria and neur-
asthenia, in both sexes, it occurred to us that this might be a good
place to plant the electrode so as to affect the brain. Another consid-
eration of practical moment was, that this place in both sexes is quite
accessible, even with the present methods of arranging the hair. Look-
ing at the subject from the standpoint’ of anatomy, physiology, and

. pathology, also, it was sufficiently clear that in galvanizing the brain,
the object should be,.not so much to affect the anterior lobes as the
base and posterior portion, where originates the great cranial nerves.
We soon found by clinical observation, that little dizziness was caused
when the electrode was placed in this position, and that a stable current
of a number of cells could be borne without unpleasantness, and that
oftentimes a peculiar sensation was experienced, very different from the
stinging and pricking sensations that are felt when the electrode is
placed on the forehead. Last of all we extended the application, so as
to include the whole length of the spinal column, passing the electrode
beneath the clothes of the patient, loosened and pulled up for that pur-
pose. Since the first publication of this method of central galvaniza-
tion, we have modified it by changing the position of the negative pole,
up and down the breast and abdomen, so as to avoid over-irritating the
stomach.

Some of the processes of central galvanization had been used by
other physicians, long before we worked up the complete method as he
described. Dr. Althaus writes us, that several years since he had em-
ployed the first step in the process—one pole at the epigastrium and
the other at the back of the neck, but becoming alarmed by unpleasant
symptoms, had abandoned it; and Dr. Meredith Clymer, of this city,
informs us that during the past three or four years he has independently
used the processes of central galvanization with tonic results that have
been most pleasing.

The ill-fortune of Dr. Althaus was due, we suspect, to the fact that
he used powerful or interrupted currents—a mistake that we repeatedly
made during our earlier experiments, a mistake that is frequently made
by those beginning any new method of electrization.
232 DEPENDENT ON OTHER SCIENCES.

The method of central galvanization is not yet as extensively used as
general faradization, for the twofold reason that very many electro-
therapeutists have no galvanic apparatus, and the full description of the
method has been only a short time before the profession.

In reviewing the above history of electro-therapeutics and compar-
,ing it with the history of electro-physics and electro-physiology, we
are impressed with several important lessons. These have important
practical as well as scientific bearings, and are of interest not only
to electro-therapeutists, but to physicians and scientists in general,
and.are rich in instruction and suggestion for every thoughtful mind.
We shall therefore make no apology for considering them in detail.
We believe that a thorough general study of the history of electro-
therapeutics in all its relations will do much toward dissipating many
widely prevalent errors both in theory and practice.

1. The progress of Electro-Therapeutics has been dependent on the
progress of other sciences.

In the advance of science it has often happened that one division
has been arrested in its march and forced to wait for other and allied
divisions to come up and support it. No science stands alone. In the
genesis of knowledge, each specialty is evolved from and with other

and more general specialties, and without which it could have no exist-
‘ence. Between all the sciences there is a consensus or harmony ; all
act and react upon each other, and as Spencer well says, ‘in the pro-
gress of the world the sciences may become arts to each other.” The
speculations of Copernicus were merely speculations until optics ad-
vanced and reduced them to a science. It is impossible to ascertain
the position of a star in the sky, without making use of the recent ad-
vances in optics, in thermology, in barology, and in hygrometry. Sim-
ilarly also, ali or nearly all great discoveries and pioneers in science
would have been impossible had not other discoveries and pioneers in
the same or allied departments preceded them. It was the careful
observations of Tycho Brahe that made it possible for Kepler to dis-
cover his great laws. ,

Not until the telescope was discovered could the present theory of
the universe be established.

Newton had abandoned his theory of gravitation, when Picart’s accu-
rate measurement of a degree of the surface of the earth enabled him
to demonstrate the correctness of his theory. Before Newton could
work out his theory of gravitation at all, it was necessary for Galileo to
reveal the laws of falling bodies and the composition of forces; ter-
HISTORY OF ELECTRO-THERAPEUTICS., 233

restrial physics must precede physics celestial. Before Young could
work out his undulatory theory of light, he must be preceded by
Huyghens and Newton, and before Darwin could announce his theory
of evolution there must be a Lyell to make an era in geology. The
grand hypothesis of the conservation of forces results through a com-
bination of all the physical sciences of the world. Science is system-
atized knowledge. In order to reduce any form of knowledge to a science,
there must be some method of measurement. We measure space, and
so we have the science of geometry. We measure force and space, and
so we have the science of statics. We measure time, force, and space,
and so we have the science of dynamics. Measurement need not ne-
cessarily be mathematically accurate—there may be some indefinite and
even varying standard by which we estimate our ideas on various sub-
jects ;—in this way geology, physiology, theology, metaphysics, and soci-
ology are admitted among the sciences, although none of them are exact.

We have no science of smells and tastes, because we have no way
of measuring them. Formerly our knowledge of the great forces of

, nature was just as indefinite as our knowledge of smell and taste, until
the invention of the thermometer, dynamometer, barometer, etc. Now
this necessity of obtaining some method of measurement or comparison,
in order to develop the sciences, makes them more or less depend-
ent on each other. Invention must precede discovery, and discoveries
in one science prepare the way for greater discoveries in the future.
The first steps in measurement are qualitative merely ; the quantitative
stage is usually reached but slowly, and after long experimenting.*

While some sciences are in the quantitative stage, others are in qual-
itative merely ; but these latter may be raised to the condition of the
quantitative stage by the aid of the former.

Thus it is that one science may be bluffed and baffled in its advance,
until some other science, that may perhaps be in no way allied to it,
comes to the rescue, and proves a inutual relationship that had not be-
fore been suspected.

Thus the progress of the science of acoustics was suspended until
thermology came to the front and carried it forward. The atmospheric
refraction of light, and the rate of density of the atmosphere, were not
understood until Boyle and Marriott discovered the relation between
the density of gases and pressure: thus we see that optics and astro-
nomy were dependent on barology.

The Bessemer process, that has made an era in applied sciences,

* For some of the above facts and reasonings we have been indebted to the able
essay of Herbert Spencer on the “‘ Genesis of Science” in Recent Discussions, etc.
New York, 1871.
234 THE GENESIS OF ELECTRO-THERAPEUTICS.

is in a measure dependent on the spectroscope, which in its turn was
dependent on the experiments of Sir Isaac Newton ; and Newton himself
would have been an impossibility had not Kepler, Galileo, Descartes,
and other great discoverers preceded him. The discovery of America,
and all the countless results that are flowing from it, was made a pos-
sibility only by the discovery of the mariner’s compass.

Watt, in his pamphlet on the steam-engine, acknowledges his indebt-
edness to an earlier experimenter, and without Watt there could have
been no Fulton. The discovery of oxygen by Priestley paved the way
for Berzelius and Lavoisier, with all the nomenclature and complications
of modern chemistry, scientific and applied. In 1807 chemistry was
halting, wearied with its march, when electrolysis, made possible by
the discovery of the Voltaic pile, seven years before, in the hands of
Davy, gave it a new impulse.

The new metals, as thallium, etc., that have been recently added to
chemistry, are the offspring of the spectroscope, discovered in 1859.

The history of electrology, in all its departments, illustrates, in a
most interesting manner, the great laws by which science and art are
developed. The discovery of zinc by Paracelsus, several centuries
ago, placed at ready command a metal which is now used in nearly
every form of electric battery.

The discovery of the Leyden jar, in 1746, stimulated Franklin to
demonstrate the identity of lightning and electricity ; and the experi-
ments of Galvani, ill-directed and mistaken as they were, inspired Volta
to the construction of the pile that is bearing his name to the future.
Here electrical science long halted, and both franklinic and galvanic
electricity had fallen into comparative disuse, when the discovery of
electro-magnetism by Oersted appeared just in time for Faraday to make
his immortal researches on induction, which have placed at the disposal
of electro-therapeutists a vast variety of faradic machines, as well as
created our enormous system of land and ocean telegraphy. The
machines constructed under the impulse of Faraday’s researches were
ready just in season for Masson and Duchenne to apply them to elec-
tro-physiology and therapeutics. Fifteen years earlier faradic ma-
chines were unknown, and faradization would have been impossible.
The invention of the galvanometer in 1825, caused Nobili, in 1827, to
make researches in animal electricity, which were subsequently carried
to greater perfection, with more refined apparatus, by Du Bois-Rey-
mond and his disciples. ‘i

The invention of the batteries of Smee, Daniell, Bunsen, and Grove,
based on the law of Ohm, announced in 1827, prepared the way for
HISTORY OF ELECTRO-THERAPEUTICS, 235

Remak to introduce the galvanic current to medicine, which with the
inconstant and inconvenient Voltaic pile would have been impossible ;
and also opened the door for Crussel to pioneer electrolysis, and for
Middeldorpff to develop the surgical uses of the galvano-cautery. For
general faradization as well as localized, we are first, of course, indebted
to Faraday ; and central galvanization, though it might have been de-
vised immediately after the invention of the Voltaic pile, could only be
popularized in the profession after batteries had been made that were
cheap, constant, and convenient. Physiology and pathology have both
come in to guide, to stimulate, and to sustain electro-therapeutics, for
the method of application, and the kind of current employed, must vary
with the real or supposed pathological condition in the disease we treat.
The more accurate diagnosis that follows in the wake of the ophthalmo-
scope, the otoscope, the laryngoscope, the endoscope, the stethoscope,
the esthesiometer, and of electricity itself, and the better knowledge of
the body in health and disease that comes from post-mortem examina-
tions, and experiments on animals, have made all our electrical appli-
cations more intelligent and more successful. They have not only
added new territory to electro-therapeutics, but they have helped te
subjugate that which was already acquired. The discovery of the
pathology of locomotor ataxy made an era in the method of using elec
tricity in that disease.

The old notion that dyspepsia was say a purely local disease,
would never have suggested its treatment by general farddization or
central galvanization ; and if hysteria were a disease of the womb, and
insanity were a spiritual and not a physical symptom, their treatment
by galvanization of the brain and spine, and cervical sympathetic and
general faradization, would seem utterly out of place. Had we ad-
hered to the dogma that diabetes was a disease of the kidneys or
liver, we should never have thought of treating it by galvanization of
the brain, and neck, and spine. The suspicion, amounting well-nigh to
a positive conviction, that certain diseases of the skin, that had usually
been classed as local or peripheral, were really dependent on the cen-
tral nervous system, first induced us to treat them by central galvani-
zation, and with a success that has been amazing. The growing belief
that malignant’ tumors are originally local in their character, has en-
couraged electro-therapeutists to treat them by various methods of
using electricity, and with a certain degree of success. The idea that
neuralgia is a central and not a peripheral disease, has revolutionized
its electrical treatment. In the present volume we hope to be able to
show that all or nearly all the functional diseases allied to hysteria,
236 OPPOSITION TO ELECTRO-THERAPEUTICS,

have in general a common pathology, and demand a similar treatment
by electricity. Conversely, it has been shown in the department of
modern ophthalmology and otology, that the symptoms of blindness
and deafness, for which electricity was so freely used a century or more
ago, depend on pathological conditions that are in their very nature
incurable, and that the time and force spent in treating them by elec-
tricity are wasted.

The same is true of certain forms of paralysis and some painful
nerve affections.

2. The introduction of Electro-Therapeutics into the profession has
been accomplished only with great difficulty.—This fact is not peculiar
to electro-therapeutics : it applies equally to the history of every radical
and revolutionary branch of medicine. There is among some friends
of electro-therapeutics a shadowy suspicion that their specialty has had
an exceptional history ; that it has been despised and rejected by science
and left to the mercies of charlatans more than any other great depart-
ment of therapeutics. This misconception arises from the recentness
of the subject of electro-therapeutics, and from the fact that its early
history and struggles are-personally and painfully familiar to this genera-
tion. But the experience of electro-therapeutics is the experience of
every advance in the medical art, and even of the science of medicine
itself. In every land, and in all recorded times, the profession’ of
medicine has been a despised profession. For five hundred years
Rome was without regular physicians, and when at last they were re-
cognized as a needful body, they were forced to take the lowest seat
in the social circle. When the Roman grandee was sick nigh unto
death, he summoned in consultation a medical adviser, for whom he
had about as much respect as we have for the menial who blacks our
boots or polishes our knives. For ages the ensign of medicine was
borne by the most ignorant of slaves, and was then transferred to the
hands of monks and charlatans, from whom it was with great difficulty
wrested.

If any branch of medicine is honored to-day, it is general surgery ; but
for centuries the profession of barber and surgeon were one, and only
by painful and slow degrees have the surgeons obtained their present
eminence.

As with general medicine and surgery, so with all the special
branches—the uniform history is one of growth out of early struggle
and despising. One of the very best tests of medical skill and genius is
midwifery, and yet we have to go back but a short time to see obstet-
rics the exclusive art of the most degraded and despised. Ophthalmo-
HISTORY OF ELECTRO-THERAPEUTICS. 237

logy and otology, now refined and developed into exalted and exacting
sciences, wherein learned practitioners and professors find material for
life-long thought and toil, with liberal honors and rewards, were, even in
the memory of the youngest of us, so largely the province of pretenders,
that few would be willing to be called an oculist or aurist. Laryngol-
agy, gynecology, syphilography, neurology, and electro-therapeutics, all
speak the same history, and in all, the laws of growth and development
have been substantially the same. First, new instruments, or modes
of using instruments, are devised (usually by scientific men), skill in the
management of which requires a knowledge and patience that transcends
the capacity of the average charlatan or of the laity in general. With
the use of new apparatus, arrives a more accurate and refined pathology
and a more discriminating and successful therapeutics, all of which
scientific advantages are in time appreciated by the profession and ulti-
mately by the people, who slowly realize the fact that it is possible
even for scientific men to cure disease; and thus it happens that char-
latans fall back in the race and give way to scholarly and observant
men, for the same reason that stages give way te railways, and canal-
boats to steamships.*

The history not only of electro-therapeutics in general, but of all the
special branches and advances in electro-therapeutics, is the history of
persecution. First, localized electrization with the faradic current, then
localized electrization with the galvanic current, must fight their weary
battles ; then electrolysis and galvano-cautery ; then general faradization
comes in to be at first despised and rejected; and last of all, central gal-
vanization has sought for a recognition amid the same jeers and deri-
sion that greeted all its sisters in art. In the portals of science, every
new-comer is at first unwelcome, and is received with a frown, a kick,
or a sneer, to be afterwards greeted with warm and loving embraces.
In the history of the application of electricity to the various diseases,
the same principles are illustrated: those who believe or think they
believe in electricity as a therapeutic agent in general, begin to bristle
and howl as soon as it is recommended for any disease for which it had
not previously been used, and thus it is that the value of this powerful
and protean agent to nervous dyspepsia, to neurasthenia, to hysteria
and insanity, and to general debility, has been admitted only after bitter
struggles.

* Messrs. Tiemann & Co., the well-known instrument-makers, inform us, that since
ophthalmology, otology, and gynecology have been recognized in the profession and
faithfully studied by specialists, there has been little sale of instruments for these depart
ments to charlatans.
238 PERSECUTIONS AND STRUGGLES.

The leading and basic idea of electro-medicine, that electrization is
a tonic as well as a stimulant, although now generally received even
‘by some of the French writers, was rejected without examination,
especially by those who were supposed to have some knowledge of
electro-therapeutics. And here we may remark that the most violent
opposers of any new fact are usually those to whose specialty it be-
longs. Before a new idea can enter the brain of a specialist in any
branch, it must first displace some old idea, and thus a double task is
laid upon it. Thus is explained the historic fact, that localized electri-
zation and general faradization were in successful use among the laity
long before they were introduced to the profession. These men have
in some instances aroused the interest as well as the opposition of
the profession, and have inspired able men to investigate the subject
for themselves. The opposition and persecution to which scientific
electro-therapeutics has been subjected at the hands of their brethren
in the profession, have redounded to the glory of the cause. Wrath
has stimulated inquiry, and sneers and gibes have fed the flame that
they were designed to extinguish. The sorrows of the pioneers have
been the seeds of science. Opposition has called forth latent forces
in the ranks of electro-therapeutists, which they dreamed not that
they possessed, for they have been enabled to transcend themselves,
arid to attain a success that has surpassed their most sanguine expec-
tation.

In obedience to this inevitable law, electricity has fought its way into
neurology, ophthalmology, and otology, into gynecology and laryngology,
and into surgery, where it has become an essential adjunct. One of the
most recent and important advances of electro-therapeutics is its ap-
plication to diseases of the skin, in which, as will appear in the course
of the present volume, we have obtained some remarkable and sugges-
tive results. This statement has been met by the majority of derma-
tologists with doubt, derision, and neglect.* | Physicians who are
excellent friends of ourselves and of electro-therapeutics, have expressed
sincere regret that we should attempt to treat diseases of the skin by
electricity, and have consoled. themselves with the hope that our en-
thusiasm would be cured by time and-experience.

* Shortly after we had accomplished some of our early experiments with central
galvanization and localized electrization in eczema, prurigo, and other cutaneous dis-
eases, we wrote to an acquaintance who is one of the very ablest of European electro-
therapeutists, and requested him to repeat our experiments. He wrote in reply that
he would be thought insane if he should make such an attempt.
‘HISTORY OF ELECTRO-THERAPEUTICS. 2329

It is but six or seven years ago that our statements in regard to the
tonic powers of electrization and its application to a large variety of
diseases of debility were similarly received. The conclusion of the
whole matter is, that electro-therapeutics, in the neglect and insult
and persecution through which it has passed, has only worked out
the general law of development of all original thought everywhere.
Every ascent of the heights of knowledge bristles with obstructions,
staring upon us like the guns of a fortress. Science advances only at
the. expense of old faiths that struggle hard for life, and with every
step in its progress some loved idol of the world is crushed beneath its
feet.

No man who is afraid of neglect and scorn ought to attempt any
original thinking, for as it has ever been, so must it ever be of those
who would advance knowledge, as of those who would “live godly”
in the world, that they ‘‘ must suffer persecution.” The first revelations
of nature’s laws are made only to those who have the calm courage that
can face a frowning world. So high an honor as that of making a dis-
covery in science is not allowed, except to those who above the cross
can see the crown, and beyond the silence of the present can hear the
plaudits of the future.*

3. Ln electro-therapeutics as in all other sciences, most of the important
discoveries, inventions, and advances have been made not by accident,
but as a direct result of patient research.—Those who will study the
admirable treatise of Whewell, on the History of the Inductive Sciences,
will be surprised to find how utterly erroneous is the common idea that
the discoveries and inventions of the world have been made by chance.

Accident alone does not advance humanity. In the realm of scien-

_ tific discovery, as everywhere, force answers to force, and if one man
accomplishes more than another in any direction, it is because he has
greater force in that direction and uses it to better advantage. Accident
may be the incidental contingencies of discovery, but they are not the
discoveries, and of themselves, unaided by previous thought and labor,
would come to naught. The accident of the convulsions of the frog’s
leg did not immortalize Galvani, but the long series of research that fol-
lowed the accident. The accident of the deflection of the needle under

* Morton, one of the discoverers of anesthesia, thus sadly writes: ‘‘It were better
for me, infinitely better for me and my wife and children, better for me and them in
all respects, if I had buried the secret of the victory over pain in my breast forever,
and suffered centuries to elapse before it came forth to the knowledge of the world by
some other hand, than to do as I did—hasten to make it known by all forms and modes
of speech, and at every risk of health, prosperity, and even life,””
240 ADVANCES MADE BY SPECIALISTS.

the electric current would have been nothing to Oersted, had he not for
fifteen years been deeply engaged in the study of electrical phenomena,
and especially in the solution of the very question that the accidental
observation helped to solve. Similarly also the various batteries and
appliances used in electricity, from the first frictional machine and
the pile of Volta down to the beautiful reflecting galvanometer of
Thomson, and all the wide variety of apparatus for electro-therapeu-
* tics, are the products of toil and experiment, the sifted results of name-
less failures.

None of the important methods of using electricity in the treatment
of disease have been stumbled upon. Localized faradization and gal-
vanization, general faradization, electrolyzation, galvano-cauterization,
and central galvanization, each represent years of experiment on the
part of some one or of many physicians and surgeons.

4. The advances in Electro-Therapeutics have been made almost
entirely by so-called specialists.

Until quite recently, it had been the fashion in modern times, and par-
ticularly in America, where all other terms of abuse have been proved
inadequate to express contempt for any man, to call him a specialist.
The inappropriateness of this designation becomes quickly apparent in
the light of the history not only of electro-therapeutics, but of every
branch of modern knowledge. In the days of Plato and Aristotle
philosophers could rarely be specialists, for the reason that there was
nothing to specialize upon; there was little to be known in any‘ one
branch or in all branches of human acquirement. ,

Past history was a blank or a myth, and future history no one could
predict. The sciences, save astronomy, were not born; yet even in
that childhood of the world, nearly all who became eminent in Grecian
history—artists, poets, statesmen, orators, and generals—were specialists ;
and if Aristotle encompassed all knowledge, it was because there was
so little existing knowledge to compass.

In the larger sense of the word, all scholars must be specialists. This
necessity of giving special attention to any department in order to
attain mastership in that department, becomes more imperative as the
evolution of humanity goes on. Although the capacity of the human
brain has increased in important percentage during the past few
thousand years, yet it has in no way kept pace with the advance of
knowledge. To master any one of the special divisions of modern
thought costs more of brain force than was required in the days of
Aristotle to traverse the whole field of knowledge. Hence it is that
all the great advances that have been made by the tuman race have
HISTORY OF ELECTRO-THERAPEUTICS. 241

been organized by men who have given special attention to some
special line of thought or action, on which they have concentrated most
if not all of their mental forces. Civilization is the product of
specialization. Eliminate from human society the labors of specialists
and their results, and we put the human race back thousands of years.
It is only in rude and savage communities that some one man or some
few men as chiefs or leaders are expected to know everything and
decide all questions. ‘The first sign that a tribe is beginning to rise in
the social scale, is the birth of a specialist who commands influence
and leads his people in advance of their previous state by virtue of his
special investigations. ‘Those philosophers who, like Comte and Spencer,
Mill and Hamilton, survey the whole area of the sciences, do not profess
to acquire mastership in any one: they are not regarded as authorities
in any one branch, and are known and recognized as generalizers
from the labors of others. ,

Every medical man in our time, be he general practitioner or not, be
he physician or surgeon, whatever he may be called, is a specialist.

There have been men, and the history of medicine gives examples,
who, after rambling amid various realms, have at last settled down in
some field and cultivated that exclusively, thus obtaining distinction ;
though no specialists all their lives, they were so at the time that they
made their discoveries. The histories of vaccination, of anesthesia, of
many physiological discoveries, illustrate this fact. The history of
electrology includes a large number of the greatest names of modern
science; philosophers who have acquired’ fame in various walks of
learning have helped to hasten the march of electricity.

Galvani, Volta, Franklin, Oersted, Arago, Ampére, Davy, Faraday,
Tyndall, would have been more or less illustrious, even: had they never
‘identified themselves with the history of electricity. Similarly, it may
be said of Duchenne, Remak, Althaus, and other authorities in electro-
therapeutics, that they have cultivated with success other departments
of science.

5. The ignorance and prejudice of men in the profession and out of
it have helped to advance the cause of Electro-Therapeutics.

In the grand evolution of science, the evil as well as the good
qualities of men have a glorious part to perform. With high wisdom
Dr. Holmes has said, “The ignorance of people is as much their
possession as their family Bible,” and should be respected accordingly.

An opinion may be false, may be utterly false--may contain not
even a shadow of truth—and yet be convenient, necessary, and even in-
dispensable for the human race at certain stages of its development.

16
a

242 ADVANCES MADE BY YOUNG MEN.

Prejudice even, and narrowness and superstition, may be divinely ap.
pointed means for the reformation of the world.

In the history of electro-therapeutics, it has been shown over and
over again, that the laity have been emboldened by their very igno-
rance to make experiments from which the true scientist would have
recoiled. Such experiments have been of service, although they have
subsequently needed the aid of science to perfect, expound, develop, and
systemize these results and make them of genuine service to the
world.

Most of the pioneer experiments in this branch, especially during the
last part of the last century, were made by monks, priests, physicists,
and natural philosophers, as Hehl, Kleist, Volta, Franklin, etc., in
short by almost every class except physicians and surgeons ;* and in
our day, and especially in this country, the banner of electro-therapeu-
tics is still borne from town to town and from city to city by an
innumerable army of clergymen and teachers—professors so called—
clairvoyants, and by every other sort of “what is it” conceivable.

6. The Advances in Electro-therapeutics have been made mostly by
Young Men.—This fact also is not peculiar to the history of electro-thera-
peutics. In every sphere and in all recorded times, the original thoughts
and deeds of the world have been the work of youth and middle life.

The golden decade for original pioneering—creative work that leads
humanity and raises it to a higher plane—is from 30 to 40, the silver
decade from 40 to 50, the brazen decade from 20 to 30, the iron
decade from 50 to 60; and soon. Strikingly this is illustrated in the
history of medicine everywhere. For the discoveries of vaccination
and the circulation of the blood we are indebted to the earlier decades,
and so of nearly all the leading advances in science and art. Con-
cerning the merits of the rival claimants for the discovery of an-
zesthesia there has been much dispute, but one fact is undisputed—that
Wells, Morton, and Simpson were all young at the time that they made
the experiments that have immortalized their names.

In electro-therapeutics as in all other branchesf practical medicine,
special and general, the aged are too much occupied with the details
of practice to engage in original research—even when they have the
ability and disposition to do so.

* Otologists will recall the fact that the Eustachian catheter was first used by a
layman, a postmaster in France.

+ The general subject of the relation of age to work has been discussed by Dr.
Beard in a recently published treatise, and will be discussed in greater detail in a
larger work now in preparation,
HISTORY OF ELECTRO-THERAPEUTICS. 243

7. Electro-therapeutics has not been developed exclusively by any one
nation, but is indebted to all the leading nations of civilization.—
France and Italy, Germany and Russia, Great Britain and the United
States, have all contributed to swell the march of this important
branch of science. It is interesting to note, that Italy, the land
of Galvani and Volta, and which may be said to have been the
birth-place of electrology, has dropped far behind, and in recent times
has done but little in the way of original research or popularization ;
in this as in every other branch of science the land of Galileo has
fallen from her ancient glory. France, which was at one time in
advance of all other European nations in electro-therapeutics, is now,
excepting Tripier, Onimus, and the lamented Legros, as behindhand in
this as in nearly every department of modern science. Here as every-
where, Germany during the last ten years has led the science of the
Continent.

Duchenne at one time stood not only in the advance of the electro-
therapeutists, but almost alone; and during the last ten years the
writers of Germany, England, America, and even Russia, have pushed
on far in advance of him and left him far out of sight. Even the latest
editions of his work are at least ten years behind the times, and give
but a very narrow and imperfect idea of electro-therapeutics. The
writings of the English and Americans are broader, more generous, and
on the whole more true as well as more philosophical, than the writings
of the Continental authorities, not excepting even the Germans.

Rapid Progress of Electro-therapeutics in America.—During the
past few years America has contributed more to electro-therapeutics
than any other nation, if not indeed more than all others combined.
Of the six principal methods of using electricity in the treatment of
disease, two — general faradization and central galvanization—are purely
American ; and both in medical and surgical electricity, and in many of
the special diseases included under them, original research has been
bolder and more successful than’ in any other country.

The progress of electro-therapeutics in the United States during the
past five years is a fact unparalleled in the history of medicine. Those
who have entered the profession within the past two or three years,
would credit only with great difficulty a detailed history of our earlier
experiences in introducing this department. With some few exceptions,
elsewhere noticed, those who used electricity half a dozen years ago,
were the refuse of society ; when you had seen an “ electrician,” as they
were called, you had touched bottom ; whatever of ignorance was below
that level was a dark and deep unknown, where no explorer would
244 POPULARITY OF ELECTRO-THERAPEUTICS.

presume to venture. Ignorance seemed, in short, to be drawn toward
electro-therapeutics, as particles of iron are drawn towards a magnet.
Electro-therapeutics was allied with spiritualism, mesmerism, phrenology,
and we know not how many other absurdities.

This period was shortly after Duchenne had published the first
edition of his work on localized electrization ; but there is no reason
to believe that the teachings of that work were at that time at all
familiar to the majority, of the self-styled “electricians” of this
country. They used various modifications of the method of localized
and general faradization blindly and recklessly, though oftentimes with
brilliant success. Their performances, however, seemed to repel rather
than invite the profession, and when we sought for scientific instruction
on this subject there were scarcely any that could give it. For that
reason we closely studied the clinical experience of those who were to
the last degree ignorant, and the assistance thus obtained we are happy
to acknowledge. With much of error there was mingled much of
truth, that we have sought to sift and purify and bring forth to the cleai
light of science. When in 1866 we began together to work up this
subject, the difficulties in our way were more than appalling ; friends
who were very near to us, and whose judgment we most highly valued,
warned us that to touch electricity was to touch pollution. Electro-
therapeutics was believed to be fit only for those who were fit for
nothing else. To apply or even suggest the application of electricity
was a folly if not a crime.

‘¢ Well enough for a plaything,” “good for nothing except in para-
lysis,” “a good thing to humbug people with,” ‘a quack remedy,”
“the moral effect is all there is in it,’—in some such complimentary
phrases as these were the profession accustomed, even as late as the
early part of the present decade, to express their opinion of the value
of electricity as a therapeutic agent.*

One would as soon look for a spectroscope in the office of a physi-
cian as for an electric battery, and those who professed in certain cases
to employ electricity, depended in most part on old and worn-out
magneto-electric machines, that half the time would not go, and the
other half went only to do evil. The machines in the market were sold
mostly to the laity, who, ignorant as they might be, were on this subject

* It is but three or four years since a medical friend of ours in a neighboring city,
a gentleman of liberal education, who had given attention to electro-therapeutics,
began to treat some of the patients of his class, in a dispensary of that city, by elec-
tricity. He was notified that such treatment was displeasing to the managers, and
consequently he resigned.
HISTORY OF ELECTRO-THERAPEUTICS. 246

better informed than their doctors. Although every fool was not an
electrician, yet every electrician was prima facie a fool.

The revolution was as rapid as it was decided. The first formal pre.
sentations of the subject, superficial as ‘they necessarily were, before
societies and in medical journals, brought to light a latent interest, and
longing for knowledge on that subject, that we did not believe existed ;
from every part of the land came letters of encouragement and in-
quiry.

The ablest minds in the profession promised to co-operate by every
possible method in the attempt to raise electro-therapeutics to a
science ; and most faithfully and beyond our most sanguine hopes they
kept that promise, and some of them have made and are making origi-
nal researches in this department.

All the prominent medical journals, with but few exceptions, were
glad to publish articles on electro-therapeutics; and reviews of
works on this subject manifested the same fairness as that which
governed the consideration of any other special branch of science.
Science is not a matter of geography: it knows no destination of
language and no boundaries of race; higher than the mountains and
deeper than the sea, it embraces all its disciples in one common
brotherhood. It is not for America to boast of her scientific achieve-
ments as a nation, but only as a part of the great world of science ; but
this thought we may surely entertain, that it is eminently fitting that
the nation which first brought lightning from the sky, and then utilized
it as the fleet messenger of civilization, should also be the foremost in
popularizing electricity as a remedy in disease. In no other land had
electro-therapeutics sunk so low as here; in no other land does it seem
destined to rise so high and spread so far. What but a few years ago
was sown in weakness, has been raised in power. The stone which
the builders rejected, the same is becoming the head of the corner in
the temple of science.

This progress is due partly to the enthusiasm and patience of the
pioneers in this department, who have left no stone unturned to force
electro-therapeutics on the attention of men of science, partly to the skill
and enterprise of the mechanicians, who now furnish us with apparatus
which for convenience and for perfection of workmanship are unrivalled,
and not a little to the harmonious co-operation of general practitioners
with specialists, both in original researches with a view to discovery,
and in the popularization of what has been discovered. From the out.
set of’ our electro-therapeutical experience, we saw that the value of
electro-therapeutics to science would depend on the extent to which it
246 SCIENTIFIC ELECTRO-THERAPEUTICS NEGLECTED.

could be popularized in the profession, and to that end neither time nor
toil have been spared; for, while it.is true here as everywhere that the
secret of the highest success lies in concentration, and that those who
expend their entire force in tlis single direction should attain thereby
exceptional confidence and skill, yet to confine the department to a
scattered few, and to surround it with an atmosphere of mystery and
wonder, would be a crime against science. Therefore it is that in the
simplification of apparatus and in the directions for using them, and in
the clear and intelligent study of the diseases for which electricity is
indicated, it has been sought in recent times to make electro-therapeu-
tics the common property of all practitioners everywhere—among
the mountains and on the prairies equally with the great centres of
science ; at the bedside as well as in the consulting room. In thus
uniting their forces and dividing their labors, general practitioners and
specialists have done wisely and well; for they are like musicians play-
ing the same air, though on different instruments, and if there be dis-
cord it is because one or the other strikes a false note.

The profession in America are in taste and in talent intensely and
distinctively practical, and consequently they have entered the depart-
ment of electrology from its practical side: they have entered it with
eagerness and enthusiasm, because it vastly increases their power over
disease. On the other hand, the distinctively scientific relations of
electrology have been, and still are, altogether too much neglected in
America. Electro-physics and electro-physiology, and the intimate
study of the obscure diseases for which electricity is used, are but little
considered. The history just detailed has shown that the scientific and
the practical branches of this department must to a certain extent be
studied together and in their relations to each other, and that from the
earliest era of electro-therapeutics until now, the advance of the prac-
tical part of electricity has been in a measure dependent on the
advance in the scientific part.

8. Many of the important deductions of recent exfiments in electro-
physiology had been empirically anticipated.

Duchenne discovered that irritation of the skin produced sparks,
crackling, and a burning sensation, and that electro-muscular con-
tractility and electro-muscular sensibility were produced by irritation of
the nerves and muscles, by experiments on wounded patients ; but the
electric currents had been used to irritate the skin and produce muscu-
lar contractions long before his time. His earliest work on localized
electrization was presented to the Academy in 1847, but the electric
current from a faradic apparatus had been used in various ways, for

«
HISTORY OF ELECTRO-THERAPEUTICS. 247

the treatment of diseases, many years before; and sparks from frictional
apparatus, as has been shown, had been more or less employed by a
large number of observers, both in this country and in Europe, for over
half a century. Many of these experimenters were empirics in the
worst sense of the word; but many of them also, with all their mani-
fest ignorance, were, as has been said, not unfrequently successful in
the treatment of disease.

During the last century there have been a large number of experi-
menters in electro-therapeutics who in all their lives never contributed
a line to the literature of the subject, and did little or nothing to en-
courage or inspire others to prosecute the same studies, and who yet
not only achieved most decided therapeutical results, but also empiri-
cally anticipated the deductions of the ablest electro-physiologists of
our time,

Very many of our so-called discoveries in this, as in so many other
branches of science, are but revivifications of ancient theories and
practices, refined, modified, and developed by modern research.

It is quite recently that it has been established by the observations
of ourselves and others in pathological cases, and by the experiments of
Erb, Birchardt, and Ziemssen on the dead subject, that the electric
currents, when applied over the head and back, passed through and di-
rectly affect the brain and spinal cord ; but the theory that they do thus.
affect the central nervous system had been received for years, and has
led to successful results in practice.

The proposition of Du Bois-Reymond, that the electric current, after
penetrating the tissues beneath the epidermis, diffuses itself through the
tissues in various directions, according to the conductibility of the parts.
was probably anticipated at the earliest dawn of electro-therapeutics.
It was certainly received and acted upon by numerous experimenters long
prior to the elaborate researches of Du Bois-Reymond, and in America,
and unquestionably also in Europe, has been for years the empirical
basis of electro-therapeutics.

Electro-physiology has but very recently demonstrated that the audi-
tory nerve. could react to the galvanic current ;. yet galvanism, almost
from its discovery, has been used for diseases of the auditory nerve,.
and in occasional instances with success. So also the recent deduc-
tions of physiology concerning the changes of irritability that take place
when a nerve is subjected to the action of the galvanic current, have
peen vaguely and unscientifically anticipated in therapeutics for more
than a quarter of a century. Not until recently was it demonstrated
chat the sympathetic could be directly affected by external electrization,
248 IN ADVANCE OF ELECTRO-PHYSIOLOGY.

and yet the sympathetic had been directly affected, for good or ill, by
all who had previously made applications of electricity over the head,
neck, and spine. Very recently, indeed, has it been demonstrated by
physiological experiments of ourselves and others that electrization has °
a marked influence over nutrition, but improvement in nutrition was
one of the earliest as it has been one of the most constant effects that
have been obtained from electrical applications.

That so many of the recent deductions of physiologists had been
anticipated by empirics in no way derogates from the honor and the
‘gratitude that science owes to its latest discoverers. Reckless and .
‘misguided empiricism alone would not have raised electro-therapeutics
to ascience. It was necessary that scientific physicians should take
electro-therapeutics from the hands of the ignorant, reduce it to order
and system before it could be entitled to a place among the sciences. |

The efforts of the laity alone could never have made electro-thera-
peutics popular. The difficulties and disappointments in its use were
great; left to the ignorant alone, it would have died a natural
‘death.

9. Electro-therapeutics has been in advance of electro-physiology.
Starting’with some electro-physiological assumption, or, more frequently,
without any theories whatever, men have blindly and empirically resorted
to electricity as a panacea for an immense variety of diseases, and,
amid many blunders and absurdities, have stumbled on many impor-
tant results. The truth is, that among the advanced minds of our day
the conviction is ever deepening and strengthening that therapeu-
tics is not yet, and may never be, an exact science; that the time may
indeed never come when it shall be possible to treat any disease by the
rule of three. So profound is our ignorance of the chemical constitution
of the body ; of the molecular and other changes that incessantly take
place in health and disease ; of the modifications which these changes
undergo by the infinite and varying influences of climate, temperament,
diet and mode of life ; and so limited and uncertain is our knowledge of
the nature and action of medicines, that we may well resign the hope
of reducing therapeutics to an exact science to distant generations.
The number of those in the profession who will subscribe to the em-
phatic words of Niemeyer, ‘It is idle to hope for a time when a medi-
cal prescription should be a simple resultant of a computation of known
quantities,” is rather increasing than diminishing with the advance of
science, and the belief is extending that therapeutics is largely a matter
of empiricism ; that, while we are waiting and toiling to perfect our
knowledge of pathology, and determine its relation to therapeutics,
HISTORY OF ELECTRO-THERAPEUTICS. 249

in other words, to make our therapeutics rational, we must not allow
our patients to suffer, but should faithfully use those remedies and sys
tems of treatment that experience has recommended. Such has been
the practice of many of our most successful experimenters with electriza.
tion. For more than a century physicians have treated diseases of
which they knew but little, by electric currents, of which they knew even
less, and that too not unfrequently with good results. Duchenne in-
troduced localized electrization with the faradic current in 1847, and
Remak published his first essay on the constant galvanic current in
1855, but the faradic current had been locally applied by moistened
electrodes many years before, and the use of the constant galvanic cur-
rent even antedates the discovery, of the voltaic pile. Indeed, there is
scarcely a disease for which electrization is now employed by modern
neurologists in which it had not been used, more or less, during the
last century, though usually by methods less scientific and results less
uniform than at present. It will be seen that paralysis, neuralgia,
chorea, epilepsy, rheumatism, diseases of the eye, ear, indeed many of
the morbid conditions in which electrization is now of service, were treat-
ed by electricity, and not unfrequently with success, before the pres-
ent century. Some of the theories of electricity, electro-physiology, ana
therapeutics have either failed to be sustained by modern investigation,
or have been actually disproved. Thus it is now pretty well established
that electricity and nervous force are not identical, but the supposition
that there was identity between them inspired and encouraged many of
the early experimenters. So also there are a vast number of theories
concerning the action of electricity on the body, the relation of the
poles, etc., that at present are not regarded. The admission must be
made, however, that these erroneous hypotheses sometimes led to ex-
periments producing important therapeutical results.

10. The progress of electro-therapeutics has not been uniform or
steady, and until recently has been slow ; it has been marked by alter-
nations of eras of extravagant faith and activity, with eras of equally
extravagant distrust and neglect.

Beginning with the mythical procedures of the Roman physicians
with electric fishes, it had long slumbered in the forgetfulness of ages
when it was revived in the 18th century by the experiments with
frictional electricity, and the great discovery of Galvani and Volta.
The interest thus aroused by galvanism, and the invention of the
voltaic pile, rose to a height of enthusiasm that believed that the
problem of therapeutics was solved forever, until from repeated
failures and disappointments there ensued a reaction of indifference,
250 PRESENT PERIL OF ELECTRO-THERAPEUVICS,

which for many years was only disturbed by the birth of electro.

puncture and by experiments in electro-surgery. The discovery of

induction, in 1831-32, and the modern improvement in galvanic
batteries, have inaugurated a new revival of electro-therapeutics, in

which the enthusiasm of the profession, rendered skeptical by past

history, but now convinced by unequivocal demonstration, has been

slowly and reluctantly enlisted. This last revival, it is safe to predict,

will be as much more extensive and permanent than any of its prede-

cessors, as its growth has been more gradual and more scientific.

The history of electro-therapeutics, with its varied alternations of
failure and success, and its ultimate triumph, may not inaptly be com-
pared to the incoming of the tide upon the shore, where, although
each successive wave apparently recedes as far as it advances, yet the
level of the waters is ever gradually rising, with a force at once sure
and irresistible.

Present popularity and peril of Llectro-Therapeutics.—Vo those
who, like ourselves, espoused the cause of electro-therapeutics when
humble, and early shared its wretched crust, its present popularity is
as surprising as it is satisfactory. Both by general practitioners and
specialists, electric treatment is prescribed as regularly as opium or
quinine.

In city and in country this once despised agent has become so fash-
ionable, that the laity ask for it and expect it as they ask and expect
pills and powders. :

This popularity of electro-therapeutics is complicated with one draw-
back ; there is danger that it will be studied too much as an art and too
little as a science, and that it will be made too common, in the bad sense
of that word, and be thought so easy that the wayfaring man, though a
fool, may not err therein. ‘There is danger that now, as of old, the details
of the applications will be entrusted too much to the patients themselves,
or their friends or servants, or, what is but little better, to physicians who
know nothing of electro-therapeutics as a science or as an art. The
prevailing impression that it requires no brains to apply electricity is the
curse of electro-therapeutics. Any idiot or mere infant can hold two
sponges on the body while the current is passing, and if that were all of
electricity in medicine, writers on this subject would be needless. A
dose of quinine or opium any fool can give or take, but to know when to
give these drugs, ow to give, and when of to give, requires oftentimes
the best skill and experience. Similarly with electricity. To know the
management of the apparatus so as to keep them always in working
order ; to know the diagnosis and pathology of subtle and obscure dis-
HISTORY OF ELECTRO-THERAPEUTICS. 251

zases ; what form of application each disease requires; to know when
to use localized faradization, when localized galvanization, when general
faradization, when central galvanization, when electrolysis and when
galvano-cautery, and how and when to combine two or more of these
methods, and how to vary them with the changes in the patient’s condi-
tion; to know when to modify the strength of the current according to
the wants of each case—all this knowledge comes only by observation
and hard study, and much experience. Books alone will not teach it,,
and genius will not supply its place. The present danger is that the
profession and the laity may become disheartened by the failures that
occur through the excess of their ignorance, and kick out of doors
the remedy that they are welcoming with open arms. This evil ten-
dency must be counteracted on the part of specialists, at least ; and of
young practitioners who can command the leisure, by careful and con-
scientious study of the science as well as the art of electro-thera-
peutics. .

They must not be content with a little success in applying electricity
to certain cases, but must rise to that higher level where their eyes can
take in the whole field of electrology. Let them aim to be masters
in electro-physics and electro-physiology, as in the art of applying elec-
tricity. Let them master neurology in all its branches, and become
experts in all the branches of modern diagnosis.

Under the direction of a physician who thoroughly knows what he is
about, a patient, or the friends of a patient, may make a portion of the
applications, in cases of local paralysis or rheumatism, or some other
affections where merely routine treatment is required ; but in our own
experience nearly all attempts of this sort are more or less unsatisfac-
tory.

In diseases of any moment, little dependence can be placed on what
the patients do for themselves, or in their own households. They per-
haps begin well, make or try to make a few applications, then the
apparatus gets out of order, and they know not how to repair it, or are
too indolent to make the attempt, and the treatment is abandoned.
This has been our experience so often, even in dealing with intelli-
gent patients, that we now advise doing nothing whatever, to any such
scientific dabbling as domestic electro-therapeutics. When we con-
sider that there are six different methods of using electricity—localized
faradization, localized galvanization, general faradization, central gal-
vanization, electrolysis, and galvano-cautery, and each one of these re-
quire long and patient study, and an extended experience, before its
details can be mastered; that some morbid conditions are benefited by
*

252 PRESENT PERIL OF ELECTRO-THERAPEUTICS.

one method and injured by another, and that some are best treated by
a number of them combined ; that the methods must frequently be varied
during a course of treatment; and finally, when we consider that the
scientific and successful use of any one of these methods requires an
intimate knowledge of the most complex and obscure diseases known
to medicine, and that a certain proportion of temperaments, whether
healthy or diseased, will not bear electricity at all, however administered,
—when we consider all these facts, we see the absurdity, if not crimi-
nality, of prescribing electricity as a domestic remedy.

Those physicians and surgeons who recklessly and indiscriminately
recommend patients to purchase batteries and have the applications
made by themselves or their friends, or their servants, do injury in vari-
ous ways. As a rule, ‘their patients receive no benefit from an agent
which rightly used might have done them good. This is a negative in-
jury, so called, but none the less real. They injure themselves by failing
to help their patient ; they injure the profession by making it appear that
the medical use of electricity is a simple and trifling thing, and there-
fore the peculiar province of ignorance and charlatanism.

Manufacturers of instruments, who were formerly dependent solely or
mainly on the patronage of the laity, are reminded of the fact, which
we are in a position to state with authority, that the present position of
medical and surgical electricity, and the present demand for machines,
is due entirely to the efforts of scientific men, working by scientific
methods, and for scientific purposes. Left to the people alone, this de-
partment would never have achieved popularity, and if ever scientific
men should desert it and it should be relegated to the laity, it will de-
serve to die, and it will die; the demand for machines will sink to a
minimum, and the manufacturers will find their occupation gone.

The duty of the profession in regard to this matter is very clear.
They should familiarize themselves with electro-therapeutics, so as to
make the applications themselves, or through trained assistants, or
they should send the patients to those who are masters of the subject ;
or, in case neither of these courses is practicable, they should as a
rule not attempt to have electricity used at all, or should confine them-
selves mainly to.its use as a palliative, and with the understanding that
they are submitting to a necessary evil.
CHAPTER II.

GENERAL THERAPEUTICAL ACTION OF ELECTRICITY.

Electricity in its Medical Relations is a Stimulating Sedative Tonic.—
The cause of medical electricity has been, and still is, greatly re-
tarded by vague and incorrect notions of the position of electricity in
the materia medica. It has been classed as a stimulant, and up to the
time when we began to write on the subject, in 1866, nearly all the
writers on the subject had assumed without question or discussion that
the stimulating action was the main if not the only action of electricity.
The idea that it was also a tonic was not even discussed. The first
formal presentation of the use of electricity by the method of general
faradization appeared in a paper by Dr. Rockwell, based on consid-
erable experience and many experiments, and entitled “ Electricity in
the Treatment of Rheumatic Affections,” and published in the Afedical
Record in 1866. In this and subsequent papers by both the authors
of this treatise, the tonic effects of electricity were fully demonstrated,
Those few in the profession who used electricity at all had gone no
further than Duchenne, and supposed that when they had used this
agent to kick up palsied muscles, they had exhausted its therapeutic
indications. In obedience to the same narrow and exclusive dogma,
electricity was supposed to be exclusively contraindicated in febrile and
inflammatory affections, and was supposed to be of value only in a
very limited range of subacute and chronic diseases. The acceptance
of the view that electricity is a tonic has wrought a revolution in
electro-therapeutics. An agent which was formerly used mainly if
not exclusively in paralysis and rheumatism, is now used, and with far
more brilliant success, in hysteria and affections allied to it, in insanity,
anenia, neurasthenia, in nervous dyspepsia, neuralgia, chorea, in the
convalescence from fevers, and all forms of pain and debility whatso-
ever.

It is necessary to state, at the outset, that in classing electricity as a
stimulating sedative tonic, we use the words in the sense in which they
are ordinarily understood and employed when applied to other reme-
dies and systems of treatment, and without any reference to the mere

2
*

254 STIMULANTS vs. TONICS.

verbal distinctions that may be or have been made in the classification
of materia medica.

Stimulants are usually understood to be those agents which guzchly
excite the system, and temporarily arouse its activity. They are like
the goad, which forces the exhausted beast to draw the burden, but
does nothing to increase his strength; or like the blast of the fur-
nace, which increases the combustion, but adds no fuel. We do not
accept this definition, but would prefer to regard stimulants as those
agents that correct, intensify or economize the forces of the system,

Sedatives may be severally defined as those agents that allay irrita-
bility and pain and induce natural repose.

Tonics are ordinarily understood to be those agents which gradually
improve nutrition, restore enteebled functions, invigorate the system,
and permanently increase its capacity for labor.

It is because electrization is capable of producing at once the effects
which are ascribed to all these classes of agents, that we have defined
it a stimulating sedative tonic.

These various effects are not always mathematically distinct, but run
into each other. The stimulant effect may at once lead to sedation,
and the permanent improvement to nutrition follows after a long time,
and is in part a result of both stimulation and sedation.

Of these three orders of effects, stimulation, sedation and improve-
ment in nutrition, stimulation is the one that is of the least importance,
and yet it is the one that first strikes the observation, and the one which
until very recently has been regarded as thé exclusive test for the use
of electricity in medicine. If electricity were merely a stimulant it
would scarcely pay to use it in the treatment of disease, for its range
would be so narrow, and the result of its use even in that narrow range
so temporary and unsatisfactory, that physicians would not find it to
their advantage to spend time and labor in making the applications.

The ill success of all previous attempts to popularize electro-thera-
peutics is to be explained in part by the fact that those who experimented
with it looked upon it as a simple stimulant and nothing ‘more, and
recommended it accordingly. If it depended on its stimulating action
only, the cause of electro-therapeutics would have little vitality. The
reason why electricity is now growing in popularity in the profession is
because it is found to relieve all forms of pain, and to add tone to the
system and improve nutrition after ordinary sedatives or tonics have
failed..

Tonic Effects of Electricity best elicited by General Faradization ana
Central Galvanization.—Reasoning from analogy, as well as from experi:

*
GENERAL THERAPEUTICAL ACTION OF ELECTRICITY. 255

ence, it would seem that the full effects of electricity on the human body
could only be obtained by making the applications a// over the person and
on the central nervous system in such a way as to affect the whole system.
The influence of any drug or remedial agent on the constitution can
only be ascertained by bringing the zwole system under that influence.
A man who habitually washes one of his fingers in cold water ap.
preciates the tonic effects of the cold only in that finger; but a man
who habitually takes a shower-bath, or plunges into a tub of cold
water, realizes powerful tonic effects on his entire system. If a man
daily exposes one arm to the sunlight, while the rest of the body is
enclosed in a dark cell, he receives direct tonic effects only -in the
exposed member ; but he who walks forth and exposes his whole per-
son to the solar rays will in time experience the full tonic effect of suh-
light on his system. If one hand or one foot is vigorously and regu-
larly exercised, the muscles of that limb exhibit the tonic effects of the
exercise, and increase in hardness and perhaps in size; but if all the
portions of the body are vigorously and regularly exercised, all the
principal muscles will increase in firmness and perhaps in size, and
tonic effects will be appreciated by the entire system.

Just so with all other tonic remedies and influences. If quinine,
strychnine, iron, arsenic, oil, etc., could be localized in a single limb,
only that limb would be directly influenced by them. Their tonic
effect is only obtained by administering them in such a way that they
will penetrate every portion of the body.

Electricity is no exception to this law. In order to ascertain its full
effects on the system at large, and to determine its position among
remedies, the applications must be made in such a way that the whole
system shall, so far as possible, be directly or indirectly brought under
its influence. This is best accomplished by the methdds of genera:
faradization and central galvanization that are hereafter to be ex-
plained in detail.

In making a detailed comparison, therefore, between the effects of
electrization and the effects of recognized tonics—quinine, iron, strych-
nine, physical exercise, sunlight, cold bathing, etc.—it is logically neces-
sary that the applications should be so given that the whole body
should be brought under the direct influence of the current, just as it is
brought under the influence of other.recognized tonics as ordinarily ad-
ministered.

The immediate effects of an application of general faradization and
central galvanization are often a feeling of enlivenment and exhilaration,
drowsiness, temporary relief of pain, and increased warmth of the body.
256 LIKE OTHER STIMULATING TONICS.

The same effects are notably observed after the shower-bath, a tumble
in the surf, a brisk walk in the open air, or from the administration of
alcohol.

Like other stimulating tonics, general faradization, and central gal-
vanization, when given in an overdose, or in too great strength for the
constitution of the patient or the condition of the system at the time,
may be followed by secondary or reactive effects that are both dis-
agreeable and positively alarming. The second or third day after an
injudicious application, the patient, especially at the outset of treat-
ment, may experience soreness in the muscles, an indefinable feeling of
nervous exhaustion, irregularity of pulse, and sometimes exacerbation
of special symptoms. It is well known that severe physical exercise
will produce all these unpleasant secondary effects, especially in pa-
tients who are feeble and unaccustomed to muscular exertion. A cold
bath, either in the surf or at home, that is too prolonged may give rise
to all these symptoms the night or day following. Unpleasant effects
may secondarily follow an overdose of our ordinary stimulants, as
alcohol, or from internal tonics, as iron, quinine, strychnine.

The permanent effects of general faradization and central galvaniza-
tion are as closely analogous to those which come from other tonic
remedies and systems of treatment as are the immediate and second-
ary effects.

‘The very marked permanent effect of general faradization and central
galvanization is improvement in the sleep. Physical exercise—walk-
ing, boating, gymnastics, bowling—cold bathing, and the ordinary
internal tonics do the same, though not so markedly and with far less
uniformity.

General faradization and central galvanization also permanently im-
prove the appetite and digestive capacity, and regulate the bowels.
Improvement in the various operations of digestion is one of the most
uniform effects of our ordinary tonics, and it is for that purpose, more
perhaps than for any other, that they are employed.

Like other tonics, general faradization and central galvanization
equalize the circulation. This effect, when it zmmediately follows an
application,.is nearly the femporary excitement, similar to what follows
a rapid walk, or gymnastics, or alcoholic stimulants, and soon passes
away. But when it becomes a permanent condition—when the patient
feels less annoyance from chilliness and cold extremities—-it is a result-
ant of the improvement in nutrition.

Like other tonic measures—gymnastics, active games, and outdoor
amusements, etc., etc. --general faradization and central galvanization
GENERAL THERAPEUTICAL ACTION OF ELECTRICITY. 257

cause the muscles to develop in size and hardness, and sometimes,
though by no means uniformly, produce important and rapid increase in
the weight of the body, the result of the improvement in nutrition. In-
crease in weight is familiarly observed after a trip of pleasure, a vaca-
tion in the country, a voyage by sea, and very frequently indeed from
the use of cod-liver oil and strychnine. General faradization some-
times causes the patient to increase in weight from the very outset of
the treatment, and to an extent that is most surprising.

Like other tonics, general electrization, faradization and central
galvanization, in their ultimate effects, increase the disposition and the
capacity for labor of the brain or of the muscles. This is indeed the
chief end to which all tonic treatment is directed, inasmuch as dimin-
ished capacity for labor is perhaps the condition for which tonics are
most frequently advised, and it goes not usually increase the capacity
for toil until it has first improved the sleep, the appetite, the digestion.
The same is true of many other, if not all, tonic remedies.

Experience shows that general faradization and central galvanization
are usually contraindicated in those diseases and for those temperaments
that will not bear any of the internal tonics. We find almost invariably
that they must be used most cautiously, and meet with their worst failures
in cases where quinine, strychnine, iron and stimulants have proved to
be injurious.

Whatever difference of opinion there may be concerning the ration-
ale of electrization, or whatever dispute there may be concerning the
use and the meaning of the words stimulant, sedative, and tonic, the
majority of advanced practical electro-therapeutists must substantially
endorse the emphatic words of Prof. Niemeyer: “ lz the constant cur-
rent we have a means more powerful than any other of modifying the
nutritive conditions of parts that are deeply situated.” *

Rationale of Electrization.—The stimulating, the sedative, and the
tonic effects of electrization are resultants of the various and diverse ac-
tion of the currents on the tissues. These effects have been defined as
mechanical, physical, catalytic (increase of circulation and absorption),
electrotonic (modification of nerve), electrolytic (electro. chemical decom-
position), and cheiical. The mechanical effects are more markedly
observed from the faradic current, the other effects from the: galvanic.
These terms, considered as explanations of the action of electrization,
are, it must be admitted, quite unsatisfactory, since they are incapable.

* Text-Book of Practical Medicine; Translation of Drs. Humphreys and Hacke
ley, vol. ii., p. 290.
7
258 IS ELECTRICITY TRANSFORMED INTO NERVE FORCE?

of exact and complete definition, and must, to a certain extent, include
each other. It is safe to say that we know as much of the rationale
of electrization as of most of our internal remedies. (See chapter on
the subject in Electro-Physiology.)

‘s Electricity Transformed into Nerve Force?—Nearly all of the
earlier and very many of the latter experimenters in electro-therapeu-
tics assumed without argument, that electricity was identical with the
nerve force, or, at least, that it was directly transformed into it. Although
the weight of evidence is at present decidedly against the theory of the
identity of those forces (see Electro-Physiology, p. 207), yet the assump-
tion that they are identical or can be directly transformed into each
other, still lingers. The taking phrase, “ Electricity is Life,” is con-
stantly used as the war-cry of rival instrument makers, and as the
motto of travelling charlatans, on the street corners and at country
fairs. Whatever future science may unfold, we are now forced to say
that not only is there no evidence that electricity is identical with life,
but also that the theory that electricity, when applied to the body, is ever
directly transformed into nerve force has few if any facts or arguments
in its favor. That the body can be charged with electricity, and that
the-normal electricity of the body can be changed in character is clear
enough; but it does not follow that such changing of electrical condi-
tion has any direct influence on the quantity or quality of the nervous
force. Whether galvanic or faradic electricity charge the body to any
extent in passing through it may rightly be doubted; if they leave
more electricity in the body than they found in it, it must be by virtue
of the direct influence of the current over the nutrition. Electricity
is no more life than light and heat are life. Like light and heat it may
sustain life, not by direct transformation, but indirectly through its in-
fluence over nutrition. When the light of the sun falls on a plant or
animal, when artificial heat is applied to a cold and paralyzed limb,
growth is stimulated and nutrition improved, but not, so far as can yet be
demonstrated, by any direct transformation of light or heat into nervous
force. Similarly, also, we have no sufficient evidence as yet that the
varied and marvellous improvement in nutrition that follows electriza-
tion is the result of anything more than the indirect improvement in
nervous force, which is a part and result of the general improvement in
nutrition.

In the time and manner of their development the tonic effects of
general faradization and central galvanization resemble those of other
tonics in these ¢zo particulars.

1. They are Developed Slowly.—This slowness of development marks
GENERAL THERAPEUTICAL ACTION OF ELECTRICITY. 259

a radical distinction between tonics and mere stimulants. The agree-
able stimulating etfects which immediately follow an application of
general faradization and central galvanization, just as they follow the use
of jgymnastics, walking, active games, etc., soon pass off or merge into
the permanent or tonic effects that come more or less slowly, and
after repeated treatment.

2. They are often Developed long after the Treatment is Abandoned.—
Weeks and months after a patient has taken a course of general treat-
ment by general and central electrization he may continue to improve-
in his general condition, even though very little progress may have
been made while the applications were being received. Just so the
tonic effects of a trip by land, of a sea voyage, of our ordinary summer
vacations, are sometimes not appreciated until after we have returned
home, and are again fully at work.

Why were not the Tonic Effects of Electricity sooner Discovered ?—
The inquiry now very naturally arises, why it is that the important fun-
damental fact--that electrization is a powerful means of improving
nutrition, and capable of producing effects on the constitution similar
to those which are familiarly obtained from the tonics in every-day use—
has escaped the observation of the very able writers who in different
lands have devoted themselves to electro-therapeutics, until we called
attention to them.

The inquiry is thus answered :—

1. Because most of the recent scientific observers whose writings are
authorities in electro-therapeutics have used electricity locally, in some
form of “localized electrization.”

For obvious reasons, that have already been presented, localized elec- .
frization must produce chiefly local effects, which although they are
tonic in their character,so far as they-go, and reveal themselves by
marked improvement in the local nutrition, would not ordinarily sug-
gest the powerful constitutional tonic powers of which electrization is
capable when applied all over the body, any more than the feeble
effects of washing the hands, the face, or the feet, or any single meimber
or organ, would suggest or give any intimation of the well-known con-
stitutional effects of surf-bathing or the shower-bath.

Indirect constitutional effects result from localized electrization of the
central nervous system, and especially from galvanization of the brain,
spine and cervical sympathetic, although, as will be seen, they are not
as marked as those which follow general faradization and central gal-
vanization,

It is a very interesting and significant fact, however, that since the
260 TONIC EFFECTS RECENTLY DISCOVERED.

introduction into medical practice of the methods of localizing the
galvanic current in the nervous centres first suggested by Remak, elec-
tro-therapeutists have achieved success in a variety of diseases asso-
ciated with debility and impaired nutrition, where before electrical
treatment was supposed not to be indicated, at least by those who con-
fined themselves to localized electrization.* A suggestive fact relating
to this subject is that Gubler, who is one of the very few European
writers who had used faradization in such a way as to directly affect the
whole system, also remarked tonic effects in conditions of debility, even
from his very awkward and imperfect method.t

2. Because the immediate effects of electrization are so markedly
stimulating as to suggest the idea that it is simply and oxy a stimulant
or irritant. In some of the cases for which localized electrization are
used the stimulant are the effects which are chiefly desired. But, as
has already been shown, many of our ordinary tonics are primarily
stimulating, and so much so that they have been classed as stimulating
tonics.

There is little question that if many tonics in ordinary use, had
been used only locally, as electricity has been used, they might have
been regarded merely as stimulants.

3. Because until quite recently most of the recognized authorities
and writers:on electro-therapeutics of modern days have not used
electricity in those diseases and morbid conditions where tonics, par
excellence, were demanded. They have used the agent mainly with a
view to stimulating effects, and in some form of localized electrization.
On this principle they have treated paralysis, rheumatism, neuralgia,
etc. As we shall demonstrate hereafter, besides those diseases in
which the efficacy of localized electrization is fully established, the
morbid conditions and symptoms for which electrization is most rapidly
and permanently successful, are precisely those in which we use our
ordinary tonics—such as dyspepsia, nervous exhaustion, insomnia,
hypochondriasis, hysteria, general neuralgia, chorea, spinal irritation,
and some forms of paralysis dependent on or associated with general
debility.

Furthermore, in prosecuting this inquiry we myst not overlook two
important historical facts :—

1. In the latter part of the last and early part of the present

* Vide the writings of Remak, Meyer, Benedikt, Niemeyer,

+ De l’Electrization générale considerée comme agent tonique et stimulant dif-
fusible. Budletin de Thérapeutigue, Décembre, 1863. (For description of his
‘method, see p. 246.)
GENERAL THERAPEUTICAL ACTION OF ELECTRICITY. 261

century franklinic electricity and the current of the voltaic pile were
used for a variety of diseases for which we now use tonics, and often-
times with some success. But the agent was used mostly empirically,
without any definite idea of its nature or the rationale of its operation!
Partly on account of the inconstancy and uncertainty of the voltaic
pile, and partly on account of the many failures that were necessarily
inevitable with such poor apparatus and desultory experience, partly
also as a reaction from the .extravagant hopes and promises of the
earlier experimenters, this system of treatment soon fell into disrepute.

2. Tonic’ effects have been obtained from various methods of em-
ploying electricity by non-professional men—charlatans and outsiders
—in the United States at least, for many years, although very few of
them have known or suspected the nature of the agent they dealt
with, or of the diseases they have treated.
CHAPTER III.

GENERAL SUGGESTIONS IN REGARD TO THE USE OF ELECTRICITY
AS A THERAPEUTIC AGENT.

Berore describing in detail the different methods of using elec.
tricity, it may be well to offer some suggestions of a_ general
character that will apply to all the different methods of electrization,
localized and general, with the faradic and with the galvanic currents.
It is of the first importance that those who are beginning to study and
practice electro-therapeutics should have correct notions not only of
the general therapeutical action of electricity—-the principle on which
it is used—but, also, of the general laws of its application. Such
knowledge fits one to intelligently study the special methods of appli+
cation, and the treatment of the various diseases. A want of this knowl-
edge is a constant hindrance, and not unfrequently utterly discourages
the beginner in this science.

General Indications for the Medical use of Electricity.—An error
that appears prominently in nearly all the works on medical electricity,
and one that seriously interferes with the progress of healthy and philo-
sophic electro-therapeutics, is the habit of treating the name of the
disease rather than the condition of the system of which the symptoms
are the result and expression. Men ask whether electricity is good for
this disease or that disease without any well-defined idea of the position
that this powerful agent occupies in the armory of therapeutics. It should
be understood that electricity is a powerfitl stimulating sedative tonic, and
as such is indicated in any subacute or chronic disease, where stimulat-
ing, sedative or tonic effects are indicated, and without reference to the
name of the disease by which the condition expresses itself. With this
general principle before us, we cease to wonder that electricity is used
and recommended in such a wide variety of diseases, many of them of
an apparently opposite character, and we see the injustice of that
criticism which condemns electricity because it is good for so many
different affections. Just as quinine, which is not a specific for any
GENERAL SUGGESTIONS. 263

disease—unless it be chills and fever—is yet used freely as a tonic in
an indefinite number of diseases where tonic effects are required, so
electricity, which is not a specific for any one disease, is yet used with
good results in any number of diseases where local or general nutrition
is impaired and needs to be improved. The indications for the use of
‘electricity are wider than the indications for the use of quinine, for
the threefold reason that it has a powerful sedative action which
quinine, or indeed any other single tonic remedy does not have ;
that its stimulant and tonic effects are more decided, and that its
effects, sedative, stimulating or tonic, can be confined mainly to certain
organs, nerves or muscles, or be distributed through the whole body, as
may be thought necessary. When the propriety of using electricity in
any medical case is discussed, the first questions to be answered are:

1. Is there any pain to be relieved ?

2. Is there any need and chance for improvement in local or general
nutrition ?

If these questions can be answered in the affirmative, then electricity
in some mode of application may be administered. The result of the
treatment will depend on the skill with which it is conducted, on the nature
of the lesion and length of time that it has existed, and on the agree-
ment or disagreement of the temperament of the patient with elec-
tricity.

Stage of Disease when Electrical Treatment ts Indicated.—Electricity is
indicated mainly for subacute and chronic diseases ; at least the best results
that come from the use of this remedy have thus far not been obtained in
the acute stages of disease. And yet there is no question that in the
acute stages of rheumatism faradization is of value, and there is reason
to believe that future experiments will show that relief of pain, of
sleeplessness, and of general nervousness—with perhaps permanent
benefit—inay be obtained in the active stages of febrile and inflammatory
affections. The chief theoretical objection to the employment of
electricity in acute diseases is the fact that the tonic effects of
electrical treatment require so much time that any disease that runs
but a limited period will not be able to appreciate them. This objec-
tion does not, however, apply to the stimulating or sedative effects :
these can be felt instantaneously or within a few hours after an application.
Electricity is certainly one of the mést potent of sedatives, and in
very many acute affections sedatives are constantly indicated.

The old notion that electricity was merely a stimulant aided in forming
in the professional mind another very gross error, that in active inflam-
mations electricity-is contra-indicated. Experience proves every day
264 DIFFERENTIAL ACTION OF THE’ POLES.

that the sedative effects of electricity are exceedingly grateful in even
the acute stages of sprains and diseased joints.

The dogma that in hemiplegia from cerebral effusion it is better to
wait for several months until all the active irritation has subsided,
before beginning electrical treatment—which error is yet maintained by
many of the ablest writers on medical electricity—took its origin in
the erroneous conception of the position of electricity in the materia
medica.

It is difficult to conceive of any actively inflamed or febrile state,
where electricity, in the hands of one who knows how to use without
abusing it, may not be used without injury even if 1t does no good.

Differential Action of the Poles, and of the Ascending and Descending
Currents. —This is a subject on which much has been thought and writ-
ten, and concerning which opinions have been expressed with an
absoluteness not justified by experience. Almost the first question that
the beginner in electro-therapeutics asks, is, ‘‘ Which pole shall I use?”
as though that were the fundamental problem to be solved. Another
question that is put in almost the same breath is, “Shall the current
be ascending or descending ?”

These queries seem to the novice to be of supereminent importance,
and he is annoyed that his instructor or text-book does not lay down
such positive rules on the subject as to set his doubts at rest forever. In
after years, when he shall have had much experience, he will learn these
two facts: First, that the question, which pole or which direction of the
current. to use in any given case, is one of various complexity, and can-
not always be solved by a dictum. Secondly, he will learn that the prac-
tical therapeutical difference in the action of the pole or of the ascend-
ing and descending currents, is much less demonstrable than he sup-
posed, and that the special directions for each disease are not at hand.

The difference of the physiological action of the poles of the galvanic
current, when applied to the body, is, as we have shown under electro-
physiology, of a radical character. It has specially been shown that
the anelectrotonic region at the positive pole is in a condition of dimin-
ished, while the catelectrotonic region near the negative pole is in a
condition of increased irritability. Moreover, it is easy of demonstra-
tion that the negative pole of both currents is more painful than the
positive, and this fact, as we have seen, enables us to distinguish the
poles in cases of doubt, or when we do not understand the construc.
tion of the battery. Still further we have seen that on the nerves of
special senses—notably on the optic and auditory nerves—the poles
have a differential action of a specific and demonstrable character.

‘
GENERAL SUGGESTIONS, 265

When now we leave physiology and enter into the complex realm
of therapeutics, we find that it is usually better that irritable parts of
the surface of the body should be treated mainly by the poSitive pole.
This relative position of the electrodes is not usually departed from in
general faradization and central galvanization, for the reason that the
majority of cases that require these methods of treatment are abnor-
mally irritable.

The negative pole, being more irritating than the positive, is indicated
when it is desired to cause contraction in a paralyzed muscle, and the
difference between the poles in producing muscular contraction is chief-
ly a difference of degree only, since both poles cause contraction when
placed on the body of a muscle or over its motor point, but with the
same strength of current a more vigorous contraction will be produced
by the negative than by the positive pole.

In regard to the differential action of the ascending and descending
currents there has been an almost infinite amount of shallow observation
and impulsive writing ; for how the differential therapeutical or differ-
ential physiological action of the ascending and descending currents is
to be rightly discriminated from the action of the poles we cannot well
understand.

The object of applying électricity to the body in disease is to zm-
prove nutrition, and nutrition is a process of infinite complexity ; in-
‘deéd, the most complex and most mysterious of all the wondrous pro-
cesses of nature. He who solves it will become immortal, both as
the greatest scientist and the greatest theologian of history, leaving
Newton and Calvin far behind. The relief of pain, the reduction of
tumors, the increase in size of muscles—all these everyday results of
electrization are signs of improvement in nutrition, and it is impossible
to exhaustively explain them by anything we now know of electro-phy-
siology. Any man who attempts to base all his electro-therapeutical
procedures on the laws of electrotonos will find himself involved in com-
plications that have no end. ;

‘The one practical rule in regard to the poles, which we have arrived
at, is that the positive pole is the less irritating. In accordance with this
rule we place the negative pole at the feet or coccyx in general faradi-
zation, and at the pit of the stomach in central galvanization, so that
the head, neck, and spine, and other sensitive parts affected may be
under the influence of the positive pole.

That differential effects—physiological and therapeutical—may arise
from a difference of current direction is not at all improbable—cer-
tainly no one can well prove the negative—but we see no way of
266 DIFFERENTIAL EFFECT OF CURRENT DIRECTION.

demonstrating such differential effect. In every attempt that we make
the differential folar effect comes in to complicate, and in our
judgment, to override any differential effect there may be in current
direction. Take the familiar experiment: an electrode in each hand;
in one arm the current will be ascending, in the other descending.
If now one arm were differently affected from the other, have we any
right to rush to the conclusion that such differential effect is due to the
fact, that in one arm the current is ascending, in the other descending ?
Is it not far more probable that such differential effect is due to the
fact that the positive pole is in one hand and the negative in the other?
The differential effect of the poles can be demonstrated in various
ways, and our knowledge of it influences our practice ; the differential
effect of current direction, if it be not entirely a myth, is to say the
least undemonstrated.

Take again, for illustration, the method of galvanizing the spine. If
the negative pole be placed at the nape of the neck, and the positive at
the lower end of the spine, the current is ascending, and if a certain
effect is produced, or believed to be produced, such effect is attributed
to the fact that the current is ascending. The upper part of the cord
is under the influence of the negative pole, and the lower part of the
cord is under the influence of the positive pole, and what evidence is
there that there is any differential action of current direction aside from
the differential polar action ?

Similar difficulties beset us when we place one pole, say the negative,
on some indifferent point, as the feet, or thigh, and pass the positive
up and down the spine. Have we any right.to attribute the effect pro-
duced to the fact that the current is descending, when we know that the
positive pole has a very different physical, physiological and therapeuti-
cal effect from the negative pole, without any regard to current direc-
tion, while we, as yet, do not know that the ascending current has a
different effect from the descending current, without any regard to the
differential polar effect. One thing is clear and indisputable, and that
is that the differential effect of current direction, assuming that it
exists, is largely overborne by the differential polar effect. This is true
of both currents. A crucial experiment for determining the question of
the differential action of the ascending and descending currents, would
be to experiment on a piece of nerve in a physiological condition, all
parts of which give the same response to electrical excitation, and are
known to have the same function.

If such a nerve-piece could be supposed, and if the positive poie
could be placed on the middle of it, and the negative pole at the peri-
GENERAL SUGGESTIONS. 267

pheral end, we should have a descending current ; the positive pole re-
maining at the middle and the negative transferred to the central end
of the nerve, would give the ascending current. If now the effect after
these procedures should be different, the strength of current, pressure
employed, and time of stimulation being the same, and if the effect of
previous stimulation could be eliminated before the second part of the
experiment is made, we should have a conclusive demonstration of the
differential physiological effect of the current direction. But such an
experiment is ideal, and the complications are too great for science at
present to make it actual. In all physiological experiments of this kind
differential polar effect complicates, if it does not neutralize, the dif-
ferential effect of current direction.

In therapeutics, the complications of the subject are all the greater,
because all the statements that have been and are made in regard to
the advantages or disadvantages of the ascending or descending cur-
rent in this or that direction are of little worth.

The practical rules on this subject to which experience, enlightened
and fortified by physics, physiology, and pathology, have led us, may be
thus recapitulated.

1. The stimulating, sedative and tonic effects of electricity, faradic
and galvanic, are obtained by either pole, or by both combined or in
alternation, the difference in their therapeutical action being merely
a difference of degree. ,

2. In cases where the sedative effects are more indicated than the
stimulating effects, the positive pole is preferable to the negative, since it
is less irritating, and with the uninterrupted galvanic current, produces
catelectrotonos, or a condition of dininished irritability.

In the great majority of the nervous cases, where general faradization
or central galvanization are used, sedation is more needed than stimula-
tion ; hence the general rule to use the positive pole in these methods.

3. Incases where the stimulating effects are more indicated than the
sedative effects, the negative pole is preferable to the positive, since
it is more irritating, and with the galvanic current produces cat-
electrotonos, or increased irritability.

For those temperaments, now and then met with, that are exceedingly
tolerant of electricity, who can bear it in any doses, however given, and
for cases of local or general anzesthesia and paralysis of motion, whatever
may be the pathological cause, stimulation is more needed than sedation ;
hence it is an advantage in such cases to use the negative pole, and in
some cases “voltaic alternatives,” which are more irritating than either

pole when used alone.
268 SEAT OF DISEASE AND EFFECTS TO BE TREATED.

Inasmuch as we cannot tell the degree of electro-susceptivity in
a patient until we have tested it, it is well always to begin general
faradization and central galvanization with the positive pole. This rule
is especially important in the United States, where the majority of our
patients of both sexes are susceptible and nervous and require sedation
more than stimulation.

Both the Seat of the Disease and the Effects of the Disease to be
Treated.—The query whether in localized electrization we should direct
the treatment mainly to the seat of the disease—the pathological Zesion,
or to the seat of the prominent symptoms—the effects of the lesion—has
given rise to some discussion.

It sounds very practical to advise the treatment of the symptoms
without regard to the seat of the lesion. It sounds very scientific to
claim that the electricity should be confined to the exact seat of the
disease. Now the wise physician is both scientific and practical, and
keeping clearly before the mind this central thought, that the leading
action of electricity is that of a stimulating tonic with a powerful
sedative influence, we can readily discern the truth on this subject.
Both the seat of the disease and the seat of the symptom should be
treated, for in both there is need of improvement in nutrition. In
this view common sense and experience accord. In hemiplegia, for a
typical example, the lesion, the seat of the disease, is in the brain,
while the leading symptom is in one-half of the body, which is para-
lyzed. The muscles of that side become atrophied, and the nerves
become anesthetic. To restrict the electrization to the brain, and to that
side of it where the lesion is or is supposed to be, is so imposing and
scientific in theory that electro-therapeutists of limited experience
might advise this treatment exclusively. To purify the ‘stream, first
purify the fountain. Lay the axe at the root of the tree. All these
analogies are beautiful, but they are fallacious. The symptoms of the
disease will not disappear when the disease disappears. The effects
remain after the clot is absorbed. In the larger number the half of
the body is as much the seat of the disease as the brain; for the
several parts of this human machinery are all members one of another.
When one suffers all suffer. To confine the treatment to the paralyzed
muscles is also irrational, although the purely peripheral treatment is
far more successful than purely central. If we are to be exclusive and
one-sided and theoretical in our treatment, it is better to exclusively
treat what are called the symptoms or effects of the disease, and to
neglect the brain altogether. But it is the part of the higher wisdom
to use both methods—central and peripheral, to attack the seat of the
lesion and the seat of the symptom.
GENERAL SUGGESTIONS. 269

The most satisfactory results in hemiplegia come from a combination
of peripheral and central treatment. Similarly with diseases of the
spinal cord, as congestion, sclerosis, resulting in paralysis of motion
or sensation. Purely central treatment—galvanization of the spinal
cord—is not sufficient; the symptom also, the paralysis, must be
treated directly in the muscles and nerves where it is most prominent.
In diseases of the spinal cord, treatment confined to the seat of the
disease does more good than in diseases of the brain, for the reason
that the cord is more accessible to the current, its surface being more
exposed, as it were, throughout its entire length. But those who
content themselves with treating diseases of the cord by simple galvani-
zation, to the exclusion of peripheral treatment, make a grave mistake ;
they fail where they ought to succeed, and they succeed only in a small
percentage when a large percentage was possible. Cases of ataxia,
as well as of motor-paralysis need peripheral treatment with the moist
sponge or wire brush, or both, as well as galvanization of the spine.
On the same principle our method of central galvanization is some-
times more effective in diseases of the cord and brain than localized
galvanization of these parts, as usually practised. In neuralgia also,
where the seat of the disease is in the nerve-centres, the application
should be made both to the tender and painful points, as well as over the
root of the nerve, and a very good method of application is to place
one pole over the origin of the painful nerve, as near as possible, and
the other over the tender point and along the whole course of the
nerve. Frequently neuralgia, as we shall see, yields to our method of
central galvanization—where not only the painful and diseased parts, but
also the whole central nervous system, whether healthy or not, is treated,
—when it does not yield, at least as rapidly or as surely, to local appli-
cations either central or peripheral.

Healthy parts may be benefited by Electrization.—There is a kind of
unconscious idea abroad among electro-therapeutists that in applying
electricity to the body it is necessary to avoid acting on healthy parts,
and that the direct effects of the current should, so far as possible, be
confined to the part that is supposed to be in a diseased condition.
This erroneous doctrine takes its origin, first, in the teaching of
Duchenne and other advocates of localized elettrization, and, secondly,
in the narrow and incorrect ideas of the general physiological and thera-
peutical action of electricity.

Duchenne, by embodying the term “ localized” in the title of his work,
has done much to popularize in the profession the notion that in elec-
trical applications the aim should be to concentrate the current on the
270 GENERAL SUGGESTIONS.

part where it is supposed to be needed, and to avoid affecting other
parts.

The idea that electricity is a mere stimulus, and only valuable as a
means of exciting paralyzed muscles or waking up dormant nerves,
would very naturally lead.to the adoption of the view that it should be
used only in those parts that are in need of stimulation, and that
healthy parts would be injured by it. The false ideas that have pre-
vailed in regard to effect of stimuli, which we have elsewhere discussed,
have tended to increase this absurd dread of applying electricity to
healthy parts. A little common sense applied to this subject may per-
haps help us to find the truth without great difficulty.

First of all, we must bear in mind always that the doctrine taught by
the European writers, that electricity is a stimulus merely, is narrow
and erroneous. Electricity, applied to the body, acts as a stimulating
tonic with a powerful sedative influence. Then, again, stimulants are
something more than mere goads or spurs; they correct and intensify
the forces of the body, and may be useful and as necessary in conditions
that we call healthy as in those that we call unhealthy. Stimulants,
tonics, and sedatives are called for every day, and are every day em-
ployed by nearly every member of the human race, young or old, sick
or well.*

Still further, pathology is not so much a special and separate condi-
tion as a degree of the normal condition of health. No one can tell
just where physiology ends and pathology begins. Reasoning from all
these considerations, it is clear not only that electricity need not be
confined to diseased parts, but that the parts that we call healthy may
be benefited by it just as truly as those that we believe to be un-
healthy, and the benefit they receive may react favorably on the dis-
eased parts, and thus aid the treatment.

These views are enforced by analogy. Very few of our stimulating
tonic or sedative remedies are limited in their action to parts that are
diseased. The medicines that we give by the mouth or by the syringe
go whither they please, and if they sensibly affect some diseased organ,
it is not because their action is confined to that organ, but because that
organ, on account of its readier operation or of its disease, is more sensi-
tive than other parts to the influence of remedies. Alcohol or opium go
to the brain, lead affects the exterior muscles of the forearm, and the
influence of chlorate of potash is quickly felt in the mucous membrane

* This subject is discussed in detail in Dr. Beard’s work on ‘Stimulants and
Narcotics,” :
GENERAL SUGGESTIONS. 271

of the mouth ; but none of these remedies restrict themselves to the
parts that are the most perceptibly affected by them.

Indeed, the fact that our most valued medicines are used for such a
variety of local and general affections shows that their effects are not con.
fined to separate parts of the body to the extent that has been supposed.

Electricity can be localized, in cases where it is desirable to do so,
better than almost any other remedy, and yet the most careful and suc-
cessful localization of the current is more or less imperfect. The re-
flex effect of electrization that always complicates the direct effects,
and which are sometimes of more value than the direct effects, cannot
be avoided. Then, again, the branch currents, which, as we have
seen, move in undulations not only directly between the electrodes, but
at a considerable distance on either side of the median line between
them, will be likely, in nearly all forms of application, to touch healthy
parts that do not stand in especial need of treatment. The most com-
plete form of localized electrization is electrolysis when the needles are
placed close together, but even here the reflex effect is most powerful,
and operates with a mild as well as with a strong current.

But fortunately it is never necessary to localize electricity, in the
strict sense of the term. It is sometimes necessary, however, to avoid
producing too strong reflex effects, and in applications near sensitive
parts the possibility that the branch currents, .1f powerful currents are
used, may over-irritate, should ever be borne in mind. Experiment and
experience show that healthy animals and men can be electrized with
benefit all over the body, or in any part of it. In applying electricity
to any part of the body we improve the nutrition of that part; im ap-
plying electricity to the whole body we improve the nutrition of the
whole body, or, at least, of those parts which are directly or indirectly
influenced by the current. Faradization of a healthy muscle makes
it grow faster than it would grow without faradization ; in other words,
it produces the same effect that it would if the muscle were paralyzed.
When a part is in a pathological condition—when, for example, a
muscle is atrophied—any improvement in nutrition under electrization
is more quickly observed, and is probably more rapid and important
than when the same muscle is treated in a physiological condition ;
but the improvement of the healthy muscle is none the less real,
though it may be relatively less important than in the diseased muscle.

The tonic effects of general faradization and of central galvanization,
and, indeed, of many forms of localized electrization are due to the
direct or indirect action of the current, on parts which are more or less
healthy, or which, to say the least, are not in any recognizable patho-
272 DOSE OF ELECTRICITY.

‘logical state. The objection sometimes brought against these methods
that they do thus affect healthy parts, simply attempts to prove too
much. The same argument would banish all, or nearly all our stimu-
lants, tonics, and sedatives from our materia medica, and practically
discourage all attempts to relieve or cure chronic diseases of the ner-
vous system.

Dose of Electricity—Nearly all our medicines are prescribed by an
average standard dose. This average standard is derived from experi-
ment and experience, and, with the majority of drugs, is a safe guide
in administration, although every judicious and thoughtful physician
studies each case by itself, and varies the dose according to the ap
parent indications. ; ,

In the case of electricity, when medically employed, the dose cannot,
in the present state of science, for obvious physical reasons, be arbitra-
rily or mathematically stated.

The dose of an application of electricity consists of these factors :—

1. The strength of the current, or the quantity of electricity that
flows in a given time.

2. The length of the application.

Both of these factors are so modified in various ways that they can-
not attain anything like mathematical precision. The strength of the
current, or the quantity of electricity that flows through the circuit, as
we are taught by Ohm’s law, is the electro-motive force divided by the
resistance. We have previously shown (in Electro-Physics, chapter vii.)
that both of these factors are susceptible of almost infinite variations,
some of which are and others of which are not understood. -

In the time of the application there is less vagueness, but even in
this factor the precision 1s more apparent than real ;. for the effect of
electricity depends so much on the manner in which application is
made, whether with interruptions or without interruptions, whether
with large or small electrodes, etc. The method of the application,
whether local or general, and if local, to what part, and how directed,
also modifies seriously the determination of the dose from the length
of the application. Ten minutes of general faradization or central
galvanization will have a much more powerful general effect than
ten or even twenty minutes of local electrization. Five minutes of
galvanization of the brain will accomplish more good or evil than
fifteen minutes’ faradization of the uterus, or of any one of the extremi-
ties.

The time may yet come, in the advance of science, when electrical
measurement will attain such a degree of precision that we shall be able
GENERAL SUGGESTIONS. 273

to prescrive so many farads of electricity, as we now prescribe so. many
grains of quinine, or so many drops of laudanum; but the day when
such exactness shall be possible in applications to the human body is
probably not very near. Our present method of measuring the gal-
vanic current by the number of degrees of deflection of the needle of a
galvanometer is very unsatisfactory, for the twofold reason that the de-
flection beyond a certain angle does not accurately represent the relative
strength of the current, and especially because when applied to the

’ body a different and varying resistance is encountered, which at once

destroys the value of the comparison. Electro-therapeutists have some-
times stated the amount of the deflection which the current caused
before being applied; but all such statements are of little or no
value, and particularly when we do not know the construction of the
particular galvanometer which they employ. A further difficulty in
measuring electricity by the galvanometer, is that the strength of the cur-
rent in most of the batteries in common use declines during the appli-
cations, so that a current which is powerful at first may in the course of
ten or fifteen minutes be only medium.

The graduated scale on some of our faradic machines, and which in
dicates the number of inches that the rod or helix or tube is moved,
is also a practically useless guide, except as far as it may be resorted
to to encourage and amuse silly and weak-minded patients. In any
faradic machine the strength of the current in the cell, and consequent.
ly the strength of the induced current in the coil, varies from day to day,
and varies during the application ; and the amount that passes through
the patient is dependent on the size of the electrodes, and the amount
of moisture in them, and their relative position.

In default therefore of any trustworthy means of prescribing electricity
by farads, or other definite measures, we are compelled in practice
to depend on these two indications :

1. Lhe sensations of the patient.

Very fortunately the sensation of the patient during the application
indicates with considerable correctness whether the current is of the,
proper strength. Zhe rule is that where strong currents are borne
without discomfort strong currents are beneficial ; where only mild cur-
rents are borne only mild currents are indicated. The difference in the
natural sensitiveness of patients to electricity is very great. This dif-
ference is further modified by disease. In anzesthesia local and general,
in sclerosis of the nerve centres, and certain local affections, very power-
ful currents cause but little pain. On the other hand in hyperesthesia,
in hysteria and allied affections as a rule, and in acute and subacute

13
274 DOSE OF ELECTRICITY.

local inflammations, only mild currents can be borne. To disregard
the feelings of the patient and make the applications exceedingly pain-
ful will tend to produce the evil rather than the good effects of elec-
tricity. To give only mild applications when painful ones could be
well borne is to rob the patient of a part of the benefit to which he is
entitled.

To the rule that the sensations of the patient are the guide in elec.
trical applications there are some exceptions, just as there are some
exceptions to the rule that the appetite is the guide in the quantity*
of food that we eat. It is partly to guard against these exceptions, and
to keep on the safe side, that the first few applications on a new pa-
tient whom we have not before treated by electricity, should be mild and
short.

Not only do different individuals vary in their sensitiveness to electri-
city, but different parts of the surface of the body in the same individual
also vary, as we have seen through a considerable range; and in the
cavities of the body and on the mucous surface the range of variation
in sensitiveness is yet greater. The mucous membrane of the mouth,
tongue, urethra, is very sensitive, and this sensitiveness should be re-
spected by the electro-therapeutist.

There are some quite rare cases of hysteria where the great sensi-
tiveness of the patient may be disregarded, or chloroform or ether may
be administered. The sensitiveness of the patient is a guide only or
mainly in regard to the strength of the current. In regard to the
length of the application we must be guided by—

2. Lhe immediate, secondary, and remote effects. —This second guide
serves to correct the mistakes of the first. A meal that disagrees
with us may show its ill effects in a few minutes or hours, or the
following day. Similarly we should study the effects of electrical ap-
plications. So far as any one or all of the good effects described in this
chapter follow an application, so far we may judge that the applica-
tion has done good ; so far as any or all of the evil effects described
in this chapter follow an application, we may judge that it has done
evil. The evil and the good effects may sometimes be associated.
To rightly interpret these effects, and to distinguish between those that
are produced by the applications and those that are produced by
moral, hygienic or medical causes is one of the severest tests of medi-
cal skill, There is less liability to deception in studying the immediate
effects, since there is less chance for other forces to complicate the
results. After a few hours, the complications of diet, exercise, weather,
medicine and so forth begin to appear, and obscure the effects of the
GENERAL SUGGESTIONS. 275

electricity. The secondary and remote. effects can therefore only be
ascertained by repeated observations. A single application gives us
little opportunity to answer the question whether electricity is really
the remedy that the case requires.

One caution must not be forgotten: the immediate and secondary
effects may be evil while the remote effects may be good.

A long walk that much fatigues us is often beneficial, though the
benefit does not appear for several days. Those who take travelling
vacations to recruit exhausted energies, frequently feel worse while
they are travelling, but are stronger on their return and for months
following. The fatigue and soreness and stiffness that sometimes fol-
low skating and gymnastics, and other exercises, do not always indi-
cate that benefit has not been derived. The next day the appetite
and spirits may be better, sounder sleep may follow; the evil and the
good effects contend for the mastery, and the good effects triumph. .

The best results of Electrical Treatment usually obtained with Mila
Currents.—¥or the average constitution, and with the exceptions that
come from certain idiosyncrasies and certain diseases, such as anzesthesia,
the best results of electrical treatment are obtained by mzéd currents.

The temptation to disregard this rule and use painful currents is,
even for the experienced electro-therapeutist, very great, and sometimes
irresistible. The dogma, “no smart no cure,” which has wrought so
much misery in the world, still lingers, even among the intelligent.

‘The descendants and near relatives of the man who growled at his
dentist for extracting his-tooth without pain or bluster, because he
had been accustomed to being hauled all around the.room during that
operation, are yet very numerous. Even in cultivated circles there
can be found those who have no faith in medicine unless it is bitter,
and no respect for the doctor unless he half kills them. Then again
some patients make a virtue of bearing pain, and will pretend that they
do not feel the current when they know they are suffering all the
horrors of the damned. Moreover, mercenary patients wish to get
their money's worth, and if they pay so many dollars for an application,
they want so many dollars’ worth of agony. For all these reasons com-
bined, we are, in spite of our experience and caution, continually
making the blunder that we here warn against. Over the doors of the
electro-therapeutist, and in full view of the operating chair, we would
inscribe this motto, “Better give much too little than a little too
much.” ;

The use of Salt on the Electrode.—A very good device to prevent using
too strong currents, particularly the ga/vanic current, is to saturate the
‘

276 CARE IN DETAILS OF APPLICATIONS.

.

sponges or cloths of the electrode with plenty of salt water. Salt water
is a good conductor, much better than simple water, and will cause
the patient to sensitively feel a current, of which, if the salt water
were not used, he would not be conscious.

With the same strength of current, a sponge or cloth electrode
saturated with salt is more painful than a similar electrode not so
saturated. The current when conducted though salt seems to pass in
points from the electrode to the body just as when conducted through
metal or the metallic brush. In a word, an electrode saturated with salt
not only conducts a greater quantity of electricity, in accordance with
Ohm’s law, but conducts it more painfully than an electrode saturated
with ordinary water.

Care in the Details of the Applications.—There is as much differ-
ence between a skilful and an awkward application of electricity as
there is between a skilful and an awkward operation in surgery. By
those who desire to become experts in applying electricity, the follow-
ing points should be considered :

1. To avoid suddenly interrupting the currents in cases where inter-
ruptions are not required,.and especially in applications on or near the
head. In the treatment of paralysis of motion and of sensation, inter-
ruptions are required, but in the treatment of the brain, spinal cord,
and sympathetic, and in very many peripheral applications stable cur-
rents only are required. In all such cases the current should be closed
gradually and delicately, if possible by means of a rheostat of some
kind, or by increasing or diminishing the pressure on the sponge of the
electrode. Interruptions made in the metallic part of the current are
always more sudden and violent than those made in the electrodes, for
the physical reason that the connection of the current is more sharp and
abrupt.

Delicate patients should be treated with delicacy. Those who are
sensitive and apprehensive should never be annoyed by sudden breaks
in the current, except in those forms of disease where sudden breaks
are required.

In presenting this caution we do not intend to endorse the notion that
serious pathological lesions are caused by interrupting the current, even
on or near the brain. There is little or no evidence besides the case
of Duchenne, that any serious injury to the retina, or to the auditory
nerve, or to any part of the brain, or sympathetic, or spinal cord, has
been produced by faradization or galvanization with the strength of cur-
rent ordinarily employed in electro-medical applications. The dizzi-
ness, the sour taste in the mouth, the flashes of light before the eyes,
GENERAL SUGGESTIONS. 277

the shock or agitation produced by the sudden interruption of the
galvanic current, are annoying, and to the delicate patient unaccus-
tomed to them, sometimes alarming, but with the batteries in ordinary
use, and with the strength of current that is, or ought to be employed
through the head and neck, they are rarely if ever dangerous : they
are temporary effects that soon pass away, and are forgotten. But
they are to be avoided in cases where they are not required, for the
three-fold reason that they do no positive good, that they may interfere
with the success of the treatment, and that they alarm or annoy the
patient. We are to avoid worrying our patients in this way, for the
same reason that we are to avoid treading on their corns, because it is
disagreeable and discourteous.

2. To avoid making the applications unnecessarily painful through
carelessness in the management of the electrodes. By the use of fine
and soft sponge—the best that can be found in the shops—the smarting
and stinging pain of the applications can be much diminished. Aside
from the fact that, with some exceptions, less satisfactory results follow
painful than pleasant currents, the feeling of pain should, so far as pos-
sible, be avoided. There are, as we have said, a certain number of pa-
tients who carry into medicine the same views that once dominated in
religion, and who desire to suffer, and have very little respect for any
treatment that does not cause more or less agony. ‘Such patients will
sometimes find, after one or two severe and painful applications, that
they are injured more than benefited, and will submit to the advice of
the physician and take the treatment that is best for them.

3. To avoid surprising and startling the patient by allowing the wires,
or the metallic portions of the electrodes, to touch any part of his ex-
posed body. If the connecting wires slip out of their connections with
the electrodes they are liable to fall on the exposed skin and give a
painful shock. If the edge of the electrode not covered with sponge
or cloth touches the skin, it will give the patient sudden pain, and
annoy both him and the operator. Connecting wires that are not pro-
tected by rubber are liable to lose their silk or cotton coverings in
places, which when they touch the skin cause pain.

4. To be always and every moment sure that the current is running.
The batteries should be tested before the application, either by the
galvanometer or through the hand or person of the operator, that he
may be sure that it is in order, that the connections are properly made,
and that the electrodes are sufficiently wet to conduct the current.
When mild currents are used, salt may be added to the solution in
which the electrode is dipped, so that a slight stinging sensation
278 DISROBING OF THE PATIENT.

beneath the electrode, may keep the patient assured that the current
is passing. ‘ '

Disrobing of the Patient.—The great majority of electrical applica-
tions require, on the part of the patient, more or less loosening or
removal of the dress. Not only is this necessary in general faradiza-
tion and central galvanization, but in very many local applications to
the spine, abdomen, and upper and lower limbs,—excepting merely the
face, head and hands. To know how to direct the patients to arrange
their clothing so as to give the operator sufficient and easy access to the
person, is a part of the art of practical electro-therapeutists, and it is
an art not to be despised. Male patients have less trouble in this re-
gard than-female patients, since their garments are fewer and simpler,
but they are more annoyed by the little they have to do than women
are by their vast paraphernalia. The art consists zz loosening and pull-
ing up without entirely removing the under-clothing, thus avoiding
trouble, exposure and waste of time.

Temperature of the Electrodes and of the Operating Room.—The
question is often raised by patients whether there is any danger of tak-
ing cold after an application of electricity. ‘The answer is clearly in
the negative.- The electricity, as such, so far as it goes, fortifies the
system against cold; but, by careless exposure while undressed in a
cold room, it is possible to take cold, just as by similar exposure when
electricity is not used. It is also possible to make the application
quite uncomfortable by using sponges moistened with cold instead of
tepid water. Our aim should be to have the temperature of the
operating and dressing-room a little higher than is necessary for a per-
son fully dressed ; to moisten the sponges or electrode covers in tepid
or—in very cold weather—in hot water; and when the feet are placed on
a foot-plate of tin or copper, to have a warm soapstone beneath the
foot-plate to keep it always comfortable.

Time of day for the Application.—Applications of electricity may be
given with advantage at all hours of the day and night. In our experi-
ence, and probably in the experience of all electro-therapeutists, the
majority of the applications are given in ordinary business hours, in the
forenoon and afternoon. We have never been able to see that anything
was gained by giving any particular heed to the hours of eating ; just
before meals, and just after them, ordinary electrical treatment may be
given with apparently as much benefit as two or three hours from a
meal. In some impressible temperaments, central galvanization and
general faradization temporarily increase appetite, and for such persons
an application might very properly be given a little before meals. For
GENERAL SUGGESTIONS. 279

those who suffer from dyspepsia, a seance pretty soon after dinner might
be of service in aiding digestion, but we cannot say that we have seen
any such results. , .

For all delicate, hysterical, sleepless patients, the evening is an excel-
lent time to receive electricity. The powerful sedative effects of central
and-general electrization are in this class of patients most gratefully re-
alized a little before going to bed, or after they have already retired.
For these reasons we have, for years, been accustomed to treat some of
our patients in the evening, before or shortly after retiring, and, were it
not for the inconvenience, we should. do it more frequently.

Time of Applications.—The time of an application is an element of
the dose of electricity that has not been sufficiently studied. Electro-
therapeutists have fallen into the conventional and routine habit of using
the current all the way from five to ten or fifteen minutes or so, ata
sitting, without sufficiently investigating the question whether the length
of the application ought not to be varied with studious care, in eaeh
case, and varied during the course of treatment.

For irritable, sensitive and impressible patients this law certainly
holds ; that long applications with mild currents are better than short
applications with strong currents. This law, which is the outcome of
all our observations in the department of electro-therapeutics, saul to
all modes of using electricity. .

A sudden shock, or a series of shocks with a powerful current, may
injure, where a prolonged application with a gentle current may work
no harm and much good. That this element of time becomes a practi-
cal difficulty in the use of electricity by.overworked general practitioners,
must be admitted: but if it be a scientific fact—as it surely is—that
time is required to gain the choicest and best effects of electrical treat-
ment, then we must recognize and accept the fact, and treat our patients
accordingly, and expect them to reward us for our labors more Waly
than for a mere prescription or suggestion.

We insist on this point, because we feel that through neglecting it
many mistakes have been made, and through a disposition to neglect it
there is danger that in some minds electro-therapeutics itself may fall
into disrepute. While many patients and many cases do well under five
or ten minutes of electrization, very many others, especially after they
have beconte accustomed to it, require at least double that time.

With all our might, we should avoid the error of supposing that the
best effects of electrical treatment will succeed by short applications
with strong currents. In this way we may both save time and lose our
patients.
280 FREQUENCY OF THE APPLICATIONS.

Economy of this sort may prove to be the worst of extravagance.

Frequency of the Applications.—Ordinary stimulanting and tonic medi
cines are given one, two, and usually three times a day. The dose of
electricity cannot usually be administered so frequently without doing
more evil than good. It seems essential to the electro-therapeutical
treatment, whatever the mode employed,—general and local faradiza-
tion, central and local galvanization, and even electric baths and the
use of the body batteries,—that there should be @ considerable period of
rest between the applications.

Electrization sets in motion forces that slowly act and react hours and
days after the electrization has ceased. The time required for these
forces to operate to the best advantage varies with individuals, but in
all cases a certain period of rest is required, and if the application be
repeated before this period or some portion of it has elapsed, the bene-
fits of the previous application are more or less neutralized, and the
patient may be weakened more than strengthened. This at least appears
to be the conclusion that long experience forces upon us. All the
way between every day or once a week the applications can be given
with benefit. Three or four times a week is about as often as the aver-
age patient cares to make his visits, and it is safer to begin treatment
with at least an interval of a day or two between sittings. Some pa-
tients. require at the outset of a course of treatment, intervals of three
or four days. If by accident or intention, strong and long applications
are made, unpleasant reactive effects may follow that at once suggest
the necessity of waiting for a day or two. Many a time does it happen
to us to visit a patient, and, on learning the history of the symptoms,
to put off the application twenty-four or forty-eight hours.

On the other hand, there are those who can take full applications every
day for a month in succession, and in some cases, as it appears to us,
with greater benefit than would be derived from applications given every
other day. At the founding of the Electro-Therapeutical Department
of Demilt Dispensary, we received patients only twice a week, and good
results were obtained under that system, but we afterwards found it de-
sirable to add another day. In private practice we make the applica-
tions more frequently than at first, and find an advantage in so doing,
for the reason, mainly, that we use milder currents than formerly, and
our patients can bear and be profited by more frequent sittings.

General and central applications require longer intervals than local
and peripheral applications, for the patent reason that they more
powerfully affect the whole system, and are more frequently followed
by reactive effects.
GENERAL SUGGESTIONS. 281

In rare cases,—when the patient has but a short time to remain in town,
or when an intolerable ‘pain is to be relieved,—we have given applica-
tions twice a day, but have not usually obtained any advantage thereby.
Chronic nervous diseases cannot be cured in a day; time is as neces-
sary as the electricity. Long standing pathological lesions are not to
be carried by assault, however bravely conducted ; they yield only to a
protracted siege.

Regularity of the Applications.—It is the custom with some electro.
therapeutists to insist on regularity in the days and hours of the
applications, and there are those who believe that the best effects
follow regular and methodical treatment. On this point we are in some
doubt. Patients who are methodical in their habits, and who are
regular in their visits, will be less likely to omit visits, and will be
more likely to persevere, and consequently will be more profited than
those who omit half of their visits and abandon treatment before it
is fully tried. There is no evidence that regularity, as such, is any
advantage; although there is strong probability that for some constitu-
tions, and, perhaps, for diseases with periodic symptoms, it might be
an advantage to give the applications at the same hour daily, or
every other day, as the case may be. Our own custom in this regard
varies. Practically we find it impossible to treat all patients with
absolute regularity, and in those cases where we are able to do so we have
not, thus far, been able to see any special therapeutic advantage.

Prolonged Applications.—A method of using electricity that has been
too little studied by the profession is that of prolonged applications
with mild currents.

In certain diseases, both medical and surgical, it is of advantage to
allow the: current—galvanic or faradic—to run for several hours—all
day or all night—as may be convenient.

We have become so accustomed to the use of short, or comparatively
short applications, that we forget that the current if sufficiently gentle
may be passed through the body, or part of the body for hours, if not
days consecutively, without injury, and with great benefit, provided
certain cautions are observed.

When the galvanic current is thus used, care must be taken not to
allow the sponges, or metals, or cloths, to remain too long in one
spot; since they will cause a disagreeable though not serious ulceration
of the skin, that may be some time in healing. In order to avoid this
ulceration, it is well to use sponges instead of metals, and to change
from time to time the position of the electrodes, so that they may not
act too long on one spot.
282 COMBINATION OF METHODS OF APPLICATION.

The details of this method of using electricity must be varied with
each case and the circumstances of the patient. °

Intervals between the Courses of Treatment.—Itis sometimes of service
to suspend a course of treatment after it has been going on a number
of weeks, and to allow an interval of one or more weeks, according to
circumstances. It is sometimes observed that patients improve as
“much during the interval as during the treatment, and when the appli-
cations are renewed, they have greater force than at the close of
the course of treatment. It is true of electricity, as of almost every
other stimulant, tonic, sedative remedy, that after receiving it a certain
time the system becomes so accustomed to it as to tolerate it, and
then its full force is not appreciated. In cases where this toleration of
electricity is observed, when the improvement halts, so to speak, a
‘brief suspension of treatment may be indicated, and on renewing it,
all the benefit at first realized may be’ repeated.

On the other hand, there are patients who seem to prosper best under
steady, uninterrupted treatment.

Combination of Methods of Application.—Comparatively few diseases
are to be treated solely by any one method of application ; many of the
purely local affections ever yield better to electrical procedure, when
the applications are varied, than when one mode only is persistently
used. Both currents, galvanic and faradic, may be tried in alternation
or succession, and both the direct and indirect methods may be em-
ployed at the same sitting or at different sittings. In all diseases where
the whole system is involved, the method of application may be yet
more varied. General faradization and central galvanization may be
used alternately, and the alternation may be by the day or week.
These methods may be varied with galvanization of the brain in all
directions, galvanization of the pneumogastric and sympathetic and of
the spine. In some diseases, as notably in those where central le-
sions are accompanied by peripheral injury and general exhaustion, as
hemiplegia, ataxia, and so- forth, all the methods of application may
be used, including faradization with the wire brush. We observe not
unfrequently that after one method of electrization has done all that
it is capable of doing, after it seems to have lost its power, another
method of electrization, or a mere modification of a method, may push
the improvement yet further, until it in time loses its force and the fresh
stimulus of another method is required.

In this respect the behavior of electricity is in no way peculiar; to
all powerful remedies the system in time becomes so accustomed, as to
tolerate them without appreciating their remedial influence. In the’
GENERAL SUGGESTIONS. 283

administration of tonics in cases of debility, and of astringents in cases
of chronic diarrhoea, a necessity for frequent change of remedy is
generally recognized.

Low to judge of the Effects of Electrical Treatment.-It is of the first
importance for the electro-therapeutist to have a clear, just and sys-
tematic method of determining the effects of electricity, both good and
evil. Much of the difference of opinion that prevails among those
who use electricity, as to its general and special value, and much of the
prejudice that exists against electro-therapeutics is the result of a want
of a knowledge of the tests by which the action of electricity on patients
is to be determined.

When we give opium, we know very soon whether it relieves pain
and produces sleep, or, as not unfrequently happens, has effects pre-
cisely opposite. We learn to judge without great difficulty whether the
chloral and quinine are doing the work that we desire. With stimulants
and tonics, as used in the chronic affections, greater difficulty is ex-
perienced, but there are certain tests which we study and look for and
by which we are guided. The effects of electricity should be similarly
studied.

The good effects of ,electrization are in general as follows :

1. Relief of Pain and Disagreeable Sensations local and general.—
This relief may appear shortly after the application is commenced,
after it has been continued for some minutes, or at its close. In some
cases there is no relief during or immediately after the sitting, but
several hours subsequently. We include painful sensations of every
kind—the vague wandering pains of neurasthenia and hysteria, the
burning of inflammation as well as real neuralgia.

2. Improvement in the Pulse-—Where the pulse is abnormally slow
it may be quickened both during and for some time after the sitting.
Where it is abnormally rapid it may be lowered. The pulse, there-
fore, may be a guide in the administration of electricity, as it is a guide
in the administration of alcohol and various other forms of stimulants
and tonics. If the quiet pulse is made much quicker and so remains
for some time, we may suspect that the application has been too
strong or too long.

3. Improvement in the Temperature of the Body, or of the part which is
treated.—Parts that are abnormally warm are cooled, or as is more fre-
quently the case, parts that are abnormally cold are warmed, during and
subsequent to the operation. The temperature may be tested by the
sensations of the patient, by the touch of the operator, or by the ther-
mometer.
284 GOOD EFFECTS OF ELECTRIZATION.

4. General calming Influence and Disposition to Sleep.— Nervousness
is allayed, just after taking wine, or food, or a bath, or a drive by the
sea. The disposition to sleep comes on usually after the application,
in rare cases during the sitting, especially when the head or neck is
galvanized.

5. Mental Exhilaration.—The effect of sea-bathing, or the inhalation
of oxygen, is to exhilarate in a way that defies minute analysis. The
effect of electrization is similar. This effect is seen more’ strikingly
in hysteria and hypochondriasis.

6. Increase of Appetite and Improvement in Digestion.—In some
instances the appetite is sharpened by a single sitting; the permanent
improvement is, of course, a slower effect, and is only observed after a
number of applications.

7. Improvement in Local and General Nutrition.—To accomplish
improvement in nutrition is the great object of electrical treat-
ment. The relief of pain and of other special symptoms, during
a sitting, may justly be 1egarded as results and accompaniments of
improvement in nutrition. At a later stage of a course of treatment,
the improvement in nutrition may be seen and studied by the senses.
Improvement in local nutrition is produced by local electrization, im-
provement in general nutrition is produced by general or central elec-
trization. Peripheral local electrization, may, however, reflexly pro-
duce improvement in general nutrition, particularly when prominent
organs, as the uterus, the stomach, and liver, are treated.

The evil effects of electrization, by the occurrence of which we may
suspect that the applications are too strong or too long, or improperly
given, or that wrong methods are used, or that the temperament and
disease of the patient contra-indicate electricity, are, in general, as
follows :

1. Headache and Backache.—Sudden shocks, or interruptions of the
current, may cause momentary headache that passes away as quickly
as it came. When the headache persists for a considerable time, one
may know that there has been somewhere a mistake in the applica-
tion. Backache follows as a rule only general or central treatment.

2. Irritability and Insomnia.—Patients may feel nervous, irritable,
and indefinably disagreeable after an application, and the sleep the
following night may be less sound and more disturbed by dreams than
usual. These are evil effects, and are to be guarded against.

3. General Malaise.—TVhis symptom, which is the reverse of the
exhilaration spoken of among the good effects, appears not unfrequently
after an over-dose, especially of general faradization. It sometimes,
GENERAL SUGGESTIONS, 285

though less frequently, follows central galvanization, and there is no
form of local electrization, central or peripheral, that may not in some
teinperaments and conditions give rise to it.

4. Excitation or Pain, or Increase of Pain already existing.—
Neuralgia is sometimes increased on the application of the current, and
particularly when the currents are strong and interruptions are made.
A harsh and rough faradic current, even when mild, may aggravate
pain. Sometimes there is no effect during or immediately following
the seance ; but in the course of a few hours, the pain is excited or
aggravated.

Similarly the pains that accompany malignant tumors may be excited
when electricity is applied during an interval, or they may be increased
if treated during the paroxysm.

5. Over-Excited Pulse.—The pulse may indicate whether the appli-
cation has done good or harm, with some considerable certainty, pro-
vided the operator is sufficiently familiar with the normal pulse of the
patient. This familiarity can only come from previous acquaintance.
A stranger, seeing a patient for the first time, and treating him by
electricity, is quite likely to be deceived. ‘The pulse may be over-excited
by the mere coming in of a new physician, or by the thought or dread
of electricity. Thus the value of the pulse as a means of determining
the degree of the ill effects of an application is much diminished. Asa
test of the good effects of electricity, it is much more worthy of trust.

6. Chilliness and other Nervous Sensations. —An application which has
been made injudiciously may be followed almost immediatly by a feeling
of chilliness, as though the patient had taken cold. There may be also
a stiffness of the neck, and pain on turning the back, as though the
patient were rheumatic, and heat and burning in the spine, and crawling,
creeping, pricking, stinging, sensations in the face, down the back, and
on the limbs and other parts of the body.

These sensations are not due to a cold, as is sometimes supposed,—
for, except through gross carelessness, patients do not take cold during
an application of electricity,—but they are merely nervous sensations, of
an hysterical character, precisely like the symptoms described under
hysteria and allied affections, and are due to over-irritation of the spinal
cord, and perhaps also of the sympathetic. They more frequently follow
faradization than galvanization, especially when a hard, rough, unpleasant
current is used. They appear only in the exhausted and neurasthe-
nic, and most frequently in women.

7..A feeling of Soreness, Stiffness, and a dull Aching.—These sensa-
tions are closely allied to those described in the preceding paragraph :—
286 BAD EFFECTS OF ELECTRIZATION.

they are the result of over irritation of the nerve-centre ; the soreness
that is felt in the muscles after severe faradization is somewhat like that
which is experienced after violent exercise in the gymnasium, on skates
or on horseback.

The dull, aching pain through the whole body is like the sensation
that is experienced after taking cold. It is a purely nervous sensation,

‘and is caused by over-irritation of the spinal cord. One patient whom we
treated for an exhausted and irritable condition of the cord, resulting
from cerebro-spinal fever, persisted that every application caused him
to “ take cold.”

8. Profuse Perspiration.—Gentle perspiration is one of the good effects
of electrization ; it is observed both after general and local treatment.
But profuse perspiration of any part, as the head, or one of the limbs,
or of one side of the body, or of the whole body, occurring during a
séance, or directly following it, is a bad symptom, and indicates over-
irritation. In some hyper-sensitive conditions profuse perspiration
may appear under a very mild current, and at the outset of the appli-
cation. We have known a paralyzed arm in hemiplegia break out with
abundant perspiration. In cases of cerebral and spinal irritation we
have known the forehead and the hands to perspire freely during
the application. Some constitutions are specially impressible in this
regard. Weonce treated a case of paralysis of the bladder by external
galvanization ; the patient was of the average strength and health, but in
less than five minutes his whole body was as freely perspiring as in the
hotest summer day. Nausea and faintness also came on and stopped
the application.

9. Prolonged Reaction of the Nerves of Special Sense.—In the section
devoted to Electro-Physiology, we have seen that the nerves of special
sense, the auditory, the olfactory, the ophthalmic and the gustatory
nerves, all have their special and peculiar reactions to electricity.
These reactions are normal and physiological, but in degree and variety
they are greatly influenced by temperament. These reactions are, on
the part of the auditory nerve, hissing, rushing, boiling, seething sounds ;
on the part of the ophthalmic nerve and retina, flashes of light ; on the part
of the olfatory nerve, under a powerful and painful current, peculiar
phosphoric or ozonic odor; on the part of the gustatory nerve, an acid
or coppery taste. For the great majority of temperaments in health or
disease, these reactions disappear with the cessation of the application ;
but where there is special susceptibility to the electricity, or when very
severe or prolonged applications have been made, some of these reactions
may continue for hours or days. Thus we have known patients to
GENERAL SUGGESTIONS. 287

complain of the peculiar taste in the mouth two or three days after an
application, The buzzing in the ears also does not always stop when
the current is opened, prolonged flashes before the eyes are sometimes
noticed, though but rarely. Prolonged reaction of the olfactory nerve
we have never observed.

We call these prolonged reactions evil effects, because they appear*
in very susceptible patients, or after careless procedures, and are usu-
ally accompanied by other effects that are unmistakably evil.

Disturbances of the Nerves of Motion and Common Sensation. —Under
this head we include hypereesthesia, general or local, that an overdose of
electrization sometimes produces in nervous and hysterical patients, or
the opposite condition of anesthesia and muscular spasnis, contractions
and rigidity. These phenomena are not frequent, but in rare instances
they have been observed ; muscular spasm, where it already exists, may
be aggravated temporarily by electricity.

Hy giene of Patients after the Applications. ~ Patients who are strong,
and are treated for purely local troubles, may be entirely indifferent in
regard to their behavior after electrical applications ; they may exercise
brain or muscle, or remain idle, as may be convenient, and the improve-
‘ment under the treatment will go on just the same. But delicate
patients who are treated for grave conditions of debility, and especially
females, do better to avoid exertion after an application : better for them
to sit awhile, or rest on a lounge, and if they are treated in bed to
remain there ; and this, we believe, is another advantage in treating such
cases just after retiring. ,

If any fancy they take cold as a result of ad application, it is a pure
fancy, or it is the nervous chill that sometimes follows over-electrization,
or it is the result of exposure in a cold room while undressing.

Cumulative action of Electricity.—It sometimes happens in the treat-
ment of a painful and tender nerve, that a sudden shock is felt, after
the electrodes have been a long time in position, even when the current
is very mild and is scarcely felt on the surface.

A medical friend, who by our suggestion treated a case of ulcer of
the stomach by the galvanic current, informed us that a very mild
current from a few zinc carbon cells, which gave no burning sensation
on the surface whatever, would, after the electrodes had been kept in
position a few minutes, one on the epigastric, and the other on the
back, cause all of a sudden and without any warning a painful shock,
as though a strong current had been suddenly interrupted in the
metallic part of the circuit. This phenomenon occurred so often that
he abandoned the treatment.
288 THE TEMPERAMENT TO BE CONSIDERED.

We have occasionally made the same observation on other parts of the
body. ‘hus, in a case of sciatica that we were treating by the galvanic
current—one pole on the course of the nerve below the trochanter,
and the other on the back—only a very slight sensation was felt for
two or three minutes, when all at once the patient gave a jump as
though shocked by a powerful current. A number of times during the
“seance the experiment was repeated. Every pains was taken to avoid
error by assuring ourselves that the current was actually running all the
time, and that there was no actual interruption.

This cumulative action, if we may call it such—would seem to be
somewhat analogous to the cumulative action of strychnine and some
other remedies. The rationale of it is in the present state of our
knowledge hard to determine. It may be that as the skin becomes
more and more moistened, its conductivity so increases that a portion
of the nerve is traversed-by the current which at first was not touched,
and that this physical explanation is sufficient. It may be that the
nerve, already in an irritable condition, may have its irritability so
greatly increased, that it develops it suddenly under continued though
mild stimulation. We have, as yet, no evidence that such shocks are
specially harmful, although they are unpleasant and startling. They
can be avoided as a rule by shifting the electrodes every moment, so
as to avoid a long irritation of any one spot.

Increased Toleration. of LElectricity—The system can become
habituated to electricity just as it becomes habituated to alcohol, or
opium, or any other potent remedy. After a long, course of treat-
ment, extending over several months, nearly all patients bear very
much longer and stronger applications than at first. This is observed
in those whose sensitiveness to electricity is at first extreme. It is
not therefore necessarily a discouraging fact if at the outset of a
course of treatment very gentle currents and very short sittings are
required.

The Temperament, as well as the Disease, to he considered in using
Llectricity.—There are individuals whom electricity always injures, the
only difference in the effect on them between a mild and a severe
application being, that the former injures less than the latter. There
are patients upon whom all electro-therapeutical skill and experience
are wasted; their temperaments are not en rapport with electricity.

It matters not what may be the special disease or symptoms of
disease from which they suffer—paralysis, or neuralgia, or neurasthenia,
or hysteria, or affections of special organs—the immediate and the per-
manent effects of galvanization or faradization, general or localized,
‘GENERAL SUGGESTIONS. 289

4

are eviland only evil. We have not arrived at this opinion by theorizing ;
we have been driven to it by the accumulating and irresistible logic
of facts. The first query that arises, in the mind of the electro-thera-
peutist, when a case under his care responds badly, is, “ Am I rightly
using this remedy; am I making the application too long or too
severe, or by improper methods? Would a change of current be de-
sirable?” But after we have tried all electrical applications ; after we
have gone from galvanism to faradism, from general to localized elec-
trization, from long and severe to short and gentle treatments ; after we
have rung the changes on all these, and yet persistently ‘aggravate
rather than mollify the disease, and instead of strength and relief, pro- .
duce weakness and distress, and instead of calmness cause irritation, —
then we have only to make as graceful a retreat as possible, and put
that patient down as a case that was not born to be treated by elec-
tricity. We have no explanation to offer of the phenomenon; and the
popular belief or supposition, that the excess or deficiency of animal
electricity has something to do with these matters, is as undemonstrable
as it is plausible ; he who should attempt to prove or disprove it would
find he had undertaken anything but an easy task. It would seem to
come in the list of those strange but familiar likes and dislikes in regard
to certain articles of food or drink, or of certain sights or odors. We
know of no physiognomical or rather external appearances by which
to determine whether a patient does or does not belong:to the unfor-
tunate few who can have no lot or share’in electro-therapeutics. The
strongest equally with the weakest, the plethoric and the enervated,
are found among these Gentiles of science.

The reverse proposition, that there are certain constitutions for
which, by whatever form of chronic disease they may be afflicted, elec-
tricity is always indicated, is equally true. There are patients who
find in electrical treatment almost a specific. Whether they suffer from
dyspepsia or neurasthenia, from hysteria or diseases of special organs,
rheumatism or neuralgia, electrization always relieves them up to a
certain point, at least, if it does not positively cure. Zhe broad fact to
be understood is, that it is not so much the disease or the symptoms, as
the temperament that indicates or contraindicates electrization.

While some chronic diseases are more amenable to electricity than
others, among all patients there are individuals to whom it is a matter
of indifference what special affection they may suffer from ; so long as
improvement in local and general nutrition is indicated, they will be
benefited by electrical treatment.

To all this it should be added that some persons are indifferent to

19
290 THE TEMPERAMENT TO BE CONSIDERED,

electricity—they can bear almost any strength of either current very
frequently and for long applications, without experiencing any effect
either good or evil. Electricity may be poured over them in limitless
measures ; they may be saturated with it, and they may come out from
the applications not a whit better or worse. Patients who are. quite
delicate and sensitive exhibit this supreme and provoking indifference
to electricity. We are inclined to believe also that patients vary in
their susceptibility to electricity at different times of life. Susceptibility
to stimulants and narcotics oftentimes undergoes strange modifications
during the lifetime of an individual. Those who at one time cannot
drink coffee, sometimes find that a few years so modify the tempera-
ment that they can drink it with absolute freedom, and vice versa.
Similarly, also, alcoholic liquors act in a most capricious way, some-
times benefiting, at other times injuring even when nearly all the other
condittons except age are the same. Idiosyncrasies in regard to cer-
tain articles of food are by no means constant through life—they may
change either way, and that too in the course of a few years; they
may be modified by febrile or other diseases that revolutionize the
system, or by residence in. various climates, or by mere lapse of years.
Analogy would lead us to suppose that susceptibility to electricity might
also be thus modified, and our observations seem to convince us that
such is the case.

We are further inclined to believe that susceptibility to electricity,
favorable and unfavorable, like all other constitutional tendencies, is
subject to the laws of hereditary descent, and runs in families. We
have treated by electricity three members of the family of a physician,
who are afflicted with quite diverse maladies, but all of whom not only
improved under the treatment, but can be electrized with great freedom
by either current ; and yet none of them are strong, and two of them
are delicate.

On the other hand, we have treated families where several of the
members are so susceptible to the electric current that the application
must be made with great care lest unpleasant results occur. Weare fully
convinced also that the proportion of those who do zof bear electricity
well is larger among the higher than among the lower classes; in
hospital and dispensary practice, the number of patients who exhibit
excessive susceptibility to the electric treatment is quite limited, whereas
in private practice, ainong the intellectual classes, one out of five or
ten, take the cases as they run, must be treated with very considerable
caution, lest disagreeable symptoms arise.

Relation of Electro-susceptivity to Prognosis.—-Between electro-suscep-
GENERAL SUGGESTIONS, 291

tivity and prognosis there would appear to be no constant relation. One
patient may be extremely susceptible to electricity, and another capable
of bearing it in large doses, and both shall be benefited. If there be
any law in the matter it is this, that those who occupy the medium
ground, who are neither specially sensitive nor the reverse—offer the
best prognosis under electrical treatinent. It is equally sure, however,
that those who are exceedingly sensitive may become so tolerant of
the remedy as to derive great benefit from it. For this reason we
should not be discouraged, even by extreme electro- sensibility or
electro susceptibility in our patients.

The most provoking class are those who cannot be influenced in any
way by electricity, but who can even from the very first receive it
in enormous doses without showing or feeling any good or evil effect,
and yet even such cases may by protracted treatment be benefited.

Regard for Age.—In the apportioning of the dose of electricity the
only general rule to be considered is, that the extremes of life—the
very young and the very old—demand rather more caution than those
in youth and middle life. It is not however necessary to divide the
doses of electricity for infants and children, as we divide the doses of
ordinary medicines ; children from three years down to three months
and even younger may be treated by general faradization and central
galvanization almost as freely as adults. On theoretical considerations,
and in order to be on the safe side, we do not usually treat very young
children as long, or with as strong currents as adults, nor quite so
frequently, but we have not often seem any especially bad results from
quite prolonged applications, provided mild currents are used. The
rule is to give the average baby about half as much treatment as the
average adult. Children cry when the current hurts them, and this to
the merciful physician operates as a check against over-dosing them.

Very old patients— between seventy and ninety—need to be
treated with reasonable, but not extreme caution. The moderately
aged—between fifty and seventy—often bear electricity better than
those in the more active period—between twenty and fifty.

Regard for Sex.—As arule females are somewhat more susceptible to
electricity than males, and require to be treated with greater caution ; not
that there is any difference of susceptibility of the sexes, but because in
civilization woman is more delicate than man, and more readily influenced
for good or evil, by all remedies and systems of treatment. But
although the law that woman is more impressible than man holds well
on the average, yet the individual exceptions are very numerous.
Some women—even those who are exquisitely delicate—can bear enor-
*

292 REGARD FOR METHOD OF APPLICATION.

mous doses of electricity, while some men who are very hardy can bear
none at all. The rule however, is constant enough to make it
advisable always to begin the treatment of delicate females with con-
siderable caution.

The higher susceptibility of women to electrical influence, makes
them yield more rapidly than men to the treatment, when it suits the
temperament and disease, and hence it is that many of the most delightful
results of general faradization and central galvanization, have . been
obtained in neurasthenic, anemic, hysterical women.

The menstrual period in women does not contraindicate electrical
treatment at all, but on considerations of delicacy the operations of
general faradization and central galvanization cannot well be performed
at that time. Local applications to the periphery can be made without
regard to the menses. ?

Regard for the Method of Application and the Skill of the Electro-
therapeutist.—It is not electricity in the abstract, but electrization,—that
is, electricity applied to the body—that cures disease. Everything, there-
fore, depends on the method of application. Patients frequently.say that .
they have “tried electricity” and it did no good. We have long since
ceased to pay any heed to such statements, or to allow them to influ-
ence our pregnosis, unless it is expressly stated who gave the electrical
treatment, what methods were employed, and how faithfully the treat-
ment was carried out. Some of the best successes we have are gained
with patients who have “tried electricity” and found it wanting.
What should we think of a patient afflicted with a broken leg who
should say that he had “tried surgery,” and it had failed to set the
bone? Would we not ask, “ What surgeon? Was he a pretender, or a
man of science? And did he have a fair chance?” It is possible, even
if good treatment at the hands of good men failed some time ago, that
the conditions may now be so altered that the same or different treat-
ment will be successful. :

It is not the remedy, it is the manner of using it that determines its
value. There is as much difference in electro-therapeutists as there is
in general surgeons, ophthalmolologists, or aurists, or gynecologists, or
obstetricians. In the ranks of those who use batteries are all grades
of genius, and lack of genius, especially the latter. In electro-thera-
peutics two currents are used, and six different methods of application,
and these methods are all capable of indefinite variations, dependent
on the taste, skill or experience of the electro-therapeutist. When one
mode of application fails, another may succeed; when one electro-
therapeutist fails with any mode of application, another with the same
GENERAL SUGGESTIONS. 293

mode of application may succeed. And yet, patients with some
obscure disease, that requires the best diagnostic as well as therapeutic
skill, who have had, perhaps, half a dozen applications of the magneto-
electric or rotary machines, at the hands of some stupid servant-girl,
declare that they have “tried electricity.” As well might a sailor
whose broken bone had been badly set at sea by a comrade before the
mast, declare that he had “ tried surgery.”

The Differential Prognosis of Accidental and Hereditary Disease,
under Electrical Treatment.—The prognosis of any case under electrical
treatment depends more on the ¢ime that the disease has been existing
than on the nature of the disease itself. Very grave and severe symp-
toms of the most threatening character yield promptly, when they are
recent, and, so to speak, accidental, while mild and nameless symptoms,
that appear to be of the most trifling character, when long standing, and
especially when they are inherited, may be exceedingly obstinate. It
becomes therefore of the first importance to inquire how long the mor-
bid symptoms, or other symptoms allied to them, have been existing in
the patient, before making a prognosis. ‘his principle applies to all
diseases for which electricity is employed. It is illustrated in a most
interesting manner in hysteria and allied affections. If two cases pre-
sent themseives, both suffering from symptoms of hysteria and neuras-
thenia, but in one case the symptoms are a life-long heritage, while in
the other they have arisen recently, and, so to speak, accidentally,
the prognosis in the latter case is, other conditions being the same, con-
sequently more favorable. Even if the symptoms in the recent case be
of a severer type, the prognosis may be much better than in the inher-
ited case. On this account it becomes necessary to inquire with dili-
gence, and repeatedly, of the patients and of their friends, in‘order to
see whether any allied symptoms have been their portion through life,
and whether the special disturbances for which they require treatment
are simply branches of a great tree of disease that has grown up in them
from the moment of their inception.

When, for example, a patient appears with sciatica, or tic-douloureux,
it is not enough to learn how long that particular symptom has dis- |
tressed him in the present attack. The questions to be asked are:
Has he ever at any period of his life had this or any other form of
neuralgia ? Is he of the nervous diathesis? Have his parents or any
of his near relations suffered from neuralgia, or from any disease, or
symptoms of disease that are allied to it? On the answers given to these
queries will depend our probable prognosis, not only as to the rapidity
of relief under electrical treatment, but also as to its permanency.
294 AFTER-EFFECTS OF ELECTRICAL TREATMENT.

Inherited diseases are inclined to relapse: the symptom may give
way, apparently, before the force of treatment, but may reappear as
easily as it disappeared, even while the treatment is continued.

After-Effects of Electrical Treatment.—It is a fact well recognized
that the tonic effects of a trip to Europe, or to the mountains, or of
a short vacation anywhere, or at any season, are frequently but little

“appreciated while the patient is travelling or recreating; but appear
days, weeks, and months subsequently. A debilitated man may receive
no strength while on the ocean, or at the hotel, or farm-house in the
country, may, indeed, seem to grow weaker instead of stronger, and
may become disheartened thereby, but on his return to his duties, health
may gradually, perhaps imperceptibly, come to him, and he may experi-
ence a renovation and a recuperation that can only be explained as the
after effects of his vacation.

It is, perhaps, not so well recognized that tonic remedies, and systems
of treatment of various kinds, may act just in the same way. Not only
the evil but the good effects of medicines may be cumulative. We may
see this principle illustrated in the administration of quinine, strychnine,
arsenic, phosphorus, and iron.

Electricity obeys the same law, and in certain constitutions, and cer-
tain slates of the system, especially those of debility, it does little or
nothing that the patient can see or feel during the treatment itself,—
but prepares the way for a perfect and permanent recovery. We have
seen this principle illustrated in a large variety of cases of chronic dis-
ease. The practical lesson that we are to derive from this is to en-
courage patients who do not feel fully satisfied with the progress that
they make while under treatment, to watch closely, if possible, their
career long after treatment is abandoned.

LElectrization in its Relations to other Forms of Treatment.—The ques-
tion, so often asked, whether electrical treatment will interfere with
internal medication, or with gymnastics, the Russian, Turkish or other
baths, and so forth, is very easily answered. It harmonizes with all other
tonic remedies, and methods of treatment that are employed for the.
common purpose of relieving pain, or building up broken-down consti-
tutions.

Except in cases where we wish to experiment and learn the therapeu-
tical value of electricity by itself alone, uncomplicated with other
healing factors, it is a positive advantage oftentimes to employ, at the
same time with electricity, external or internal medication of various
kinds. So far as we now know there is no medicine that is incom-
patible with electricity. There is no evidence that any remedy has any
GENERAL SUGGESTIONS, 295

specific reénforcing effect upon electricity, such, for example, as certain
stimulants have on hydrate of chloral. Some of the best therapeutical
results are obtained from a combination of electrical with other
treatment.

On the Use of Electricity by the Laity.—Even at this advanced stage
of electro-therapeutics, it seems to be necessary to constantly warn the
profession against indiscriminately intrusting the details of electrical
applications to the nurses, friends of patients, and the patients them-
selves. Having just rescued this department from the hands of the
laity, and given it a position among men of science, it seems strange
that those physicians who are familiar with the subject should even now
use their influence to return it to the ‘people at whose hands it for-
merly suffered so much ; to restore it to the captivity of prejudice and
ignorance. ,

The temptation on the part of the people to use electricity them-
selves, and on the part of the profession to allow them to do s0, is very
strong. The majority of physicians know little more of electro-thera-
‘peutics than their patients. Some have a theoretical, but not a practical
acquaintance with it. Then there are those who are well practised in
the art, but are too closely occupied to employ it. They have no ap-
paratus, or if they have any it is very likely out of order. Perhaps no
specialist is accessible, or the patient is, or is supposed to be, too poor
to employ one. The physician, forgetting that it is not electricity, but
electrization that cures disease, forgetting that there are two kinds of
electricity in common use, and six different methods of application,
every one of which is capable of various modifications, forgetting that
there are certain temperaments that will not bear electricity, however
applied, and that there are others who must be treated at first with
great skill and caution, and on whom the currents and methods em-
ployed must be studiously varied during a course of treatment, in
short, forgetting that electro-therapeutics, considered as a science or an
art, is wonderfully complex and exacting, orders the patient to “ get a
battery and try electricity.”

This prescription is usually carried out in the following manner: An
old magneto-electric machine (rotary) is trumped up from some neigh-
bor’s garret, where, after having failed to cure any member of the family,
it has been rusting for years. If the patient be wealthy, perhaps a new
faradic machine is ordered, that gives a harsh, rough current, and when
applied, drives the patient to despair. The friends of the patient are
bored with the request of the patient to apply electricity, and only half
do their duty ; consequently the patient tries to make the application
.296 ABBREVIATIONS USED IN ELECTRO-THERAPEUTICS.

to himself, and, of necessity, makes awkward work. Pretty soon the
metals become corroded, and the current ceases to flow, and the battery
is soon consigned to the closet or garret, where it will do no harm,
and probably as much good as in the hands of the patient.

This picture is not drawn from fancy ; it is a picture of genuine and
frequent experience.
» Abbreviations used in Electro-Therapeutics.—It is a decided con-
venience and saves much time in recording cases, in giving private
instruction, inepublic lecturing, and in conversation, to describe elec-
trical applications by abbreviations. About a year since we devised
the following abbreviations, which have been used with satisfaction in
giving private instruction and in conversation with our assistants and
others who are familiar with it, and in records of cases from day to day.
We do not adopt it in the present treatise, for the reason that it is not
yet widely known, and might perplex and bewilder the reader :

L. F. Localized faradization.

L. G. a galvanization.
G. F. General faradization.
C. G. Central galvanization.
G. B. Galvanization of the brain.
G.C.S. ¢ «sympathetic.
G. S$. .# «spine.
E. Electrolysis.
G. C. Galvano-cautery.
CHAPTER IV.

COMPARATIVE VALUE OF THE GALVANIC AND FARADIC CURRENTS.

Mucu of the confusion that exists concerning the differential indica-
tions for the use of the galvanic and faradic currents arises from an im-
perfect or erroneous or exaggerated conception of the distinction in
their physical and physiological effects. The general belief or supposi-
tion is, that there is between them a radical and important difference
in Rind, as though they were two different agents or forces.

We can most intelligently compare the therapeutical effects of the two
currents, if we first compare their physical characteristics and their phy-
siological effects.

By referring to the section on electro-physics, it will be seen that both
currents—faradic and galvanic—are capable of producing chemical de-
composition, of deflecting the needle of the galvanometer, of producing
sparks, and of being changed into heat. Generally speaking, these
effects are produced more powerfully by the ‘galvanic current ; but in
Gramme’s machines we shall see that magneto-electricity is capable of
producing great heat and of electroplating on an enormous scale.

Both currents are obedient to the law of Ohm, with this qualification,
that the faradic current must be regarded as having passed through a
great resistance.

Faradic and galvanic electricity are therefore the same force—elec-
tricity, only each variety is modified by the nature of the substance
through which it circulates, as well as the manner of its production.

Light is light, whether its waves are shorter or longer, and in spite of
‘interference and polarization, and whatever may be the color that it ex-
cites in the retina ; sound is sound, whether its undulations move slowly
or rapidly. So electricity is electricity, however generated or however
modified by the medium through which it moves; and all forms of it,
magnetism, as well as franklinism, galvanism, and the many varieties of
faradism, are merely different expressions of the one great force—elec-

tricity.
298 GALVANIC AND FARADIC CURRENTS COMPARED.

In their physiological effects the two currents approach each other
even more closely, It is true that the phenomena of electrotonos have
only been demonstrated under the galvanic current ; but it is not proved,
that similar phenomena, to a less degree, may not be caused by the faradic
current, and every-day experience in electro-therapeutics shows that with

«the faradic current, as with the galvanic, the positive pole is the more
calming, and the negative the more irritating. Both currents act on the
skin so as to modify the circulation, the galvanic having a greater chemi-
cal effect and causing a feeling of burning, while the faradic causes a feel-
ing of stinging and pricking. Both currents applied to the brain and
spinal cord excite contractions of peripheral muscles. Applied to the
sympathetic both currents, according to the degree of irritation, cause
contraction or dilatation of the cerebral vessels; the faradic producing
the same effect as the galvanic, only more slowly. Applied to the pneu:
mogastric, whether cut or injured, both currents produce about the same
effects on the heart. Even in their action on the nerves of special sense
the currents approach each other far more closely than has been
supposed.

In temperaments of a high order of susceptibility the faradic current
may so excite the retina as to cause flashes before the eyes, and may
produce a metallic taste in the mouth, and even the auditory nerve re-
sponds to the faradic current, though less distinctly than to the gal-
vanic current, and without the peculiar differential action of the
poles.

Applied to motor and sensory nerve branches, both currents and both
poles cause sensations of pricking, tingling and numbness, and contrac-
tions of the muscles which the nerve supplies. Applied to voluntary
muscles both currents cause contractions, the faradic more readily than
the galvanic ; applied to involuntary muscles both currents cause slow
contraction at both poles and in the intermediate region. The electro-
lytic action of the faradic current on the blood or on the tissues of the
body is but feeble as compared with that of the galvanic current; but
yet it exists, and from the inner, or primary coil, is easy of demonstration ;
and yet it must be confessed that in their chemical action the currents
diverge more widely than in any other physiological effect.

Over nutrition both currents and both poles have a powerful influence,
the faradic acting more prominently through the muscular, the galvanic
through the nervous system.

From the accuniulating results of experiments and experience in
electro-diagnosis and therapeutics, we think that there is strong reason
for regarding the essential distinction in the effects of these currents on
ADVANTAGES OF GALVANIC OVER FARADIC. 299

the body as mainly of degree,—practically amounting, it is true, to a
difference in kind,—and that this is the scientific basis for their differen.
tial employment.

In the form of localized electrization both can produce muscular
contractions in paralyzed muscles, and relieve local neuralgias ; both
cause absorption of abnormal secretions ; and both can directly affect
the brain, spinal cord, sympathetic, and all the internal organs, pro-
ducing, in different degrees, the various therapeutic results that directly
and indirectly flow from electrical excitation of these parts. In the
form of general electrization both currents, besides producing most of
the other results of localized electrization, act as powerfully stimulating
tonics, and thus form most efficient aids in the relief and cure of nerv-
ous exhaustion, nervous dyspepsia, constitutional neuralgia, and of a
wide range of nervous diseases associated with or dependent on general
debility.

In electro-surgery both currents avail to discuss tumors, heal ulcers,
and hasten absorption, although for these purposes the galvanic is.
incomparably the more effective.

And yet the difference in degree between the effects of the two cur-
rents is so marked and so clearly demonstrable, as to be practically
equivalent in certain instances to a difference in kind, and to give very
important and remarkable advantages to one current or the other, ac-
cording to the indications required.

The advantages of the galvanic over the faradic are :—

1. A greater power of overcoming resistance. It therefore affects the
brain, spinal cord, and sympathetic more powerfully than the faradic,
since the anatomical position of these parts is such that considerable
resistance must be overcome in order to directly affect them. For the
same reason it is usually to be preferred when it is desired to affect the
middle and internal ear, the retina, and the muscles of the eye.

2. A power of producing muscular contractions in cases where the
faradic fails. This peculiarity of the galvanic current has now been
observed so frequently, and in such striking instances, that it has be-
come, an accepted fact of electro-therapeutical science. Illustrative
examples will be given in the section on paralysis. After a certain
amount of treatment by the galvanic current the paralyzed muscles
frequently resume their susceptibility to the faradic.

3. A far more potent electrotonic, electrolytic, and thermic action.
The chemical power of the galvanic current is most markedly seen
when used for the purposes of galvano-cautery or electrolysis. The
superior efficacy of the galvanic current to the faradic, so often
300 GALVANIC AND FARADIC CURRENTS COMPARED.

observed in the treatment of neuralgia, of atrophied muscles, rheuma-
tism, is probably due to its greater “catalytic” action. It probably
induces more rapid and more important molecular and other changes in
the tissues. This superiority of the galvanic current is supposed to be
due to its more continuous duration ; it moves constantly in one direc-
tion, and thus produces more powerful electrolytic effects than the fa-
radic current with its rapid interruptions can possibly produce.

The advantages of the faradic over the galvanic current are these :—

1. By virtue of its frequent interruptions it more easily produces
muscular contractions when passed over the muscles or the nerves that
supply them. Jn order to produce full muscular contractions with a gal-
vanic current of moderate strength it is necessary to interrupt the cur-
rent, and, unless it is quite powerful, to localize at least one of the
electrodes over the motor nerve by which the muscle is supplied—that
is, over the so-called “motor points.” On the contrary, the faradic
current is in a condition of rapid interruption and produces contractions
when indifferently passed over the surface of the muscle, as well as when
localized on the main motor nerve that supplies it.

This advantage of the faradic current is best appreciated in general
faradization, the powerful tonic effects of which, as will be seen, are
partly and quite largely due to the passive exercise and consequent
oxidation and other important changes of tissue that result from the
several thousand muscular contractions that take place during an ordi-
nary sitting. In localized electrization this advantage is not so clearly
and strongly marked, since, in this method, by a proper knowledge of
electro-therapeutical anatomy and sufficient care, it is possible to direct
one of the electrodes on the “motor points ;” and yet even here the
faradic current is much more convenient, because its employment re-
quires no arrangement for interruption, and less minuteness of attention
to the situation of the motor nerves. The exceptional cases of paraly-
sis, where the muscles have lost their susceptibility to the faradic cur-
rent, do not interfere with the general rule.

2. It produces greater mechanical effects. "These mechanical effects
of the faradic current are due to its rapid interruptions, which cause
contractions not only of the muscles, but also of the contractile fibre-
cells, thus stimulating the circulation, and with it the processes of
waste and repair. In this respect its action is similar to that of rub-
bing, pounding, movements and vibrations. ‘These mechanical effects
are especially indicated in the treatment of diseases of the abdominal
viscera, which are supplied with contractile fibre-cells ; anzesthesia, and
general muscular debility.
ADVANTAGES OF FARADIC OVER GALVANIC. 301

3. Lt is less likely to produce unpleasant or harmful effects, when
incautiously used, than the galvanic.

To confirm this statement we rest mainly on the evident results
of clinical observation. We may indeed refer to a number of cases of
severe constitutional neuralgia and excessive nervous exhaustion where
the faradic current invariably relieved, and where the galvanic current
as invariably aggravated, the symptoms. For this reason it is better to

‘begin the practice of electro-therapeutics with the faradic current, and
for those families who desire a scientific plaything, the faradic machine
is safer than the galvanic apparatus.

In all applications to the head, neck, and spine especially, applica-
tions of the galvanic current can rarely be protracted without injury,
while in many cases the spine and neck may be faradized through very
prolonged sittings, with positive benefit to the patient. To the head,
also, a faradic current of a proper quality may be applied much longer

‘than a galvanic current, before unpleasant dizziness or headache is
excited. The belief, pretty generally entertained in Europe, that the
faradic current cannot be applied to the head without injury, is to be
accounted for by the fact that most of the electric machines there em-
ployed are separate-coil machines, and do not furnish a current of suff-
cient smoothness for faradization of the head. Most of those who at-
tempt this method of treatment use too small electrodes, and thus give
the current greater density than the brain can bear. Galvanization of the
eye or ear, or of the cervical sympathetic, must always be shorter than fara-
dization of the same parts. These considerations, however, need not inter-
fere with the use of the galvanic current to these parts, in all cases where
it offers a positive advantage over the faradic. There is no real danger
in using either current on any patient, provided it be used properly.

A consideration of some practical importance with general practi-
tioners is, that the faradic apparatus is more convenient, more portable,
than even the compactest galvanic apparatus that has yet been devised.
It is impossible, however, for any practitioner to realize anything like
the full benefit of electrization without apparatus for the galvanic as
well as the faradic current.

The general differential indications for the use of the two currents
may be thus summed up. The galvanic should be used—

1. Zo act with SPECIAL ELECTROTONIC AND ELECTROLYTIC POWER 07
the brain, spinal cord, sympathetic, or any part of the central or periph-
eral nervous system.

2. To produce contractions in paralyzed muscles that fail to respond
to the faradic.
302 GALVANIC AND FARADIC CURRENTS COMPARED.

3. Ln electro-surgery, to produce electrolysis or cauterization.

The faradic should be used—

1. Zo act MILDLY ox the brain, spinal cord, sympathetic, or any part
of the central or peripheral nervous system.

2. Zo excite muscular contractions wherever the muscles are not so
much diseased as to be unable to respond to it.

3. Lo produce strong mechanical effects.

Both are essential in electro-diagnosis—the faradic-especially for the
muscles, and the galvanic especially for the nervous system ; and both
are adapted for general as well as localized electrization, although in
general electrization the faradic current is chiefly used. It logically
follows from what has been said that very many—perhaps the majority
—of diseases are best treated not by one current exclusively, but by
both currents, either in alternation or succession. Special indications
will be given under the special diseases.

The tuo currents compared to bromide of potassium and hydrate of
chloral.

We are accustomed to compare in a rough way the differential action
of the currents with the differential action of bromide of potassium and
hydrate of chloral, the faradic current being the bromide of potassium,
and the galvanic the hydrate of chloral.

Bromide of potassium is a safer remedy than hydrate of chloral,
but there are very many cases where it is powerless, and the hydrate of
chloral acts as a specific; so the faradic current is safer than the gal-
vanic, and therefore better adapted for general use, and, for those who
use but one current, fulfils a larger requirement ; and yet there are
many cases where it fails and the more powerful galvanic is demanded.
Except for the cases where the galvanic current. is clearly indicated, it
is well to begin with the faradic current, just as we use bromide of
potassium before resorting to hydrate of chloral.

A combination of bromide of potassium and hydrate of chloral is
frequently more effective in producing sleep and relieving pain than
either remedy when used alone: similarly the combined or alternate
use of the faradic or galvanic currents will sometimes accomplish much
more than either current used exclusively.

GALVANO-FARADIZATION.

In order to secure the advantages of both currents, and at the same
time to avoid the trouble and inconvenience of employing them in suc-
cession, or alternately, as is so frequently necessary, we have devised a
GALVANO-FARADIZATION. 303

method of using them simudtaneously. To this method we have given a
name which sufficiently expresses its character—galvano-faradization.
It may be either general or localized.

The method of general galvano-faradization requires a double
electrode, with one part for the galvanic and the other for the faradic
current. The copper plate may be connected at one part with the
pole of the faradic, and at another with that of the galvanic apparatus ;
thus the circuit is completed for both currents.

In localized galvano-faradization it is necessary to have in use two
double electrodes; for this purpose the double excitors of Duchenne
answer very well. By a proper construction and adjustment of the
electrodes it is possible to localize the two currents very near to each
other. Whether any special therapeutical advantage arises from the
simultaneous use of the two currents, we are unable to state.

We allow the above description of galvano-faradization to stand just
as it appeared in the first edition.

Since we have used central galvanization—a method to be subse-
quently described—we have dispensed almost entirely with general
galvano-faradization.
CHAPTER V.

THE PRINCIPLES OF ELECTRO-DIAGNOSIS (ELECTRO-PATHOLOGY).

In this chapter we shall speak only of the prizcigles on which
electricity is used as a means of diagnosis in medicine. The details
and special applications of these principles will appear under the vari-
ous diseases.

A history of the use of electricity as a means of diagnosis would very
likely be the history of electro-therapeutics itself. As soon as men
began to use the voltaic pile in the treatment of paralysis and kindred
diseases, about the middle of the last century, just so soon, probably,
they began to test the power of the electric current to diagnosticate
disease. We logically infer that electrization was used as a means of
diagnosis much earlier than the published treatises on the subject would
show, from the fact that it has been so used—in a blind and empirical
way, it is true—in this country, for thirty or forty years. Mankind,
always and everywhere, are superstitious, credulous, ready to receive
whatever approaches them with an air of mystery, much more so in the
last century than in the present ; and it is certainly not unfair to sup-
pose that the earlier experimenters in this department consulted, to a
greater or less extent, the diagnostic or prophetic power of the subtle
agent—electricity. Their experiments, we may suppose, were unscien-
tific and unsatisfactory. They were probably neither based on any
well-defined principles, nor conducted by any intelligible system. Ac-
cordingly, they secured very few tangible, or at least communicable, re-
sults, and if scientific men had not espoused the cause of electro-thera-
peutics, the phrase electricity as a means of diagnosis, would neyer have
been known. Nearly all that has been accomplished in a scientific
way, in this department, is comparatively recent ; though Marshall Hall
earnestly called the professional attention to the fact that Electricity
might assist us in differentially diagnosticating paralysis as far back as
1839.* Since that time the subject has been studied by nearly all the
prom‘nent workers in the department of electro-therapeutics.

* Medico-Chirurgical Transactions, 1839.
MODIFICATIONS OF ELECTRO-SENSIBILITY. 305

‘In order to be expert in electro-diagnosis, it is necessary to be
thoroughly familiar with the normal reaction of the different parts and
organs of the body to faradic and galvanic electricity. The founda-
tion principles, on which Electricity can be made a means of diagnosis
of disease, are simply these-four :—

First. The fact that all the parts and organs of the body are more or
less sensitive to the electric current, and that this sensitiveness is modified
by disease. This electro-sensibility may be either increased or dimin-
ished.

If an electric current be passed through a boil, or irritable ulcer, or
the skin, like any other irritant, it excites more pain than when it is
applied over the healthy skin; and this pain which it causes usually
bears quite a direct proportion to the nature and condition of the
morbid process. This is so familiar and so apparent an example of in-
crease of electro-sensibility, that to state it is to demonstrate it. The
electric currents, during the various processes of electrization, penetrate
beneath the skin, and, as it has been experimentally and practically
demonstrated, traverse, to a greater or less extent, the principal vital
organs. It is evident, therefore, that those organs which are abnor-
mally sensitive, through disease of any kind, must feel the current much
more appreciably than when in a condition of health.

But the mechanical effects of the electric currents work both ways,
and organs which are indurated or changed into an anesthetic condi-
tion by disease are Jess sensitive than is normal to the electric current,
just as they are less sensitive to any other mechanical cause acting upon
them.

Accordingly, we find that when even powerful electric currents are
passed through an indurated joint, or an atrophied liver, or any part the
sensory nerves of which are paralyzed, they may produce little sensa-
tion.

Before making examinations to determine the sensitiveness of the
different parts of the surface of the body, it is necessary to know their
relative normal sensitiveness, as indicated and described in the chapter
on Electro-Therapeutical Anatomy.

No absolute Standard of Electro-sensibility—We have no absolute
or mathematical standard of electro-sensibility by which to compare
the deviations that appear in disease. We can only compare the
sensitiveness of parts with the average sensitiveness of the same parts
in health. When half the body is diseased, as in hemiplegia, it may
readily be compared with the electro-sensibility of the healthy side.
In all these examinations into sensibility we are dependent on the

20
306 PRINCIPLES OF ELECTRO-DIAGNOSIS.

statements of the patient, and the results will be influenced by his in.
telligence and honesty.

It need hardly be said that the diagnosis obtained by observing this
increased or diminished sensitiveness, of any part or organ, must, of ne-
cessity, be a very general one. It simply informs us of, and directs our
attention to, the fact that such a part or organ is in some way diseased.
The special nature of this disease must be determined by the ordinary
means of differential diagnosis at our command.

This sensitiveness to the electric current is particularly marked over
the prominent nerve-tracts, and in those regions endowed with great
tactile sensibility. If even a mild current be applied at those points on
the upper or lower limbs where the prominent nerves are superficial, a
feeling of tingling or numbness is felt through the branches of the
affected nerve ; and if the current is very much increased in strength,

a decidedly anzesthetic effect is experienced. In paralysis of sensa-

tion, or anzesthesia, this feeling of tingling, thrill, and. numbness is
very much diminished under the influence of the electric current, or is
entirely absent. It is on this principle that electricity becomes a most
valuable means of diagnosis in the various stages of anesthesia, A
condition of anesthesia or analgesia (loss of sense of pain) can readily
be detected by the brass ball employed in general faradization, or by
the metallic brush, or by any other form of electrode. To detect
analgesia the electrode should be moistened so that the current may
penetrate the epidermis.

General faradization is found to be of practical utility in aiding us to
determine the locality of certain diseases, if not their precise nature.
In dyspepsia, electrization often reveals great sensitiveness in the
epigastric region, and on the left side over the spleen. In severe
dyspepsia, accompanied by emaciation, a current is sometimes pain-
fully transmitted from the middle of the back to the stomach, through
the solar plexus. A peculiar sinking sensation is sometimes felt at the
pit of the stomach when a strong current is applied over the seventh
cervical vertebra, or over the brachial plexus. All these symptoms,
taken together, undoubtedly suggest. an aggravated case of dyspepsia,
and usually of the nervous variety. Congested or irritable states of the
liver are revealed by an abnormal and peculiar sensitiveness when the
current is applied over the right hypochondriac region. Care must be
taken, however, not to confound the normal sensitiveness of the superficial
nerves over the ribs, with an abnormal condition of the liver. There

‘are certain diseases of this organ in which it is less sensitive than usua.

to electrization, and sometimes it appears to be decidedly anesthetic.
MODIFICATIONS OF ELECTRO-SENSIBILITY. 307

A lady patient of ours who had suffered for years from hepatic disor-
der was very sensitive to the current excepting over the right hypochon-
driac region, where she could bear the whole power of the apparatus
without any discomfort, except that which was necessarily caused by
the natural tenderness of the skin. ‘The precise condition of the liver
at that time we were not able to ascertain. The evidence, however,
was sufficient to confirm our previous suspicions in regard to the exis-
tence of some affection of that organ. It may be said in general,
that those diseases which cause the liver to be sensitive to external
pressure, also cause it to be sensitive to electrization. The same
general principle will apply to the stomach, the spleen, the intestines,
and the ovaries. Our experience in the electrical treatment of diseases
of the lungs has not been large, but it has been sufficient to make it
quite probable that certain sensitive conditions of tuberculous deposit
may be suggested by abnormal sensitiveness to the faradic current over
‘the apex of the chest.

Electro-diagnosis of the sensory nerves requires us to examine the
condition not only of the various portions of the skin, but also of the
nerve-branches, and the plexuses.

If in cutaneous anesthesia we find normal sensitiveness on the nerve-
branches, we judge that the disease is confined to the nerve ramifica-
tions only.

If in complete anesthesia of an extremity the nerve plexus exhibits a
normal reaction, we also judge that the disease is not central but peri-
pheral, including the nerve-branches.

For the purpose of testing the condition of sensation the faradic cur-
rent is usually to be preferred, for the reason that its mechanical effects
are greater than those of the galvanic.

The electro-sensibility may be normal or nearly so when ordinary
sensibility is much diminished. In some cases of posterior spinal scle-
rosis, for example, a moderate electric current may be fully perceptible
while a pin may be thrust into the flesh without causing any pain.

The Head.—In health the head is very sensitive both to galvaniza-
tion and faradization, in all parts except the posterior. This electro-
sensitiveness of the frontal and parietal regions of the head is due to
the superficial nerves, and not to the brain itself. In pathological cases
this sensitiveness may be either increased or diminished.

Spine.—In health the spine is but little sensitive to the current. In
pathological cases it may exhibit a sensitiveness to the electric current
that is not revealed by pressure or by any other method of irritation.
This condition is found in neuralgia, spinal irritation, hysteria, etc. It
308 PRINCIPLES OF ELECTRO-DIAGNOSIS. -

is interesting, also, to know that electric examination sometimes indi:
cates abnormities in the sensitiveness of certain parts of the body that
exhibit no functional derangement.*

Sympathetic and Pneumogastric.—The ganglia of the cervical sympa-
thetic and the pneumogastric may be examined electrically by the inner
border of the sterno-cleido-mastoid muscle. Sometimes there is abnor-
mal sensitiveness all along the border of the sterno-cleido-mastoid
muscle in the track of the pneumogastric. This sensitiveness is found
in a large number of pathological conditions, locomotor ataxia, muscular
atrophy, various cerebral affections, etc. We have observed it also in
spinal irritation, and during paroxysms of sick headache. This abnor-
mal sensitiveness may be frequently demonstrated by mechanical pres-
sure. We are disposed to regard this sensitiveness as due to the pneumo-
gastric more than to the sympathetic.

Llectro-muscular Sensibility.—Electro-muscular sensibility includes a
fecling of pain and a feeling of contraction. The latter may exist with-
out the former.

Success in investigating electro-muscular sensibility depends on the
condition and intelligence of the patient.

In conditions of cutaneous hyperzsthesia it is exceedingly difficult,
even for the most intelligent patient, to distinguish between the sensi-
tiveness of the skin and that of the muscle.

In paralysis electro-muscular sensibility is frequently diminished,
together with the electro-muscular contractility; they often rise and
fall together. In hysteria, electro-muscular sensibility to pain is some-
times greatly increased. For remarks on the physiological nature of
electro-muscular sensibility, see Electro-Physiology, p. 160.

Secondly. The fact that the electro-muscular contractility and irrita-
bility are more or less modified by disease.

frritability strictly refers to the quivering which muscles exhibit
under mild currents ; contractility to the power of actually contracting
under whatever strength of current may be necessary. ‘The two terms
are very frequently used interchangeably.

That muscular contractions can be produced by the electric currents,
has been known since the period of the earliest investigations in the
department of electro-physiology.

The first systematic attempts to make this a basis for establishing
differential diagnosis were made by Dr. Marshall Hall, and subsequently
by Dr. Todd. The conclusions of these distinguished experimenters
are quite familiar, and as they were unsatisfactory and partly erroneous,

* Benedikt op. cit., p. 60.
ELECTRO-MUSCULAR SENSIBILITY AND CONTRACTILITY. 309

it is not necessary to present them in detail. More recent investiga.
tions have established that the behavior of the deep-seated muscles, in
regard to their contractility, is a much more complicated question than
was formerly supposed. The contractile power of a muscle is made up
of two factors, viz.: the excitability of the intra-muscular nerve-fibres,
and the functional capacity or irritability of the muscular substance
itself. When, therefore, the contractile power of a muscle differs in
any respect from the normal, this variation may be due to an abnormal
condition of either one or both of these factors. Still further, it is
stated that when the excitability of the intra-muscular nerve-fibres and
the irritability of the muscular substance are increased, yet if the
former has suffered more than the latter, the contractile power may be
diminished, and vce versd. :

In comparing healthy with diseased sides in paralysis, it is necessary
. to use not only the same strength of current, but also the same relative
position and pressure of the electrodes.

The general principles that have thus.far been established, in regard
to the relation of electro-muscular contractility to disease, are as fol-
lows :—

1st. In paralysis of motion, the electro-muscular contractility is
sometimes normal, occasionally increased, and very frequently dimin-
ished.

Jnecrease of electro-muscular contractility, or at least of irritability, may
be observed in diseases of the brain, attended with irritative lesions, in
certain spasmodic and hysterical affections, and occasionally in loco-
motor ataxia. Diminution of electro-muscular contractility is usually
observed in grave lesions of the anterior columns of the spinal cord,
and motor tract of the brain, in rheumatic paralysis, lead-palsy, in well-
marked progressive muscular atrophy, and in paralysis from injury of a
nerve in some part of its course.

2d. In certain central diseasés, the electro-muscular contractility is
at first normal or diminished, and afterwards increases with the progress
of the disease, until it becomes greater than normal.

The length of time that is necessary to illustrate these variations de-
pends on the nature of the disease. In chronic inflammations of the
spinal cord, in effusions in the brain, causing hemiplegia, these varia-
tions may run through many weeks and months. In cases of hemiple-
gia also, these different conditions of the electro-muscular contractility
may run in a circle; being sometimes normal, sometimes increased,
and sometimes diminished (Benedikt). All these changes correspond,
of course, to certain changes in the pathological condition of the
.

310 PRINCIPLES OF ELECTRO-DIAGNOSIS.

diseased brain. Just what this correspondence is in each case, cannot
in the present state of electro-pathological science, be well determined.

3d. The fact that certain forms of paralysis behave very differently
under the faradic and the galvanic current. Muscles over which a
faradic current can have no influence, may contract easily under a
_milder galvanic current than is necessary to produce contractions of the
“same muscles in health. Sometimes, as the paralyzed muscles recover,
they regain their power of contracting under the faradic current, at the
same time proportionately losing their contractility under the galvanic
current. This law is most readily demonstrated in peripheral facial
paralysis.

This fact, that in certain peripheral paralyses galvano-muscular con-
tractility may remain after farado-muscular contractility is wholly lost,
was first pointed out by Baierlacher in 1859. His observations have
since been confirmed by Schulz, Meyer,* Althaus, Hammond, Radcliffe,
Ziemssen,} I.egros and Onimus,{ ourselves,§ and other observers. (See
section on peripheral paralysis.)

From the experiments of Neumann and Briickner, it would appear
that this difference in the action of the two currents is due to the’ longer
duration of the galvanic current, which allows it to produce an effect
on the diseased muscles which the faradic current, on account of the
rapidity of its interruption, could not produce. It was found by these
observers that, in cases of muscular degeneratiun, where contractions
under the galvanic current were more readily excited than in the cor-
responding muscles of the healthy side, no effect was produced if the
current was very rapidly interrupted. The same phenomena were ob-
tained from experiments on the sciatic, crural, tibial, and peroneal
nerves. It has been suggested by Eulenburg that just as the sensory
nerves have several distinct functions, as touch, sensibility to pain,
temperature, pressure,—one or more of which may be abolished while
the rest are intact,—so the motor nerves may have three distinct
powers,—response to galvanization, to faradization, and to the will,—
one or two of which may be separately injured or abolished by disease.

In regard to their irritability when in a pathological condition, mus-
cles and nerves are subject to different laws.

It has been shown by Erb,|| and corroborated by Ziemssen and

* Op. cit., p. 417-

+ Electricitaét in der Medicin, 1866, p. 76.

$ Op. cit., p. 64.

§ New York Medical Record, 1868, p. 409.

| Deutsches Archiv fiir klinische Medicin, Band iv., 1866.
GALVANO- vs. FARADO-MUSCULAR CONTRACTILITY. 311

Weiss,* that the motor nerves, when they have been so injured as to
lose their irritability to the faradic current, also lose their irritability to
the galvanic current, and that the increased irritability which is seen in
such cases under galvanization is due to the muscles.

After the nerve has been injured by actual division, by bruising, or
by rheumatic effusion, it at once begins to lose its irritability to both
galvanic and faradic currents.

This diminution of irritability advances from the centre towards the
periphery, and at the end of the second week both galvanic and faradic
irritability are destroyed. As the nerve recovers, irritability to the gal-
vanic and the faradic currents reappear together.

With the muscles, on the other hand, there is at first no lessening of,
the irritability to either current until after a week. At this time the
faradic irritability begins to fall and the galvanic irritability begins to
tise. In a few days the galvanic irritability becomes so much increased
that the muscles respond to a much feebler current than usual. At this
stage there is a change in the character as well as in the degree of the
irritability of the muscles.

This change is twofold :—

1. The negative pole produces as great or greater effects on opening
than the positive : in a normal condition of the muscles the positive
produces greater effects on opening than the negative.

2. The positive pole produces a greater effect on closing than on
opening ; in a normal condition of the muscles the greater effect at the
closing is produced by the negative pole.

In about twelve weeks there is a renewed diminution of galvanic ir-
ritability ; this diminution goes on until twice as great a strength of
current is necessary to produce contractions as in the corresponding
muscles of the healthy side. Slight contractions may now be produced
by the faradic current.

These changes of irritability seem to bear no definite relation to the
volitional power.

Lffects of Paralysis or Electric Reaction not always immediate.—It
should be remembered that the characteristic reaction of paralyzed
muscles to the electric influence is frequently not observable at the out-
set of the disease: sometimes several weeks elapse before there ap-
pears the diagnostic evidence of changed electro-muscular contractility
or sensibility. Especially is this the case in spinal paralysis, also in
rheumatic and facial paralyses, sometimes also in hemiplegia. Again,
it is necessary, in doubtful cases, not'to depend on any single examina-

* Ibid,, Band iv., 1868,
312 PRINCIPLES OF ELECTRO-DIAGNOSIS.

tion, but to form an opinion from a number of examinations taken at
different times.

Volitional Contractility may exist when Electro-contractility is di-
minished.—The volitional power may remain when the electric contracti-
lity is diminished. If a muscle exhibits diminution of contractility under
electricirritation, but reacts normally to the w//, the conclusion is that
the muscle is not injured, but that the abnormity is caused by change in
the irritability of the intra-muscular fibres. ‘This is observed in certain
stages of traumatic and lead paralysis. We arrive at the same conclu-
sion in those cases where the muscles refuse to contract under direct,
but respond normally to indirect, electrization.

. Muscles of the eye are an exception to’ this rule, since, from their
anatomical position, they cannot be made to contract by direct, but
only by indirect, reflex action from the fifth pair.

Cases where reaction is lost both to the will and electricity indicate
actual injury of the muscle.

Furthermore, it should be considered that the electro-muscular con-
tractility and sensibility of diseased muscles may be and are greatly
modified by the treatment, both permanently or temporarily. Modifi-
cation may take place even during the séance.

Thirdly. That the special physiological reactions of the central
and peripheral nervous systems to the galvanic current are essentially
changed when the nerve is in a pathological condition.

This is true of the spinal cord, the motor and sensory nerves, spinal
cord and nerves of special sense, and of the sympathetic. According
to Benedikt, if the negative pole is placed, for example, on the pero-
neal nerve, and the positive on the patella, with an interrupted current,
a weaker irritation appears than when the positive pole is placed on
the cervical or lumbar vertebrae. The more the central parts are in-
cluded in the circuit the greater the irritation. In pathological con-
ditions this reaction is changed.

Opening contractions are regarded by Benedikt as characteristic
evidences of certain forms of locomotor ataxy. They are observed
also in neuritis and in chorea minor. They indicate a molecular dis-
turbance. They accompany both increased and diminished irritability,
usually the latter.*

Nerves of Special Sense.—The changes of the reaction of the nerves of
special sense to electric irritation may be both guantitative and qualitative.

* These views of Benedikt, concerning the significance of ‘* opening contractions,”
have been severely criticised by Brenner (‘‘ Untersuchungen,” &c., Bd, ii., 1869, p»
215, et seq.).
ABNORMAL REFLEX IRRITABILITY. 313

Auditory Nerve.—it has been shown that the reaction of the auditory
nerve to galvanic irritation—the strong subjective sensations of sound
—is materially changed by disease; and by this we judge of the
condition of the nerve. (See Diseases of the Ear.)

Optic Nerve.—The reaction of the optic nerve under the influ-
ence of the galvanic current, is attended with flashes of light. The
qualitative changes in reactions of the optic nerve to electrical irrita-
tion are numerous. In certain pathological cases, as we have observed,
flashes of light may be produced by the faradic current. In other
pathological cases, as severe atrophy of the retina, the flashes of light
do not appear during galvanization, or only when a very strong current
is used. We have observed very marked differences in the reaction of
the optic nerve in the two eyes when one was diseased and the other
healthy. Flashes of light from galvanization of the lower part of the
spine are indicative of abnormal irritability or organic disease of the
spinal cord. They aré observed in locomotor ataxia and spinal
irritation.

Olfactory and Gustatory Nerves.—The peculiar smell that is ex-
perienced on galvanization of the olfactory nerve may be either in-
creased or diminished by disease. It is absent in paralysis of the olfac-
tory nerve.

‘The peculiar metallic taste that follows galvanization of the tongue,
or that is experienced by reflex action when the galvanic current is ap-
plied on the neck and upper part of the spine, is subject to various
modifications by disease. In irritable conditions of the cord we have
observed that this metallic taste will appear when the application is
made in the lower part of the spine. In two striking instances it was
experienced from faradization of the cé/io-spinal region.

Fourth. The fact that in certain central diseases, and in conditions
of great irritability, as hysteria, the reflex effect of the current is so
exalted as to excite reactions that in a normal condition of the body never
appear. Thus, in a lady of middle life, who for several years had suf-
fered from all the symptoms of declared chronic myelitis, we were first
struck by the fact that even a very mild current over the upper portion
of the back was sensitively felt down the right leg. This symptom we
have never known to occur in a perfectly healthy condition of the
spinal cord. Afterwards we found that a very short as well as very
mild application of the current to one leg caused a disagreeable feeling
of pain and heaviness not only in this leg, but also in the other, for
several days following the application. In another case of general
razalysis dependent on hysteria, a very feeble current localized in one

 
314 PRINCIPLES OF ELECTRO-DIAGNOSIS,.

hand, or in one foot, would be appreciably, and oftentimes painfully,
felt through all the four extremities. The patient declared that the
sensation was like that of ‘waves rolling through the body.”

A still more marked illustration of this diagnostic power of electriza-
tion was the following:

In the case of a lady whose lower limbs had been somewhat para-
lyzed for two years, who presented no marked symptoms of severe
organic disease of the cord, we were inclined to suspect that her para-
plegia might be due to nervous exhaustion, until this abnormal reflex
sensitiveness to the electric current seemed-to establish the existence
of myelitis, or at least meningitis. We first observed that a feeble cur-
rent in the neck was felt down the spine, and subsequently the patient
complained that a strong current down the lower extremities trans-
mitted pain to the back. The occurrence of this abnormal symptom
forced us to the unwilling conclusion that we were dealing with a case
of organic disease of the spine. The subsequent history of the case
has confirmed this diagnosis. It has been shown by Benedikt,* that,
in certain morbid conditions, electrization of one extremity produces
contractions in the other. This phenomenon has been observed in
progressive muscular atrophy, and in certain reflex neuroses. In a case
_of rheumatic gout that we treated the application of the galvanic cur-
rent to the left knee caused a sharp pain in the corresponding Rat of
the right knee.

This fact enables us not only to make a diagnosis of central disease,
but in certain cases even to suspect the seat of the affection.

We are confident that in all cases of crossed reflex contractions
—Jjust as in the cases of crossed reflex sensation above cited—there is
always some central disease. This symptom when it occurs may per-
haps then be regarded as so far forth diagnostic.

Crossed reflex sensations and crossed reflex ee may be
manifested simultaneously in a patient affected with organic disease of
the spinal cord. This singular coincidence was observed in the case
above recorded of the lady who complained of waves‘of sensation all
over the body when the current was applied to any one of the four ex-
tremities. These peculiar sensations were sometimes accompanied by
feeble and spasmodic muscular contractions.

General shaking and tremor of a limb, or of the whole body, after
electrization, is also diagnostic of central disease. We have observed it
in one case of softening of the brain, and in a number of cases of hemi-
plegia. This general or partial tremor does not appear unless a con-

* Die Elektrotherapie, p. 63.
DIPLEGIC CONTRACTIONS, 315

*
siderable strength of current has been employed, or the application has
been much prolonged.

Diplegic Contractions—Remak,* of Berlin, was the first to note the
fact, that contractions of the muscles of one or both of the upper extremi-
ties may sometimes be produced by placing the positive pole in the
auriculo-maxillary fossa, just posterior to the ascending ramus of the lower
jaw, and the negative by the side of the sixth cervical vertebra. The
theory of Remak, that these contractions, to which he gave the name of
“ diplegic,” were caused by irritation of the superior ganglia of the sym-
pathetic, was apparently confirmed by Fieber,} by experiments on ani-
mals in whom the sympathetic was exposed, and subjected to the action
of the current.

Strong currents—from twenty to forty elements—are usually, though
not always, necessary to produce these contractions. The contractions
may be of various degrees, from mild drawing, with scarcely perceptible
oscillations, to violent movements resembling chorea. They may appear
in the interossei or in the muscles of the arm or forearm of one or both
sides. They may also appear in other positions of the electrode than
the one described. From one to five minutes are usually necessary to
excite them, and they may continue for a few moments after the appli-
cation has ceased.

That these so-called diplegic contractions are a reality and not a de-
lusion, as some have declared, we have demonstrated in a number of
cases, and especially in progressive muscular atrophy. The cases where
they are readily demonstrated, are, according to our observation, not
frequent, and we can easily see that one might practise electro-therapeu-
tics for a long time without seeing any, especially as currents of con-
siderable strength, applied in a certain manner, are necessary to pro-
duce them.

The evidence that these contractions occur exclusively through the
sympathetic is not to our view satisfactory, and there is stronger proba-
bility that the spinal cord is the centre, which in certain irritable con-
ditions exhibits these manifestations under strong electrical stimula-
tion. In none of the methods of application where these diplegic con-
tractions are called forth is it possible to localize the current in the
sympathetic. The special diagnostic value of these contractions is not
great. They occur not only in progressive muscular atrophy, but in
hysteria and hysteroid affections, and would appear to be pathogno-

* Application du courant constant au traitement des neuroses. Paris, 1865.
+ Die diplegischen Contractionen nach Versuchen an Menschen und Thieren.
Berlin, 1866, pp. 21, 22, 23-
316 PRINCIPLES OF ELECTRO-DIAGNOSIS.

.

monic of no one special disease, but rather of a condition of irritability
of the nerve-centres that may appear in many different diseases.

Freigned Diseases.—By the application of the principles stated above
the electric currents may be of great service in helping us to distinguish
real from feigned disease. A case of pretended paralysis of motion o1
sensation can readily be settled by applying the current to the limb,
since no force of will can fully resist the energy of the contractions that
electricity may excite in healthy muscles, or the pain that can be pro-
duced by strong faradization of the skin. The principle will work both
ways, and, if the electro-muscular contractility is diminished below the
normal standard, we may know that the disease is real. Where one
side or one limb only is affected, the comparison between the healthy
portions and those where disease is suspected can easily be made. Dr.
Russell Reynolds * mentions a patient with hemiplegia who was sup-
posed to be malingering. Electrization of the limbs on both sides
showed clearly a diminution of contractility on one side, as the patient
represented, and accordingly the case was pronounced to be one of real
hemiplegia.

Dr. Althaus + records a case of suspected malingering that he studied
by the aid of electricity. A member of a workingmen’s benefit soci-
ety professed that he had lost the use of his arm in consequence of an
accident—a fall—three years before. The question was whether the
society should give him the £100 to which permanently incapacitated
members are entitled. The patient, though tall and strong, had done no
work since the accident, and professed to be unable to undress himself.

On examination with the faradic current, Dr. Althaus found that all
the muscles of the arm responded without difficulty ; he therefore con-
cluded that the nerves and muscles were uninjured—in other words,
that there was no paralysis. He found, however, that when a very
strong current was used the patient appeared to suffer, but the arm did
not execute the movements it should do when the muscles contract.
Accordingly, he had the patient anesthetized by nitrous oxide gas, in
order to see whether any anchylosis existed that might interfere with
the movements of the arm. It was found that no anchylosis existed.
Dr. Althaus gave a certificate that the patient had no paralysis and
no anchylosis or dislocation, but that there was a painful affection of
the joint which would yield to subcutaneous injections of morphia and
galvanism, and that the patient could use the arm if he wished to.
The claim for benefit money was disallowed.

Faradization as a means of distinguishing real from apparent death—

* Lancet, April 16, 1870. + Third Edition, p. 455.
ELECTRO-BIOSCOPY. 317

Electro-Bioscopy.—The use of electricity as a means of distinguishing
real from apparent death was suggested as long ago as 1792, by Drs.
Behrend and Creve. Subsequently Boer, of Vienna, used franklinic
electricity on newly-born infants, and found that when muscular con-
tractions still existed, then the child was not dead, but could be re-
stored. .

In 1852, Dr. Crimotel, of Paris, wrote a memoir in which he stated
that when farado-contractility is gone, life is extinct. He stated fur-
thermore that farado-contractility gradually disappears after death, and
that after a period ranging between half an hour and two hours it en-
tirely disappears. He suggested the term e/ectro-bioscopy, and recom-
mended that those who are apparently dead from drowning, syncope,
apoplexy, freezing, hysteria, and the inhalation of poisonous gases,
should, before burial, be tested.

Rosenthal, of Vienna, has also studied the subject with much care.
He has found that both farado- and galvano-contractility gradually disap-
pear after death. He agrees in the main. with Crimotel in the follow-
ing general conclusions :

Llectro-contractility disappears more rapidly after death from chronic
than acute diseases; it persists longer in well than in badly nourished
bodies, and it usually disappears within three hours.

Rosenthal found that in amputated limbs the farado- and galvano-con-
tractility were active the first hour, and entirely disappeared in ninety
minutes. In case of drowning electro-contractility disappeared in three
hours and a quarter. In some cases where rigor mortis has not ap-
peared, where the temperature of the body is yet quite high, and where
the joints are flexible, the absence of electro-contractility yet proves
beyond question that the person is dead.

Rosenthal further records a very remarkable case of trance in a hys-
terical woman, where it was declared and believed by the physician
that the patient was dead. The skin was pale and cold; the pu-
pils contracted, and not sensitive to light; no pulse could be felt ;
the extremities were relaxed; melted sealing-wax dropped on the
skin caused no reflex movements, and no moisture appeared on a
mirror held before the mouth. Respiratory murmurs could not be heard,
but a feeble intermittent sound in the cardiac region was just percepti-
ble on auscultation. For ¢hirty-two hours the patient had been appar-
ently dead; but on electric examination Rosenthal found farado-con-
tractility in the muscles both of the face and the extremities. He
therefore urged the use of the faradic current to restore the patient.
In twelve hours the patient recovered her speech and movements.
318 PRINCIPLES OF ELECTRO-DIAGNOSIS,

Two years afterwards she was alive and well, and informed Rosenthal
that she knew nothing about the commencement of the attack of the
trance, and that afterwards she heard people talk about her death, but
she was powerless to help herself.
CHAPTER VI.
ELECTRO-THERAPEUTICAL ANATOMY.

Electro-therapeutical anatomy includes a description of the localities at
which the different nerves, muscles, and organs can be best affected by
the electri¢e currents, and also the relative electro-sensibility of the dif-
ferent parts of the body. It is therefore to electro-therapeutics what
surgical anatomy is to surgery.

Motor Points of Muscles.—The subject of the motor points was first
systematically studied by Ziemssen, who experimented on the recently
dead subject, and marked with nitrate of silver the points at which the
individual nerves and muscles most readily responded to faradization.
Many of these points can be easily and successfully studied on the living
human subject. Those which we have represented in the cuts are derived
mostly from numerous observations on persons in health. They have
been found to agree in the main with those of Ziemssen, with which
they have been compared, and by which they have been made more
accurate and complete. Those who wish to examine the subject in
greater detail are referred to the work of Ziemssen.* *

It will be found, however, that those which are here described are
sufficient for most of the purposes of electro-therapeutics.

The best method of verifying these points is to place one large
sponge electrode, well moistened, on some indifferent point, and to
firmly press a small negative + electrode, also well moistened, over the
spot where the nerve or muscle should be affected. If the right place
is touched, and the strength of the current and the pressure be suffi-
cient, the normal physiological action of the part affected will at once
appear. In the case of muscles contraction will take place, accom-
panied with a feeling of contraction; in the case of nerve-branches and
plexuses, there will be sensation more or less painful along the periphe-
ral ramifications of the nerves, and, if the excitation be sufficiently
strong, contraction of the muscles which they supply.

* Die Electricitat in der Medicin. Berlin, 1866. p. 154, et seq.

+ The negative is to be preferred, because it is the stronger, and acts more power:
fully in producing contractions,
320 ELECTRO-THERAPEUTICAL ANATOMY.

It is not to be understood that a studious regard for all of these elec-
tric points is always necessary in making applications of electricity. In
the normal condition most of the superficial and many of the deeper
muscles and nerves are easily excited by ordinary labile applications
with large sponge electrodes. Some of the muscles have two or more
motor points, and are therefore more readily affected by large than by
small electrodes. : ,

A large sponge electrode of from 3 to 6 or 8 inches in diameter, folded
over a brass ball, such as is used in general faradization,—causes full
contraction of a majority of the superficial and deep muscles when rapidly
passed up and down the limbs.

But when the muscles have become diseased, so that they respond
with difficulty to the electric current, it becomes necessary to give spe-
cial heed to the situation of these motor points, in order to determine
their actual electric condition, or to aid in restoring them to their nor-
mal condition by exciting artificial contraction.

It should be remarked furthermore, that these motor points vary in
different individuals, just as the anatomical relation of the nerves and
muscles varies, and that the representations of the cuts can be only
approximately correct.

The points at which the nerves and muscles of the eye, ear, and
larynx can be best electrized, also the best method of electrizing the
cesophagus, rectum, genital and abdominal organs, will be described in
the chapters devoted to the diseases of those parts.

We present below a brief description of the points at which the prin-
cipal nerves, plexuses, and branches can be best excited electrically,
and also the physiological effect on the nerves and muscles produced
by such excitation.

facial—at its exit from the stylo-mastoid foramen, between the mas-
toid process and the angle of the lower jaw, or at the opening of the
external auditory canal.

Pneumogastric—at the lower and anterior part of the neck, between
the common carotid artery and the jugular vein; inferior laryngeai—
between the cesophagus and the trachea of the ganglia of the sympa-
thetic.

The superior cervical ganglion of the sympathetic can be reached in
the anterior maxillary fossa, just behind and below the angle of the
lower jaw; the middle cervical, by the side of the sterno-cleido-mastoid
muscle, opposite the fifth cervical vertebra ; the zzferior cervical, also
by the inner border of the sterno-cleido-mastoid muscle, opposite the
second cervical and first dorsal vertebrz.
MOTOR POINTS. 321

Accessor'y—at its exit from the sterno-cleido-mastoid muscle.

“Ly poglossus—between the stylohyoid and hyoglossus muscles, under
the hyoid bone. ;

Phrenic —at the outer border of the sterno-cleido-mastoid muscle,
by the anterior border of the scalenus anticus, near the omohyoid mus-
cle. Excitation of this nerve causes strong movements of the chest.

Brachial plexus—in the supra-clavicular space, posterior to the
outer border of the sterno-cleido-mastoid muscle. Excitation of this
plexus causes a feeling of tingling and numbness in the fingers and
down the arm, and, when the current is strong, flexion of the forearm
and fingers.

Dorsatis scapule—at the border of the trapezius, near the accessory.

Supra scapularis—just before its entrance into the scapula, and ex-
ternal to the omohyoid muscle.

Anterior thoracic—at the upper border of the pectoralis major, below
the clavicle.

Posterior thoracic—above the clavicle, near the trapezius.

The thoracic nerves are irregular in their distribution, and therefore
difficult to find.

Axillary—at the upper and posterior border of the axilla.

Musculo cutaneous—between the biceps and coraco brachialis.

Median—in the lower third of the arm, at the point where it crosses
the brachial artery. Mild excitation of this nerve causes tingling in the
arm and fingers; a strong excitation causes closure of the fingers and
pronation of the hand.

Uinar—at the groove between the olecranon and the internal con-
dyle. Excitation of this nerve causes pain in the inner surface of the
forearm and contraction of the flexor carpi ulnaris, flexor digitorum
profundus, adductor pollicis lumbricalis, and interossei of the little
finger.

Radial—in the lower third of the arm, at the point of its emergence
from beneath the triceps. Excitation of this nerve causes tingling in the
outer part of the-arm and forearm, and down to the wrist; strong
excitation produces extension of the first phalanges of the fingers, ex-
tension of the hand and thumb and supination of the forearm, contrac-
tions of the extensor carpi radialis and ulnaris, extensor digitorum com-
munis, extensor minimi digiti, extensor indicis prop., extensor pollicis
longus and brevis, adductor pollicis.

Sciatic—in the thigh, posterior to the head of the femur, at’the point
where the nerves issue from the pelvis, or in the pelvis, through the
posterior wall of the rectum. Electrization of this nerve causes sensa-

2
322 ELECTRO-THERAPEUTICAL ANATOMY.

 
  
   
   
  
   

Frontalis.
Corrugator supercilii.
Zygomatic major.

acial nerve.
Superior cervical ganglion sympathetic.
Inferior maxillary nerve. ‘si
- Sterno-cleido-mastoid.

Stern
Inferior cervical ganglion symputhetic.
Phrenic nerve.

Brachial plexus.

Pectoral muscles.

 

Biceps muscle and mus. cut. nerve.

Brachialis internus.

Median nerve.
Ulnar nerve.

Palmaris longus.
Radialis internus.
Flexor digitorum profundus,

Flexor digitorum sublimis.

Flexor digitorum sublimis, IT., III., digit.
Ulnar nerve.

Flexor pollicis longus.

Median nerve.

Abductor pollicis brevis.

Volar branch ulnar nerve.

Opponens pollicis.

Lumbricales, I., 1I., TI., TV.

Crural nerve.

Sartorius.
Rectus femoris,
* Vastus externus,

Crural nerve and vastus internus.
Vastus externus.

Peroneal nerve.

Peroneus longus.
Tibialis anticus, and exten. dig. com.

 

. Soleus.
Peroneus brevis.

Flexor dig. com. longus.
Extensor hallucis longus.

. Tibial nerve.

Extensor digitorum brevis.

Extensor digitorum com. brevis.
Abductor hallucis.
i pedis d

Fic. 54. Electro-therapeutical Anatomy of the Human Body, Anterior view.
(For explanations see letter-press.)
 

POSTERIOR VIEW OF HUMAN BODY. 323

  
 
  
     
    

External head triceps.
.

Radia nerve
Bracuialis internus..

 

Supinator longus...

Radialis externus brevis.

Extensor digitorum conim
Extensor digs min, prop
xtensor indicis propri
Abductor pollicis longus:
Extensor pollicis Jongus
Sciatic nerve..

Extensor pollicis longa

 

Abductor minim digitl.
Interosseus, I......+ .
Interossei, IT., III, 1V.....

 

  

Sciatic nerve,..cseesesoas

 

Biceps, long head.

 

Biceps, short head...

Popliteal nerve,

 

Peroneal Merves.reresesssestecee reas eeceen cere

Gastrocnemius externus......eessereeeeecsees

SOLEUS... saccccesesernccsnsovarconrecaceeresees
Gastrocnemius internuseresssesersstoessveves

Fic. 38, Electro-therapeutical Anatomy of the Human Body. Posterior view.
(For explanations see letter-press.)
324 ELECTRO-THERAPEUTICAL ANATOMY.

tions of tingling in the leg below the knee, and foot, similar to those
which we so often experience when we accidentally sit on the sciatic
nerve.

Crural-—just after its exit from beneath Poupart’s ligament, exterior
to the crural artery. Electrization of this nerve causes sensations in
those parts of the leg that are supplied by its branches.

Obturator—on the horizontal branch of the pubic bone. If the ap.
plication is successful, and the current used sufficiently strong, the thigh
is abducted.

Popliteal—in the outer part of the popliteal space. Electrization of
this nerve causes vigorous contraction of the muscles that move the
foot upward and outward. :

feroneal—on the posterior border of the capitulum fibula. Excita-
tion of this nerve causes contraction of the tibialis anticus, peronei
muscles, extensor digitorum communis longus, extensor digitorum com-
munis brevis, and extensor hallucis longus.

Tibial.—This can be reached on the middle and outer part of the knee.
When strongly electrized, contractions arise in the muscle of the pos-
terior part of the leg. The tibial nerve can more easily be reached in
the depression posterior to the internal malleus.

Farado-sensibility of the Surface of the Body.— Very many muscles
have no accessible motor points, and must therefore be electrized intra-
muscularly. Practically this is done in the majority of cases. We pre-
sent in the accompanying cuts a bird’s-eye view of the electric points of
‘the prominent nerves, plexuses, and muscles, and of the relative sen-
sitiveness of different parts of the surface of the body to the faradic cur-
rent.

The relative sensitiveness of the different parts of the surface of the
body to faradization, we have also ascertained by numerous comipara-
tive observations on persons in health, with the moistened hand and
well-moistened sponge electrodes. The method of making these obser-
tions is to place the patient in the position for general faradization, with
his feet on the plate to which the negative pole is attached, while the
experimenter applies the positive all over the surface of the body.

Degrees of Farado-sensibility.—We have distinguished five degrees
of sensitiveness, the highest being marked one. For all practical pur-
poses these are sufficient ; approximate accuracy is all that is attempted.
The sensitiveness of the body when irritated by the faradic current is
due partly to the quality and position of the sensory nerves, and partly
to the peculiar feeling that attends muscular contraction (electro-mus-
cular sensibility).
ELECTRO-SENSIBILITY OF SURFACE OF BODY. 325

The feeling of muscular contraction amounts in some instances to
actual pain, so that a part which is not richly supplied with sensory
nerves may yet be very sensitive to the current. This is especially the
case with the sterno-cleido-mastoid muscle, which on being touched
near its centre contracts with a painful jerk. The same is true, toa
less extent, of the trapezius, the flexors of the arm, and of the peronei
muscles. In all parts where no muscular contractions are produced,
the sensitiveness of the surface of the body depends on the quality and
position of the sensory nerves, and bears a pretty constant relation to
its sensitivenéss to ordinary mechanical irritation.

Thus it will be observed that the parts which are most sensitive to a
blow or fall, or to any mechanical injury,—as the head, face, or surface
of the bones, clavicle, sternum, scapula, patella; etc.,—are likewise
marked highest in the scale of sensitiveness to the current.

To guard against error it is necessary—

1. Touse always the same electrode and the same direction of the
current ; therefore the negative pole should be kept at the feet during
the entire sitting. :

2. To make the pressure of the electrodes uniform, and to moisten
well all parts supplied with hair.

3. To use the moistened hand for the head and face. The head, es-
pecially, is so exceedingly sensitive to the faradic current that it will
hardly bear a sufficient strength of current through a sponge to make a
comparative estimate.

It will be observed that only a few parts are marked 5—the middle
of the back, the outer surface of the thigh, and the testicles. The peri-
nzum, which cannot be represented in the cut, should also be marked
5. It will be observed that the points most highly sensitive are those
where very sensitive nerves pass over the surfaces of bones, as the head .
and jaws. Of the other parts not represented in the figures, the external
auditory canal should be marked 1 ; the middle of the sterno-cleido-mas-
toid muscle, 2; the axilla, 3; and the ends of all the fingers, 2; the
under side of the penis, 2; the point between the penis and scrotum, 4 ;
the under surface of the heel, the plantar arch, the ball of the foot, 4. If
the external auditory canal, drum of the ear, conjunctiva, nasal mucous
membrane, tongue, and larynx were represented, they should be marked
a degree or two higher than 1, since they are more sensitive than any
portion of the surface of the head. The best point to test a current of
extreme feebleness is the tip of the tongue.

The rectum, urethra, and vagina are but little sensitive to the current
in comparison with the mucous membranes of the mouth, except at their
.

326 ELECTRO-THERAPEUTICAL ANATOMY.

external orifices» They might be marked 4 or 5. The os uteri and the
bladder would be marked 4, 5.

It should be distinctly understood that these remarks apply to the
applications of the faradic current with electrodes sufficiently moistened
to allow the current to pass readily through the epidermis. In dry
faradjzation the results are somewhat different, the pain at all parts be-
ing far less.

Farado-sensibility as compared with Galvano-sensibility.—The gal-
vanic current causes a burning sensation wherever it is applied ; but this
is most sensitively felt at those parts that are abundantly supplied by
sensory nerves. This burning feeling increases with the length of time
that the current is applied.

The greater sensitiveness of the bones to the faradic current, as com-
pared with the galvanic current, is due to the greater mechanical action
of the former. An interrupted galvanic current, of sufficient strength
to produce muscular contractions, produces the same sensations as the
faradic current, with the addition of the burning feeling at the surface
beneath the electrodes. The fact that the galvanic current is less pain-
ful to the surfaces of the bones gives it a certain advantage in making
applications to the head, although the pain of the faradic current, when
applied to the head by the moistened hand, may be reduced to a mini-
mum.

A Knowledge of the Normal Electro-sensibility of the Body essential in
LElectro-diagnosis and Electro-therapeutics.—A knowledge of the relative
sensitiveness of the different parts of the body tothe electric current
is indispensable both in electro-diagnosis and electro-therapeutics. It is
at once obvious that to determine by the electric test the extent of anzes-
thesia,.or loss of electro-muscular sensibility, in cases of paralysis, with-
out a previous knowledge of the normal sensitiveness of the parts to the
electric current and the normal feeling of electro-muscular sensibility in
the affected muscles, is simply impossible. From a want of this knowl-
edge very important mistakes are made in electro-diagnosis. In local
and general faradization a knowledge of the relative sensitiveness of all
the parts of the surface of the body enables one to make an application
which would otherwise be painful, and perhaps injurious, both painless
and refreshing. :
CHAPTER VII.
APPARATUS FOR ELECTRO-THERAPEUTICS.

.TueE general principles on which batteries are constructed, as wel
as minute description of some of the best known elements, have already
been presented in the section on electro-physics. In this chapter we pro-
pose to speak only of those combinations of elements that are used in
electro-therapeutics, and our descriptions will be of a general character,
having reference mainly to the practical use and care of them by the
electro-therapeutist.

Before entering on the description of apparatus a few general re-
marks maybe appropriate.

1. A good battery is not all that is necessary to make a good electro-
therapeutist.

There exists an impression, quite widely prevailing in the profession,
that the beginning and the end of the great science of electro-therapeu-
tics is to get a battery. This impression has wrought much evil. It
has been the means of leading physicians to invest time and patience
and money in a department for which they have no qualification. The |
purchase of a battery is simply a first step in the right direction ;
it is the beginning of a long road. -

One who uses electricity in medicine requires good apparatus, just
as the surgeon requires good instruments and the carpenter good tools ;
butas tools cannot make a carpenter, nor instruments a surgeon, so a bat-
tery cannot make one skilful in the tnerapeinical use of electricity. It is
not the battery, it is the brains, that makes 'a good electro. therapeutist.

2. The best and most recent apparatus is not so simple as to entirely
dispense with the need of care and experience on the part of the physi-
cian.

The advance in the construction of apparatus for electro-therapeu-
tics has been very great, but not sufficient to make it possible for
faradic or galvanic apparatus to keep in order without attention.

Just as the fire in the grate goes out unless the coal is replenished,
just as the gas is extinguished when the supply is shut off, so electricity’
328 APPARATUS FOR ELECTRO-THERAPEUTICS.

generated in a battery ceases to flow unless the metals consumed in the
chemical action are replaced or repaired.

The best and simplest of batteries will sometimes get out of order.
Unexpected contingencies will arise that demand some knowledge of
applied electro-physics. The knowledge can be obtained only by study
and experience.

3. Whatever choice we make in our apparatus at the present day, we
shall probably not make any very serious mistake. A few years ago it was
impossible to get a really good apparatus for electro-therapeutics ; now
it is almost impossible to get a really bad one.

4. An apparatus to which we are accustomed is much more tractable
in our hands than a far superior apparatus, the management of which is
newtous. It is with batteries as with babies—every man thinks his own
is the best. We see the same principle illustrated in instruments for
general and special surgery.

Continuous-coil and Separate-coil Faradic Machines.—There are in the
market, and in common use among physicians, two quite different forms of
faradic apparatus. In one of these forms which we call the continuous-coil
machine, the helix is composed of one long wire varying in thickness,
tapped at different points, so as to obtain different qualities of current.
This wire may be wound in‘three, four, or more coils. The inner coilis
usually comparatively short, and is of thick wire; the second coil is
longer, and of finer wire; the third still longer and finer, and so on ;
but the metallic connection is complete, and it is all a continuous wire.

The machines of Kidder, Hall, and others are of this construction.

In the sefarate-coil machines the helix is composed of two entirely

- separate and distinct wires ; the inner wire, which like that of the inner
coil of the continuous machine is short and thick, has no metallic con-
nection with the outer wire. The outer wire is longer and thinner than
the inner wire. The faradic machines of Stéhrer, of Drescher, and of the
Galvano-Faradic Manufacturing Company are of this construction.

The quality of the induced current generated by these two types of
machines are quite different. We have already seen (Electro-Physics,
p. 2) that electricity is a force—a mode of motion of the ether and of the
particles of the substance in which the force circulates. It follows from
this definition—if we accept it—that the quality of the current must be
modified by the nature of the substance through which it is conducted.
Every modification of the conductor, increase or diminution of its dia-
meter, increase or diminution of its length, or any change in its consti:
tution, must affect more or less the character of the current that flows
through it. Henceit is that the currents coming from the different points
SINGLE AND SEPARATE COIL MACHINES. 329

of the continuous-coil machine are somewhat, though slightly, different
from each other in quality and in their physiological effects. Hence also
the current from the separate-coil machine is quite different from that
coming from the continuous-coil machine.*

Single-coil and Separate-coil Faradic Machines compared in their
Therapeutic Effects.—The conclusions at which we have arrived on this
question are formed from avery wide experience with single and separate
machines, in public and private practice as well as from conversation and
correspondence with many physicians who are using one or both varieties,
and whom we have requested to study their comparative effects. Our
conclusions may be thus stated :

1. For nervous, hysterical, and greatly debilitated patients, and in
nearly all cases where general faradization is required, a single-coil ma-
chine is preferable.

This conclusion is based not on any physical, physiological, or theo-
retical considerations, but simply on clinical experience. Again andagain
have we attempted to treat nervous, delicate, and hysterical patients
with the separate-coil machine, and have been compelled by unpleasant
symptoms to return to the machine witha single coil. The reasons why
the current from the single-coil machine is less irritating and more agree-
able to delicate patients, are to be found in the physical differences of the
currents already referred to. This conclusion is not peculiar to our-
selves ; it is held by many, though’not by all, the electro-therapeutists
with whom we are acquainted.

It is not even necessary that the patient should be very delicate in
order to test this difference ; any individual of average strength and
health will appreciate without difficulty the general fact, that the cur-
rent from the one machine is more agreeable and less harsh and weary-
ing than the current from the other.

That the tonic and sedative effects of general faradization can, how
ever, be obtained by separate-coil machines, is proved in Germany
where the faradic machines in use are chietly of the separate-coil variety,
and general faradization is used there continually by the highest authori
ties in electrology, and with all the brilliant effects over nutrition that
we have in our writings claimed for it.

It must, however, be admitted that the Germans are much less sensi:
tive and nervous than the Americans.

But the advantages of a smooth and pleasant current are not confined

* Onimus, of Paris, has recently shown that helices formed of copper, silver, and
lead have a differential physiological action.— Four. de P Anatomie et de la Physiolo-
gie, Mars, 1874.
330 APPARATUS FOR ELECTRO-THERAPEUTICS.

to general faradization ; in localized faradization of the muscles of the face,
legs, and arms, and in applications to special organs that are irritable,
the current from the separate-coil machine is more irritating and un-
pleasant than that of the single-coil machine. In children with infan-
-tile paralysis, and in delicate women who perhaps are afraid of elec-
tricity, this consideration becomes one of practical importance.

On the other hand, there are very many cases, especially in public prac-
tice, where it is a matter of apparent indifference which current is used.

2. For patients who from idiosyncrasy or from disease are greatly in-
sensible to electricity, the separate-coil machine seems to be preferable
to that of the single coil.

Cases are not very uncommon, even among the better classes, where
there is enormous and inexplicable tolerance of electricity. Power-
ful and protracted applications leave them as they find them ; they are
not painfully felt during the sitting, and they leave no appreciable
effects behind them. In the anzsthesia that accompanies posterior
spinal sclerosis and certain injuries of nerves, the harsh and irritating
current of the separate-coil machine is not disagreeable at all, and ap-
pears to be, in our hands at least, more efficacious than the current from
the single-coil machine. We are, we believe, the only observers who
have called attention to this fact. Formerly we supposed that the dif-
ference in the quality of the current of different machines depended
mainly on the construction of the rheotome ; this view is not sustained
by our more recent studies in the department. It is the coil more than
the rheotome, and more than the kind of cell, that determines the
quality of the current, although the frequency of the vibrations as de-
termined by the rheotome has a decided influence

The Comparative Value of Slow Interruptions —There are a large
number of physicians who find or think they find a great therapeutical
advantage in slow interruptions to the treatment of paralysis. A blind
deference to authority has prevented a careful, original, and impartial
investigation of this subject, and statements of European writers and in
strument makers had been received without dispute, until we incidentally
spoke of our experience in the matter less than two years ago..

With a slow interruption a stronger current can be borne than with
a rapid interruption, and hence it sometimes happens that a paralyzed
muscle will contract under the former when it will not under the latter.
In occasional ‘instances this advantage niay be utilized for those phy-
sicians who have only the faradic and no galvanic apparatus.

For those who have a galvanic current of good strength the slow in-
terruption is unnecessary, even granted that it has some advantage over
331

FARADIC APPARATUS.

SSS SSS i
2 Mh

= | fl

 

ngement (Kidder).

Fic. 56.
Faradic Machine, with a tip arra'
332 APPARATUS FOR ELECTRO-THERAPEUTICS.

the rapid interruption in producing muscular contraction, for a strong
galvanic current interrupted will cause muscles to coritract that will
not respond to the faradic current whether slowly or rapidly inter-
rupted.

In this battery the cell is placed on pivots so that it can be easily
turned over go°. When upright, the metals are immersed ; when turned

“over, the metals are out of the solution. The stopper is of rubber,
and it is provided with a rubber funnel for the escape of the gases.
This arrangement is a very great advance on the old one, where each
time the machine was used, there would be pouring of the acid and
necessary spilling into and from a bottle.

For the past year we have used only this tip element, having dis-
carded entirely the old arrangement. It is not ornamental, but is very
convenient.

Smee's cell is a very convenient cell to take care of, and when not
kept too long immersed, or used with too strong solution, is very en-
during.

The current of Kidder’s faradic machine is a very pleasant one, and
is especially adapted for nervous and sensitive patients, on whom gen-
eral faracization is employed. The agreeable character of the currents
that come from it is to: be explained in part by the fact that it isa.
continuous-coil machine—all the different coils, from three to six in
number, being connected—and in part by the construction of the rheo-
tome ; but mainly, we think, by the former, since, as has been stated,
all separate-coil machines, other conditions being the same, give a
pleasanter current than single-coil machines.

The character of the current is, as we have seen, modified by the length
and fineness of the wire in the different parts of the coil. The inner
coil (A B) is of thick wire and is short, and gives a very mild current ;
the second coil (BC) is of thinner wire, and is longer, and gives a
stronger current; the third coil (C D) is still finer and longer, and gives
a still stronger current. The majority of these instruments have but
three coils; but in some of the larger instruments one or more coils
(E and F) have been added. All these coils are metallically con-
nected, so that they really constitute one long coil, varying in different
parts in the fineness of the wire.

All the currents that conie from this battery (A B, BC, C D, DE,
A D, AE, etc.) may, therefore, be regarded as modifications of the
primary current (see Electro-Physics, p. 62). Inasmuch as electricity
is modified by the nature of the substances through which it circulates,
it follows that coils of different length and fineness will give different
RULES FOR USE OF FARADIC APPARATUS. 333

varieties of currents ; this is found to be the case with the battery under
consideration. It is found that the currents vary not only in strength,
but in the nature of their effects, with the portion-of the coil from which
they come; that they cause different sensations when applied to the
body. The differential therapeutic action of these currents is too com-
plex to be readily or satisfactorily demonstrated.

RULES FOR THE USE AND CARE OF KIDDER’S FARADIC APPARATUS.

The directions that we give under this head will apply in gneral to
all, or nearly all, faradic machines, and, therefore, need not be repeated
in the descriptions of other machines that are illustrated in this
volume.

To prepare the Apparatus for Use.—Fill the glass jar with a solution
of water and sulphuric acid—one part sulphuric acid to eight or twelve
parts water. It is not necessary to be rigidly mathematical in regard to
the quantity of the sulphuric acid. The average proportion is one-
tenth, but it may range between one-sixth and one-sixteenth. The jar
should be about two-thirds filled with the solution.

It is also necessary to put about a teaspoonful of quicksilver in the
cup. This touches the lower end of the zincs and keeps them con-
stantly amalgamated. (See Electro-Physics, p. 43.)

The quicksilver should not be allowed to touch the central plate of
platinum, as it may injure it. In some of the modifications of this
apparatus it is necessary to close the prongs between one of the brass
posts that is labelled and the one in the middle that has no label.

The apparatus is now ready for action. If the spring does not at
once vibrate, give it a slight stroke with the finger. If it still refuses to
vibrate, it may be necessary to readjust the screw. If the spring
vibrates, but irregularly or too slowly, the evil may usually be remedied
by readjusting the screw.

Now connect the strings attached to the electrodes with the lettered
posts. A is always the positive pole, and B, C, and D are always nega-
tive relatively to A.

To distinguish the Poles.—It is always possible to distinguish the
negative pole by holding the electrodes for a moment in the two hands’;
the one in which the current zs strongest felt is the negative pole.

If the apparatus refuses to go, or if it stops at any time while in use,
the cause may be looked for—

1. In the screw of the rheotome or current-breaker. This may not
be properly adjusted. The point may be too far from the spring, or too
334 APPARATUS FOR ELECTRO-THERAPEUTICS.

clesely pressed upon it. This want of proper adjustment of the screw
is the most frequent cause of a stopping of the machine, and of the re-
fusal of the spring to vibrate. ‘The spring may sometimes be corroded
at the point where the screw touches it.

2. Ln the connection of the wires. The wires that unite the zincs and
platinum may not be properly screwed at their point of connection, or
may be corroded.

3. Ln the battery itself. The battery—that is, the zinc and platinum,
with the solution in the glass jar—may get out of order in four ways.
first, the solution may lose its strength. This difficulty may be reme-
died either by pouring in some sulphuric acid or by making an entirely
new solution, or by simply adding more water. Secondly, the zincs ray
become so corroded and incrusted as to become incapable of generating
acurrent. When the zincs have lost their amalgam, local action may
take place; this will be indicated by rapid evolution of hydrogen
Thirdly, a portion of the mercury may have fallen on to the platinum,
and covered it. When this happens, little or no current can be obtained.
When we have reason to stispect that stich is the case we should clean
them with an old tooth-brush or cloth, or amalgamate them. Fourthly,
the platinum and the zincs will, in time, by hard and long usage, wear
out, and will need to be replenished.

4. Ln the helix. It is very rarely indeed that the helix of this appar-
atus ever becomes so injuted as to become incapable of service. If,
after we have properly adjusted the screw and spring, made sure of the
connections of the wires, replenished the solution and cleaned the zincs,
the apparatus persistently refuses to go, we have reason to suspect that
something may be wrong with the wires that compose the helix. If
such be the case the evil can be remedied only by the inventor himself,
or, at least, by some one practically familiar with the construction of
helices. But we should try very patiently and perseveringly before we
accept the conclusion that the helix is thus out of order, for it is an ac-
cident of extreinely rare occurrence.

When no current is felt at the electrodes, although the apparatus acts
properly, we know that ¢e connection is broken somewhere in the insu-
lated conducting wires. Sometimes the union of the wires with the
electrodes is imperfect, and occasionally the wire in some part is broken.
Finally, the electrodes themselves may become very much corroded,
and may need cleaning before a good current can be obtained.

To take care of the apparatus. —When not in use, the element can be
taken out of the solution, When the tip battery is used, all that is ne-
cessary is to merely turn over the jar. If the element remains too long
FARADIC APPARATUS, 335

a time in the jar an incrustation of salt will sometimes accumulate on
the top of the zincs which will need to be brushed or washed off. ‘This
salt is the sulphate of zinc, resulting from the action of the sulphuric
acid on the zinc.

We may know that action is taking place in the battery when bub-
bles of hydrogen are rising up by the sides of the zinc.

Methods of modifying the Current.—The strength of the current of
this machine may be modified in several ways, as foliows :

1. It may be modified by withdrawing or pushing in the metallic, tube
that covers the helix.

When this tube ‘covers the helix an indefinite number of branch
currents are induced in it that interfere with the main current and
weaken it. In proportion as this is withdrawn, the induction of branch
currents, and the consequent interference with the main current, grows
less.

‘This method of modifying the strength of the current must be used -
continually both in general and localized faradization.

   
  
  

  

ETN

|
|

i
i
i
i

  

 

 

Fic. 57

Faradic Machine, separate coil, double cell, in box (Galvano-Faradic Manufacturing
Co,). F F are the two elements of zinc-carbon ; A A the rods by which the zine
is raised from, and lowered into, the solution; D the hammer, and 4 the helix
partly drawn out, These machines are run by one or two zinc-carbon cells
(Walker’s Battery, see p. 41, in Electro-Physics),

2. The current may be modified by increasing the quantity of the
solution, or of the sulphuric acid in it. This measure can be resorted
336 APPARATUS FOR ELECTRO-THERAPEUTICS.

to when the current fails to accomplish our purpose, even when the
metallic tube is entirely or nearly withdrawn.
3. When the current passes through the body of the operator, the

Fic. 58.
Faradic Machine, without the box (Galvano-Faradic Manufacturing Co, ).

 

current may be modified by increasing or diminishing the pressure of
the hand on the sponge connected with the positive pole. (See Gen-
eral Faradization.)
FARADIC APPARATUS. 337

‘The direction of the current can be changed, at any time, by revers-
ing the position of the electrodes, or by reversing the conducting wires
in the posts, or by the current-reverser, when one is attached to the
machine.

The faradic machines of this Company, besides being of the separate-
coil variety, giving both the primary and the secondary current, have
also a very convenient contrivance for producing slow or rapid inter-
ruptions,

 

Fre. 59.
Faradic Machine (continuous coil) (Thomas Hall),

The machine of Hall is a neat, compact arrangement, and gives a
very pleasant current. Chromated lead is used for the electro-nega-
tive element. One of the metals is raised out of the solution by a
very convenient spring, instead of the jointed-rod.

Magneto-Electrie Machines.—The magneto-electri¢ (or so-called rotary)
machines (see Electro-Physics, p. 69) are not much used at the present
day, and are not ordinarily to be recommended. They have been em-
ployed largely and indiscriminately, especially in this country, and have
done the cause of electro-therapeutics much evil. Although the cur-
rent afforded by them is well adapted to produce muscular contractions,
and is frequently of service in the treatment of paralysis, rheumatism,

and kindred disorders, yet, for all the wide range of diseases in which
22
338 APPARATUS FOR ELECTRO-THERAPEUTICS.

faradic electricity is indicated, it is neither sufficiently reliable nor suf-
ficiently effective. In most of the conditions of irritability, in which
generai faradization is most effective, this form of electricity, as generated
by most of the machines, is contra-indicated, on account of the rough
and disagreeable quality of the current.

Another very prominent objection to most of the rotary machines in
this country is, that they require the aid of an assistant to turn the
crank. This objection may be met by clock-work attachment. An
arrangement of this kind is employed by Dr. Morell McKenzie, of
London, in the treatment of paralysis of the larynx ; but even for this
special purpose it would seem to have no advantages, but positive dis-
advantages, as compared with a compact, convenient, and reliable
electro-magnetic apparatus as described in the preceding pages.

M. Gramme * has made a magneto-electric machine which furnishes a
continuous instead of an interrupted currént, which in its effects re-
sembles the ordinary galvanic current. The machine consists of three -
rings of soft iron, around which is an endless coil of copper wire. Each
of these rings rotates between the poles of a powerful magnet, and the
arrangement is such that the opposite currents in the halves of each
ring form a single continuous current.

The machine is turned by hand, and in its large form generates a
large quantity of electricity. It can produce all the effects of the ordi-
nary galvanic current. It makes platinum wire red hot, fuses metals,
and is. used in electro-plating.

If this machine can be reduced in size, and modified in shape, it may
become of value in electro-medicine and electro-surgery.

Galvanic Apparatus.—The merit of placing in the market, in an
accessible form, convenient and reliable galvanic batteries, was in this
country pioneered by the Galvano-Faradic Manufacturing Company.
Before the organization of this establishment the faradic machines of
Kidder and others had been long in use, but suitable galvanic machines
could not be obtained.

Hydrostat.—The hydrostat is an admirable contrivance for keeping
the fluid from spilling when the battery is carried in a buggy or ona
long journey. It consists of a rubber covering accurately fitted on the
top of the cells, and we have found it a most trustworthy arrangement.
A battery of sixteen cells, made by this company, we once took with
us charged three hundred miles into the country on a consultation, and
not a drop was spilled.

* Althaus on Medical Electricity, third edition, 1874, p. 88,
GALVANIC APPARATUS. 339

We may remark here that on the street or steam cars, a battery that
is charged will not usually spill. It is in omnibuses and in buggies that
the hydrostat is needed.

in

SERRE

SAE

SS RN

FIG. 60. 2
Thirty-two cell zinc-carbon office battery, with slide, current interrupter and reverser, and hydrostat
(Galvano-Faradic Manufacturing Company)

 

RUAN entre ni tin ngage

9
p

SACL MMA A

 

The zinc-carbon ‘batteries are also constructed on the same general
principle of sixteen and eight cells. The sixteen-cell combina‘ion is
340 APPARATUS FOR ELECTRO-THERAPEUTICS,

portable, and about as heavy, when charged, as a medium-sized valise,

well-packed.
The eight-cell combination is no heavier than a common faradic

machine, and when well charged gives a current of sufficient strength
for miny applications to the eye and head.

 

Fic. 61.
Sixteen zinc-carbon cell galvanic battery (Galvano-Faradic Manufacturing Com-
pany).

 

Two eighteen zinc-carbon cell batteries unted. These can be used separately or
together, as may be coriyenient (Kidder).
‘DIRECTIONS FOR GALVANIC APPARATUS. 341

Practical Directions for the Use of Zine-Carbon Galvanic Batteries.

The following directions will substantially apply to all or nearly all
forms of the zinc-carbon battery, by whomsoever manufactured.

ffow the Battery is Constructed and Used.—These batteries are com-
posed of plates of zinc and carbon in a solution of bichromate of po-
tass, sulphuric acid, and water. ‘The solution is contained in glass jars
that are raised up to the plates of zinc and carbon by the keys at. the
ends of the box, or by acrank. When the jars are raised by the keys

    

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Thirty-six large zinc-carbon cell galvanic battery, with circular switch, reverser, and
interrupter, for ae or hospital wu: se (Ki der).

to the top of the box, ¢urn the keys at right angles, or turn the crank,
2 the jars will stay in position, and the battery is ready for use, if the

a e properly filled with the elton:

Whe n the battery is not in use the jars sho uld be le nana from the
ea s of the keys. If allowed to r nersed day after
day the pies ry will rapidly lose its stre i See ee tro-Physics,
p- 42.)

How to Charge the Battery.—The solution is made in about the fol-
lowing proportions: sulphuric acid, 1 oz.; bichromate potass, 14 oz. ;
342 APPARATUS FOR ELECTRO-THERAPEUTICS.

 

Fic. 64,
Eighteen-cell zinc-carbon battery (Kidder),
DIRECTIONS FOR GALVANIC APPARATUS, 343

water, 10 oz. The best way to make the solution is to dissolve the bi-
chromate of potash in cold water and then add the sulphuric acid.
The mingling of the water and sulphuric acid causes great heat. Do not
use the solution until it is cool. We had not been able to get any sat-
isfactory explanation of the fact that solutions when /of injure the bat-
tery, until Prof. Brackett, of Princeton, informed us that from experi-
ments he made several years ago he proved that when the bichro-
mate of potash solution is used hot a layer of ozone is formed on the
carbon ; this at once weakens the current.

Lift out the plates by the middle piece to which they are attached,
lift up the jars by the keys and fill each jar with two, or three, or three
and a half ounces of the solution. They should be filled pretty uni-
formly, and care should be taken that no more should be put in than the
jars will hold after the plates are immersed.

How to clean the. Battery and Amalgamate the Zincs.—Every few
weeks or months, according to the extent to which the battery is used,
it will be necessary to wash the plates and scrape off the exudation and
renew the solution, or, at least, to add more acid or water, and amalga-
mate the zinc. The chrome alum that collects in the bottom of the jars
(see Electro-Physics, p. 42) and becomes very hard can be softened by
allowing warm water to stand in the jars for a time, and then loosening
the deposit with any sharp instrument. A good way to amalgamate
the zincs is, take a strip of zinc, dip it in a solution of sulphuric acid
and water, then dip it in mercury; the mercury will adhere to and run ,
over it; then rub up over the surface of the zincs of the battery until
all are well covered with mercury. During the process of amalgama-
tion the zincs should be kept well moistened with a solution of sul-
phuric acid and water. (See Electro-Physics, p. 43.)

Flow to tell the Strength of the Current.—Those who have no galva-
nometer can tell whether the current is running and how strong it is by
putting one pole in the hollow of the hand and the other between the
thumb and forefinger. The poles should be wet with salt water or
simple warm water. Those who have been accustomed only to the
noisy and violent faradic (induced) current, will be disappointed to fad
that this galvanic current causes only a slight burning sensation, with no
shocks except when interrupted. A current that is scarcely felt when
applied in the hand, may be too strong to apply to the head, or face, or
neck. Zhe greatest mistakes are made by using the galvanic current

.too strong. ;

How to distinguish the Poles.—The current is felt strongest at the

NEGATIVE POLE. When both poles are dipped in a solution of iodide
344 APPARATUS FOR ELECTRO-THERAPEUTICS.

of potassium, the brown color of the iodine appears at the POSITIVF
POLE.

Chromated Lead as an Electro-Negative Element.—George Beards
ley, of Brooklyn, has patented the discovery of chromated lead as 4
substitute for carbon in the battery.

The recognized disadvantages of carbon are that it is easily broken,
that it absorbs gases, and that it does not conduct as well as could be
wished.

The position of chromium in the series of elements would indicate that
it would be a superior electro-negative, but pure chromium in the metal-
lic state cannot be obtained. That lead makes a good electro-nega-
tive has long been known.

Mr. Beardsley covers lead with powdered chromium just as silver is
covered with powdered platinum. The result is a flexible, light, neat,
not easily breakable electro-negative, which can be used as a substitute
for carbon, for platinized silver or copper in the ordinary galvanic bat-
terles.

Its apparent advantages, which experience must test, are these :

1. It conducts better than even the best carbon. Hence it gives
more electro-motive force.

2. It gives a steadier and more enduring current, according to Gen-
eral Abbott, of West Point, who has experimented extensively with this
and other elements, trying them by the most elaborate tests. The cur-
rent from a battery, of which the chromated lead is one of the ele-
ments, not only maintains its strength, but actually increases in strength
during a pretty long use, while the ordinary Smee’s and zinc-carbon
batteries diminish very markedly.

3. It is less friable than either platinized silver or carbon.

Platinized silver, as every one knows, is liable to be injured by the
mercury in the Smee’s cell. To these advantages it may be added,
that chromated lead is quite inexpensive. It may be used with sul-
phuric acid solution, with bichromate of potash solution, or with sal
ammoniac that is employed in Lechanché’s battery.

The Cabinet Battery.—A little more than a year ago it was sug-
gested to the Galvano-Faradic Manufacturing Company the possi-
bility of arranging a combination of sixty or more Siemens-Halske
elements of moderate size, in such a way that all the cells and all the
connections and appliances should be contained in a small movable
desk or bureau. The suggestion was made in: the belief that all the.
supposed or real advantages of the combinations of large cells that
-are usually placed in cellars or basements, and connected by wires with
THE CABINET BATTERY. 348

the operating room, could be secured at far less trouble by a simple,
convenient, and accessible arrangement, in which many of the difficulties
connected with removal, cleaning and overhauling should be reduced
to a minimum.

In the roughest possible manner a general plan of a bureau with
drawers and cover was drawn and it was further suggested that it would
be well to have a current-selecter, current-reverser, rheostat, and gal-
vanometer interposed in the circuit, and that the appliances should all be
in a plane surface at the top; and that the drawers containing the cells
should be so made that they could be easily taken out whenever neces-
sary to inspect and replenish the battery. We thought little more of
the matter until November last, when the Company called our attention
to the fact that they had completed a battery which they called the
Cabinet battery, and which is represented in the accompanying cut.

| —

te

yt

| |
I

HH i

 

The Cabinet battery is so simple that a very brief description of it
will be sufficient. The Siemens-Halske cell is merely a modification of
346 APPARATUS FOR ELECTRO-THERAPEUTICS.

Daniell’s cell. It consists of a small cylinder of glass, attached at the
bottom to a cylinder of porcelain. In this cylinder is placed a coil or
ribbon of copper, and a little water. Outside of this cylinder is a cylin-
der.of zinc, and the space between it and the outer glass jar is sawdust
on the top, and at the bottom powdered papier-maché packed closely,
and wet with water slightly acidulated with sulphuric acid. The object
of the sawdust and papier-maché is to hold the fluid and avoid spilling
and to make the action of the battery gentle and uniform. A cork
is placed in the cylinder so as to prevent mingling of the fluids-of the
outer and the inner cells.

These cells, like ali modifications of Daniell’s cell, are very con-
stant ; that is, they give a steady and uniform current, and can be used
for a long time without recharging. It is necessary, now and then, to
drop a little water into the inner cylinder to make up for the loss by
evaporation, and to put in a few pieces of sulphate of copper ; this,
however, can be very easily done by pulling out the drawers and
removing the corks. Each cell is about the size of an ordinary
tumbler. There are three drawers, each containing twenty cells.

The metallic connections of the cells are made at the back part of
the drawer, and are completed when the drawer is well pushed in. On
the top of the bureau are the current-selecter, by which one cell or
sixty cells can be brought into the circuit; the current-reverser; the
short-coil galvanometer for indicating the presence and direction of the
current merely, and the hydro- or water rheostat, for gradually increas-
ing or diminishing the strength of the current. J

The water rheostat is the perfection of neatness and convenience,
and is differently arranged from any that we have seen. The water is
contained in a small case or cup, with a glass top. By turning a small
brass disk, connected with a brass lever, a small or large area of the
water can be brought into the circuit. Beside all the appliances for
the galvanic current, this Cabinet battery also provides the faradic cur-
rent. I'wo Lechanché cells in the upper drawer are connected with a con-
tinuous coil and interrupter, on the right hand of the top of the bureau.
The faradic current can be increased or diminished by pulling out or
pushing in a metallic rod in front of the top piece.

The advantages of this Cabinet combination are these :—

1. Zt is very easily moved and managed. The whole Cabinet, con-
taining sixty cells, the electrodes, connections, etc., for both currents,
and the cover to place over the top, is but three feet high and seven-
teen inches broad. It is placed on castors, and can be easily moved
from one ward of a hospital to another ward, or about the room, by one
THE CABINET BATTERY. 347

person, as easily as an ordinary centre-table. The combinations of
Daniell’s cells are generally placed in the cellar, and the apparatus
throughout is permanent, and when the physician wishes to move his
office the labor of resetting the battery is very great. This combina-
tion, without taking out the drawers, can be transported bodily from
one house to another as easily as any bureau the drawers of which
are filled with heavy goods,

Although the battery will probably go for years without thorough
overhauling, yet occasional inspection and Tefilling will be required,
and can be very easily performed. :

2. Lt gives a constant, uniform, and steady current ; and is, therefore,
better adapted for the treatment of irritable and sensitive conditions than
the small cells of the ordinary portable batteries.

This advantage it shares with all modifications of Daniell’s battery.
The explanation of the constancy and steadiness of the current from
these combinations of Daniell’s cells is found in the fact that on. ac-
count of the feebleness of the solution, and the interposition of the
porous cell, the chemical action is slow and uniform, with no inter-
ruptions or even variations. In the single zinc-carbon cells the solution
is very strong, and the chemical action very vigorous; the plates are
rapidly polarized; the density of the solution, and with it the inter-
nal resistance of the battery, is continually changing as a result of the
vigorous chemical action, and consequently the strength of the current
not only diminishes after a protracted use of the battery, but 7 varies
from moment to moment.

‘The potential quantity of electricity may’be the same in a combina-
tion of single zinc-carbon cells, as in a combination of sawdust Daniell’s
cells, and may even be far greater; but there is great difference in the
1apidity with which they evolve it. For short work, such as is required
in powerful electrolytic operations, the single zinc-carbon cell is far
preferable to the Daniell, for the reason that the quantity of electricity
that it generates in a short time, say half an hour, is very much greater
than a similar number of Daniell’s cells would generate in the same
time. This Cabinet battery is therefore not a good battery for elec-
trolysis, and we never attempt to use it in any important electrolytic
operations. In experimenting with it we find that it causes but a very
feeble decomposition of iodide of potassium, or chloride of sodium,
It could not indeed be otherwise ; in electrolysis, as everywhere, force
answers to force; the amount of chemical action owfside of the cell—
electrolysis—must. be proportioned to the amount of chemical action
inside of the cell. In the Daniell’s cell the chemical action is very slow
348 APPARATUS FOR ELECTRO-THERAPEUTICS.

and feeble ; hence, the electrolysis it causes is slow and feeble, but it
is constant and steady; it does not give out so much electricity in an
hour as the single zinc-carbon cell, but it continues to give it out long
after the zinc-carbon cell is exhausted.

_ Two men have each a thousand dollars; one spends recklessly, rap-
idly, and extravagantly, and in a few days is penniless: the other
spends regularly and slowly, and uniformly, one dollar each day, and
makes his thousand dollars last a thousand days. The single zinc-car-
bon cell makes an extravagant battery ; but in electrolysis extravagance
is neecled, and besides the solution can be removed from the plates, so
that no action can take place when the battery is not needed. The
Daniell’s cell makes an economical battery, since it spends slowly and
regularly, even though it is kept constantly immersed. Hence its ad-
vantage in the treatment of the neuralgic, the hysterical, and the nerv-
ously exhausted, who in some cases, at least, require to be treated with
feeble, mild, steady, and faduless currents. The current from these
Daniell’s cells is less painful than the current from small and active
cells, for the reason mainly that it is more uniform.

The notion entertained by some that these large double-cell batter-
ies send a larger guantity of electricity through the body than small
cells, is at war with Ohm's law, and has no foundation in experience.
The resistance of the body is so great in comparison with the internal
resistance of the batteries, that it makes but little difference in regard
to the quantity of electricity that flows through the body whether the
cells are large or small. Asa matter of fact, the small single zinc-car-
bon cells, or even the ordinary Smee’s cell, give larger quantity of elec-
tricity for a short time than the large Daniell’s cell. (See Electro-
Physics, pp. 77-95-)

The arrangement in Fig. 66, is very light, compact, and portable.
The cells are quite small, and of course need refilling more frequently
than larger cells. The cord spools (S S) are convenient contrivances
for winding up the cords when not in use.

These batteries are made also of ten, twenty-four, and forty cells.

The combination in Fig. 67, embraces both the faradic and the gal-
vanic currents, forty zinc-carbon cells—and a rheostat. ‘The same coil
that furnishes the faradic current can also be enclosed in the circuit
of the galvanic current so as to form a rheostat. Connected with the
apparatus, on a board in front of it, is a current-reverser, a current-
interrupter, and a galvanoscope.

The faradic current is supplied by a continuous coil with many wind-
ings, and gives a very pleasant current.
THE CABINET BATTERY. 349

These batteries (Fig. 68, p. 351) are of twelve, or twenty-four, or thirty-
six cells. The general construction of the Lechanché cell has already
been described in Electro-Physics.

Curt W. Meyer also manufactures a combination of Lechanché’s cells
that is conveniently portable, and is said to be quite enduring. These
small Lechanché cells are not as enduring as those of a larger size, and
when frequently used must be frequently cleaned, like the zinc-carbon
batteries.

Raines’ Battery.—Prof. George W. Raines, of Augusta, Georgia, has
described * a portable galvanic battery, composed of strips of zinc and

i

\

is)

i

  

Fic. 66.

Portable galvanic battery, twenty zincscarbon cells (Drescher),
platinum, united by copper strips in the shape of the letter V inverted.
These zinc and platinum strips thus united are passed through holes
made in a rubber plate, beneath which is a square trough of rubber, di-
vided into forty-nine cumpartments or cells. These cells contain the
acid solution, which can be raised to the metallic strips so as to immerse
them. ‘The whole battery is about the weight of a No. 4 faradic ma-
chine of the Galvano-Faradic Co.’s manufacture.

Galvanometers or Galvanoscopes.—-Yhe general principles on which
galvanometers are constructed have been already described (Electro-
Physics, p. 46).

A galvanometer which, by Dr. Rockwell’s suggestion, was made by
Messrs. Chester & Co., is represented in the cut. It is of the long-coil
variety, and is provided with a “shunt,” which has a resistance equiva-
lent to 150 miles of telegraph wire. This galvanometer measures with

* Scientine American, September 28, 1872.
 
GALVANIC APPARATUS. 351

 

AISTED—FARWELL—SO.

Fic. 68.

Portable Beetz-Lechanché battery, twenty cells (Thomas Hali).
considerable accuracy the strength of the galvanic current, since the de-
flection of the needle is in tolerably exact proportion to the number of
cells introduced into the circuit. Itis very useful, therefore, in compar-
ing different batteries, or the same battery at different times, in order to
determine how much power it has lost. When a thirty-two-cell zinc-
carbon battery is in perfect order .it will detlect the needle of this gal-
vanometer from 40° upwards ; fifteen cells will cause a deflection of
about 20° or 25°, ‘The deflection of the latter part, when a large num-
ber of cells are introduced, is not exactly proportional as in the first
part, but sufficiently so for all practical uses.

The ordinary “ short-coil” galvanometers (galvanoscopes)are so deli-
cate that one or two cells send the needle round.to go®, and are there-
fore useful only to determine the presence and direction of the current.
352 APPARATUS FOR ELECTRO-THERAPEUTICS.

  
 
 

   
 

  

9 Ai f
i un

 
  
 

SSS
SSS

Fic. 69.

Brenner’s Apparatus, including Stopper Rheostat, Galvanoscope, Faradic Coil, etc.

(Galvano-Faradic Manufacturing Co.), This apparatus may be connected with
any desired number of large cells in the cellar,

Rheostates.—The general object and principle of the rheostat has
been already described (Electro-Physics, p. 48). It remains here to
speak of those forms that are best adapted for electro-therapeutics,

 

Fic. jo.
Galvanometer used by the Authors, (Chester & Co.)

A form of rheostat, very well known to electro-physiologists and
electro-therapeutists, is that of Siemens, and introduced into electro-
therapeutics by Brenner in his researches on the ear. The unit of
Siemens is a column of mercury, one metre long, with a transverse sec-
tion of one square millimetre at 32° F, The rheostat may contain
1,110 or 2,100 units, The metallic blocks or pieces on the top are
attached to insulated coils of wire, which in their length correspond to
RHEOSTATES. 69

 
      

ii
ii

Fic. 71.

Siemens’ Stopper-Rheostat.—On the circle B, the metallic disks are numbered by
units from o to 10; on the circle C, by tens, from o to 100; on the circle D,
by hundreds, from o to 1,000. To use the rheostat, connect the wire A with
one of the poles of the battery, and the wire E with one of the electrodes: in
this way the resistances of the rheostat are included in the circuit, constituting
what is called a ‘‘ secondary closure.”

the numbers 1, 2, 3, 4, 5, 6, 7, etc., 10, 20, 30, 40, 50, 60, etc., Too,
200, 300, 400, etc., marked over them. At the central end of each divi-
sion of the star-shaped top-piece there is a hole for receiving the stop-
per. When all the stoppers are inserted in the division marked a,
there is no resistance in the rheostat, and the current goes directly
through it, and not at all through the body of the patient, for the rea-
son that metal conducts electricity very much better than the body, and
when it has a choice it will take the path through the best conductor.

When new, the stoppers are inserted so that somé of the coils of wire
connected with the divisions of the top-piece, say those marked 5, 50
500, are brought into the circuit, the current will have to overcome not
only the resistance of the metallic connections, but also the resistance
of 550 Siemens’ units, represented by corresponding lengths of copper
wire, and by preference much more of the current will pass through the
body. If all the resistances, 1,110 or 2,100 units, are interposed,
most of the current passes through the body. If all the stoppers are
removed, a part of the current goes through the rheostat.

Rheostat of Mayer & Wolff.—Mayer & Wolff, of Vienna, have
constructed a simple form of rheostat—a wooden box containing coils
of wire corresponding to 1,605 Siemens’ units.

Hydro-rheostat (water rheostat, or liguid rheostat).—For all the prac-
tical purposes of electro-therapeutics, even for the most delicate appli-
cations to the most delicate organs, as the ear, eye, etc., the common
water theostat—or, as it is sometimes called, hydro-rheostat, or liquid

23
354 APPARATUS ‘FOR ELECTRO-THERAPEUTICS.

theostat—is sufficiently precise, and in convenience is incomparably
superior to the stopper rheostates. ?

The water rheostat, represented in the cut, is simply a column of
water, interposed in the circuit, and so arranged that the distances be-
tween the extremities of the metals that close the circuit through the
water can be increased or diminished at pleasure.

 

Fic 72.
Hydro-Rheostat (Galvano-Faradic Manufacturing Co.).

The precision that physiologists and physicians obtain by the use of
the stopper rheostat is more apparent than real. A study of Ohm's
law will show that the quantity of electricity that flows through the body
in any electrical application, depends not alone on the nature of the
conducting wire, and the number of cells employed, but also on the
nature of the electrodes, the quality and degree of moisture in them,
the amount of pressure used, their distance from each other, and the
part of the body that is treated. Those who are particular to state the
number of cells employed, and the number of units interposed, are
therefore much less precise than they suppose ; for, besides all the qua-
lifications just given, the strength of even the most constant cells varies
more or less from time to time (see chapter on Ohm's Law, pp. 77-95.)
Reports, therefore, that contain in full detail the number of elements
employed, and the number of units interposed in the circuits, are appar-
ently but not really precise ; the careful physiological researches on defi-
nite and very limited portions of tissue, the statement of the kind of cell
employed, and the number of them and the number of resistances of
ELECTRODES. 355°

the rheostat interposed, may convey an approximate idea of the
strength of current, and thus may be of service to other investigators,
but in the very nature of things they cannot be accurate. In the ordi-
nary applications of electro-therapeutics, unless it be limited electroly-
sis, we oftentimes state the number and kind of cells employed, but
always with the implied proviso that we are suggesting approximate and
not mathematical truth.

So far as producing delicate shades and grades of sensation is con-
cerned, the water rheostat, when properly constructed and adjusted, is
fully as trustworthy as the stopper rheostat, and far more convenient
for the operator. A rheostat of some form, though not indispensable
in electrical applications, is yet a great convenience, and, especially in
central galvanization and in local galvanization of the nerve-centres, a
very great convenience. In ordinary peripheral applications, unless it
be to very sensitive parts, the rheostat is not required.

Electrodes. —Of the many varieties of electrodes, we ‘shall describe
those only that are practically useful.

 

Fic. 73.

Universal Handle for Electrodes, with Interrupter (Galvano-Faradic Manufacturing
Co.).

 

2 Fie. 74.

Universal Handles for Electrodes, with Interrupter—insulated (Galvano-Faradic Man«
ufacturing Co.).

‘The peculiarity of these handles (Fig. 74) is, that there is no exposed
metallic surface, the connection being made at the closed ends. A dis-
advantage of these electrodes is that they can be used only with one
conducting wire, to which they are permanently attached.
356 APPARATUS FOR ELECTRO-THERAPEUTICS.

   

Fic. 76.
Our electrodes of various sizes :
in graduated series, to be at- Fic. 77.
tached to universal handles Hard Rubber Handle
FIG. 75, (Kidder and Galvano-Faradic and Electrode, with
Long Sponge Electrode, Manufacturing Co.), ~ Interrupter (Kidder),

 

Fic. 78, Fic. 79.
Plain Wooden Sponge-holder, Small Sponge Electrode (Kidder),
with Sponge attached (Kidder). ;

   

Fic. 80, Fic, 81.

Duchenne’s Electrode. Rockwell’s Brass Ball Electrode for
General Faradization (Kidder),

A large, soft sponge, loosely folded about this ball, makes the most
convenient possible electrode for general faradization.
ELECTRODES. 357

 

Fic. 82.
Beard’s Stationary Electrode (Galvano-Faradic Manufacturing Co.).

This can be screwed to the edge of a table. The sponge at the top
can be unscrewed and moistened. In many applications to the ear

 

: Fic. 83. .
Adjustable Electrode, with Band—(Kidder),

eye, head, and face this is a most convenient electrode for the hand of
the patient to rest upon.
*

358 APPARATUS FOR ELECTRO-THERAPEUTICS.

These adjustable electrodes, which are made of several different
sizes, have long been to us indispensable. They can be fastened by
means of a simple cloth band to any part of the body, and kept there
as long as may be necessary.

In diseases of the skin, in rheumatism, in sprains, and in tumors, and
in all cases where it is desired to keep the electrode long in one spot,
they are most convenient. A second advantage which they have, is,
that they can be passed easily under the clothing, thus saving much
undressing on the part of the patient.

These adjustable electrodes can be covered with a sponge, which can
be sewed through the hole at the edge, or what is very much better,
with electrode covers, to be hereafter described.

We use these adjustable electrodes in central galvanization, galvan-
ization of the cervical sympathetic, and brain and spine, and in a large
variety of peripheral applications. In some applications, as in central
galvanization, one electrode is adjustable, while the other held by the
patient is of the ordinary form with a handle. We do not munch use
the bands that accompany them, preferring to hold the electrode in
position by allowing the clothing of the patient to rest against it, or
having the patient hold it, by a little pressure.

Tn galvanization of the sympathetic, for example, the adjustable elec-
trode can be easily placed under the collar at the back of the neck,
and kept there by the pressure of the clothing.

  

Fic. 85.
Beard’s Adjustable Electrode—small Flannel Cover for Adjustable Elec-
size—with flannel cover, trode—small size.

These flannel covers are provided with elastics in their edges so that
they remain in position when put on the electrode, and are easily slipped
off and on. They can be washed like towels, and the expense of mak-
ing them is so slight, that a large number can be kept constantly on
hand. Another advantage of these flannel covers is that the current is
more painfully felt through them than through sponges, and hence there
is, while using them, less liability to give too strong currents. We have
long been accustomed to use these covers in all central applications of
the galvanic current.
ADJUSTABLE ELECTRODES. 359

  

Fre. 86. Fic. 87.

Adjustable Electrode, with sponge (Gal- Oblong Adjustable Electrode (Gal
vano-Faradic Manufacturing Co. ). vano-Faradic Manufacturing Co.).

These adjustable electrodes with sponges are very convenient for
application to patients confined.to bed. They may be placed under
the patient against the back, or on the abdomen, or on any part of the
body, without seriously disturbing the position of the patient.

   

Fic. 89. FIG. go.

Metallic brush The same with brush pushed within Spinal Electrode.
(Kidder). the cylinder for protection. Galvano-Faradic M’fg. Co.

A current-reverser with flexible electrodes.—Cut 91 represents a cur-
rent-reverser recently devised and perfected, and which was first con-
structed by Messrs. Tiemann & Co. It is now also made by the Gal-
vano-Faradic Manufacturing Co.

It differs mainly in this feature from other devices to accomplish the
same purposes, viz.: that the current is reversed by simple and slight
360 APPARATUS FOR ELECTRO-THERAPEUTICS.

pressure of the thumb, without the intervention of a slide, or any com-
plex arrangement whatsoever.

The letter D represents the button of the spring, by pressing which,
the current is interrupted or reversed. Pressing it lightly, iaterrupts
the current ; pressing it firmly, reverses it.

il GATIE

=== ae
SF] FMANN &CO. |
ee

 

Fic. gt.
Beard’s Current-Reverser, with flexible electrodes,

In the vertical section of the hard rubber handle, A A is represented
as springing up against the metallic plate on the upper and inner sur-
face of the handle. Pressing this slightly down, metallic connection is
broken and the current is interrupted; pressing it firmly down, the
connection is made and reversed at B B, the metallic plate on the lower
surface of the handle.

C represents the wires that connect with the battery, enclosed in a
rubber tubing E.

F and G are flexible wire electrodes armed with sponges ; they can
be separated several inches and kept there, or put close together as
represented in the cut. The advantages of this‘ are these :—z. In
many of the applications of localized electrization this neat and simple
arrangement saves considerable expenditure of muscle on the part of
the operator. One hand can be perfectly free while the other. holds
and guides the electrode. In electrizing the muscles of the hand and
arm, and of the face especially, it is far more convenient than to use
separate electrodes.

2. In cases of paralysis of motion and of sensation, where volfaic
alternatives are sometimes indicated, this is the easiest conceivable
method of reversing the current. We find the arrangement of the flexi-
UNPOLARIZABLE ELECTRODES. 361

ble electrodes very convenient in external applications to tumors, rheu-
matic joints, and sprains.

The special electrodes that are needed for local applications to spe-
cial parts, as the eye, the ear, larynx, cesophagus, rectum, vagina, ute-
rus, bladder, urethra, and so forth, will be described in the chapters de-
voted to the electrical treatment of these organs. We propose here to
represent and describe only those that are of general use in all the or-
dinary applications, both of general and localized electrization.

The variety of shapes and modifications that may be given to elec-
trodes is limited only by the taste, inclinations, and peculiarities of the
operator. In describing those that we chiefly use and recommend, we
do not desire to give the impression that we regard them as better than
have been or may be devised by others; but simply that they have
satisfactorily answered our purposes, and will, we believe, in the main
be satisfactory to others.

Onpolarizable Electrodes.—It is well known to electro-physiologists
that in consequence of the electrolytic changes that take place during
the passage of a current from the electrodes to the body, a change
takes place at the surface of the electrodes, by which a new electrical
action is set up that to a certain extent interferes with the main current
and also causes pain. Electrodes thus affected are called polarized.
(See Electro-Physics, p. 37.)

Dr. Hitzig,* of Berlin, has devised electrodes in which this secondary
electrical action at the surface does not take place; to these he has
given the name uwsfolarizable electrodes. These are made unpolariza-
ble by a solution of sulphate of zinc. By the courtesy of Dr. Hitzig,
we were enabled to test them while in Berlin, and were favorably
impressed with their action. The pain produced by stable galvanization
is sometimes very disagreeable, and by these electrodes it was certainly
diminished. They can be used several hours without exhibiting any
polarization. The subject of unpolarizable electrodes had previously
received the attention of Regnauld, Matteucci, and Du Bois-Reymond.

Rubber Covers for Conducting Wires.—The conducting wires con-
necting the electrodes with the apparatus are covered with silk ; they
may be still further insulated by flexible rubber. We have long been
accustomed to use these rubber covers, and are much pleased with
them. If the rubber is properly prepared it will not injure the silk
covering beneath it. Some electro-therapeutists have rubber coverings

* Ueber die Anwendung unpolarisirbarer Electroden in der Electrotherapie, Ber-
iner Klinische Wochenschrift, 1867, No. 89.
362 APPARATUS FOR ELECTRO-THERAPEUTICS.

of a different color for the two poles, thus affording a ready means of
distinguishing them.

Care of Electrodes.—Electro-therapeutics is a series of details ; and
among the more important of these details is the care of the electrodes.
The chemical action, even of the secondary coil and faradic current, is
sufficient to corrode any metal that is used, except platinum ; and plati-
num electrodes are rarely, if ever, used except in electrolytic operations.
The copper plates used at the feet in general faradization become more
or less corroded and require occasional cleaning, in order to keep them
bright. All the general and special electrodes of all kinds require oc-
casional polishing with sand-paper, emory-paper, or whiting. It is an
advantage to have the electrodes, as well as the batteries, nickelized,
so as to reduce corrosion to a minimum.

The sponges that are attached to the electrodes need to be frequently
washed in warm water, and those that are much used should be occa-
sionally disinfected with chlorinated solutions. It is better, however, to
make delicate and particular patients, especially ladies, supply their
own sponges. But a physician who has a large general or special
practice will find it very difficult, if not impossible, to keep a large as-
sortment of electrodes, sponges, and electrode covers always separate ;
and hence it becomes necessary to treat many of the patients with the
same electrode. To meet this difficulty we devised the electrode covers,
elsewhere described. ‘These can be thrown off with every application
and washed weekly, like towels. The expense and labor of making
them is so slight that some electro-therapeutists, after using them a few
times, cast them aside entirely.

European Batteries.—¥or the sake of our European readers, we give
very brief descriptions of a few of the batteries that are at the present
date most used by European electro-therapeutists. All who consult
this book—Americans as well as Europeans—may find it of interest to
compare the workmanship of the different countries. A fact which such
a comparison constantly suggests is, that all advanced and active electro-
logists in all countries have realized the same difficulties and wants of
the specialty, and have sought to overcome them by similar or nearly
similar methods, and nearly all have in a greater or less measure succeed.
ed. On the whole, with special advantages or disadvantages on both
sides, the American batteries for the faradic current, the galvanic cur-
rent, and for the galvano-cautery, are superior to the European.*

* For the electrotypes of the cuts that accompany these descriptions of the English
apparatus we are indebted to the kindness of Dr, Althaus. The descriptions are con-
densed from the third edition of his treatise on Electricity.
EUROPEAN APPARATUS. 363

This is enclosed in a small mahogany box, six inches high, three and
a half inches deep, and six inches wide. It is run bya zinc-carbon cell.
The primary and secondary currents are obtained without shifting the
position of the wires.

 

Fic. 92.
Meyer and Meltzer’s Faradic Machine.

/

Stéhrer’s Faradic Machine.—This well-known separate-coil machine,
which is run by a zinc-carbon cell, is widely used in Europe.

, Duchenne's faradic apparatus is of the separate-coil variety ; it is
inferior in portability and convenience to many other European as well
as to the American machines. It is run by a Bunsen’s cell.

Legendre's faradic apparatus is popular in France, on account of its
portability and cheapness.

Gaffes faradic apparatus is very portable, and gives a fair strength
of current. He has made two forms of faradic machines, one run by
a chloride of silver element, and the other by a sulphate of mercury
element.
304 APPARATUS FOR ELECTRO-THERAPEUTICS,

Du Bois-Reymond’s faradic apparatus, or “ sledge,” as it is called, is
run by an element of Grove or Bunsen. It is provided with a “ gal-
vanic key” for opening and closing the circuit at pleasure. The ma
chines of Benedict and of Siemens-Halske are modifications of that of
Du Bois-Reymond.

Kriger & Hirschmann, of Berlin, have constructed a good faradic
machine, which is run bya Lechanché element. It is arranged for slow
or rapid interruptions,

So far as we are able to learn, none of these machines have any
special advantages over those of American manufacture previously
described, and some of them are much inferior to the most recent
American improvements, .

Stéhrer’s Zine-carbon Galvanic Battery.—Dr. Emil Stohrer, of
Dresden, is the pioneer in the art of making convenient and trustworthy
galvanic apparatus for electro-therapeutists. He makes combinations
of zine-carbon cells, both portable and non-portable. He was, we be-
lieve, the first to devise convenient and simple current-reversers and
current-selecters. These batteries have the disadvantage of all zinc-
carbon batteries, that the carbons are friable. They also polarize
rapidly, though not so rapidly as Smee’s cell, and if the plates are kept
long in the solution the current becomes very weak.

Foveaux's battery (Fig. 93), which is quite portable, consists of from
twenty to fifty small Smee’s cells. It is furnished with a switch, by
which any desired number of elements can be brought into the circuit.
It is provided with a dial or current-selecter, for bringing any number
of cells into the circuit. The jars are ade of hard rubber or porce-
lain. ‘The tray containing the jars is lifted and let down at pleasure.
This battery is much used in England. It has, however, the disad-
vantage of all constructions of Smee’s cells, that it rapidly polarizes
and weakens. We prefer similar combinations of zinc-carbon cells.

Becker-Muirhead or Siemens-Meidinger Stationary Galvanic Bat-
tery.—This battery, which is highly praised by Althaus, consists of
fifty modified Daniell’s cells. No acid is used in it, but only water for
the zinc surface and sulphate of copper for the copper surface. The
cells, which are quite large, are kept down cellar, and contained in two
boxes. The advantages of this battery are, that on account of no acid
being used the chemical action is very feeble, and polarization is re-
duced to a minimum; and that, like the Cabinet battery, on account
of its steadiness of action, it is better adapted for nervous and irritable
patients than the small batteries.
 
366 APPARATUS. FOR ELECTRO-THERAPEUTICS.

good indeed, would appear to be inferior in convenience to the Ameri-
can Cabinet battery, previously described.

 

Fic. 94.
Mayer & Meltzer’s Portable Galvano-Faradic Apparatus,

The idea of combining both currents in a single apparatus seems to
have occurred almost simultaneously to the electrologists and mecha-
nicians of Europe and America. The practical advantages of any
combination that has yet been offered are not, for portable use at least,
so great as was expected. The galvanic current which they give is apt
to be too feeble for all occasions, and the size of the apparatus is
much larger than is needed for the faradic current alone. on of

This apparatus of Meyer & Meltzer is provided with a galvanoscope,
current-selecter and current-reverser. It is so arranged that the- first
or the last portion of the cells may be used at pleasure, thus avoiding
the disproportionate use of the first portion. Zinc-carbon cells are
used, and they are raised and depressed as in the American zinc-
carbon batteries.
CHAPTER IX.
LOCALIZED ELECTRIZATION.

The object of localized electrization is to confine the direct action of
the current, so far as possible, to some particular part of the body.

This is accomplished by placing electrodes so that the current, in
passing from one to the other, shall chiefly traverse only that particular
part that is to be affected,

Both currents may be localized in this way, hence the division of
localized electrization into localized faradization and localized galvani-
zation,

The scientific use either of localized galvanization or faradization
requires as accurate as possible preliminary diagnosis of the disease.

In cases of doubt it is necessary to electrize in succession all the
suspected localities until the results of treatment show conclusively
that we have hit upon the seat of the disease. Accordingly, in obsti-
nate or doubtful cases the head, the cervical sympathetic, and the
spine, and in some instances the uterus or organs of the abdomen, are
to be successively electrized.

In the very numerous cases of doubt also, when the locality of the
disease cannot be ascertained, as well as in conditions of irritation
where electrization of the seat of the disease will not be borne, peri-
pheral applications alone are frequently of decided service. For peri-
pheral applications both the galvanic and faradic currents are used ;
for central applications, chiefly the galvanic. In some diseases, as, for
example, locomotor ataxia, in certain stages it is better to treat the
prominent symptoms, as, for example, the anesthesia, than the seat of
the disease in the spine.

Instruments for Localized Electrization.--In localized electrization
the same galvanic and faradic apparatus are used as in general electri-
zation. For localized electrization in all its modifications there are
needed a variety of electrodes of different shapes and sizes, to reach
the various localities and accomplish the different indications.
368 LOCALIZED ELECTRIZATION.

Of the electrodes there are three general forms: the electric hand ;
the metallic brush; solid metals and metals covered with sponge,
flannel, linen, or chamois, thoroughly moistened.

Dry or Cutaneous Faradization—-To accomplish dry faradization
the portion of the skin over which the application is to be made should
be wiped thoroughly dry, or, what is better stili, sprinkled with some
absorbing powder, as the common nursery powder; and the applica.
tion may be made with the dry hand of the operator, or with metallic
electrodes.

In dry faradization with the hand there is heard a peculiar crackling
sound, which is caused by the sparks that take place as the current
passes from different points of the hand to the skin.

When the dry hand is used, the operator passes the current through
his own person, one of the electrodes applied to some near point by
an assistant, or held in the hand by the patient himself. Solid metallic
electrodes of various shapes may be used for dry electrization.

Dry electrization by the metallic brush with a strong current, faradic
or galvanic, is a very painful method of application, and is to be re-
sorted to only in those cases where there is profound cutaneous anzs-
thesia or in neuralgia. In all cases where there is great sensitiveness
the hand is to be preferred to any form of artificial electrodes.

Llectric Moxa.—The so-called electric moxa is produced by using a
metallic brush, plate or point, and one moistened electrode. The dry
electrode is rapidly touched to the surface where the moxa is to be
made, while the other is kept firmly applied to some near and in-
different point. The surface of the skin may previously be rubbed
very dry, or sprinkled with some absorbing powder.

The operation requires a current of some strength, and is exceed-
ingly painful. It is chiefly employed as a counter-irritant in neuralgia,
in which affection it is frequently successful. The electric moxa may
also be produced by means of two metallic brushes, one of which is
pressed on the skin.

Llectrization with Moistened Electrodes.—When it is desired to affect
the tissues lying beneath the epidermis, it is better to use electrodes
covered with sponge, chamois, or flannel, thoroughly moistened with
salt water-or ordinary water.*

The size and shape of the electrode employed must be modified ac-
cording to the situation and sensitiveness of the part where the current

* In faradization we never or but rarely use salt in the water; in galvanization

it is sometimes a great advantage, because it makes the current more painfully felt,
and thus prevents the use of too strong currents,
DEFINITION OF TERMS. 369

is to be localized, and also by the sensitiveness of the patient. Asa
rule, small, finely-pointed electrodes are required for localized faradi-
zation of single muscles, larger electrodes for large muscles, or groups
of muscles, and those with the largest surface for galvanization, of the
sympathetic, brain and spine.

When the current is localized by means of moistened electrodes, it
diffuses itself through the body between the electrodes in various di-
rections. The extent of this diffusion will be variously modified by the
situation of the electrodes and the structure and relation of the parts
that lie between them (see Electro-Physiology). It is manifest also that
the density of the current, other conditions being the same, will be great-
est near the electrode and least at the farthest point between them. Zhe
strength of the current being the same, small electrodes are more painful
than those with a broad surface, and metallic more than the wet sponge
or flannel. The least painful form of artificial electrode is a soft sponge,
with a broad surface, and well moistened.

Direct and Indirect Electrization.—Two general methods of localized
electrization are recognized—the direct and the indirect. In direct elec-
trization the application is made over the muscle to be excited. In in-
direct electrization the application is made to the nerve which supplies
the muscles. In the former method, large electrodes are preferred ; in
the latter, usually those which are small and pointed. The faradic cur-
rent is best indicated for direct electrization, and the galvanic for indirect.

The points where the motor nerves enter the muscles are called
‘motor points.” They have been carefully demonstrated and located
by Ziemssen and ourselves.

Definition of Terms.—In stable applications both electrodes are kept
in a fixed position.

In /adile applications one of the electrodes is moved or glided -over
the surface ; sometimes both of the electrodes are moved simultaneously.

A current is called continuous when it is allowed to flow in one direc-
tion without interruption. Only the galvanic current can be continuous,
since the faradic is always in a condition of interruption.

A current is called interrupted when it is broken by removing one of
the electrodes, or by some form of current-breaker in the electrode, or
by any method of breaking the circuit. The faradic current is always
interrupted by its rheotome, but it may be still further interrupted by
removing one of the electrodes.

A current is called uniform when it remains of the same strength

during the applications of the electrodes.
' A current is called by us zxcreasing, when its strength is gradually
24
370 LOCALIZED ELECTRIZATION.

augmented during the applications. This method possesses a great ad-
vantage in treating conditions:of irritation and inflammation. It may
be used with both galvanization and faradization. A much more pow-
erful current can be borne when its strength is gradually increased than
when it is suddenly let on in full force with the first closure of the cir-
cuit, as is usually the custom with the majority of electro-therapeutists.
A current which when suddenly closed may cause unbearable pain, and,
when applied near the nerve-centres, may induce dizziness and faintness,
may oftentimes be borne without discomfort and with positive advantage
if it is gradually increased from a very mild current. With the faradic
current a mild anzesthesia is produced.*

Increasing currents are indicated in applications tothe brain, sympa-
thetic, spinal cord, the eye and ear, urethra, inflamed joints, and to
all conditions of great irritation in any part of the body.

The faradic current (of Kidder’s apparatus) may be increased by
slowly withdrawing the metallic tube. To gradually increase the gal-
vanic current, a rheostat of some kind is needed. The galvanic current
can also be increased by an arrangement that gradually adds to the num-
ber of elements without interrupting the current, or when a sponge
electrode is used, by slowly increasing the pressure.

The term voltaic alternatives is applied to those applications in
which the direction of the current is reversed continually, while the
electrodes are kept firm. The current-reverser is a very convenient
instrument for producing voltaic alternatives (see p. 360).

For electrization of muscles, labile or stable interrupted currents are
preferred. For electrization of the head, spinal cord, sympathetic, and
nerve-tracts and plexuses, stable continuous currents are indicated, and
these again may be either uniform or increasing. Labile or stable in-
terrupted currents are best adapted to produce muscular contractions,
and cause most potent physical and mechanical effects, while stable
continuous currents, whether uniform or increasing, produce the strong-
est electrolytic or catalytic action.

In cases where the electro-muscular contractility is not greatly di-
minished, it is an advantage to use electrodes with a broad surface,
since thereby several motor points may be influenced simultaneously,
together with a considerable extent of muscular tissue, and because
they are less painful than small electrodes. In such cases the faradic
current is preferable.

When the electro-muscular contractility is very greatly diminished, as

* See an article on Faradic Anzesthesia, by Dr. A, Tripier, of Paris, in Archives of
Electrology and Neurology, May, 1874.
DETAILS OF APPLICATIONS, - 371

so frequently happens in paralysis, contractions are best produced by
small, finely pointed electrodes, applied at the motor points of the in-
dividual muscles ; yet even here electrodes of moderate size are usually
preferable. Such cases often require the galvanic current.

Details of Applications of Localized Electrization.

Galvanization of the Central Nervous System.—It is necessary to bear
in mind at the outset, that to produce powerful electrolytic effects on
the brain, spinal cord, and sympathetic, the galvanic current is prefer-
able to the faradic, although the faradic current certainly affects the
nerve-centres.

Galvanization of the Head.—The head may be electrized in a variety
of ways, according to the supposed seat of the disease. One pole may
be placed on the forehead and the other on the occiput ; or both poles
may be placed over the ears, or on the mastoid processes. Another
method which we frequently adopt is to place the positive pole on the
summit, over the supposed organ of firmness, and the other at the oc-
ciput, or under the chin:

To affect the base of the brain, the electrodes may be placed on or
behind the mastoid processes. To confine the action to one side of
the brain, one electrode may be placed on the forehead, over the eye, |
and the other on the mastoid process of the same side: The patient
may hold one of the poles in the hand. Still another method less used
is to place an electrode on each temple.

Less dizziness is caused if the current is opened and closed with the
positive than with the negative pole. It is well, therefore, to first apply
the negative pole.

Less dizziness is caused when the current flows through one side of
the head, or from the forehead to the occiput, than when it is sent from
one side to the other, through the mastoid processes (see Electro-
Physiology, p. 125). * ;

The use of some kind of a rheostat, so as to avoid interrupting the cur-
rent or giving sudden “ shocks" on closing and opening, is almost indis-
pensable in electrizing the brain and neck. With regard to the direction
of the current, it is usually better to place the negative pole nearest the

“neck, and the positive pole nearest the forehead. But this rule is liable

to many exceptions, and each case must be studied by itself.*
Electrization of the head produces flashes of light through irritation
of retina, and dizziness, which with many is disagreeable. If the ap-

* See remarks on polar effects, p. 281.
372 LOCALIZED ELECTRIZATION.

plication is too long continued, headache and insomnia, and general
malaise, may result. Patients whom a short application through the
head benefits, are sometimes injured when the séance is protracted.
ralvanization of the head should be made with broad electrodes, with
a stable current,-which may be either uniform or increasing, and should
not exceed from one-half a minute or three-quarters of a minute, to
five or ten minutes, and with a mild current.

To all these rules in regard to the strength of currents there are ex-
ceptions. There are cases of even very delicate patients that will bear
almost any amount of electricity through the head and neck.

Galvaniszation of the Cervical Sympathetic.—The portion of the sym-
pathetic to which galvanization is chiefly directed for therapeutical pur-
poses is the cervical, although the cephalic, thoracic, and abdominal
ganglia are unquestionably affected by it, though not with so specific,
demonstrable, and immediate results,

There are a number of methods by which the superior, middle, and
inferior cervical ganglia may be demonstrably affected by the galvanic
current.

 

ORAKF

FIG. 95. i
Galvanization of the Cervical Sympathetic

1. One electrode with an oblong extremity is placed in tne auriculo-
maxillary fossa, while the other with a larger surface is applied over,
or by the side of the sixth and seventh cervical vertebrae (see Fig. 95).

The second electrode may also be applied at any point along the
spine, from the occiput to the coccyx. It is by this method that diplegic
contractions are usually produced with most success.

a
GALVANIZATION OF CERVICAL SYMPATHETIC. 373.

2. The first electrode being placed as before, in the auriculo-maxillary
‘fossa, the other, with a surface of moderate diameter, is applied just
above the manubrium sterni, by the side of the sterno-cleido-mastoid
muscle (see Fig. 96).

 

Fic, 96.
Galvanization of the Cervical Sympathetic, including the Pneumogastric,

The second electrode may also be applied higher up in the neck, op-
posite the middle cervical ganglion.

The above are the two methods which have been most eduently em-
ployed. Other methods are the following.

3. The first electrode being placed as before, the other may be ap-.
plied on the shoulder, elbow, or in the hand of the opposite side, or in
the axilla. ,

4. Both sides may be galvanized simultaneously, by placing an elec-
trode over the mastoid processes.

5. One electrode is placed just above the manubrium sterni, and the,
other at any point down the spite.

6. One electrode is placed over the sixth and seventh cervical verte-
bree, and the other over the brachial plexus, at the pit of the stomach,
just above the manubrium sterni, in either hand, or at the feet.

In all these methods either direction of the current may be used, ac-
cording as calming or irritating effects are desired (see p. 281).

Concerning the physiological effects of galvanization of the sympa-
thetic see Electro-Physiology, p. 128.

Applications to the sympathetic should be made from one to ten
374 LOCALIZED ELECTRIZATION.

minutes, and with from five to twenty-five cells. Several methods may
be tried at a single sitting in cases where the applications are well
borne.

Bearing in mind that in all such attempts to galvanize the cervical
sympathetic, the pneumogastric and spine must be more or less influ-
enced, the general indications for the use of this method of treatment
to which experience would seem to point are these :—

1. Cerebral anemia and hyperemia. These conditions are associated
with and are a part of a large variety of diseases. Insomnia, hemiplegia,
tic douloureux, many diseases of the eye and ear, as neuro-retinitis, ner-
vous deafness and tinnitus aurium, are all more or less associated with
cerebral anzemia, hyperzemia, and all have been treated by galvanization
of the cervical sympathetic, with more or less success.

2. Disorders of the vaso-motor nerves. Under this head may be in-
cluded some cases of deficient circulation, cutaneous hyperesthesia, and
certain diseases of the skin.

3. Functional diseases of the digestive and genital apparatus. Gal-
vanization of the sympathetic in these conditions seems to work, partly
at least, by reflex action, and partly, also, by the influence which the
spinal cord and pneumogastric receive during the applications.

It is scarcely necessary to remark that the exclusive use of galvant-
zation of the cervical sympathetic is indicated only in exceptional cases.
It is to be employed in connection or alternation with general faradiza-
tion and galvanization of the brain, spinal cord, and periphery. A note-
worthy advantage of this method of treatment in those cases for which
it is of service is the comparatively short time required for its employ-
ment.

The objection that galvanization of the cervical sympathetic is a
dangerous procedure will be considered in the chapter on central gal-
vanization.

Galvanization of the Spine.—The spine may be electrized by placing
one electrode at the occiput, and the other at the coccyx. One of the
electrodes may be kept i situ, while the other is slowly passed up and
down the entire length of the cord. Either pole may be passed up and
down in this way according to the effect desired.

The current may also be localized in any part of the spine that may
be required, by giving the electrodes the proper position. The appili-
cations may be made with ten cells and upwards, and should not usually
exceed five or ten minutes. The applications should be sensitively
felt, like a gentle mustard plaster, but should not be excessively pain-
ful, like a blister,
PERIPHERAL FARADIZATION. 375

 

FIG. 97.

Faradization of the Facial Nerve and Muscles. Eyelid firmly closed and mouth
drawn to one side,

 

Fic. 98.

Muscular Faradization with metallic electrodes (Duchenne),
376 LOCALIZED ELECTRIZATION.

 

4
Fic. 99.
Faradization of the Muscles of the Thigh, contraction of the quadriceps,

 

FG. 100.

Faradization of Popliteal Nerve and Peroneal Muscles, Foot brought upward and
outward,
PERIPHERAL FARADIZATION. 377

Llectrization of Plexuses, Nerves, and Muscles.—Plexuses, nerves,
and muscles are treated by both currents (see chapter on differential
indications for the use of the galvanic and faradic currents).

One electrode may be applied to a plexus and the other to one of its
branches, or to a muscle or group of muscles. Both electrodes may be
applied to the nerve, or one to the nerve and the other to a muscle ; or
both may be applied to a muscle or group of muscles. All these appli-
cations may be made either with or without regard to the direction of
the current, and different methods may be tried at the same séance.

In all the positions described in the above cuts, contractions should
be produced with mild faradic currents, when the electrodes are in the
position represented. Jf very strong currents are necessary or no con-
tractions are possible, the muscles are in a condition of disease.

Peripheral applications are indicated where the disease is purely of a
peripheral character; the partly central applications are indicated where
the disease is of a central origin.

Labile interrupted applications are indicated where it is desired to
produce mechanical effects or muscular contractions, as in anesthesia
and paralysis. :

Stable continuous applications are indicated where it is desired to
produce electrotonic, chemical, or catalytic effects, as in neuralgia.

Benedikt * makes the following somewhat over-refined subdivisions
of the methods of ga/vanization of the centre and periphery :

Spinal-cord current: both poles are. placed on the spine, either near
together, or at some distance from each other.

Spinal-cord-root current: one pole is placed on the spine, and the
other is passed up and down by the sides of the vertebree.

Spinal-cord-plexus current: one pole is placed on the spine, and the
other on a plexus of nerves.

Spinal-cord-nerve current: one pole is placed on the spine, and the
other on a nerve.

Spinal-cord-muscle current: one pole is placed on the spine and the
other on a muscle.

Plexus-nerue current: one pole is placed on a:plexus of nerves and
the other on a nerve.

Nerve-muscle current: one pole is placed on a nerve and the other
on a muscle.

These currents may be either s¢adle or labile, continuous or inter-
rupted, uniform or increasing.

\

* Op. cit., p. 56.
378 LOCALIZED ELECTRIZATION.

 

Fic. 101
Spinal-cord-brachial plexus current.

 

Fic. 102.
Spinal-cord-median nerve current.

The method of electrizing the eye, ear, nose, larynx, cesophagus,
heart, lungs, stomach, liver, kidneys, spleen, intestines, rectum, bladder,
male and female organs of generation, will be described in the chapters
(levoted to diseases of these organs.

The method of electrizing individual nerves and muscles has been de-
scribed and illustrated in the chapter on electro-therapeutical anatomy.
EFFECTS. 379

Effect of Current modified by the Length of Application.—The sensa-
tions and the effects of electrical applications are considerably modified
by the length of time that the electrodes are kept in position. When the
faradic current is first applied to the skin, it causes a stinging, pricking
sensation, perceptibly strongest at the negative pole; if the electrodes
are kept in position the sensation may gradually diminish, and the parts
will become very slightly benumbed, and if now the strength of the cur-
rent be gradually increased, little or no additional pain is caused. If
the current is at first very strong, it cannot be borne long enough to pro-
duce this benumbing effect.

When the galvanic current is first applied to the skin it causes no
sensation or scarcely any, unless it be very strong or is directed over or
near a motor nerve; if the electrodes are kept in position for a few
seconds, a slight burning sensation is felt at both poles, but strongest at
the zegative. This burning sensation increases quite rapidly until the
sensation it causes is like that of a strong mustard plaster, or hot iron, and
becomes unendurable. The benumbing effect of the faradic current is
not experienced. ‘The fact that the galvanic current is but little felt at
first, leads those physicians who have not been accustomed to it to use
it altogether too strong. This increase of the pain under the galvanic
current is due to two causes—the moistening of the skin through the
moisture of the electrode, so that it becomes a better conductor of elec-
tricity, and the special chemical action of the poles (see Electro-Physi-
ology, p. 192). This increased conductivity of the skin is the partial if
not complete explanation of the fact that the muscles contract under a
feebler current after the electrodes have been some time in one place. It
is not impossible, however, that the nerves or muscles may be so stimu-
lated by the current as to contract more readily than before stimulation.

The reverse proposition, that strong currents used for a long time
enfeeble the nerves and muscles so that they respond less readily to the
current, is certainly true, and is easy of demonstration, especially in cases
of facial paralysis. For this reason, prolonged applications frequently
do more harm. than good.

Effects of Localized Electrization.—Localized electrization has to a
limited extent the same direct effect on the part to which the applica-
tion is made that general electrization has on the whole body. It acts
as a locally stimulating tonic.

Improvement in Local Nutrition the leading effect of Localized Elec-
trization.—The leading and general effect of localized electrizatiun, and
one which is a complex result of the various special effects, is zmprove-
nent in local nutrition.
380 : LOCALIZED ELECTRIZATION.

Localized electrization of an atrophied or poorly nourished muscle
causes that muscle to improve in size and strength ; localized electriza-
tion of an atrophied or poorly nourished organ, as the uterus, causes it
to increase in size and improve in functional activity.

Localized electrization of any part of the cerebro-spinal system im-
proves the nutrition of that part, and as a result the whole body, over
which the cerebro-spinal system presides, may improve in nutrition.
Thus localized may indirectly have some of the same effects as general
electrization. Similarly, also, as we descend from the centre toward the
periphery electrization of any nerve branch or plexus improves the nu-
trition, not only of the nerve acted on, but also of its various branches,
and of the muscles and organs that it supplies.

When the nutrition of an atrophied part is improved it grows larger +
when the nutrition of a hypertrophied part is improved it grows smaller.
The same treatment that makes a flabby muscle increase in size causes
a goitre to diminish in size. These opposite effects of the local use of
electricity, though apparently inconsistent, are yet quite consistent (see
Electro-Physioloyy, p. 203 ; and Electro-Surgery, chapter on Tumors).

"The special effects of localized, unlike those of general electrization,
cannot be broadly stated or classified, for the obvious reason that they
must so largely depend on the locality to which the application is made.

Although applications to the central nervous system are sometimes
followed by mild and limited degrees of the primary, secondary, and
permanent effects that result from general faradization or central gal-
yanization ; yet the cases where the full order of these effects is so
marked and decided as to be observed are comparatively unfrequent.

Applications to the brain and sympathetic system may be followed
primarily by relief of pain, slight exhilaration, a feeling of warmth or
somnolence; secondarily by fatigue, headache, or soreness of the
muscles, or exacerbation of the morbid symptoms ; and permanently by
improvement in sleep, strength, and capacity for labor.

But this order of effects from localized electrization is exceptional, even
from applications made to the head. More frequently the permanent
effects are experienced without the primary, or perhaps both the per-
manent and secondary, and sometimes only the latter.

Yet none of these constitutional effects, in whatever order they may
occur, are experienced to the extent that is derived from general fara-
dization.

The agreeable symptoms which are most frequently observed after
localized applications to the nerve-centres are disposition to sleep, relief
of headache or other pain, and occasionally slight exhilaration.
ABSOLUTE LOCALIZATION IMPOSSIBLE. 381

Sometimes the beneficial results of electrization of paralyzed muscles
follow immediately after the application. The patient is conscious of
an ability to use the muscles treated with greater ease and freedom.
This improvement may be merely temporary, or, as is more frequently
the case, partial relapses occur, leaving a certain amount of permanent
benefit. Immediate relief of neuralgic pain, and of the reverse con-
dition, anzesthesia, may follow localized as well as general electrization.
The temporary relief of the neuralgia may be complete, while that of
anzesthesia is usually only partial and limited. In both conditions the
evil symptoms may recur, or a certain amount of permanent benefit
may remain.

Among the disagreeable symptoms are dizziness, heaviness, oppres-
sion, headache, soreness in the muscles, exhaustion, and indefinable ner-
vousness.

These disagreeable symptoms are most likely to result from applica-
tions that have been either too severe or too protracted for the con-
dition of the patient ; and yet they should by no means excite alarm,
since they often accompany the most successful results. These un-
pleasant symptoms are more likely to follow the use of the galvanic
current than the faradic, especially when the applications are protracted.
The opinion that has been expressed by certain writers, that the head is
more likely to be unpleasantly affected by the faradic than the galvanic
current, is not sustained by experience. The phenomena of dizziness,
heaviness, etc., frequently experienced after even a very short applica-
tion to the head, are but rarely observed when the faradic current of a
continuous-coil apparatus is employed, with a large soft sponge, or the
hand of the operator. ;

Applications of localized electrization to individual muscles or groups
of muscles rarely give rise to any constitutional symptoms whatever,
unless the electrodes are placed on or near the head.

The special effects of localized electrization of special organs, as the
éye, ear, larynx, stomach, liver, intestines, uterus, ovaries, bladder, etc.,
will be described in the chapters devoted to the treatment of the diseases
of these organs.

Absolute Localization of Electricity impossible.—It should be con-
sidered that exclusive and absolute localization of the effects of electriza-
tion is impossible. The effects of both currents extend, either directly
or by reflex action, to parts beyond the circuit. This is demonstrated, not
only by physiological experiments, but by the observed facts of clinical
experience. Thus it is observed, in some irritable conditions, that
galvanization of the spine, and even of the extremities, causes a metallic
382 LOCALIZED ELECTRIZATION.

taste; that galvanization even of the hands or feet sometimes hastens
or increases the menstrual discharge, relieves headache, and produces
sleep. The same effects to a less degree are sometimes observed from
faradization.

Some of the illustrations of this fact are quite striking. Thus in the
case of the wife of a physician whom we were treating by faradization of
the shoulder for rheumatism, the menstrual flow was so much increased
and prolonged that it was necessary to abandon the treatment, although
only very mild currents and short applications were used.

In the case of a lady whom we were treating for sciatica, by localized
galvanization of the painful portion of the nerve, the pain was de-
cidedly relieved, but the effect was to bring ona recurrence of the
menses after they were suspended, so that the patienf was nearly all
the time menstruating.

These illustrations are extreme and comparatively rare, but they
serve to show clearly enough that the effects of electrization cannot
well be localized to the points between the'electrodes, and that other
and distant parts must, of necessity, be more or less affected.

The term /oca/ized electrization, introduced by Duchenne, is therefore,
strictly speaking, a misnomer, since we are taught by physics that the
vibrations of the electrical force must diffuse themselves in various direc-
tions, and at a considerable distance from the electrodes, and we are
taught by clinical experience that the effects of electrization, however
near together the electrodes may be placed, are not entirely confined
to the points between or near the electrodes, but may be felt, and in
some instances far more demonstrably, in distant parts and organs.

To the use of the term localized electrization, there is no objection,
provided it be used understandingly, and with the idea that it is merely
a term of convenience. The term local electrization is often used
synonymously with localized electrization, and for the reasons here
suggested is preferable to it. Localized electrization has the advantage
of being first in the field, and has become, to a certain extent, con-
secrated by usage.
CHAPTER X.
GENERAL FARADIZATION.

The object proposed in general faradization is to bring every portion
of the body under the influence of the faradic current, so far as is pos-
sible, by external applications. This is best accomplished by placing
one pole (usually the negative) at the feet or the coccyx, while the other
ts applied over the surface of the body.

The faradic is the current which is almost exclusively employed in
general electrization, and, for that reason, the directions and explana-
tions given in this section, with the exceptions that will be noted, apply
mainly and specially to general faradization. Since the discovery of
central galvanization, to be hereafter described, we have discarded the
term general e/ectrization, and substituted general faradization, for the
reason that the galvanic current is preferably used in the form of cen-

tral galvanization.

In the majority of cases it is more convenient and satisfactory to
have a sheet of copper at the feet. This position is indeed the rule in
general faradization. The broad, callous soles of the feet are but
slightly sensitive, and will bear a stronger current than any other por-
tion of the surface of the body. But the passage of electricity through
the ankles causes vigorous contractions of the flexors and extensors,
which, when the current is very strong, may be somewhat painful. Ac-
cordingly, when the patient is peculiarly nervous and sensitive, or when
a current of unusual strength is to be employed, and in all cases where
a stronger application is desired than can be borne through the ankles,
or when it is desired to save time or inconvenience, it is advisable to
have the patient sit on the plate, or a sponge electrode with a broad
surface may be applied to the coccyx.

In general faradization, as in localized, the currents may be stable
(stationary) or /abiZe (moving), uniform or increasing.

_ Increasing currents are adapted for certain important centres, as the
head, spine, cervical sympathetic, and cilio-spinal and epigastric regions.
384 GENERAL FARADIZATION.

The advantage of this method of application is that it allows the use of
a stronger current than will otherwise be borne; the strength of the
current may be so very gradually increased that the increase within
certain limits may be almost imperceptible to the patient. This arises
partly from the fact that the current has a slight benumbing or anzesthetic
effect (see Electro-Physiology, p. 122), and partly from the fact that by
a gradual increase of the strength of the current the patient is spared
the shock that is experienced when a strong current is suddenly directed
through sensitive portions of the body.

Labile and interrupted currents are adapted for the muscles, especially
of the extremities.

General faradization is very far from. being so easy a process as it
might appear from this brief description. Its successful employment
requires, on the part of the operator, some mechanical dexterity, entire
familiarity with the instruments required, a complete knowledge of
electro-therapeutical anatomy ; a personal acquaintance with the sen-
sations and behavior of all portions of the body under the different
electric currents ; close and patient study of the diseases and morbid
conditions in which it is indicated, and of their response to faradization.
There are those who by long practice are enabled, when necessary, to
readily manipulate any portion of the body with either hand, while there
is passing through them a current so powerful as to keep many of the
principal muscles of the arms in a state of contraction. This qualifica-
tion, however, though convenient, is not indispensable.

On the side of the patient, success in the use of general faradiza-
tion requires something of the same patience and perseverance that
are conceded to be necessary for success in the use of any other form
of electrical treatment.

Nothing is more difficult than to fully and accurately describe in
words an operation that in its very nature demands actual sight and
experience. The true method of learning the art of general faradiza-
tion is by repeated observations of its application to the diving subject,
by personal experience of its sensations and results at the hands of
practised adepts, and by long and various experimenting on diverse
temperament, and in opposite states of disease. We shall endeavor,
however, to present the best possible substitute for a course of private
lessons or extended clinical observation in this department, by answer-
ing in detail the practical questions that naturally present themselves
to one who approaches the subject ad initio, and who has no oppor-
tunity for personal interviews with those to whom the various steps of
the operation have become already familiar.
POSITION OF THE PATIENT, 385

 

 

’ Fic. 103.

GENERAL FARADIZATION—application to the head by the hand of the operator.
(In this, as in all of the cuts of general faradization, for convenience of illustra-
tion the patient is represented without any covering, In the majority of cases
they are protected by a shawl or wrapper, and frequently the underclothing is
not removed,

Position of the Patient.—The patient should be seated on an or-
dinary stool, with his face toward the instrument, and his feet on the
sheet of copper to which the negative pole is attached. Any chair that
has a back or arms will somewhat interfere with the manipulations of
the operator.

Those patients who, through paralysis or debility, are unable to sit
up at all, can receive the treatment while lying in bed or on a lounge.

25
386 GENERAL FARADIZATION.

In such cases the sheet of copper may be placed upright against a
pillow, and the feet of the patient pressed against it, or an electrode
may be placed at the coccyx. Assistance will then be required to. turn
the patient when the application is made to the back and spine, but in
such cases partial applications are frequently all that are required.

Infants and very feeble or very timid children should be held in the
lap of the mother or nurse, while an assistant holds the sponge to the
coccyx.

While the application is being made to the lower limbs it is well for
the patient to stand, in order that the operator may have access to the
gluteal regions and the posterior and anterior surface of the thigh.

Position of the Operator.—While making applications to the trunk,
the operator may either stand or sit by the side of the patient, conve-
niently near to the table, on which are placed the apparatus, electrodes,
sponges, bowl of water, and other appliances that may be called for
during the application.

While operating on patients taller than himself the operator will find
it easier to stand, especially while treating the head and upper portion
of the trunk. While treating short patients the operator will find it
less fatiguing to sit in a chair. Most operators will find it very conve-
nient to change their position from a sitting to a standing posture, or
from one side of the patient to the other, while making the applications
to the various parts of the trunk.

Minor Apparatus.—Electrodes, sponges, and copper plate.

The best electrode for the pole that is applied over the patient is a
brass ball of about one inch in diameter.

Around this brass ball should be loosely folded a soft wet sponge,
.of about six inches in diameter. This is found, by experience, to be
by far the most convenient form of artificial electrode that can be
devised. Next to the moistened hand of the operator it is the most
agreeable to the patient of any shape or quality of electrode. The
sponge can be pressed or folded over the brass ball so as to make a
comparatively small electrode, or its entire surface may be applied.

When the operator allows the current to pass through his own
person, and uses his hand as an electrode, holding the sponge and ball
in his other hand, he can modify the application to any degree of
strength or mildness that he may desire, by simply increasing or di-
minishing the pressure of his hand or fingers on the sponge. Used in
this way the sponge holding the water acts like a hydro-rheostat (see
Pp. 354). When itis necessary that the application should be particularly
gentle and cautious, it is well to rest the ball and sponge on the table,
POSITION OF THE OPERATOR. 387

  
   

  
 

a

ie

mT TTA
ao 0

  

Fic. 104.

GENERAL FARADIZATION--application to the spine. The hand of the operator
is on the metallic tube, in a position to increase or diminish the current as may be
needed,

and to begin the treatment by first pressing one hand jirmdy over the
part desired to be affected, and with the other lightly and. delicately
touching the sponge, at first with one finger, then with two, three, and
four successively, and finally with the whole hand, thus giving a very
gradually increasing current. Raines’ electrode, which is a sponge
covered at the back with rubber, is very convenient for general fara-
dization.

A piece of copper plate is recommended for the negative electrode,
because it is found by experience to be, on the whole, more conve-
388 GENERAL FARADIZATION,

nient than any other arrangement that has yet been suggested. The
bowls of warm water, large sponges, etc., that have been suggested,
are not only much less cleanly and convenient than the copper plate,
but are also much poorer conductors. Metallic slippers are more
troublesome than the broad plate, though their appearance, perhaps,
is more ornamental. It needs more care to put on the slippers, and
if the patient loses his self-control during any stage of the application,
and throws up his feet, it is something of a task to find the slippers
again and accurately adjust them.

In the use of the copper plate these details must not be forgotten :
first, to keep it well warmed, in cold weather, by a piece of heated
soap-stone beneath it; secondly, to keep it slightly moistened with
warm water, in order to improve the connection.

If only one foot is applied to the copper plate, the pain in thé ankle,
during certain stages of strong applications, will be unendurable. In
mild applications it is sufficient to have one foot on the plate. It is
necessary ever to bear in mind the rule, that the pain of electrical
applications, other conditions being equal, is in zzverse proportion to
the surface of the electrode. The /arger the surface of the electrode—
whether positive or negative—the less the pain. In this fact consists
the advantage of using large sponges.

In general faradization the pain at the negative pole is chiefly felt at
the ankles, and somewhat at the toes, but not on the bottom of the
feet. The feeling of constriction in the ankles is caused by the rapid
and violent contractions of the muscles. If only one foot is applied to
the plate the entire force of the current must, of course, be borne by
that foot, and furthermore, the other limb will receive no direct benefit
from the treatment.

The trouble of removing the shoes and stockings may be obviated by
placing a large sponge connected with the negative pole at the coccyx,
or on the thighs.

Facility, skill, and readiness in use of the various methods of modi-
Sying the strength and quality of the current is one very important secret
of success in the use of general faradization. A skilful operator will
cause less discomfort with a strong current than one who is awkward
well cause with a very weak current.

Details of the Applications to the Different Parts of the Body.—As
the various parts and organs of the body differ very widely in their sus-
ceptibility to faradization, and in the effects which they receive from it,
it becomes necessary to explain the modus operandi of the applications
with, considerable fulness of detail.
.

APPLICATION TO HEAD AND NECK. 389

Applications to the Head.—The head, especially’ the forehead, is, by
far, more sensitive to the electric currents than any other portion of the
surface of the body. The ¢zo reasons for this are sufficiently obvious.
The surfaces of bones are always sensitive to the faradic current, as to
any other mechanical influence ; and the cranium is no exception to
this law. Then, again, the fifth pair is an exceedingly sensitive nerve
in all its ramifications, and especially over the forehead.

There are many cases that do not bear even mild applications to the
front and top of the head, and who seem to be injured rather than
benefited by it. With others, the effects are highly agreeable.

In treating the forehead the operator should first press his moistened
hand firmily over the head, and then making the connection with his
other hand on the ‘sponge and brass ball of the positive pole, should
allow the current to pass steadily, without interruption, for one or two
minutes. In Kidder’s faradic apparatus, A B is the best current for
the forehead. The use of the hand as an electrode is particularly de-
sirable in making applications to the forehead.

Moistening the Hair.—The dry hair is a non-conductor, and there-
fore it is always necessary to wet it freely before electrizing any portion
of the head that is covered by it. It is not usually desirable to com-
pel lady patients to pull down their hair, or to thoroughly moisten it.
A very important centre for affecting the brain is the crown of the head,
between the ears, over the so-called organ of firmness,—the cranial cen-
tre. Ifthe hair at this point be sufficiently moistened to admit the pas-
sage of a mild current with any convenient form of electrode, a peculiar
and slightly painful sensation is experienced.

In some exceptional cases of disease the head will bear currents of
considerable strength. The back of the head over the cerebellum will
usually bear quite strong applications. The current is felt through the
ramifications of the occipital nerves, giving rise oftentimes to sensa-
tions not only painless, but absolutely agreeable.

Applications to the Neck and Throat._-The back part of the head
and upper portion of the spine will usually bear powerful applications.
It is an interesting and important fact that very marked effects may be
produced by general faradization, even when the applications are made
only to the back and sides of the neck.

The reason for this will be clear when we come to study the electro-
therapeutical anatomy of the parts. From. the upper portion of the
spine and base of the brain proceed the most important and most sen.
sitive nerves of the body—the pneumogastric, and the brachial plexus,
and the phrenic nerves,
390 GENERAL FARADIZATION.

Furthermore, the sympathetic or ganglionic system runs close by the
spine, near to the carotid artery, and may be reached and affected elec-
trically by pressing firmly with the fingers, by the anterior border of
the sterno-cleido-mastoid muscle, at those points where the pressure of
the carotid is most readily felt.

 

Fic 105.

GENERAL GALVANO-FARADIZATION.—Application to the spine by a sponge holder.
A double electrode is used, one part of which is connected with the galvanic and
the other with the faradic apparatus. The copper plate is also connected with
both currents. Galvano-faradization we do not now employ, but the cut illus-
trates perfectly one of the steps in general faradization.

If the sponge be pressed firmly on the cilio-spinal centre, over the
sixth and the seventh cervical vertebrae, and moved slightly on either
APPLICATION TO NECK. 391

side of the spine, while a powerful current is passing, the electric influ-
ence may be perceptibly communicated, not only to the spine but
also to the larynx through the laryngeal nerves; to the stomach
through the pneumogastric ; to the lungs through the phrenic; to both
arms and hands through the brachial plexuses and their branches—iz
short, to the most important nerves and organs of the body. The sym-
pathetic is also directly affected at this point.

There is no other single place on the surface of the body where the
electrical influence can be communicated to so many important nerves
as at the cilio-spinal centre. In order, however, to affect all these
nerves and organs above mentioned by faradization it is necessary to
use a powerful current, and to press the sponge very firmly against the
skin.

In very fleshy patients it is sometimes quite difficult to affect the
brachial plexuses and their branches in the arms and hands without
using a stronger current than can well be borne through the feet and
ankles at the negative pole. This application, so far from being pain-
ful, is to many positively agreeable. The ¢#ri// which it communicates
to the nerves and vital organs is often so delightful that the patient re-
quests to have the application prolonged. In patients who can bear it,
this application at the cilio-spinal centre may be varied by suddenly
interrupting the current.

This application is a very important factor in general faradization, and
will achieve decided tonic effects on the system, even when no other
portion of the body is touched by the current. The immediate sensa-
tions which it produces, however, are by no means uniform. Some pa-
tients, through the irritation of the laryngeal nerves, cough spasmodi-
cally, and even violently, under the excitation even of a comparatively
mild current ; with others, even the most powerful currents, and the
firmest possible pressure of the sponge, fail to produce any such effect.
In nervous and sensitive patients this application often causes a pecul-
iar and decided sensation in the stomach, through the pneumogastric
nerve ; the strong and vigorous rarely experience any such sensation,
even under currents of great power.

Another important locality in the electro-therapeutical anatomy of
the neck is in the posterior triangle, just by the posterior border of the
sterno-cleidu-mastoid muscle. If the fingers of the operator, with a
current of considerable strength, or the sponge with a current compara-
tively mild, be pressed firmly on this space until the posterior border
of the scalenus anticus is reached, the patient will at once experience a
tingling or pricking sensation in the arm and hand on that side, caused
392 GENERAL FARADIZATION.

by the excitation of the brachial plexus, and in some cases a thrill is
communicated by means of the pneumogastric to the stomach, and by
the phrenic nerve to the diaphragm.

Applications, to the Upper Extremities.—It is not alwaysenecessary
to go to the trouble of faradizing the extremities, but in many cases it
is a decided advantage to do so. In faradization over the extremities,
the sponge, or the hand of the operator, should be passed thoroughly
over the surface of the hands and arms, and with sufficient force to pro-
duce agreeable contractions of all the superficial muscles. Except in
infants and corpulent females, contractions of the superficial muscles
of the arm are obtained with a mild current.

Applications to the Spine.—Stronger currents of electricity may be
borne over the middle of the spine than perhaps over any other portion
of the body. There are no very sensitive peripheral nerves in the back,
and the spinal cord is so thoroughly protected by its bony covering that
the currents are never felt in it painfully, except when it is greatly ex-
hausted or organically diseased. ‘The nerves that issue from the spinal
cord are more or less affected by powerful applications to the back, and
through them the various parts and organs which they supply are con-
siderably influenced.

The best method of electrizing the back is to pass the sponge down
its entire length beneath the under-clothing, in case it is not removed,
from the first cervical vertebra to the cauda eguina, carefully avoiding
the prominences of the scapula and the ossa innominata. Below the
inferior angle of the scapula the sponge may be moved from side to side
over the region of the kidneys, liver, and spleen.

If a strong current be applied over the lower portion of the spine,
between the upper borders of the ossa innominata, a slight sensation is
sometimes, though by no means uniformly, communicated to the rectum
and the male genital apparatus, the penis and the testicles, through
their spinal nerve-supply.

In view of these considerations it is manifest that in the employment
of general faradisation particular attention should be given to the spine,
even at the expense of neg ecting other portions of the body.

That the lungs and heart are less influenced by electrization than other
important organs, is chiefly accounted for by the anatomical structure of
the chest. The ribs, with the intercostal muscles and ligaments, form
an unyielding wall. Furthermore, the pleura and pericardium are not
closely adherent to the inner wall of the chest, but lie loosely over the
lungs and heart. These organs, therefore, are best affected electrically
by applications above the sternum, around the neck, and over the upper
APPLICATION TO ABDOMEN, 393

half of the spine, whence the nerve-supply of the viscera proceeds, and
by direct electrization of the vagus in the neck.

Applications over the chest are, however, of positive and permanent
service, by developing the thoracic and intercostal muscles, and for this
reason, if for no other, they should not be neglected. But it should not
be forgotten that the surfaces of the ribs, like the surfaces of all other
bones, are sensitive to electrization, and that therefore the chest will
not bear as severe applications as the spine, neck, or abdominal re-
gions. ‘This sensitiveness is, of course, more in the thin and nervous
than in the corpulent and phlegmatic. It is usually most marked on
the inferior ribs on the right and left side of the body, over the liver
and spleen. The peculiar sensitiveness of the ribs at these points is
sometimes erroneously supposed to indicate disease of the organs be-
neath them.

We have stated above that the anatomical structure of the chest ren-
dered it difficult to send the electric current through its anterior walls
to the lungs and heart. In the abdominal regions the anatomical
structure is directly reversed, and instead of an unyielding wall, partly
composed of bones and ligaments, we have a flaccid skin lying loosely
against the peritoneum that covers the moist viscera beneath. No
other organs. of the body contain so large a percentage of water as those
which are situated in the cavity of the abdomen. It is obvious, there-
fore, that when the resistance of the epidermis is overcome by the mois-
ture of the sponge or hand, and the peritonzeum and viscera are brought
into coaptation, the current must directly traverse all the parts desired
to be affected.

To reach the stomach and solar plexus, place the sponge or palm of
the hand below and under the sternum, and as far back as possible.
This pressure brings the peritonzeum and stomach into coaptation, and
forces the current to pass through them. If the under-clothing be
simply slipped up without being entirely removed, the stomach and ab-
domen can be readily treated.

The bowels may be trea‘ed either with the labile or the stable cur-
rent, and, in cases of obstinate constipation, by sudden interruptions or
shocks.

Corpulent and pursy patients usually bear much stronger currents
over the abdomen than the thin and emaciated. Adipose tissue is
comparatively a poor conductor of electricity, and it is difficult to affect
the bowels of the very corpulent through the abdominal walls by elec-
trization, unless we employ firm pressure and currents of considerable
strength. But in the vast majority of cases currents of moderate
394 GENERAL FARADIZATION. ‘¢

strength, applied lightly over the surface.of the abdomen, will readuy
produce contractions of the abdominal muscles, and, if pressure be em-
ployed, the intestines and all the organs of the abdominal cavity are di-
rectly traversed by the current.

=
ii

1H
ll

i

——N

 

Fic. 106.

General Faradization—Application to the stomach.

Applications to the Female Genitals.—Direct applications to the
vagina or uterus are rarely called for in general faradization.

Applications to the Lower Extremities.—Unless there is weakness
or paralysis of the lower limbs we do not always apply the current
directly to them, because, when the copper plate is at the feet, the
muscles below the knee are more or less exercised during the whole
treatment.

Before proceeding to make the applications to the lower extremities,
‘he patient should be required to stand up, still keeping the feet on the
copper plate. Male patients who, during the earlier stages of the.
operation, have entirely removed their clothing from the trunk, should
APPLICATION TO LOWER EXTREMITIES. 395

‘be allowed to again put it on, both in order to avoid unnecessary ex-
posure and to protect them from the cold.

With female patients the applications to the lower limbs, except in
cases of paralysis, can be made under the clothing, if the drawers be
slipped down, without exposure.

 

Fic. 107.

General Faradization.—Application to the Lower Extremities,

The operator, sitting by the side of the patient, on a low stool or
ottoman, should then pass the sponge or the hand lightly down the
entire surface of both limbs, from the thighs to the feet, avoiding, so
‘ar as possible, the prominences of the bones at the hip, knee, and
ankles.

The outer portion of the thigh, like the back, is very little sensitive
to the electric current, because its surface is not supplied by very sen-
396 GENERAL FARADIZATION.

sitive nerves. The inner side of the thigh, on the contrary, is supplied
by branches from the sensitive anterior crural nerve, and in nervous
persons especially is very susceptible to electrization. In passing the
sponge or the hand down the lower limbs great pains should be taken
to carefully graduate the current according to the sensitiveness of each
locality. This precaution is more necessary in treating the lower limbs
than the upper, because the contrasts in the normal sensitiveness of the
different parts of the lower limbs are much greater than in the arms,
and because any severe shocks suddenly felt in the legs sometimes throw
patients off their feet.

Jn cases not complicated with paralysis, contractions of the superficial
muscles of the lower limbs, as of the upper limbs, can be produced by
comparatively ferble and painless currents.

Special Rules to be Observed in the Employment of General Fara-
dization.—In the employment of general faradization there are certain
special suggestions, on the observance of which the results of the appli-
cations will very materially depend.

1. The Strength of the Current and Length of the Application.—\t
is better that the first tentative applications should always be made with
a gentle current, and, if the patient be particularly sensitive, it isan ad-
vantage to use the hand of the operator instead of an artificial electrode.
After the patient has become somewhat accustomed to the treatment,
the general rule should be to make the applications pleasantly painful.

Patients who have long been accustomed to the treatment—who have
become, in a certain sense, insensible to the strength of current ordi-
narily used—may frequently be benefited by very powerful currents.

Usually, but not invariably, we may be guided by the sensations of
the patient ; but exceptions to this rule are sometimes very striking,
and should put us on our guard. Some who feel no pain during the
applications may on the day following experience the most disagreeable
reactive effects. (See p. 285.)

2. Thoroughness of the Applications.—General faradization does not
require that all portions of the surface of the body should be touched
by the electrode at every sitting. In nervous and susceptible patients
we can approach the full measure of the treatment only by slow.degrees.
It is oftentimes sufficient to make the first application only around the
neck, shoulders, and on the upper portion of the spine. :

Lt is not always necessary to make the applications to all portions of
the surface of the body, even in a prolonged course of treatment. The gen-
eval tonic effects of this system of treatment can undoubtedly be achieved
without touching either the upper or lower extremities. But, on the

‘
PERSISTENCE IN THE TREATMENT. 397

other hand, it is just as undoubtedly true that the muscular development
that results from long-continued electrization of the arms and legs reacts
favorably on the whole system and materially aids the treatment.

The neck and spine should be treated in all cases, except during the
first and tentative applications, or in patients of very unusual suscepti-
bility. During menstruation it is usually better to avoid the abdomen
and lower part of the spine, or to suspend the treatment altogether,
except in those cases where it is desired to increase the menstrual flow.

Length of the Applications.—The duration of the sittings may range
between five and twenty-five minutes, being modified by the nature of
the constitution, the strength of the current employed, the stage of the
treatment, and the results of the previous applications..

The smallest fraction of this time should be devoted to the head, the
largest to the spine ; next to the spine the abdomen should receive the
largest share of attention.

1. An average application of say 15 minutes may be thus appor-
tioned :

To the head............. silgebasereddiar bvansie narelahe a hs - I minute.
‘* neck, sympathetic and cervical spine..... - 4 minutes,
© hacksiecesonuerer get aes Seieede arcing eek a e 3 «e
SS abd OMeUe 2 4 «5.4 waarmee as te ea seek e 3 me
‘* upper and lower extremities..........-..6 4 oe

As compared with the time required in localized faradization and cen-
tral galvanization, general faradization has not the great disadvantage
that has been supposed. Nearly all the ordinary peripheral applications
of electricity for paralysis require as much time as general faradization.

Frequency of the Applications.—The applications of general faradi-
zation may be repeated daily, every other day, once or twice a week, or
by still longer intervals. Every other day is about as often as is neces-
sary to secure the full tonic results of the treatment; but patients who
are so situated that they can take the treatment but a short time may
receive an application daily, provided they are not in a condition of un-
usual debility, or are not more than ordinarily susceptible to the current.
For the very nervous and susceptible, and especially for those who com-
plain of the secondary or reactive effects, it is often necessary to give
intervals of several days, at least until the permanent tonic effects begin
co he developed (see p. 258).

Persistence in the Treatment.—For the majority of cases, the treat-
ment by general faradization, in order to secure its full results, must be

persistent. The reasons why this perseverance is demanded are quite
398 GENERAL FARADIZATION.

obvious. In the frst place, most of the diseases and morbid conditions
for which general faradization is indicated are exceedingly chronic in
their character. It is necessary ever to keep in mind the emphatic
words of the great Trousseau, ‘Chronic diseases demand chronic treat-
ment,” whatever may be the method employed.

Secondly, Tonic remedies of all kinds, external and internal, are al-
ways more or less slow in their action.

While great and beneficial effects are often derived from two or three
applications, a complete or approximate cure of long-standing morbid
conditions, such as dyspepsia, hypochondriasis, nervous exhaustion,
hysteria, paralysis, can only be achieved by persistent treatment, vary-
ing the strength, of the current and frequency of the applications ac-
cording to the progress which is made. |

The length of time over which the treatment should be extended may
range from one week to several months, with longer or shorter intervals,
according to circumstances.

Comparing the history of all our cases, we find that the average num-
ber of applications administered to each successful case is about 15-25,
and the length of time over which the treatment was extended 4-8
weeks.

The Use of the moistened Hand as an Electrode to the Head and Sen-
sitive Parts.—The advantages which the moistened hand sometimes
possesses over the sponge in general faradization are the following :

1. Ln certain cases it is more agreeable to the patient. It is but a
truism to assert that no form of electrode that human skill shall ever
devise can ever compare with the hand in flexibility and power of adap-
tation. Its shape, its flexibility, the number and arrangement of the
fingers, and the vast and delicate combinations of movement of which
they are so readily capable—all these familiar and wonderful character-
istics of the hand, united to the peculiar softness of the skin, and the
lightness with which it can touch, or press, or handle, render it superior
for the nicer processes of general faradization to any artificial arrange-
ments of which the genius of man could conceive.

For applications to the head and sides of the neck, the brachial plex-
us, and pit of the stomach, the use of the hand electrode is a very
great convenience ; and we sometimes meet with patients who are so
sensitive and so fearful that they will not endure even the softest sponge
on any portion of the body, or at any stage of the treatment. To ap-
ply a mild faradic current to the forehead and crown of the head, with
the softest sponge and largest possible surface, is at best an unpleasant
process for a strong man in perfect health, and for the delicate invalid
USE OF HAND AS AN ELECTRODE. 399

is often unendurable ; but when the hand of the operator is made an
electrode, the operation of faradizing the most sensitive portions of the
head may be made not only tolerable, but positively agreeable. Except
in cases of severe local disease or unusual debility, the sponge can be
borne down the spine, over the abdomen and extremities, and down the
lower extremities without great difficulty.

2. It keeps the operator continually informed of the strength of the
current, and thus enables him to carefully graduate it, according to the
sensitiveness of each locality.

As the current passes through his own person, the operator can judge
by his own sensations whether it is too strong or too weak, and by in-
creasing or diminishing the grasp of his other hand on the sponge, can
modify the strength of the application without disturbing his apparatus.
The wet sponge on which he presses with the other hand, acts, as we
have seen, like a hydro-rheostat.

The use of, the hand as an electrode enables the operator to instantly
modify the applications in any of the various degrees of weakness and
strength, and also to suspend the passage of the current instantaneously
without shock or violence. When the sponge is used we must continually
question the patient, or watch his expression and movements, in order to
judge whether the current is of proper strength.

That most, if not all, of the tonic effects of general faradization can
be obtained in perhaps the majority of patients by the use of the
sponge, there can, we think, be no question; but the use of the hand
of the operator, according to the principles above indicated, enables us
to achieve these results, and with less discomfort to the patient, in those
peculiarly sensitive cases where the artificial electrode could not be
borne at all. Very many of our patients we treat only with artificial
electrodes.

To sum up, in a word, it is a convenience and oftentimes a positive
assistance for the operator to be able and willing to use his hand in ap-
plications to sensitive parts and nervous patients, but for the majority of
cases it is sufficient to use a large soft sponge.

Effects of the Current on the Operator.—The question now arises,
What effect must the operator experience from the repeated passage of
the electric currents through his own person P

It should be understood, at the outset, that the current does not
directly affect the whole person of the operator, nor indeed any of the
prominent organs, and that only the faradic current is used in this way.
The current passes from hand to hand, through the arms and shoulders,
and does not reach or directly influence the brain or any of the organs
400 GENERAL FARADIZATION.

of the chest or of the abdomen. The effects of thus using the current
on the nutrition of the muscles of the arm have already been consider-
ed (see Electro-Physiology, p. 205).

Those physicians whose temperaments do not tolerate electricity,
would do well to avoid passing the current through their own per-
sons in this way. Those, however, and they constitute the ma-
jority, who are more or less benefited by the use of electricity, in this
way, need never fear any evil effects. If they treat a very large num-
ber of patients a day by general faradization, using the hand as an elec-
trode a considerable portion of the time, and with strong currents, they
will be much more wearied at night than if they used the sponge chiefly
or exclusively. This method of general faradization has been and is
now used by hundreds of physicians, and we have never heard of any
serious effects in any instance. The few whose temperaments contra-
indicate electricity soon abandon the use of the hand as an electrode,
since they find that it is a luxury and not a necessity. The majority ex-
perience either negative or beneficial effects, and arrive at that state
where it is a matter of indifference whether they use the hand or
sponge.

Special Effects of General Faradization.—The general effects of
electricity on the system have already been considered (p. 300). We have
here to speak only of those that are peculiar to or most marked under
general faradization.

The effects of general faradization may be subdivided into ¢hree
classes :

1. Those which are experienced during or immediately after treat-
ment.—Primary or stimulating effects.

2. Those which are experienced one or two days subsequent to the
treatment.—Secondary or reactive effects.

3. Those which remain in the system as a permanent result of treat-
ment.—ermanent or tonic effects.

Many patients, perhaps the majority, experience after each séance a
feeling of enlivenment and exhilaration that often lasts for several
hours. With some this feeling of exhilaration is very positive and de-
cided ; with others it is but just perceptible. Others, again, experi-
ence a disposition to sleep after treatment, quite similar to that which is
felt after a bath in the surf.

Relief of pain and local or general weariness is a very frequent as
well as very agreeable temporary effect of general faradization, and
one which, more perhaps than any other, tends to inspire the doubt-
ing patient with confidence in-the efficacy of this method of treat-
EFFECTS ON PULSE AND TEMPERATURE. 401

ment. Patients who suffer from indefinable nervous pains in the head,
back, side, and stomach, or from weakness in the limbs, frequently ap-
preciate relief even in the midst of the application. This relief usually
lasts for several hours, and in some cases may become permanent.

All the disagreeable symptoms that sometimes arise from an ap-
plication, as headache, malaise, chilliness, vertigo, faintness, and cold
perspiration (see pp. 284-287), like similar effects from injudicious use
of other tonics, physical exercise, the shower-bath, etc., are not usually
of any permanency whatever. Indeed, they are entirely consistent with
permanently good results; but they are apt to annoy and alarm the
patient, and for that reason, if for no other, they should be avoided.

Liffect on Temperature.—The temperature may be immediately
influenced by general faradization.

Its effect on the circulation seems to be that of an egualizer. Pa-
tients afflicted with nervous diseases are apt to suffer from cold feet and
hands, and from creeping chills over the body. The equalizing, warm-
ing effect of general faradization on such patients is most decided and
agreeable, and is so positively realized, even in the midst of the séance,
that neither the bare feet nor the exposed trunk suffer from the cold,
provided the air of the operating-room is of even a moderate tempera-
ture.

Liffect on Pulse.—The effects of general faradization on the pulse are
quite interesting and suggestive.

In a large number of cases we have carefully counted the pulse, and
also observed its quality just before and just after the treatment. The
results of some of these observations are presented below :—

Before the After the Before the After the
Application. Application. Application. Application.
I 60 60 12 68 80
2 77 76 13 104 100
3 88 80 14 68 80
4 74 80 15 70 73
5 60 15 16, 106 102
6 82, 84 17 72 60
7 80 76 18 92 67
8 76 84 19 74 79
9 80 84 20 68 76
Io Ior go 2 72 66
II 115 * 100 22 74 62

On account of the recognized susceptibility of the pulse, especially
of nervous invalids, to the influence of mental impression, we have
found it necessary, in order to avoid error, to make repeated examina-

tions before and after the sitting.
26 ;
402: GENERAL FARADIZATION,

The conclusion, from our very large number of observations in regard
to the influence of general faradization on the pulse in chronic diseases,
is that of a corrective.

When the pulse is high it depresses it more or less, and usually in
proportion to the degree of the exaltation above the normal standard.
When it is low it raises it more or less, and usually in proportion to the
degree of the depression below the normal standard. In nervous and
excitable patients, the effect of general faradization on the pulse is much
more marked than in the cold and phlegmatic. An application that is
much too strong may greatly excite the pulse.

Special and Exceptional Effects.—The immediate effect on the ap-
petite is, in rare instances, so marked that the patient at once feels
desire for food, and at the next meal eats a much larger quantity and
with far keener relish than usual.

Sensitive patients are now and then compelled to evacuate their
bladder or rectum immediately after or even in the midst of the appli-
cation, and the urinary secretion is occasionally increased. But all
these effects of general faradization on the functions of special organs
are incidental and occasional, and are not to be expected with any
uniformity or constancy.

Secondary or Reactive Effects.—The secondary or reactive effects of
general faradization are those which are experienced for a day or two
Jollowing an application. These effects are probably not observed in
more than half of the cases, and usually only at the outset of the treat-
ment. Most of these secondary or reactive effects have already been
considered (see p. 286).

Soreness in the muscles of the neck, trunk, and upper extremities is
unquestionably the most frequent of the secondary symptoms of gen-
eral faradization, and the one which patients are soonest to observe and
describe. It is the result of the muscular contractions that are pro-
duced by the electric current. They usually pass off in two or three
days, and are scarcely observed at all after the patient has once be-
come accustomed to the treatment. By making the first tentative ap-
plications gentle and short, it is possible to avuid entirely this subse-
quent muscular soreness, and in very feeble or very timid patients we
should always endeavor to do so.

Indefinable zervousness is another occasional secondary effect, and one
that often gives rise to idle and unnecessary alarm. Like the soreness
of the muscles, it usually passes off in a day or two, and is not commonly
experienced after the patient has become accustomed to the treatment.

Weariness and exhaustion may be experienced by this class of pa-
PERMANENT OR TONIC EFFECTS. 403

tients for several days after an injudicious application. It is a very
interesting and important fact, that these annoying secondary symptoms
of weariness and exhaustion are oftentimes experienced to their fullest
extent by patients on whom the immediate effects for a few hours suc-
ceeding the application are only agreeable. On account of this fact,
the inexperienced electro-therapeutist may be unpleasantly deceived,
and from the temporary enlivenment of his patient may suppose that
his application has been thoroughly successful, until the distressing
secondary effects, continuing perhaps for several days, show most
clearly that it has been either too strong or too protracted.

Permanent or Tonic Effects.—To designate any precise time or stage
of the treatment when these tonic effects are to be looked for, is
manifestly impossible. Like the tonic effects of other analogous! in-
ternal or external remedies, the time of their appearance must be
variously moditied by the nature of the disease, the constitution of the
patient, and the skill and perseverance of the treatment. They may
appear eaily in the treatment, developing themselves with great
rapidity ; or they may remain latent until after the applications are
abandoned, and then advance with sure and steady progress. They
may be so rapidly manifested at the commencement of the treatment
as to cause us to suspect them to be more the result of mental im-
pression than of the applications; and, on the other hand, they may
develop themselves so long after the treatment as to suggest the doubt
whether they are not as much due to nature and time as to the direct
electric influence.

Among these tonic effects of general faradization, those which chiefly
attract the attention and are of the principal importance are the following:

Improvement in the Sleep.—This symptom comes frst in our analysis
of the permanent effects of general faradization, because it is one of
the first to be appreciated and observed by the patient. As insomnia
is the most constant and universal symptom of those various nervous
conditions for which general faradization is indicated, just so is its relief
or cure the first and leading evidence that the treatment is having its
desired effect. As already mentioned, inclination to sleep is one of the
immediate symptoms of the applications, and may come on even in the
midst of the séance ; but the improvement in the sleep of which we
here speak, as a permanent effect, is appreciated during the intervals of
treatment, and long after it has been suspended.

Lncrease of Appetite and Improvement in Digestion.—Increase of
appetite and improvement in the digestion is not so early nor as con-
stant a symptom as improvement in the sleep.
404, GENERAL FARADIZATION.

It is by no means a constant or uniform effect, even in those cases
where it would seem to be needed, and where, too, in all other respects,
great and lasting benefit is derived from the treatment. Some patients
who are permanently relieved of neuralgia, of insomnia, and of muscular
and nervous debility, yet observe no decided improvement in their
digestion. Such cases, however, are quite exceptional.

Regulation of the Bowels.—Constipation sometimes yields very early
in the treatment. The temporary effect is probably due, in many
instances certainly, to the direct mechanical action of the current on
the intestines; but permanent relief, either of constipation or of
diarrhoea of the nervous variety, is not to be expected until the indigestion
and general debility on which they depend have first been corrected.

Improvement in the Circulation.—Permanent equalization of the
circulation is most observed in cases of dyspepsia, nervous ex-
haustion, hysteria, and similar conditions with which defective circula-
tion is so frequently associated. It is then the result of the improve-
ment in the assimilative power and nutrition of the system.

Relief of Nervousness and Mental Depression.—The indefinite,
though very well recognized condition which we term nervousness,
and the indefinable mental agony that forms so prominent and so
distressing a symptom in hysteria, dyspepsia, exhaustion, and other
nervous conditions, sometimes yield to general faradization quite early
in the treatment.

Increase in the Size and Hardness of the Muscles, and in the Weight
of the Body.—This is a natural result and accompaniment of the im-
provement in nutrition, and that it follows the use of the faradic as well
as of the galvanic current, sufficiently demonstrates that power over
nutrition is not confined to the latter.

Under the influence of protracted treatment by general faradization,
the muscles are sometimes developed in size as well as in firmness to
a degree which very naturally astonishes those who, for the first time,
have their attention directed to it. This increase in size and quality of
the muscles is, of course, chiefly observed in those portions of the
surface of the body where, under the influence of faradization, con-
tractions are most easily produced. Therefore we first look for this
effect in the arms, the legs, and afterwards in the chest. ‘This effect is
soonest observed in patients who are comparatively thin, or at least,
whose muscular tissue predominates over the adipose. On the other
hand, and for obvious reasons, it is not so perceptible in females, or
in the very corpulent of either sex. i

Under general faradization actual increase in the size and weight of
RATIONALE OF THE EFFECTS. 405

the body sometimes takes place so rapidly and perceptibly to the eye
that it need not be confirmed by reference to the scales. In other
cases, where patients, either through curiosity or accident, have care-
tully weighed themselves just before taking a course of-treatment, a
most remarkable increase of weight has often been observed in the
course even of a few weeks.

The increase of weight is simply a result of the effect of the
electric currents on nutrition, and a natural sequence of the improve-
ment in the sleep, the increase of appetite, and the relief of pain and
mental depression of which we have already spoken.

Increased Disposition and Capacity for Labor of the Muscles and of
the Brain.—Whatever tends, directly or indirectly, to improve nutrition
must of necessity increase the capacity for intellectual and muscular
toil. Accordingly we find that patients who were so feeble that even a
short walk or ride was fatiguing, and’ who were signally deficient both
in the will and the capacity for exertion, soon begin to develop, under
treatment, an activity and vigor that is sometimes surprising. They
can walk farther and more vigorously, and with greater enjoyment.
They realize a consciousness of strength to which before they were
strangers, and feel emboldened to exertion from which they would for-
merly have shrunk with apprehension.

Concerning these permanent tonic effects it is to be observed :—

1. They are not uniform. They vary not only with different individ-
uals and diseases, but also with the same individual at different periods
of life.

2. They are more rapidly appreciated by the active and the nervous
than by the cold and phiegmatic. Other conditions being the same, a
sensitive, impressible organization will recover more rapidly under gen-
eral faradization than one of an opposite temperament.

\3. They are frequently not experienced until long after the treat-
ment ts abandoned. These after effects of general faradization are
worthy of the highest attention. The possibility that they may occur
is a constant encouragement in the treatment of all slow and obstinate
cases.

4. They are usually as lasting and permanent as similar effects from
other remedies and systems of treatment. It is true that patients who
have been apparently cured by general faradization are subject to re-
lapses, yet to no greater and apparently to a less, extent than those who
have derived similar relief from internal medication. In considering
this statement, regard should be had to the fact that the diseases for

which general faradization is chiefly indicated, at least those in which it
‘
406 »GENERAL FARADIZATION.

has thus far been most successful, are just the diseases which are most
likely to relapse under any or all forms of treatment.

Rationale of the Effects of General Faradization—It has been said
of general faradization that it is not physiological ; but they who raise
this objection do not well consider what they say. Of the various methods
of electrization none can be better explained on a physiological basis
than can this. General faradization is to the whole body what localized
faradization is to an individual part or organ. All! the physical, me-
chanical, chemical and physiological effects, with the consequent in-
crease of the processes of waste and repair and improvement in nutri-
tion that electrization is capable of producing in the living tissues (see
Electro-Physiology, p. 188) and which, in exclusively localized applica-
tions, are mainly confined to the part which is traversed by the current,
are in general applications appreciated by every part of the system.
Then, again, the improvement which each part or organ receives from
the treatment reacts upon every other part and organ. Every effect
becomes in its turn a cause ; the strengthened brain sends more nervous
force to the stomach, by which the latter is enabled to send better blood
to the brain.

Comparing what is known of the conductibility of the tissues (see
p. 180), and the action of the electric currents upon them, with the ob-
served effects of general faradization, these effects may be regarded as
due mainly—

1. Zo the fact that the nutrition of the entire central nervous system
is directly influenced by the current. In an ordinary application the
brain, spinal cord, and sympathetic ganglia are all subjected to the ac-
tion of the current. In most of the applications of central localized
electrization only a part of the central nervous system is affected at
each sitting. We are warranted in believing that in nearly all nervous
diseases the central nervous system is more or less disturbed, even when
it is not organically diseased.

2. The passive exercise that results Jrom the vigorous and repeated
muscular contractions produced by the applications. When the applica-
tions are thoroughly and skilfully made, vigorous yet agreeable con-
tractions are excited, not only in all the superficial muscles, but in the
deeper layers, and also of the contractile fibre-cells of the stomach,
the intestines, and other vital organs. The augmentation of the mani-
fold processes of waste and repair which a single sitting causes in the
muscles and abdominal organs would alone powerfully influence nutri-
tion, even though the electric current exerted no direct effect on the
nervous system. #

‘
“PASSIVE EXERCISE AND REFLEX ACTION. 407

That the tonic effects of general faradization are very largely due to
the passive exercise which it produces, is proved clinically by the fact
that when a current too feeble to cause muscular contractions is used,
or when the muscles are neglected, the tonic as well as the primary
effects of the treatment are much less marked.

3. Reflex action from the sensory nerves. The reflex effect of the
faradic current even is very powerful, and in general faradization nearly
all the superficial sensory nerves are acted upon, and consequently the
whole nervous system is constantly under reflex as well as direct in-
fluence of the current.*

* Brown-Séquard and Lombard (Archives de Physiol., November and December,
1869) have shown that when one arm is pinched the temperature of that arm slightly
rises, and that of the opposite arm falls, Dr, James J. Putnam (Boston Medical and
Surgical Journal, June 23, 1870) has shown by a series of experiments on frogs that
electrization of one foot caused reflex contractions of the blood-vessels in the web of
the foot of the opposite side. These experiments, taken in connection with the fact
that nutrition is closely related to circulation, would render it clearly probable that
reflex action is an important factor of the results of application of electricity, and
especially of general faradization, where the extremities are directly affected by the
current,
CHAPTER XI.

DIFFERENTIAL INDICATIONS FOR THE USE OF LOCALIZED AND GENERAL
FARADIZATION.

In order to determine the differential indications for the use of
localized and general faradization we need to consider these four
facts :

First, That general faradization directly affects the whole body, while
in localized faradization the direct action of the current is mainly con-
fined to the part to which the application is made. .

Secondly, That general faradization may, by sympathetic or reflex
action, indirectly have a special therapeutic influence on some specias
part or organ, while localized faradization of any part, but especially
of the sympathetic or cerebro-spinal axis, by sympathetic or reflex
action, may indirectly have a general therapeutic influence on the
whole body.

Thirdly, Faradization, when properly performed, very rarely injures,
and usually more or less benefits, even those parts which are‘in com-
parative or absolute health. ‘This consideration has an important prac-
tical bearing, especially in the use of general faradization, in cases of
doubt as to the seat of the disease. (See p. 271.)

Fourthly, Jn nearly all cases it is important, and in many it is indis-
pensable, that the applications should be made to the seat of the dis-
ease as well as to the locality of the symptom. Scientific electro-thera-
peutics, therefore, requires the most accurate preliminary diagnosis ;
above all, it is important to rigidly discriminate between diseases which
are of a constitutional and those which are of a local origin.

From these fundamental considerations we logically derive the gen-
eral law that constitutional diseases are better treated by general, and
local diseases by localized, faradization.

More specifically, experience demonstrates that of the large variety of
diseases for which applications of electricity are found useful, localized
faradization and galvanization are specially indicated in.those cases
where both the seat and the effects of the disease are restricted to cer-
INDICATIONS FOR GENERAL FARADIZATION. 409

tain portions of the organism, with but slight or imperceptible influence
on the system at large. Under this head are included nearly all peri-
pheral and reflex paralyses and neuralgias, effusions, sprains, and local
injuries, and also many of the diseases of the eye, ear, larynx, and
genital and digestive organs.

On the other hand, general faradization is indicated—

1. In those diseases that are dependent on or associated with im-
pairment of nutrition and general debility of the vital functions, such as
nervous dyspepsia, neurasthenia, anaemia, hysteria, hypochondriasis,
paralysis, and neuralgia of a constitutional origin, rheumatism and
other toxic diseases, some forms of chorea, and oftentimes in func-
tional disorders of the genital, digestive, and other special organs. ‘

2. In morbid symptoms dependent on some local cause which can-
not be satisfactorily diagnosticated. It must be confessed that a large
number’ of cases of chronic diseasés are frequently dependent on or
connected with some important lesions, of which, during the lifetime of
the patient, even the most approved methods of diagnosis and the most
practised skill utterly fail to ascertain either the nature or the locality.
This is oftentimes the case with epilepsy, hysteria, and hypochon-
driasis ; sometimes, also, with affections of special organs, as the eye,
ear, larynx, and uterus. :

Benedikt emphatically affirms that electricity should be applied almost
exclusively iz loco morbi, in the place of the disease, and in cases of
doubt recommends tentative applications successively in all the sus-
pected localities until the diagnosis is made out by the success of the
treatment.* It scarcely need be said that this purely experimental
system, though sometimes successful, must be and is annoying, uncer-
tain, and very frequently unsatisfactory. /

The advantage of general faradization in such cases of doubtful patho-
logy are twofold: Firs¢, at each application it affects all parts of the
body, and thus is sure to reach the seat of the disease, wherever that
may be; and, secondly, it at the same time improves the general nutri-
tion of the system, which, in such cases, is frequently more or less im-
paired. This improvement in nutrition, as has been stated, oftentimes
reacts favorably on the local disease.

Still further, it must be confessed that very many of the diseases in
which general faradization is proved to be of most efficient service,
are those in which no special /ocus morbi can be found even on fost-
mortem examination.

* Die Electrotherapie. Wien, 1868, p. 79.
410 GENERAL AND LOCALIZED FARADIZATION COMPARED.

Future investigations will undoubtedly do much to dispel our ‘igno-
tance on these points, and will probably assign a definite local cause
to some of the diseases which are now vaguely classed as constitu-
tional. But even those diseases in which the local cause is definitely
ascertained may demand constitutional treatment as much as or more
than those in which no local cause is demonstrated. When a house is
set on fire by a burning fuse, it is not enough to snatch away the fuse ;
we must extinguish the flames. When the nervous system has been
thrown into tetanus by a wound in the foot, excision or healing of the
wound is of little avail ; remedies must be directed to the central ner-
vous system. Precisely so when chronic local disease has enfeebled
the vital functions and impaired nutrition, our applications are to be
directed to the general system as well as to the seat of the lesion.

3. In certain diseases which, though themselves incurable, are ac-
companied by impairment of nutrition that is susceptible of more or less
relief. Palsy agitans, many cases of cerebral and spinal paralysis, ad-
vanced stages of locomotor ataxia, rheumatic gout, epilepsy, and cer-
tain spastic affections, may be absolutely incurable, and yet the ema-
Ciation, nervousness, insomnia, and general feebleness with which these
diseases are associated as cause or effect or concomitant, may be sus-
ceptible of most grateful relief from general faradization. In not a few
cases of disease of these varieties, after we have failed to do any good
by galvanization of the brain, sympathetic and spinal cord, after even
central galvanization has failed, general faradization alone, given with-
out special reference to the seat of the pathological lesion, has greatly
relieved the symptoms and been of invaluable service by virtue of its
tonic effects, although, of course, it could have no permanently curative
influence.

Illustrative cases of every grade will hereafter be presented in detail.

Cause of Failures in Electro-Therapeutics—The comparison we

‘have here made reveals the cause of some of the failures and
discouragements that have been and are now being encountered
by many experimenters in the department of electro-therapeutics.
Constitutional diseases have been treated locally. Morbid constitu-
tional conditions, such as hysteria, anzemia, rheumatism, and the
like, which, as all physicians agree, demand remedies that affect the
system, are treated electrically only through their local symptoms, such
as peripheral paralysis, or neuralgia, or inflammation of the joints.
Temporary relief, or metastasis Of these local symptonis may indeed
result from exclusively localized applications in such cases, but per-
manent correction of the morbid condition on which these symptoms

ieee ex 6-5
COMBINATICN OF: THE METHODS. 411

depend can only be obtained by general treatment. In subacute rheu-
matism, for example, galvanization or faradization of an inflamed joint
frequently removes the pain and effusion in that joint, and therefore
may advantageously be used with general faradization, just as the ex-
ternal application of alkaline solutions may advantageously be com-
bined with the internal administration of the same remedies ; but to
depend on merely localized electrization in such cases is manifestly as
unphilosophical as it would be to depend on merely local apphcations
of alkalies. In general practice it will unfortunately be found that
physicians will frequently use localized in cases for which general treat-
ment is indispensable for complete results, for the reason that they
have neither the time nor the practice to enable them to use the latter
method with success ; just as the majority of general practitioners, for
want of a galvanic apparatus, are obliged to use faradization in cases
for which galvanization is imperatively demanded.

Combination of the Methods.—Many cases are most successfully treated
by acombination or alternation of the two methods. Thus rheumatism,
for example, may be treated one week or one day by general faradiza-
tion, and the following day or week by local faradization or galvaniza-
tion of the affected joints.

This comparison furthermore reveals and explains the suggestive
fact that the sphere of electro-therapeutics has, in a measure, corre-
sponded to and progressed with the advance in the method of applica-
tion. Thus, when peripheral applications were chiefly used, the scope
of electro-therapeutics, though important, was narrow, neuralgia and
paralysis being the diseases for which it was mainly employed. On
the introduction of localized galvanization of the nerve-centres, electri-
city was found to be most useful for many conditions in which pre-
viously it had been supposed to be either valueless or contraindicated.
The sphere of electro-therapeutics is by general faradization and cen-
tral galvanization still further extended to embrace a large variety of
conditions and indications which localized applications fulfil either not
at all, or but very imperfectly.
CHAPTER XII.

CENTRAL GALVANIZATION.

The object in central galvanization is to bring the whole central ner-
vous system—the brain, sympathetic and spinal cord—as well as the pneu-
mogastric and depressor nerves, under the influence of the galvanic cur-
rent, One pole (usually the negative) is placed at the epigastrium, while
the other is passed over the forchead and top of the head, by the inner
borders of the sterno-cleido-mastoid muscles, from the mastoid fossa to the
sternum, at the nape of the neck, and down the entire length of the spine.

The following representations of the principal steps in the method
of central galvanization were made from photographs taken during the
applications.

 

Fra. 108,

CENTRAL GALVANIZATION, first stage. One pole on the epigastrium, the other on
the cranial centre, the hair at that point being moistened. Before making the
application at this point the electrode may be passed over the forehead,
DETAILS OF THE APPLICATIONS. 413

A female patient is taken in order to show that this method in its
entirety requires little or no exposure.

    

 

  

CS
\ | Ne a v N
i) iN
Nari

e | l TT Fe | /)

af J Ny

Fic, 109.

  

CENTRAL GALVANIZATION, second stage. One pole same position as before, or low er
down, and the other passed up and down by the inner border of the steino-
cleido-mastoid muscle from the auriculo-maxillary fossa to the sternum.

Details of the Applications.—We do not always make the appiica-
tions all over the head, but merely on the forehead, gently passing the
electrode from one side to the other; then baptize the patient on the
cranial centre, at the top of the head, and rest the pole there for about
one minute, and sometimes longer. To the head we apply from two
to six or eight cells—for patients vary in their susceptibility—beginning
with a weak current, and gradually increasing until a sour or metallic
taste is perceived in the mouth. The cranial centre—the summit
between the ears—we regard as the most important region of the head
in all electrical applications, and especially in central galvanization. A
current passing from that point to the epigastrium, traverses the centre
of life—if life has any centre—and affects the sympathetic, and the roots
of the facial nerves. The sensation produced by this application is
different from that of any other application to the head, and is some-
times indefinable.
414 CENTRAL GALVANIZATION.

An application to this point for one or two minutes is usually about
as much galvanization as the brain needs. In exceptional cases,
where the hair is thin, or the head is bald, we make the applications all
over the surface, back and front. In applications to the head, care
should be taken to avoid sudden interruptions, or shocks that cause
dizziness; the flashes of light before the eyes are of little account, but
nothing is gained by producing them, and they are annoying to the
patient.

 

i

FIG. 110.
CENTRAL GALVANIZATION, third stage. One pole same position as before, or on the

breastbone, and the other at the back of the neck between the first and seventh
cervical vertebrze,

The electrode is then passed down the inner border of the sterno-
cleido-mastoid muscle, from the auriculo-maxillary fossa to the clavicle,
for the purpose of affecting the pneumogastric and sympathetic.
We usually make the application on both sides, and from one to five
minutes.

In galvanizing the spine, especial attention is given to the ci/io-spinal
centre, below the first and seventh cervical vertebrz, which is to the
spine what the cervical centre is to the brain. The cervical syripathetic
DETAILS OF THE APPLICATIONS. 415

and pneumogastric, as well as the spinal cord, are affected by the cur-
rent. The electrode should also be passed over the entire length of the
cord by dadile applications up anddown. The back is not usually sensi-
tive, and strong currents, from ten to thirty cells, can be borne without
any more discomfort than a burning or pricking sensation beneath both
electrodes.

 

Fic. 111

CENTRAL GALVANIZATION, fourth stage. One pole same position as before, or over
the abdomen, and the other passed beneath the loosened clothing, up and down
the cord, from the seventh cervical vertebra to the coccyx.

The back may be treated from three to six minutes, and the whole
length of the séance of central galvanization ranges from five to fifteen
minutes.

Preparation of the Patient.—All the preparation a male patient re-
quires for central galvanization is to unbutton and loosen the collar,
remove the coat and vest, and slip up the whole clothing, so that free
access can be had to the spine.

A female patient may remove her corsets and slip up her under-
416 CENTRAL GALVANIZATION.

clothing, or merely loosen the clothing at the neck and waist, so as to
make room for an electrode to be passed down to the epigastrium, and
for a spinal electrode to be passed up and down the back.

Electrodes.—For the negative electrode at the pit of the stomach,
any sponge or flannel electrode with a broad surface, so as not to be
too painful, and an insulated handle that the patient can hold, will
answer.

For the positive pole, we prefer adjustable electrodes (see p. 358), of
different sizes. These can be passed under the clothing with great ease,
and can also be provided with flanviel covers, that may be washed as
often as necessary.

Battery.— Almost any form of galvanic battery will answer for central
galvanization, but for reasons before given (p. 347), a battery that gives
a steady uniform current, and that is provided with a rheostat, is pre-
ferable. The Cabinet battery is exceedingly convenient for central
galvanization.

The method of central galvanization is based on these four as-
sumptions, all of which seem to us justifiable.

1. That in a very large number of diseases, and especially of the so-
called functional diseases, the pathology is not exclusively confined to
any region of the brain, or sympathetic, or spinal cord, but the whole
central nervous system is invaded by a condition of exhaustion and ir-
ritability. We believe this to be true not only of hysteria, chorea, and
of many affections allied to them, but of certain states of neuralgia, and
a number of diseases of the skin. It is possible, furthermore, that some
diseases that are not now regarded as in any respect of a nervous char-
acter may in the future be shown to depend so closely on the nervous
system that they can be most successfully treated, not through their
varying and local manifestations, but through the brain, spinal cord, and
sympathetic. That certain diseases, not primarily nervous, do so affect

the nervous system that they need to be treated, in part at least, by-

remedies that act on the nerves, will be conceded, I suppose, without
question.

2. That a large proportion of the most frequent and distressing chronic
diseases, as hysteria, hypochondria, neurasthenia, chorea, epilepsy,
nervous dyspepsia, neuralgia, and many forms of insanity, are so obscure
and subtle in their pathology that it is impossible to determine the pre-
cise seat of the disease in any given case, even where some local patho-
logical condition may exist, and consequently we can never know just
where the current should be localized. Even when the seat of the dis-
ease is, or is supposed to be, accurately known, if a special revelation

ad
THEORY OF THE METHOD, 417

should kindly inform us whether epilepsy, for example, takes its origin
in the brain or in the sympathetic, and should point out to us just where
the lesion occurred, we should still be in the dark in regard to the best
method of localizing the current, for without another and still more
complex revelation we could not determine the extent to which all
other parts of the nervous system had been affected by the local dis-.
ease.

The force of this objection to the use of the accepted method of
galvanizing the brain and cervical sympathetic is seen when we attempt
to give the complete pathology of any of the diseases we have just men-
tioned, and, indeed, of almost any nervous disease that can be men-.
tioned. Where is the precise seat of the disease in nervous dyspepsia ?
We know that the stomach is weak, and we prescribe galvanization of
the pneumogastric ; but what have the solar plexus and the spinal cord
to say in the matter? Who can tell just how not only they, but the.
brain itself, may be the origin of nervous dyspepsia, or how much they
share in the pathological disturbance, and consequently how much they
need treatment? After eleven centuries of medical study, who can
tell the precise and exclusive seat of the disease in epilepsy, hysteria, and
neurasthenia? Is not the probability continually growing stronger
with the advance of science, that in these and many other diseases the
whole or a large part of the central nervous system shares as a cause,
or result, or concomitant? Even in those diseases where the lesion is
understood, is there not much more of the unknown than of the known ?
In locomotor ataxia, progressive muscular atrophy, spinal congestion
and irritation, is the spine only at fault? Do the sympathetic and rain
wholly escape the infection? ‘Evil communications corrupt good
manners” in pathology as well as in morals, and the communications
between the sympathetic, and cord, and brain, and the nerves that branch
from all these, are so varied, and intimate, and complex, that when the
cord is known to be diseased we very naturally incline to consider the
other parts of the nervous system, like “ poor dog Tray,” in bad com-
pany, and we become very justly suspicious of their character. In this
suspicion we are justified by the accepted views of the functions of the
sympathetic, and by the clinical signs and symptoms of these diseases.

In cerebral hemorrhage we usually know the general locality of the
disease, if not its precise nature ; but the spinal cord, through disuse,
becomes affected with secondary degenerations, and the organs of di-
gestion also more or less sympathize.

3. That the nutrition of the central nervous system will be improved
by passing through it a mild galvanic current.

27
418 CENTRAL GALVANIZATION,

That in the great majority of cases of so-called functional nervous

disease, and in many of the cases of special structural lesions, nerve- .

tonics are indicated, will be questioned by no one. It is also coming
to be pretty generally admitted that electricity is something more than
a stimulant—that it is a Zozic with a powerful sedative influence. Still
further, it is admitted that the sedative and tonic effects of electricity
can be obtained by passing the current, with little o1 no interruption,
through any part, the nutrition of which needs to be improved.

4. It is impossible to exclusively localize the current in the cervical
sympathetic, hence it is certain that the good results that in some instances
follow the galvanization through the neck are due to the effect of the
current on the spinal cord or pneumogastric, as well as to the cervical
ganglia ofthe sympathetic. That the beneficial effects of galvanizing the
neck in cases of nausea, dyspepsia, and gastralgia, are due in part if pot
entirely to the effect of the current on the pneumogastric, is more than
probable. Conversely, we find it impossible to tell how far our attempts
to localize the current in the pneumogastric, by placing one pole at the
pit of the stomach and the other by the inner border of the sterno-cleido-
mastoid muscle, was successful ; and whether the benefit derived took
place through the pneumogastric, the sympathetic alone, or through both
combined, seems beyond the power of mortal skill to determine.

Similar difficulties are experienced in the attempt to differentiate the
effects of the galvanizing the brain; how much the results of applica-
tions to the head are due to the direct or reflex action of the current on
the brain itself, how much to its action on the cephalic ganglia of the
sympathetic, and how much to its action on the roots of the pneumo-
gastric and the upper part of the spinal cord, seems in the present state
of the sciences of anatomy and physiology absolutely impossible to de-
termine. In galvanizing the spine we are puzzled by the same com-
plications. The cervical, thoracic, and abdominal ganglia of the sym-
pathetic, with their enormous plexuses, are all liable to be affected by
the current whenever it is applied up and down the spine ; and how far
the beneficial results of galvanization are due to the effect of the cur-
rent on the cord itself, and how far to its effect on these ganglia and
plexuses, only a special revelation can determine.

Still further, the subject is complicated by the consideration that
electricity works powerfully by reflex action, and in galvanizing the
brain, the cervical sympathetic, or the spine, reflex action must continu-
ally take place through the nerve-centres, and the therapeutical results
produced by such treatment must be in part attributable to such reflex
action.
COMPARED WITH LOCALIZED GALVANIZATION. 419

The positive pole (anode) is applied over the head, neck, and spine,
because it is less irritating than the negative, andtends to diminish irri-
tability. The majority of the cases for which central galvanization is
used are in a condition of abnormal irritability, and need the calming
effects of analectrotonos rather than the irritating effects of catalectro-
tonos. To this rule there are individual exceptions: there are cases
that appear to be benefited more by the negative than the positive
pole. (See pp. 264-266.) :

The negative pole (cathode) is placed at the epigastrium, because
the epigastrium is a good, indifferent point, that will bear well the irri-
tating effect of catalectrotonos. In order to avoid over-irritating the
stomach and the pneumogastric nerve, it is well, in very sensitive
patients, and when long applications are used, to change the position
of the negative electrode by moving it up and down between the ster-
num and abdomen.

The positive and negative modifications (see Electro-Physiology, p. 114)
that take place at the breaking of the galvanic current, in the region of
the anode and the cathode, probably complicate somewhat the effects of
treatment—are, indeed, factors of some importance in producing the
effects, and not unlikely explain, in part, the disagreeable results that
come from too frequently interrupting the current when treating nerve-
centres. The positive and negative modifications can, however, be
mostly avoided by using a rheostat of some kind, and gradually reducing
the strength of the current to a minimum before the electrodes are re-
moved. :

Central Galvanization Compared with Localized Galvaniszation of the
Nerve-centres.—We claim for central galvanization a distinct and sepa-
rate position among the different methods of using electricity in medicine.
The applications of the galvanic current to the head, the neck, and the
spine, which have been variously used by electro-therapeutists since the
time of Remak, are simply forms of localized electrization, since the
object aimed atin all of them is to localize the current, so far as possible,
in the brain or some portion of it, in the cervical ganglia of the sympa-
thetic, or in the spinal cord. ‘Fhen, again, in all these forms of localized
galvanization of the nerve-centres, the poles are placed near each other
over the part to be affected, and the peculiar action of both poles is felt,
so far as is possible by external application, in the organ that is treated.

in galvanizing the head, for example, the poles are applied behind
the ears, or in front of them, or one is placed on the forehead, and
the other on the occiput, or at the nape of the neck. In galvanizing _
the cervical ganglia of the sympathetic, one pole is placed on the
420 CENTRAL GALVANIZATION. :

auriculo-maxillary fossa, or along the inner border of the sterno-cleido-
mastoid muscle, while the other is applied at the back of the neck. In
galvanizing the spine, one pole is placed at the upper or lower part,
while the other is passed up and down the entire length, or kept in one
place, or both may be moved up and down the entire length of the
cord, or confined to any portion, as is desired.

But in central galvanization the electrodes are so placed that the
whole central nervous system is brought under the influence of one pole
(usually the positive) of the galvanic current at one sitting, and without
any important change of position of the negative pole. Besides the cen-
tral nervous system, the pneumogastric and the stomach itself are also
affected; in a word, the great centres of life, of health, and of disease.
. Comparing central galvanization with localized galvanization of the
nerve centres, by the effects, we find differences of a most marked and
interesting character exist. The ordinary methods of galvanizing the
cervical sympathetic, the brain, or the spine, do not, either singly or in
combination, produce the powerful tonic results that are frequently ob-
tained by central galvanization. Sedative and tonic effects are unques-
tionably produced by these local methods, but they are frequently in-
ferior in quality and degree to those derived from central galvanization
when properly administered. This conclusion is derived from actual trial
and observation of cases. Neither the temporary nor the permanent
effects of localized galvanization of the brain, of the cervical sym-
pathetic and pneumogastric, or of the spine, are as satisfactory in many

“cases, even when they are successively used at the same sitting and
with the same time and strength of current, as central galvanization.

Still further, experience teaches that the method of central galvaniza-
tion, in its completeness, is more serviceable than partial or incomplete
applications of it. Placing the negative pole on the epigastrium, and
the other on the spine, will not accomplish the full effects of central
galvanization, although so far as it goes it is a good method, and pro-
duces sedative and tonic effects. To confine the attention to the head
and neck alone, also, is not sufficient.

Compared with General Faradization:—Comparing central galvaniza-
tion with general faradization, we find most important differences. In
the one only the galvanic, in the other only the faradic, current is
used.

In general faradization the application is made not only over the
central nervous system, but over the entire trunk, and especial attention
is given to the muscles of the abdomen and extremities. In central
galvanization the chief aim is to affect the central nervous system ; in
COMPARED WITH GENERAL FARADIZATION. 42)

general faradization the chief aim is to affect the muscular system,
although the nervous system, central and peripheral, is affected both
directly and reflexly.

Comparing the effects of central galvanization with those of general
faradization, we find that both are powerful tonics, and are adapted for
conditions of debility, by whatever names they may be known. For
some cases, and particularly for cases associated with great muscular
debility, general faradization is more effective than central galvaniza-
tion. On the other hand, in cases where simply exhaustion of the
nerve-centres is the leading condition—as hysteria, chorea, and so
forth—central galvanization is oftentimes far superior to general faradi-
zation.

Central Galvanization alternated with General Faradization.—Some
of the bést results that we have yet seen have been secured by combin-
ing or by alternating the two methods.

Sometimes, after general faradization has done all that it is capable of,
central galvanization, rightly used, helps to lift the patient still higher.
In cases where we are not experimenting, and seek only the best good
of the patient in the shortest time possible, we use in succession, or
alternation, and with changes and modifications, all the principal
methods—local galvanization of the brain, of the cervical sympathetic
and spine, general faradization and central galvanization. This course
is found to be oftentimes justified by the results. The improvement is
more positive and more permanent than when a single method is used
exclusively.

Some cases we treat one week by general faradization, the next
week by central galvanization; sometimes we alternate the methods
from day to day.

There are, however, cases not a few, where all forms of faradization,
and where local galvanization of the nerve-centres irritates rather than
‘benefits, but in which, under the method of central galvanization, there
is sure and constant improvement.

Dr. Althaus, of London, in the third edition of his most ‘excellent
work on Medical Electricity, after describing this method of central
galvanization in detaily remarks that he had never carried out the
method in its entirety, but that he had used, experimentally, applica-
tions to the head and neck with the anode, and to the epigastrium with
the cathode. He states that unpleasant results have followed these
experiments, that disagreeable cerebral symptoms were produced by it
during the application, and which sometimes continued for twenty-four
hours or more afterwards. .
422 CENTRAL GALVANIZATION.

“The patients had a general sensation of malaise and nervousness,
headache, and a feeling of giddiness and confusion.”

Dr. Althaus further states that he has used the “application of the
anode to the cervical and Jumbar spine, and of the cathode to the pit
of the stomach with advantage.”

Nothing is easier than to produce these unpleasant results in sus-
ceptible patients by any method of galvanizing the brain and neck,
provided strong currents are used, or interruptions are allowed, or the
applications are prolonged. The same effects may follow general fara-
dization and localized galvanization.

In beginning to treat a patient by central galvanization, we should
use very mild, scarcely perceptible currents, particularly around the
head and neck, and even on the cervical spine, and great pains should
be taken to avoid breaking the current, and the application should be
of only a few moments’ duration. Taking these precautions has now
become with us a mere matter of routine, and we are every day accus-
tomed to treat the most sensitive and delicate patients—cases of hys-
teria, nervous exhaustion, hypochondriasis, and allied affections——cases
which are sufficiently familiar to all American physicians, and with
sedative and tonic effects that are not obtainable by other methods.

Whenever any of the disagreeable effects spoken of by Dr. Althaus
occur, we always give the patient a longer interval, and moderate the
applications until only good, unmixed with evil, effects appear.

The American constitution is more susceptible to electricity than
the English or the German, and if our nervously exhausted, hysterical
women can bear and be profited by central galvanization, surely the
women of England and Germany might be treated by the same method,
even when used with less caution.

We have frequently treated by this method delicate women who are
too feeble to walk or stand, or even to sit up, and who, therefore, must
be treated in bed, and even in such cases, the disagreeable effects only
occur now and then, and no oftener than they occur when other
methody of electrization are employed in the same kind of cases; in-
deed, not so frequently as they follow general faradization or local
galvanization of the brain.

Reply to Objections against Ciianteniion of the Nerve-centres.—
It is proper here to consider briefly some of the objections that have
been brought against galvanizing the nerve-centres by the method of
central galvanization, or by any form of local galvanization. These
objections, which in some instances have come from persons who on
other subjects are well-informed, are of a threefold character.
OBJECTIONS ANSWERED. 423

‘t. That the current goes around the nerve-centres, and not through
them. ‘This objection is fully met by the experiments recorded in
Electro-Physiology, pp. 184-187.

2. That we do not completely understand what the current does
when it penetrates the nerve-centres—in other words, the rationale of
the effect of electricity on nutrition is not yet an exact science. This
objection is just enough, considered as a fact, but considered as an ar-
gument, it attempts to prove too much. By referring to Electro-Physi-
ology we shall see that there are few, if any remedies, the action of
which is as well understood as electricity. We do not exactly and ex-
haustively know its action on the nerve-centres, neither do we exactly
and exhaustively know its action on the peripheral muscles and nerves,
and if this objection is to hold good against galvanization of the nerve-
centres, it must also hold good against all peripheral galvanization and
faradization.

3. That it is dangerous to apply the galvanic current through the
head and neck.

Dr. Anstie, who is a very strong friend of electro-therapeutics in
general, in his excellent work on neuralgia, speaks of galvanization of
the cervical sympathetic as a method to be either avoided or used with
very great caution, and, in support of this view, adduces a case in his
own practice. In a review of Tibbetts’s little “ Hand-book of Medical
Electricity,” Dr. Anstie repeats this caution, and expresses apprehen-
sion lest great injury may follow the use of this method of treatment.
The error of Dr. Anstie consists, not in enjoining caution, since this is
needed in all electrical applications, but in suggesting the idea that gal-
vanization of the cervical sympathetic is a dangerous procedure, likely
to produce serious results. Quite recently Dr. Brown-Séquard, in a
foot-note to one of his series of very able papers, speaks as follows:

“Recently, some bold physicians have tried to galvanize the cervical
sympathetic nerve. This I did once in 1855 on my eminent friend
Prof. Ch. Rouget, to try to relieve him from a most violent headache.

“The effect was all we could desire against the headache ; but the
galvanic current, acting at the same time on the sympathetic and the
vagus (the simultaneous excitation of these two nerves cannot be
avoided), produced such a dangerous syncope, that I promised myself
that I would never try again to apply galvanism to the cervical sympa-
thetic of man.”* ‘

The best reply to objections of this nature, coming from men who

* Archives of Scientific and Practical Medicine, p. 92, No. 1, 1873.
424 CENTRAL GALVANIZATION.

are justly distinguished in the departments to which their lives are de
voted, is found in the argumentum ad hominem.

Dr. Anstie highly recommends hypodermic injections of morphine in
neuralgia.

If, now, we should say to him that we knew of a case where an injec.
tion of morphine had almost instantly caused most alarming symptoms,
and of another case where it had apparently caused death, consequently
we had resolved never again to use that method of treatment, he would
reply that hypodermic injections had been tested for years at the hands
of many of the best physicians of our time; that those who are most
familiar with them are usually the most attached to them; and that,
when properly administered with the caution that all potent remedial
measures demand, and the skill that only experience can give, they
need seldom or never do serious harm; and that the infinitely small
chance of their doing harm, when thus properly used, is so far over-
shadowed, by the infinite relief which they unquestionably do afford, as
to be hardly worthy of consideration in the practice of those who have
made themselves familiar with their administration.

Dr. Brown-Séquard has, among very many other researches, deserved
well of the profession for having given an explanation of the action of
ergot on unstriped muscular fibre, and for having, on the basis of this
explanation, suggested the value of that remedy in congestion of the
spinal cord.

If, now, we should say to him that there are cases where, with
well-defined symptoms of hyperzemia of the cord, ergot at once aggra-
vates the symptoms, we should but state the truth of our experience.
He could reply, however, with perfect justice, that just as there are those
in whom a single strawberry will cause most disagreeable symptoms, or
those to whom a mouthful of mutton is a mouthful of poison, just so
there are those who, whatever their disease may be, cannot bear ergot ;
but that, when wisely used by those who know what they are about, it
is a remedy of vast and various efficacy.

For hypodermic injections of ergot, substitute galvanization of the
cervical sympathetic, and our reply is complete. There are those to
whom electricity, however administered, is a perfect poison, and who
were not born to be treated by this most potent of remedial agents.
There are those who can bear it in well-njgh limitless doses.

There are those who can bear it and who are benefited by it, but only
when given with delicacy and great caution. Now, it is possible to
galvanize the cervical sympathetic in all three classes, except the first,
without doing any serious injury, permanent or temporary. vén those
425

who are the most susceptible to electricity, for whom this force can neve)
be beneficial, can yet be treated by the method of central galvanization,
with very mild currents and short sittings, and a rheostat of some kind
to avoid interrupting the current, unthout any permanent or temporary
mypUury.

All our most potent remedies are dangerous when used dangerously

4. ‘Chat the cases which have been treated by galvanization of the
brain have been so carelessly and unscientifically studied, and so reck-
lessly reported, that they have no scientific value. Dr. Cyon, in par-
ticular, declares that the observations that are given as proofs of the
curative effects of galvanizing the brain are valueless. This statement
is unfair. What is true of certain electro-therapeutists is not true of
all. The therapeutics of galvanization of the brain have been studied
by men who have been trained to the habit of close and discriminating
observation ; who recognize and bear constantly in mind the enormous
complications that beset aJl therapeutics ; who have worked under the
gaze of watchful skeptics, and with the everlasting motto, post hoc ergo
propter hoc, incessantly ringing in their ears; men, too, who have car-
ried conscience into science, and have reported the results to the world
just as they were revealed to them.

It is of very little practical consequence whether these effects are due
to the direct passage of the current through the brain or to the reflex
action of the current on the brain through the sensory nerves. Retlex
_action comes in to explain the therapeutic effects of electricity, however
and wherever applied.. Granting for one moment, what is not true,
that mild currents cannot penetrate the brain, this would be no reason
whatever for abandoning the electrical treatment of the brain so long
as experience shows that benefit is derived thereby.
CHAPTER XIII.

THE USE OF STATICAL ELECTRICITY (FRANKLINIZATION).

WE have already seen that statical electricity—which in the early
history of electro-therapeutics was the only form of electricity that was
recognized—has, since the discovery of galvanism, and still more since
the discovery of faradism, fallen into relative disfavor, and is now but
little used either in the electrical diagnosis or electrical treatment of dis-
ease.

The causes for this decline in popularity of a form of eiectrization
which is certainly of great absolute value, and by means of which
stimulating, tonic, and sedative effects of a most striking character are
unquestionably produced, are the following:

1. Itis a form of electricity that cannot be readily controlled ur local-
ized.

The very essence of statical electricity is diffusion ; it is everywhere,
in our bodies, in the earth, and in the air. Its tension is enormous, and
its laws are not yet fully understood. A strong argument brought by
Duchenne against the use of statical electricity, and so far forth a just
one, was that it could not, like the faradic current, be well localized. As
a matter of fact, no form of electricity can be localized in the body in
the strict sense of the word, for even in the most careful and
restricted applications of faradism or galvanism there is more or less
diffusion, but statical electricity as generally used is very widely dif-
fused. ;

2. The apparatus for the medical use of statical electricity, even those
of most recent construction, are more or less uncertain in their action,
are dependent on atmospheric conditions, and are withal bulky and
expensive.

3. A longer time is generally required for the successful use of statical
electricity than for the use of galvanism or faradism; none of the ordi-
nary methods—localized faradization or galvanization, central galvaniza-
tion or general faradization—require as much time as is generally given
to the séances of franklinization.
METHODS OF FRANKLINIZATION. 427

4. Experience shows that statical electricity, however administered, is
comparatively useless in many diseases in which galvanization or fara-
dization is most successful. On the other hand, it is yet to be demon-
strated that there are any conditions that are better met by the use of
statical electricity than by a skilful use of the galvanic and faradic cur-
rents.

Professor Schwanda, of Vienna, among others, has revived the atten-
tion of the profession to the use of statical electricity by his reports of
successes obtained by Holtz’s electrophorus machine. (For descrip-
tion, see Electro-Physics, p. 19.) He claims that it produces the same
effects in paralysis as the faradic current ; that in cutaneous anesthesia
it is more efficacious than either the faradic or galvanic current ; that
it acts as a general tonic. Something more than these general state-
ments will be necessary to reintroduce statical electricity into practice.

No evidence is adduced to show that the tonic effects of statical
electricity are in any way comparable to those which are obtained from
general faradization or central galvanization. It is difficult to conceive
how it can be more effective in cutaneous anesthesia than faradization,
which is so uniformly successful in this condition that it might almost be
called a specific for it. Very few affections yield so readily to any
method of treatment as functional anzesthesia to faradization.

As compared with the faradic current alone, statical electricity would
appear to have some advantages in the treatment of simple neuralgia,
but as compared with both the galvanic and faradic currents no such
advantage is demonstrated.

In spite of all these opposing reasons, statical electricity has contin-
ued to be used by a few experimenters even in these eras of galvanization
and faradization. Besides Professor Schwanda, above quoted, elec-
tricity from frictional machines has been used by Drs. Golding Bird and
Gull, in Guy’s Hospital ; by Dr. Clement, of Frankfort ; and in the Lon-
don Hospital for the Paralyzed and Epileptic, by Dr. Radcliffe and others.

The methods of using statical electricity that have been most fre-
quently employed are the electric bath, electrization by sparks, and
shocks from the Leyden jar.

The electric bath is either electro-positive or electro-negative. In the
electro-positive bath the patient is placed on an insulating stool, holds
the prime conductor, and receives the electricity accumulated on the
glass plate, while the negative electricity is discharged from the cushions
through a metallic chain connected with the ground.

The surface of the body of the patient becomes charged with positive
electricity, while the surrounding air is negatively electrified.
428 THE USE OF STATICAL ELECTRICITY.

It is claimed that during the application the secretions and circula-
tion are stimulated. The patient should take the bath for two or three
hours daily.

In the electro-negative bath, the patient, seated as before on an insu-
lating stool, receives the negative electricity from the cushions, while the
positive is discharged from the glass plate through a metallic chain con-
nected with the ground. The cushions must be insulated by glass. It
is claimed that the electro-negative bath has a debilitating effect ; that it
deprives the body of its normal electricity ; that it produces effects similar
to those that are obtained by bloodletting. ‘The process of “ charging
the patient”? has sometimes a most charming effect in neuralgia.

- Electrization by sparks is accomplished by drawing off the electricity
from a patient charged in the electric bath by means of some metallic
conductor or by the hand of the operator, the conductor or hand of the
Operator becoming negative and uniting with the positive electricity of
the patient with a snapping noise and a flash of light. Electrization by
sparks is accompanied by a pricking, stinging sensation, and, when the
sitting is protracted, is followed by redness of the skin and a peculiar
eruption of white circumscribed wheals. The eruption usually appears
in five or ten minutes. It disappears in the course of an hour. Some;
times the sparks are drawn through flannel, the end of the insulated con-
ductor being applied to the flannel, and passed up and down over the ~
region that is to be affected. A rapid succession of sparks may pro-
duce vibrations in the superficial muscles. Electrization by sparks has
been found efficacious in paralysis, amenorrhcea, and chorea, and many
other affections.

Shocks from the Leyden jar are produced by bringing the body, or
that portion of it on which we wish to operate, in the circuit between
the outer and inner coating. A shock may be sent through the arms
and chest by placing one hand on the knob connecting with the inner
coating (containing the positive electricity), and the other hand on the
outer coating of the jar containing the negative electricity. A shock
may be sent through the pelvis by applying one end of a branched con-
ductor connected with the inner coating to the back, and applying the
outer coating of the jar against the hypogastric region. In the same way
electricity of the Leyden jar may be localized in any part of the body.
The shock produced by the Leyden jar is sudden and disagreeable.

More recently still, Dr. Arthius, of Paris, has urged the clatms of
statical electricity. His little work * is toan extreme degree unscien-

* Treatment of Nervous and Rheumatic Affections by Static Electricity. By Dr.
A. Arthius, Translated from the French by J. H. Etheridge, M.D. Chicago, 1874.
APPARATUS. FOR FRANKLINIZATION. 429

tific and unscholarly, and the author is evidently ignorant to a profound
degree of the whole subject of electro-therapeutics.

The cases he recites are, however, of considerable interest as showing,
in spite of the imperfect manner in which they are detailed, that very
important sedative and tonic effects can be obtained by statical elec.
tricity.

His best results seem to have been obtained in neuralgia, and in
hysteria and allied affections, and other conditions of debility—the class
of cases where general faradization, central galvanization, and galvaniza-
tion of the brain and cervical sympathetic are most successful.

There is no evidence that there are any advantages in the use of stati-
cal electricity, even as a general tonic ; all the sedative and tonic effects
that, have been claimed by Arthius, or by any or all of the advocates of sta-
tical electricity, are every day obtained by skilful and varied use of fara-
dism and galvanism. Itis not impossible, however, that statical electricity
properly administered may have some therapeutic advantages over an
equally skilful use of faradism or galvanism. It is not impossible that
temperaments that wiil not bear faradization or galvanization in any:
degree may bear Franklinization. We only claim that with statical elec-
tricity, as with electric baths, no such claim has yet been established, and
that it cannot be established except by careful and protracted study by
‘ those who are masters in the whole realm of electro-therapeutics.

Apparatus for Franklinization.—Holtz’s machine (see Electro-
Physics, p. 19) or Carré’s modification of Holtz’s machine is probably
the best for electro-therapeutical purposes, for the reason that it is more
trustworthy and convenient.

Besides the machine, there are needed for electro-therapeutical pur-
poses, an insulator or electric stool, resting on glass feet, and covered
with a non-conducting varnish, to make the insulation more thorough,
Arthius* makes the insulator large enough to hold a chair, in which the.
patient sits. The feet of the patient may be placed on a glass plate.

: .The excitators are made of metal, with a point at one endand a ball
at the other. A chain connects the’ excitator with the ground and is
kept from touching the patient by a ring attached to a glass rod in the
left hand of the operator. These excitators are made of various metals,
and it is claimed by Arthius, that particles of the metal are transported
into the body of the patient, and that, therefore, differential therapeutic
results follow different metals. It is undeniable that very minute quantities
of the substance of the excitator are transported to the surface of the
body from the metallic electrode, even if they do not really penetrate be-

e

*,Op. cit., p. 38.
430 THE USE OF STATICAL ELECTRICITY.

 

Fig. 112.
Method of Franklinization. —(Arthius. )

neath the skin; for that would be in full accordance with what is known
of electro-physics (see Electro-Physiology, p. 190). The other part of
the chim, that the therapeutic results of the treatment vary with the
kind of metal, is very difficult to establish. Dr. Arthius claims that the
patient appreciates different sensations with different metals; that the
odor also varies, and that the patient can distinguish after some practice
the metal used by the odor; that there is an appreciable loss in waste
of the metal used ; and finally that where copper excitators are used there
is more relief than with other metals.

Granting all the above claims, it may be doubted whether it is not
better to give our remedies in the usual way, by the mouth, or hypoder-
mic injections, and give electricity, so far as possible, pure and uncom.
bined.
CHAPTER XIV.

ELECTRIC BATHS,

A METHOD of employing electricity that has long been popular among
the laity, though it is not yet fully introduced into science, is the electric
bath. The methods of giving electric baths are various. The requisites
are a bathing tub of some form, partly filled with water, contrivances
for sending the current—éither faradic or galvanic—through the water in
which the patient is immersed. An electric bath can be extemporized
in any ordinary bath-tub. The patient may rest his feet on one pole in
the water and hold the other pole in his hand. In that position the
body of the patient becomes part-of one or the other pole, and the cur-
rent flows through him from one pole tu the other, just as it would if
there were no water in the bath; or at most the only effect of the water
is to thoroughly saturate the part of the body in contact with the pole
in the bath. This method is, of course, exceedingly crude, and can
scarcely have any conceivable advantage over a similar position of the
poles outside of the bath, and yet it has been not a little used.

Mr. Russell uses the following form of electric bath. The tub is
of the ordinary shape, but the metallic connections are so made that
the.current cannot avoid passing through the body of the patient. One
pole—a broad copper plate—is at one end of the tub, constituting a
part of its lining surface, and the other pole—also a broad metallic plate
—is placed at the other end. Both plates are under the water. At
the head of the tub a board is placed, at a little distance from the pole.
This board has in it a slit of moderate size. Against this slit rests the
back of the patient, while his feet may or may not press against the
copper plate at the other end of the tub. By this arrangement the cur-
rent can be directed through the back of the patient, and from the back
through the body and lower limbs. Indeed, the back of the patient fits
so closely and snugly into the slit of the wooden rest, that the current,
if it pass at all, must go through the body.

In regard to the electro-conductibility of the body as compared with
water, we have already spoken. The human body is composed mostly
of water, holding in solution various salts ; it, therefore, conducts bet-
432 ELECTRIC BATHS.

ter than water of the same temperature ; and on account of this superior
conductivity of the living human tissue a considerable portion of elec-
tricity must go through the body whenever it lies in a bath, even though
it does not touch either pole. That the body conducts better than the
water is proved by this experiment, which we have often made. Place,
both hands, at some distance apart, in a bath through which a current
of considerable strength is running, and a sensation will be distinctly
felt inthem. Bring the hands, still immersed, very close to each other,
and the sensation will be much diminished. When the hands are far
apart a considerable portion of the current passes through the body from
one hand to the other. It prefers this much longer and roundabout
road to the direct path through the water.

 

Fic. 113.
Electric Bath.

In the arrangement that Russell uses (Fig. 113), if the patient presses
his feet against the copper plate at the lower end of the tub, his body
becomes a part of the pole that is attached to that plate, be it positive
or negative.

Dr. Justin Hayes, of Chicago, has a somewhat different form of elec-
tric bath. In the sides of the tub and near the bottom are a number of
electrodes connected with the battery. These electrodes are so arranged
that the current can be sent through any one or all of them, and thus be
localized on the part that specially needs treatment.

This method of using electricity, which is called the electro-thermal
treatment, is carried out by Dr. A. P. Peck, of Chicago, who has ob-
tained excellent results. from its employment.

‘The study of the comparative practical advantages of these different
forms of baths is of course beset by many complications.
EFFECTS. 433

Effects of the Electric Bath.—In regard to the therapeutic effects
of the electric bath, we have these remarks to offer:

x. The stimulating, sedative, and tonic effects of electricity are ob-
tained more or less by all forms of electric baths; not only those
where the current is localized in some part of the body, but those where
it is generally diffused without regard to localization and without re-
gard to current direction, exert, there is no question, more or less the
special and distinctive physiological and therapeutical effects of elec-
tricity. ‘Those forms of baths that admit of localization of the current
seem to us to*be far more scientific and rational than those that do
not admit of such localization, but all forms are capable of affecting the
system, for electricity cannot pass through the body without doing
more or less good or evil.

2. The question whether electricity, ad ninistered in any of the forms
of baths yet devised, has any therapeutical advantage over the ordinary
methods of using electricity—as localized faradization and galvanization,
general faradization and central galvanization—has not yet been estab-
lished. Even if it should be proved that in certain diseases or certain
conditions the electric baths are slightly superior to o:dinary electriza-
tion, the further question would still arise whether this advantage is
sufficient to compensate for the longer time and greater labor and in-
convenience of the baths. The question is one of exceeding complexity
—for the therapeutical effect of the water is combined with the thera-
peutic effect of the electricity, and to eliminate the one or the other
is no easy task. Enthusiastic advocates of the baths sometimes make
the same mistakes as the advocates of Franklinization, or the use of stati-
cal electricity, of assuming that the results which they undeniably obtain,
and which are sometimes most satisfactory, could not just as well have
been obtained by a proper use of electricity in some of the ordinary
methods.

It is claimed that the baths will be borne by temperaments that will
not bear ordinary electricity. This claim may possibly be just, and
yet the difficulty of demonstrating it is very great ; for those who take
the baths and are benefited by them may most likely have been im-
properly treated by the other methods, and thus fall into the delusion that
the baths are per se more bearable than ordinary electrization.

The true and only way to determine this question is for those who are
masters in electrology to try the baths, side by side with their other
methods of using electricity ; just as they try the two currents and the
different methods of using them on the same patients and on different

patients, and in a wide variety of diseases. Observations of this kind,
28
434 ELECTRIC BATHS.

to be of real value, must be not only numerous, but extended over a long
period.

The question whether substances can be introduced into the body or
removed from it by electricity, will be discussed in the section on
electro-surgery.

General Rules for giving Electric Baths:—In the use of electric baths
we should be guided by some of the same general principles that guide
us in the use of electricity by other methods. The temperament of the
patient should be studied, and in the length and strength of the baths
and in the frequency with which they are given we should be directed
by the peculiarities of each case. ,

It is not well to take an electric bath just after a full meal, nor is it
usually well to take exhausting exercise immediately after a bath, espe-
cially for the delicate and nervous. The temperature of the water
should be about that of the body, and may range between 95 and 105°
Fahrenheit. ‘The patient may remain in the water from 5 to 25 min-
utes. There appears to be no danger of catching cold after taking an
electric bath, even when the water is quite warm. One effect of the
electricity would appear to be to give tone to the cutaneous vessels, so
that there is less liability to take cold than after a simple warm bath.
CHAPTER XV.
HYSTERIA AND ALLIED AFFECTIONS.

UNDER this head we include hysteria, in the ordinary sense of that
term; neurasthenia, or nervous exhaustion; hypochondriasis and mel-
ancholia; spinal irritation, with the manifold symptoms with which it
is associated ; insomnia ; and astraphobia, or fear of lightning.

We give hysteria and allied affections a prominent position in thé
clinical portion of this work, because it is a class of diseases for which
electrical treatment is especially adapted, and in which its success is
most remarkable. This fact is not generally appreciated, for the reason
that the profession have looked upon electricity as a stimulant merely,
and have not fully recognized its sedative and tonic properties, and
hence have confined their attention largely to paralysis, as the one dis-
ease above all others to be treated by this agent.

Electro-diagnosis.— Usually, though not necessarily, there is exces-
sive sensitiveness to the electric current in all parts of the body. Pa-
tients sometimes can bear only the mildest currents. In some cases
even a mild current will not be borne on the middle of the back, which,
in health, is usually so little sensitive. Reflex sensations may be ob-
seryed during electrization of hysterical patients. Irritation of the dis-
eased side of the body may be sensitively felt in the healthy side.
Sometimes there is capacity for bearing very strong currents without
injury, even when there is great hyperesthesia. The electro-diagnosis
of hysterical paralysis will be presented under that disease.

Treatment.— Hysteria is a constitutional disease, and demands con-
stitutional treatment. To attempt to chase after and direct the appli- .
cation of electricity to each special symptom as it appears, is unphilo-
sophical and usually unsuccessful. General faradization and central
galvanization are methods of electrization that are indicated for hysteria.
Under whatever symptoms it may be developed, our chief and best
results have been obtained by these methods. This general treatment
does not, of course, dispense with localized electrization of paralyzed
muscles, or special attention to any localities where the disease is
436 HYSTERIA AND ALLIED AFFECTIONS.

for the time directed. Diseases of the sexual organs, hysterical hic-
cough or cough, aphonia, or incontinence of urine, may sometimes
need localized electrization ; but these symptoms frequently yield under
general faradization or central galvanization, even when no special
attention is given to the diseased parts. In nearly all cases, except,
perhaps, long-standing paralysis, it is much better to dispense with the
local than the general treatment, There are cases, however, in which
the symptoms of rigid contractions of certain muscles are most persistent
and painful in character. In such conditions of the affected muscles
galvanization should never be omitted. In cases of extreme hyper-
zesthesia it may be necessary, as Benedikt advises, to place the patient
under the influence of an anzsthetic while the application is made.
Strong currents do not appear to be injurious in such cases.

Prognosis.—The behavior of hysteria under electrization is as capri-
cious and inconsistent as are itssymptoms. Some cases yield to gen-
eral electrization with wonderful rapidity ; others, apparently no worse,
are singularly obstinate. On the average, the prognosis is so favorable
that no case should be abandoned without a fair trial of this method of
treatment. Under peripheral electrization the results are usually un-
satisfactory, since the relief of the local symptom is by no means a cure
of the morbid constitutional condition.

Violent hysterical symptoms dependent on suppressed menstruation alleviated by two
séances of general faradization and localized galvanization.

Case I.— A most violent and persistent case of hysteria, in the person of a married
lady, aged 40, came under our observation through the kindness of Dr. Oliver White.
The patient was in bed, suffering from violent paroxysms of alternate weeping and
screaming. The hands and feet were cold, the pulse feeble, and the pain in the head
was constant, and of the most severe character.

These symptoms had continued for nearly forty-eight hours, and in order to avert
serious consequences it seemed as if in some way relief must soon be afforded. The
menstrual period was delayed nearly two weeks, and to this circumstance it was
possible, in part, to attribute the attack. The patient was submitted to thorough
general faradization, and immediately atter 2 galvanic current from eight cells was
as nearly as possible localized in the uterus. These efforts were followed by decided
alleviation of the symptoms, and a tolerably quiet night was the result. The menses,
however, did not appear, and on the following night we gave again the same treat-
ment, slightly increasing the tension of the galvanic current. Before morning men-
struation became manifest, and there was no further evidence of nervous disturb-
ance,

Nearly a year subsequently this patient experienced another attack of like charac-
ter, and substantially the same treatment again relieved her completely within forty-
eight hours,
CASES OF HYSTERIA. 437

Hysteria of one year's standing in a married lady, following parturition ; strange
and indefinite sensations in the legs; twchling, crawling, pricking, waving, beat-
ing, pounding, heaving, rolling sensations over head and body; imaginary swell-
ing of the body; fits of weeping and great despondency—Rapid and decid:d
emprovenent under central galvanization with strong currents, after failure of
general faradization—Cod-liver-oii emulsion and counter-irritation used at the

same time,

CasE II.—Mrs. B., ‘a matried lady, with two children, was referred to us Novem-
ber 5, 1872, by Dr. Conkling, of Brooklyn.

The patient, though a lady of unusual intelligence and great strength of will, had
for nearly a year been a victim to many of the worst symptoms of hysteria. The
symptoms appeared ten days after the birth of her second child; up to that time her
health had been almost perfect. She came from a family in whom there was some
tendency to consumption, and she had lost two sisters by that disease. A short time
before the birth of her second child, she had fallen down stairs and had struck on the
back of her head. The query arose whether that might not have had something to
do with her disease. The symptoms came on in the night, and quite suddenly. She
became excessively nervous, almost wild, and the physician was sent for and succeeded
in calming her ; then followed a long catalogue of woes. On the top of the head
was a constant sensation of shaking or agitation, or thrilling, as shé described it, and
heaving, rolling, beating, waving, pounding sensations were felt in the head and over
the body. There had been many attacks of weeping; at all times, though naturally
hopeful, she was cast down, and imagined she did not love as she should one of her
children, The general nutrition, as usual in such cases, was well maintained.

The patient had tried, with great thoroughness, general faradization but without
substantial service,

We used on her mainly central galvanization, combined with the use of cod-liver-
oil emulsion, and mild counter-irritation over the tender vertebra.

The patient, with all her nervousness, bore the galvanic current in enormous
doses; it seemed to be impossible to injure her by over-electrization. We soon found
that the stronger the currents, and the longer the applications, the greater the benefit.
Even through the brain strong currents, now and then interrupted, did no harm,
‘She soon began to improve, and continued to improve not only during the three
months of treatment, but subsequently, and there was in this Hapeevene a consid-
erable degree of permanency. ;

In the above case there were facts of great interest. rst, the ex-
traordinary tolerance in a highly nervous patient of the galvanic cur-
rent; and secondly, the supreme advantage of central galvanization
over general faradization in severe functional diseases of the central
nervous systen..

A condition where the superiority of central galvanization seems most
apparent is that which so often accompanies the “change of life.”
Many of the symptoms of this familiar nervous state are similar to those’
recorded in the case above detailed.
438 HYSTERIA AND ALLIED AFFECTIONS.

Hysteria of a psychical origin—Puaroxysms of weeping—Pain in the ovarian re
gton— Great hyperesthesia—Improvement under general faradization,

CasE III.—The case of a young unmarried lady under the professional care of Dr.
H. Gregory, of Harlem, very well illustrated some of the main points of the above
remarks,

The patient, who was but eighteen years of age, had for several years been the
victim of constitutional debility that disqualified her for indulging in any considerable
amount of exercise, ‘

This debility, however, was not, as she asserted, sufficient to account for the indis-
position frequently evinced of making any exertion. At these times, whenever she
ascended the stairs, or even attempted to walk across the room, she complained
earnestly of severe pain in the left ovarian region, which extended down the left and
sometimes even the, right leg. She was at all times excessively low-spirited, and
usually indulged during the day in several gwéet crying spells. When her paroxysms
.of weeping were unusually violent (presenting more of the hysterical character) the
cardiac nerves seemed to suffer, as evidenced by attack of palpitation with deranged
rhythm. These paroxysms were attended by greatly increased pain in the ovarian
region, and this pain she regarded as the cause of all her unpleasant symptoms, The
fact that this part was exceedingly sensitive to pressure, while the right side was in-
sensible to ordinary impressions, was to her and her friends additional proof that, her
nervous condition was an effect and not a cause of this local irritation, As counter-
irritation and the usual tonic influences indicated in such a case seemed to afford but
little or no relief, her physician advised electrization, and invited us to treat the
patient. A gentle faradic current, applied with the hand as an electrode over the
left ovarian region, caused greater pain than pressure alone, and immediately excited
an attack of crying.

After she had been treated several times, and had become familiar with the opera-
tion, it was interesting to notice the fact that if her attention was engaged in
earnest conversation during an application, the current excited in her no manifesta-
tion of pain,

_ If her mind was recalled to the operation on hand, the part suddenly and unac-
countably became as sensitive as ever. The patient continued treatment two months,
and received twenty general applications,

Uninterrupted improvement followed our endeavors, She gradually gained in
strength and spirits, Her paroxysms of weeping became less and less frequent until
she was comparatively free from them.

As she improved in these respects, the irritation in the left ovarian region of which
she complained gradually left her, until she was annoyed by it no more.

There is one symptom occasionally accompanying hysterical condi-
tions, and which is invariably associated with hyperzesthesia of the skin,
that we do not find given in the descriptions of this disease. We refer
to an increased redness of different portions of the surface of the body.
This complication is annoying under any circumstances, but more espe-
cially so when an exposed part of the body, as the nose, is the seat of
-he increased color,
CASES OF HYSTERIA. 439

Aysteria caused by grief—Paroxysms of weeping—Unnatural redness of skin of
arms and nose—Recovery under general faradization,

CasE 1V.—The patient--a young lady 23 years of age—had lost her sister four
months previously, and from that affliction she dated all her symptoms, Before this
affliction she had enjoyed almost perfect health and was remarkably buoyant in her
disposition. During her sister’s illness she had been her constant attendant, and had
become reduced considerably in strength. i

After the burial all strength and energy seemed to leave her: the appetite was lost,
and for several days and nights she wept continually, neither eating nor sleeping.

Recovering in a measure from this prostration, she tried change of scene, hoping
thus to dissipate her miserably nervous condition, She derived but little benefit,
and when we saw her her condition was indeed pitiable, In relating how miserably she
felt ; how little inclination she had to meet her dearest friends; how the sound of
music distressed her; and what terrible choking sensations she constantly experienced,
the tears flowed thick and fast. The menstrual function was performed with perfect
regularity ; the amount of blood lost was not excessive, and was accompanied by no
pain, All her organs seemed to be in a healthy condition, The patient called espe-
cial attention to this increased redness of skin, of which mention has been ‘made. It
was particularly marked upon the arms and nose, and when she felt more hysterical
than usual the redness increased, and was accompanied by an annoying sensation of
heat. This impairment of her personal appearance weighed upon her mind constantly
and seemed to greatly increase her distress. Two general applications of a mild faradic
current so benefited her that for thirty-six hours the constriction of the throat ceased
toannoy her. As she continued receiving the influence of electricity, and the current
was increased, she improved rapidly in ber general condition, and after eight applica-
tions the heightened color which so annoyed her was entirely dissipated, and with it
nearly every other unpleasant symptom, so that she again entered society and seemed
to enjoy life as well as ever.

Hysterta—Vialent paroxysms of weeping—Great mental depression verging towards
insanity —Impairment of memory—Neuralgia, anesthesia, and dyspepsia—En-
tire recovery under general faradization,

Cask V.—In December, ‘1867, Dr. F. D. Weisse, of this city, consulted us re-
garding the condition of one of his lady patients, who was suffering from an aggra-
vated form of hysteria,

Notwithstanding his best endeavors, the case seemed to resist obstinately every form
of medication, until finally he resolved to place her under the tonic influence of
general electrization, The patient was a married lady, aged about thirty-five. Al-
though never very strong, she had until of late years enjoyed a fair degree of
health, and had given birth to several children; her whole appearance now indicated
excessive exhaustion, but there was no evidence of any serious organic difficulty.
Her symptoms were: intense mental depression, with paroxysms of violent crying ;
impairment of memory ; loss of appetite ; indigestion, attended with an excessively
annoying flatulence; neuralgia of the head; anzesthesia, that shifted from place to
place.

At times the depression and the fits of weeping which so frequently overcame her
so closely assumed the form of insanity that her nearest relatives had seriously con-
440 HYSTERIA AND ALLIED AFFECTIONS.

sidered the question whether it would not be better for her to be confined in an
asylum. It was quite common for her, without any appreciable cause, to start sud-
denly from her chair, scream, and partially faint She would sometimes weep for
hours, and yet be unable to assign any specific cause for her distress.

On the occasion of her first visit to us she became excessively nervous, and mani-
fested an almost childish fear of the operation. When she was ready for treatment
her nervous anxiety had so much increased that we thought it best to pretend merely
to make an application, Her feet were placed upon the copper plate to which the

. negative pole was attached, the instrument set in operation, and our hand as an elec-
trode applied to the back of the neck. No current passed, however, as the positive
electrode had been disconnected from the instrument. As soon as the hand of the
operator was applied to her, she declared that she felt the electricity tingling through
her whole system; but further remarked, that it was not so terrible as she had
imagined. We were able at the next visit to pass a mild current down the spine
and over her liver, stomach and spleen. Her stomach was so sensitive that even
this gentle application caused pain over that organ, together with a decided feeling
of faintness, At the third visit her condition manifested marked improvement.

Her appetite had improved ; she was less despondent and nervous ; her strength
had increased, and her sleep had been unusually quiet and refreshing.

A very decided feature of her changed condition was the fact that a current of
twice the intensity of that previously given was now borne without the slightest dis-
comfort.

The fourth application ameliorated somewhat the distressing flatulence from which
she suffered, and after the fifth it ceased to annoy her to any very considerable ex-
tent, while her neuralgic pains were entirely dissipated. It may be stated that an
application to the eyes at this time resulted in an overpowering drowsiness, which
lasted twenty-four hours, On January 8th, 1868, after having received but eight
applications, and having been under treatment but about three weeks, we summed
up the results as follows :—

Removal of mental depression.

Removal of paroxysms of weeping.

Strengthened memory.

Almost completely relieved of flatulence and indigestion.

Neuralgia dissipated.

Anzesthesia completely relieved,

Increase of strength.

This patient (in whose case the results of treatment were so gratify-
ing) was not suffering, as we were informed by her physician, from any
decided derangement of the sexual apparatus.

Hysterical and analogous symptoms are frequently, without doubt,
both associated with and dependent upon recognizable uterine dis-
orders. In many cases, however, these symptoms may be associated
with and perhaps aggravated by, but not by any means dependent
upon, such disorders. This statement would seem to be confirmed by
the experience of Dr. Rockwell at the N. Y. State Woman’s Hospital.
: HYPOCHONDRIASIS. 447

He has found, during his service there, that symptoms of excessive ner

“vousness, insomnia, impairment of motor power, etc., which were sur
posed to be merely a reflex of local derangement, have frequently
yielded to some form of electrization, before any manifest change has
been observed in the condition of the sexual apparatus.

Hypochondriasis (Pathophobia) and Melancholia.—The distinction
between hypochondriasis and melancholia is vital. The hypochondriac
readily appreciates the character of any special disease from which he
may suffer, but he has a most exaggerated conception of its importance
and of its probable results. He talks much of his symptoms, and un-
ceasingly seeks relief. The melancholic, on the contrary, possibly suffers
from no appreciable disease ; or if any evident structural or functional
trouble exists aside from the recognized mental perversion, it is un-
heeded. As Maudsley expresses it, “the former committing a murder
would certainly be hanged, the latter probably not.” The tendency
of the melancholic is frequently to suicide—the hypochondriac clings to
life. Intellectual exertion is an impossibility for the melancholic; the
hypochondriac, on the contrary, may lead the highest intellectual life.

The one suffers from such perverted habits of thought and feeling
that the strongest and most natural affections may cease to exist ; the
other retains all the normal warmth of feeling towards friends and rela-
tives. .

Melancholia is a more advanced phase of mental perversion, and to
this advanced and more serious condition hypochondriasis not unfre-
quently progresses.

There are reasons for believing that the sympathetic nervous system
is largely at fault in cases of hypochondriasis; and that if not demon-
strably diseased it is yet the medium through which disease of the other
parts reacts on the brain, and produces molecular or other disturbance.

The two leading ideas that we here desire to impress are, frs¢, that
hypochondriasis is just as truly a disease, or, more strictly speaking, a
symptom of disease, as dyspepsia, insomnia, chorea, neuralgia, paraly-
sis, or insanity, and should be treated accordingly. The popular method
of neglecting hypochondriacs altogether, or of administering placebos, is
not scientific, and, except in rare cases, is not successful. Secondly,
hypochondriasis, when not dependent on serious lesions of the central
nervous system, is susceptible of relief and of positive cure under the
skilful and faithful use of electricity. Still further, we believe—and
the results of our own cases justify the belief—that cerebral disease of a
more pronounced character itself may be relieved by electricity ; and
that that terrible form of hypochondriasis which is the precursor of
442 HYSTERIA AND ALLIED AFFECTIONS. °

organic cerebral disease—the vestibule that leads to the dark and
gloomy caverns of insanity—may be controlled or kept at bay by a per-
severing electrical treatment. (See chapter on Insanity.)

Treatment.—In hypochondriasis, general faradization, central gal-
vanization, and galvanization of the cervical sympathetic, are indicated.
We have obtained good results from all methods, though most of our
cases were treated by the first and second.

Hypochondriasis, with impairment of the functions of special sense—Weakened
memory— Sensory symptoms in the extremities, with some loss of motor power, the
result of excessive mental activity, and dependent in part on slight cerebral conges-
tion—Improvement under general faradization and central galvantization—ke.
lapse,

CasE VI.—-Mr. M., an actor of twenty years’ standing, was placed under our care
by Dr. F, L. Harris. The patient was a temperate man, and so far as his profession
permitted, regular in all his habits ; but the character of his engagements had rendered
it necessary for him to exercise his memory through a series of years to an unusual,
and as the sequel proved to a most injurious, extent. Two months prior he began to
observe that his intellectual powers were failing him. His memory became so im-
paired and his thoughts so confused, that he found it utterly impossible to ‘* commit”
anything new, or to recall readily certain ‘parts’? that had been long perfectly
familiar. He was hypochondriacal to the last degree, and at the same time his limbs
became weak, and he complained of sensory symptoms in the tips of the fingers, much
the same as those present after frostbite. The integrity of most of the senses was
markedly impaired. :

The sight especially had failed him to such a degree, that it was with difficulty that
he could read at all. The patient was exceedingly timid, and had a nervous dread of
the treatment proposed; but he was at once submitted to a gentle but most thorough
séance of general faradization, which was followed by an immediate perceptible im-
provement in the power of locomotion. After a day’s interval, central galvanization
was employed, and this alternate treatment was employed for a month.

The annoying sensory symptoms disappeared ; he gained entire mastery over his
limbs, and was more hopeful and happy ; his strength of vision became nearly normal,
and when we last saw him there had been sufficient improvement in his intellectual
faculties to enable him successfully to altempt a performance on the stage. We
learned that during an attempt to perform on a subsequent occasion he became quite
unable to pursue his part, and was led off the stage, This was sufficient to show that
recovery was not complete ; as to his condition after this we are uninformed,

Persistent mental depression—Im provement under general faradization after gal-
vanization of brain, sympathetic, and spinal cord had failed,

CasE VII.—The beneficial results of general faradization in hypochondriasis were
decidedly manifest in the case of a patient directed to us by Dr. John T. Metcalfe,
In the case under consideration there was not the slightest evidence of organic dis-
ease; every function was, as a rule, performed in a regular-and healthy manner. Tne
CASES OF HYPOCHONDRIASIS. 443

patient was a man in the prime of life, with a physique and countenance indicative of
robust health.

For several, months his daily life had been rendered salserable by an-undefinable
sense of oppression, and a fearful looking forward to of calamity and ruin.

In vain did he exercise all the philosophy and reason of a naturally well-balanced
mind: his delusions clung to him, and the only waking hours to which he looked for-
ward with any degree of patience were those of the early evening.

After a comfortable dinner and » few glasses of sherry his spirits invariably rose ;
for a time he was again himself. The patient was most persistent and faithful in
submitting to treatment, and the number of applications that he received was some-
what extraordinary. Of the faradic current some 75 were administered, Occasion-
ally we subjected him to galvanization of the brain, cord, and sympathetic, but the
results of this method of treatment were by no means tepciable Under general fara-
dization, however, he decidedly improved.

Pathophobia—Suspected disease of the ears—Improvement under general faradiza-
tion and galvanization of the brain and sympathetic—Galvano-faradization.

CasE VIII.—A still more favorable result was obtained in the person of a young
man aged 25, who, like the patient just referred to, presented every indication of health,
At all hours of the day he was annoyed by tiunitus aurium, and what to him seemed
an audible voice telling him of evil to come. We submitted him to general applica-
tions of a powerful faradic current, and also to occasional galvanization of the brain,
cord, and sympathetic. Some improvement followed. The most decided benefit was,
however, derived from the method of galvano-faradization, The faradic current, full
strength, from a Kidder apparatus, and at the same time the galvanic current from 15
cells of Bunsen’s battery, were passed through and around the body, by the method
of general electrization, Improvement was now remarkably rapid. In the course
of half a dozen applications every unpleasant symptom disappeared, and the patient
has since remained perfectly free from any evidence of their return.

Excessive debility with hypochondriasis, but associated with no organic change—
General faradization and central galvanization of no benefit,

The following case of excessive nervous prostration with mental
depression was not in the slightest degree benefited by any form of
electrization, although the most persistent efforts were essayed. (See
pp. 289, 290.)

CasE IX.—The patient was a young artist, referred to us by Dr. J. O. Stone,
who all his life had been noted for his p/uck and love of athletic sports, He gradu-
ally without appreciable cause grew weak physically, and became such a great
coward that he feared to travel any distance from home, by rail or water, without
company.

He fully appreciated this change, and endeavored to overcome it, He was examined
again and again, but it was impossible to detect the slightest structural difficulty in
any organ. It seemed a fitting case for general faradization and a most favorable
prognosis was given, but all efforts with it and central galvanization proved una-
vailing in improving his condition.
444 HYSTERIA AND ALLIED AFFECTIONS.

Melancholia of two years standing in a young married lady—Complete recovery
under central galvanization after failure of persistent internal medication
and general faradization,

CAsE X.—Mrs. Y., a married woman, aged twenty-five, came first under our ob-
servation October 8, 1871, in the seventh month of her pregnancy. Her mental
condition was lamentable in the extreme, There was chiefly a perversion of the whole
habit or manner of feeling, such as so frequently follows actual intellectual derange-
ment. She confessed and bewailed her want of interest in or love for those who
were nearest to her, and evidently suffered most intensely from a profound feeling of
depression and misery—a vast and formless idea of utter desolation, The patient
appreciated her condition, would reason concerning it, and acknowledge that there
was nothing real to which she could point as a cause of her misery.

These wretched feelings were not altogether new, but for over two years had ina
modified form annoyed her considerably. Bitten slightly by a favorite dog, she
merged immediately into a condition that may be called hypochondriacal melancho-
lia, with an exaggerated notion of the danger she had incurred. She had been treated
persistently but without avail, and as a dernier ressort genera] faradization was at-
tempted. It utterly failed in its effects, and in good faith the patient was encouraged
to hope that with her delivery her mental balance would return. The child was
born, and three months subsequently I was again called to see the mother, only to
find her condition more aggravated than at any previous time. We now resolved to
make use of central galvanization, and employed a current from six ordinary-sized
zinc carbon-cells, with a sitting of four minutes. The patient was not at all im-
proved by the séance, but seemed, if anything, slightly more sensitive to external
impressions,

In a couple of days the same application was again tried, with the evident result of
decidedly exciting her mind, A third effort was made with but three cells, from which
the current was just sufficient in tension to call into action the sense of taste. From
this trial the patient experienced undoubted relief, and at intervals of a day the ap-
plication, without being varied excepting in the length of the séance, was repeated for
some two months, Although during the treatment two or three slight relapses oc-
curred, yet on the whole the improvement was steady and satisfactory, and at the
close of the ‘‘central” treatment, when she was placed entirely in the care of Dr.
William J. Donor for uterine difficulty, her recovery was complete,

Neurasthenia, or Nervous Exhaustion.—The derivation of the term
neurasthenia is sufficiently obvious. It comes from the Greek word
veupor, a lerve ; a, privative ; and c@evos, strength ; and therefore, being
literally interpreted, signifies want of strength in the nerve. Under the
name of general debility, it is a condition sufficiently familiar to every
practising physician, and too frequently resists most obstinately all forms
of internal medication. It is not to be confounded with anzmia,
though it may be associated with it.

The one principle on which neurasthenia is to be treated is by the
concentration of all possible tonic influence on the nervous system—
air, sunlight, water, food, rest, diversion, muscular exercise, and the in-
NEURASTHENIA. ‘ 445

ternal administration of those remedies, such as strychnine, phosphorus,
arsenic, etc., which directly affect the central nervous system.

Electrical Treatment.— General faradization and central galvanization
as an adjuvant to relieve more directly the symptoms of insomnia, head-
ache, etc., which are so frequently associated with neurasthenia or after
general faradization has ‘ailed.

“The prognosis is usually more or less favorable. In nearly all cases
of uncomplicated neurasthenia general faradization alone proves deci-
dedly and sometimes rapidly efficacious. Beneficial results from either
this method or central galvanization are so uniform in this condition
that we have reason to suspect some unrecognizable organic disease
in those cases that give no evidence of improvement after protracted treat-
ment. Even the complicated forms, that are the result of incurable dis-
ease, may be much relieved. The cases that fail to be benefited by
electrical treatment are those of lifelong standing, or in which the tem-
perament contraindicates electrical treatment.

Neurasthenia—Debility and attacks of sick headache—Immediate and rapid im-
provement under general faradization—Rapid increase in weight,

CasE XI,—The power of general faradization to relieve neurasthenia and to cause
increase of weight, was illustrated in a very pleasing and satisfactory manner in the
case of a young physician whom we have treated during the autumn of 1869. He
was 28 years of age, and for a long time he had been subject to severe and repeated
attacks of nervous and sick headache. To use his own expression, he had been
‘living on a lower plane than was normal.” QOver-work and long confinement had
reduced him to a condition of serious exhaustion, and when he called upon us in
September he could not walk two miles without fatigue. Although 5 feet 9} inches
in height, he weighed but 112 pounds, afd for many months there had been no sign
of any increase. He had closely studied his own case, had been thoroughly examined,
and had tried nearly every form of internal medication.

We began treatment by a mild and general application with the faradic current.
He felt temporarily enlivened and exhilarated, but when he returned, two days sub-
sequently, he stated that he felt no special benefit, although he had gained one-half
a pound in weight, This change, slight as it was, encouraged him, for it had been
months, and years even, since he had been able to detect any increase in weight. We
may say here that he watched and studied his symptoms, and carefully ascertained
his weight, from day to day, not as a hypochondriac at all, but as a scientific man,
inspired not by any special faith in the remedy, but by an earnest desire to test for
himself the tonic effects of general faradization. He continued to increase in weight
with remarkable regularity and uniformity, and at the end of three weeks he found
that he had increased nine pounds. When we last saw him his weight was 124
pounds, The improvement in his general condition had gone on hand in*hand with
the increase in weight, His appetite was keener and his digestion much easier. His
attacks of headache still annoyed him, but his capacity for endurance had been greatly
446 HYSTERIA AND ALLIED AFFECTIONS.

enlarged. Within the last two years we learned from the patient himself that he had
suffered no relapse.

In this case the applications were made very thoroughly all over the person, from
the top of the head to the feet, and with a powerful current. Both the faradic and
galvanic currents were used, chiefly the faradic, It is worthy of remark, also, that
this patient always experienced a feeling of temporary enlivenment and exhilaration
after each application, and sometimes the headache from which he suffered was driven
away in the midst of the treatment. :

We may say, also, that when he first came we prescribed oxide of zinc, by exclu-
sion, because he had used nearly every other internal tonic. He took, however, but
two or three doses of one grain each for the first day, dropping it entirely as soon as
he found that he had increased half a pound in weight.

The above case we regarded as pre-eminently a typical one—a typical
illustration of neurasthenia, and of the benefit that may be received from
general faradization.

Neurasthenia in a plethoric patient, caused by excessive application to business—
Slow improvement under galvanization of the cervical sympathetic and general
Saradization, ‘

Case XII.—Mr. A.-was a short, stout, and remarkably plethoric man, aged 60.
Through his active business life he had confined himself most closely to his duties,
seldom taking a day for recreation, even during the heat of summer. Nineteen
years since he retired from business with greatly impaired health and strength, It
was thought that perfect freedom from all care would be sufficient to restore his na-
tive vigor of constitution. On the conirary, he gained but little, if any. His general
appearance was typical of perfect health, but ordinary exertion, either mental or phy-
sical, was sure to produce exhaustion. As pilse was normal, and the patient was
plethoric rather than anemic. It was impossible for him to read more than ten or
fifteen minutes without becoming restless and excessively nervous, and exercise in
walking, to the extent of a dozen blocks or so, would frequently produce complete
prostration, lis sleep at night was broken, and sometimes entirely destroyed,
There was not the slightest evidence of organic disease, but the whole nervous sys-
tem seemed to be unstrung. He had submitted to almost every method of tonic
treatment, both medicinal and hygienic, but had seldom experienced even temporary
relief. We felt justified in encouraging him to hope for favorable results from treat-
ment by electrization, With admirable perseverance and promptness he continued to
visit us for two months, never, in a single instance, failing to keep an appointment,

At first, general applications with the faradic current were given every other day.
At each sitting he seemed much invigorated, and for several hours he experienced a
degree of strength and lightness of spirit such as he had been a stranger to for years,

These effects, however, seemed but temporary, for the old lassitude invariably re-
turned ; consequently, after three weeks of treatment with the faradic, we resorted
to a weak galvanic current.

The negative pole was applied to the epigastric region, and the positive to the
back of the neck, near the seventh cervical vertebra and also along the anterior border
of the scalenus anticus muscle, in order to affect more thoroughly the great syme
pathetic and pneumogastric.
CASES OF NEURASTHENIA. 447

Sponge ‘electrodes were used, and the applications were prolonged sufficiently to
produce an intense redness and an acute burning sensation under them. By this
method the immediate effects were not so marked as when the faradic current was
used, but the relief afforded was more permanent.

For the first time, his sleep became more quiet and sound, and during the day fol-
lowing an application he was able to exercise both mind and body harder and longer
than usual. He now submitted to treatment by galvanization every day. Week
by week he gained very perceptibly in vigor, until, after having received the galvanic
current some twenty-five times, he left us to spend the summer months among the
mountains. He did not discontinue treatment with a nervous system perfectly
strengthened, but he had regained approximately the usual portion of mental and,
physical endurance enjoyed by persons of his years. Whereas, before treatment by
electrization, he was not able to walk half a mile without fatigue, nor read more than
ten or fifteen minutes without suffering from nervous irritability, after treatment he
enjoyed and derived benefit from walking several miles in the day, and could confine
himself to a book for an hour or two without experiencing any symptoms of mental
exhaustion,

At the date of writing, 1874, the patient enjoys a fair degree of health, and claims
to have retained all the benefit he derived from treatment.

Neurasthenia, complicated with anemia, dyspepsia, spinal irritation, and hypochon-
driasis, treated by general faradization and central galvanisation—Improvement
and subsequent relapse.

Case XIII.—Mr. E., a tall, spare man, aged about §0, was sent to us by Dr. Gurdon
Buck, He was a gentleman of wealth and leisure, and for several years had been
entirely free from any of the cares of active business life. He was frequently troubled
with indigestion, At times he would seem to regain some vigor, and would exer-
cise to a considerable extent without experiencing inconvenience, but as a rule the
most ordinary mental or physical exertion was followed by extreme exhaustion.
Pains in the lumbar region of the back were of frequent occurrence, especially after
passing a sleepless night. There was, however, no spinal tenderness. He was a good
barometer—an east wind would almost drive him to despair, and so long as it lasted
he could hardly muster strength or inclination to leave his couch, As soon as the
wind changed and the sun appeared, he observed an immediate amelioration of his
dreadfully depressed condition,

Our patient experienced the exhilaration that so frequently follows a general ap-
plication of the faradic current.

Although at first this invigoration ‘was of but temporary duration, the effects of the
treatment were gradually prolonged after each sitting, until, in a much shorter time’
than is usually the case in conditions such as the one under consideration, the patient
enjoyed a good degree of health, ,

During damp, enervating days especially, central galvanization prevented exhaus-
tion far more successfully than faradization, The patient retained the nervous vigor
that he had gained for many months ; subsequently, however, he relapsed, and again
placed himself under our care, He was decidedly benefited by this second course of
treatment, but not to the same extent as at first. When last seen he had retained a
measure of improvement, but was extraordinarily susceptible to atmospheric changes,
448 HYSTERIA AND ALLIED AFFECTIONS.

Since the publication of the first edition of this work the patient was
a third time under our care, and at the present date, 1874, enjoys, he
tells us, almost perfect health,

Neurasthenia, associated with distressing feelings, as of lead flowing through the
veins, with insomnia and severe headache—Recovery under general faradization
and central galvanization,

Case XIV.—Mrs, H., aged 32, the mother of two children, came under our care,
Nov. 8, 1871. Her constitution was delicate, and in the past she had, so far as could
be determined from her account, suffered from decided symptoms of spinal irritation.

During the birth of one of her children, the perineum bad been torn and had never
united. This condition gave rise to troublesome uterine symptoms, which failed to
yield to ordinary treatment, obviously for the reason that a cause existed that impera-
tively required surgical interference. The general symptoms of which she complained
were, Ist, want of strength. Although her appearance indicated a fair condition of
health, yet a short walk exhausted her completely, and unfitted her during several suc-
ceeding hours for every duty, 2d, Pains of a vague and uncertain character pervaded
the whole body, and she characterized them as similar to what she imagined might
be produced were lead flowing through her veins, 3d, Insomnia and headache. She
was exceedingly sensitive to the influence of general faradization, and its good effects
were not especially manifested for a number of weeks. (See pp. 280, 285.)

She then began to remark that her powers of endurance had certainly increased, and
complained less of unpleasant sensations, especially in the arms. Central galvanization
was now alternated with general faradization, and its value as an adjuvant to the more
general treatment was evinced in the readiness with which it aided in improving the
sleep and in alleviating the.other symptoms, In short, the patient was under treat-
ment until Jan, 26, 1874; received thirty-one applications of the current ; and it is
not too much to say, that it was entirely successful in dissipating the vague but dis-
tressing pains which had for so long a time annoyed her, and in restoring to her a
good degree of strength. We should not omit to state that the operation which it
was found necessary to perform on the perineum was delayed solely on account of her
neurasthenic condition. .

CasE XV.—Miss H., referred to us by Dr. Du Bois, experienced decided relief,
after seven applications of general faradization. Her symptoms were simply constant
and utter nervous prostration.

CasE XVI.—Mrs, C., a patient of Dr, Alfred Purdy, had suffered from neuras-
thenia for six years, She complained of feeble circulation, insomnia, and constipa-
sion, A dozen applications of general faradization improved the circulation and the
sleep, and decidedly relieved the constipation.

Cast XVII.—Mr,N., a youth of 17, without any very apparent cause, became
weak, nervous, and excitable. These symptoms had existed more than a year, when
he was submitted to general faradization,

Seventeen applications proved of some benefit, but his condition continued to im-
prove after his return home, and two months subsequently he informed us by letter
that he had regained his normal health and strength,
SPINAL IRRITATION. 449

Nervous exhaustion of long standing, associated with severe neuralgia, Slight re-
lief during two months of general faradization—After-effects of the treatment,
manifested by rapid improvement in all her symptoms, (See p. 294.)

Case XVIII.—Mrs. B., a young married lady, had for a long time suffered most in-
tensely from pains of a neuralgic character. ‘The head was the seat of greatest suffer-
ing, although the distress extended with more or less severity to every part of the body,

Her strength was much reduced, so that she was unequal to the slightest exertion
beyond a few ordinary household duties and an occasional walk in the street of one or
two blocks. Not the slightest evidence of organic disease could be discovered by her
physician, Dr. George A. Peters, who, having seemingly exhausted the resources of
medicine, requested us to try the efficacy of some method of electrization.

As the extreme debility was evidently the -proximate cause of the neuralgia, we
decided upon general faradization as the proper method of treatment, and accordingly
submitted her to a very gentle application. She was one of those patients frequently
encountered, who are so susceptible to the current that it was our aim to give of the
electrical influence the minimum that could be actually felt by the patient, rather
than the maximum that it was possible for her to bear without decided discomfort.

During the months of October and November, 1870, we gave thirty-six applications,
which somewhat lessened the severity and frequency of the pain, without appreciably
improving her strength, We proposed to her physician, therefore, to discontinue our
efforts for a while, hoping that the favorable after-effects of electrization, that are
so often seen, would show themselves in this case, We were not disappointed,
The patient soon began to amend, until the improvement was most marked, both
in the almost complete cessation of the neuralgia and in an approximate return of
normal strength.

Spinal Irritation.—Spinal irritation is one of those names which, like
hysteria, have become the recognized property of the profession, against
the actual or implied protest of nearly all who employ it. It is a part
of the hysterical constitution.

The term spinal irritation, originally proposed by Dr. Brown, of Glas-
gow, and described and illustrated in detail by G. T. P. Teale, in 1829,
and the Griffin Brothers in 1844, is now pretty generally understood, in
England and America at least, to express a tolerably well-defined
morbid condition, of which one of the principal symptoms is spinal
tenderness. P

Differential Diagnosis.—Spinal irritation almost always forms a part
of hysteria and neurasthenia, constituting, as it were, a subdivision or
accompaniment of them, and is only entitled to the honor of distinct
nomenclature by itself when the spinal tenderness and the symptoms that
directly flow from it overshadow other accompanying conditions. Close
examination would reveal that very many of the cases in practice that
are variously classified under hysteria, anzemia, etc., have a sufficiently
marked tenderness of the vertebrze to be regarded as examples of spinal

29
450 HYSTERIA AND ALLIED AFFECTIONS.

irritation; and if treated accordingly, would recover more rapidly than
under the methods usually employed. The best confirmation of the
diagnosis is the very favorable result of judicious and varied treatment
devoted specially to the tender spots on the spine.

Between spinal irritation and spinal meningitis or congestion the dis-
tinction is oftentimes purely one of ‘permanence and degree. In both
conditions there may be pain and heat in the spine, neuralgia or
paralysis of the limbs, plantar heat and anzesthesia, constipation, feeling
of pressure or constriction in the chest, and stiffness of the neck, etc.
It is distinguished from myelitis by the absence of other necessary
symptoms. The contractions of muscles in spinal irritation are less
painful than those of myelitis.

fathology.—In spinal irritation, as in cerebral irritation, it is
probable that there may be either anemia or hyperzemia. That many
of the cases of spinal irritation depend on passive hyperzemia of the
cord, is rendered probable.

1. By the feeling of heat and burning at the seat of the irritation.

2. By the fact that this pain is increased at night, when the patient
is in a recumbent position.

3. By the fact that it is relieved by measures that relieve congestion,
as dry and wet cupping, and by blisters over the tender vertebrz.

On the other hand, reasoning from analogy and from what we know
of the relation of the sympathetic, it is proper toassume that anemia may
account for many of the phenomena of spinal as of cerebral irritation.
This assumption is strengthened by the fact that very many of the pa-
tients who have spinal irritation are more or less anemic. And yet,
reasoning from the history of the cases, and from the results of treat-
ment, we are inclined to the opinion that anaemia exists only in a
minority of the cases of spinal irritation; that in the majority of instan-
ces there is more or less at least temporary passive congestion of the
cord and of its membrane ; and that in all cases of doubt it is safe to
assume the existence of hyperaemia, and to guide the treatment accord-
ingly.

It is not necessary to assume that this hyperzemia of the cord is a
constant condition. Except in the severe and long-standing cases, it,
1s probably not so, but is more or less evanescent, temporary and me-
tastatic. This may distinguish it from spinal congestion, which is a fixed
condition. Temporary congestion of the cord, as of the brain, the geni-
tals, the eye and the ear, may perhaps be easily excited by irritating
causes. It is not unreasonable to suppose that anzemia and hyperemia
may alternate in the patient, and in the same day or hour.
CASES OF SPINAL IRRITATION. 451

Elecite examination in spinal irritation may sometimes reveal ten-
der spots on the spine that are not indicated by pressure.

Treatment.— Electric treatment consists in general faradization, gal-
vanization of the spine and sympathetic and central galvanization.

Our experience in a great number of cases, since the first edition of
this work, convinces us that'in galvanization of the spine the positive
pole acts better than the negative in the treatment of this affection. To
depend, however, on localized galvanization alone is illogical, since the
disease, though for the time specially localized in the spinal cord, is
usually simply but a development or manifestation of the nervous
diathesis, in which the whole system shares.

Prognosis.— Under electric treatment alone, the prognosis of spinal
irritation is usually favorable for a relief, and sometimes for permanent
cure.

It is, however, of great advantage in all severe or long-standing
cases, to combine with electrization, counter-irritation (very small blis-
ters, or tartar-emetic ointment) over the sensitive vertebra, and the in-
ternal administration of phosphorus or other stimulants.

Comparative rest of brain and muscles is an important, though not
indispensable, aid to treatment. The disease is quite prone to relapse,
especially under bad hygienic surroundings. Under combined treat-
ment, consisting of blisters to the spine, phosphorus, strychnia, and
electrization, the majority of cases will rapidly improve. :

Spinal irritation of four years standing, with excessive tenderness in the lumbar
region—Decided relief from general faradization.

CasE XIX.—Mrs, ——, aged 24, was sent to us Jan. 4th, 1868, by Dr. Sewall,
toebe treated for pain, with most excessive tenderness, over the lumbar vertebrae. The
symptoms had been particularly distressing since her confinement, two months pre-
vious, but had annoyed her more or less for four years. United with this spinal ten-
derness there was considerable debility, that made a walk of half 9 mile a burden;
gastric uneasiness, feeble appetite, insomnia, and, in general, the characteristic fea-
tures of the nervous constitution.

Electric examination revealed a very great tenderness over several of. the lumbar
vertebrae ; only a feeble current could be borne at all, even with large, soft sponges,
No other abnormal condition was found beyond a general hyperzesthesia, which is
usual in such cases. The tenderness was so great that even the weight of the hand
wes distressingly painful,

We began treatment by general faradization, with special reference to the tender
spot in the spine. At this locality we used a stable increasing current, beginning
with a current scarcely perceptible, and increasing the strength up to the point where
it could be comfoitably borne. The patient shortly improved under this treatment,
though not without relapses whenever she attempted any important exertion. From
‘

452 HYSTERIA AND ALLIED AFFECTIONS.

week to week the tenderness became less marked, until the vertebrae were no longer
painful under moderate pressure, and a much more powerful current could be borne
with ease. Agreeable temporary relief followed each application—an observation
which we have frequently made in spinal irritation.

At the end of two months the patient was dismissed very much benefited.

Hyperasthesia of the cervical and upper lumbar vertebra caused by exposure to the
sun—Great susceptibility to electricity—Improvement under general and localized
_faradization and galvanization.

CasE XX.—Rev. Mr. F., aged 30, was referred to our care, March 9, 1868, by
Dr, Gurdon Buck, For several months before, he had been complaining of pain and
heaviness in the back of the neck, that had compelled him to resign his pastoral
charge and abstain from all sustained mental exertion. The symptoms dated from
an exposure to the sun on a very hot day, The patient was large, tall, well-formed,
and apparently very robust. All the functions seemed to be tolerably well perform.
ed ; but sustained mental exertion was almost impossible. He had been treated faith-
fully by counter-irritation, in the shape of wet cupping, and had derived positive benefit
therefrom.

Electric examination indicated some tenderness on the upper cervical vertebra,
and also in the upper lumbar; but this tenderness was not excessive, and a current
of fair strength, so far as the vertebrae were concerned, could be readily borne with-
out discomfort ; nor were the vertebrae so painful as they sometimes are found,

But in one respect his behavior under the electric examination was peculiar. The
sensation produced by a mild galvanic current over the upper cervical vertebrze was
painfully felt in the forehead, indicating » morbid irritability of the central nervous
system, since in health such a phenomenon does not appear. That this morbid irri-
tability was in some way related to the sympathetic, or that, at least, the sympathe-
tic was the medium through which it was manifested, was rendered probabie by the
fact that mild faradization or galvanization of the affected part caused a very pro-
fuse perspiration on the hands and feet. This same effect we have also observed in
a case of hysteria.

Strong as the patient appeared to be, it was necessary to treat him with mild cur-
rents and short applications. By turns and in succession we tried the various methods
of electrization, with both the faradic and galvanic currents, and with important
though not brilliant results.

After a treatment extending by intervals through three months, the patient left for
a visit in England, where he remained nearly a year, still slowly improving.

Great susceptibility to electricity, as in the above case, is frequently
observed after sunstroke.

A chronic condition of irritation and hyperasthesia of the spinal cord greatly bene-
fited by general faradization, in conjunction with galvanization of the sympathe-
tic and spine.

CasE XXI.—A young lady, daughter of a physician, who had suffered for many
months from symptoms both of congestion and irritation of the spinal cord, was
placed under our care by the advice of the late Dr. H. D, Bulkley. Tenderness was
HYSTERIA AND ALLIED AFFECTIONS. 453

manifest over the cervical-dorsal and lumbar regions. The patient complained of
shortness of breath, numbness and tingling in the hands and feet, cough, nausea, with
neuralgic pains around the loins and in the extremities. A very decided loss of
power was manifest in the lower limbs, so that it was impossible to take more than
a few turns around the room without fatigue. Under the tonic influence of twenty
general applications of the faradic current, the patient very decidedly improved,
The tenderness along the spine decreased, and in the cervical region disappeared alto-
gether.

The shortness of breath, the numbness and tingling, together with the neuralgic
pains, became less marked, while the-strength so far improved that she was able daily
to take short walks of several blocks, and to ascend the stairs with comparative com-
fort.

We now resorted to the galvanization of the sympathetic and the spine—spinal-
cord current—which were followed by an improvement more marked than it was
possible to obtain from the faradic current alone.

The above patient subsequently relapsed after a severe fall and was
again treated with great perseverance and even better results, so that
she is now in perfect health, and is indeed unusually vigorous. The
case illustrates the record that may follow great perseverance in elec-
trical treatment.

A condition of tingling, pricking, and a disposition to paralysis of the legs, depen-
dent on irritation and hyperemia of the cord, dectdedly relieved by galvanization
of the sympathetic and general faradization.

Casz XXII.—Mrs, W., aged 44, whose physician, Dr. H. Gregory, advised treat-
ment by electrization, was suffering from pricking sensations in the arms, and from
tingling and numbness of the lower limbs and feet. In the legs, also, there was a
decided “‘disposttion ’’ to paralysis, as manifested by a feeling of weight in the effort
of walking,

Press wre along the spine disclosed a ‘tender point, at about the third dorsal and
second lumbar vertebr. These conditions of tenderness, tingling, and weight in the
lower lumbs seemed to indicate not only an irritation, but also a hypersemia of the
spinal cord. Galvanization of the sympathetic and mild general applications of the
faradic current were followed by a marked ainelioration of these symptoms.

The limbs especially progressed rapidly, and after eight applications becarhe quite
strong, and were quite relieved of the anzesthesia. Some tenderness along the course
of the spine still remained, with-occasional tingling in the extremities, but not suffi-
cient to occasion the same annoyance as before.

Spinal irritation of several years? standing—Recovery under spinal galvanization
and general faradisation,

Case XXIII.—Miss C., a patient of Dr. Gregory, was referred to us with evi-
dences of irritation the whole length of the cord. Under six weeks of treatment by
spinal galvanization and general faradization the patient markedly improved in all her
symptoms,
454 HYSTERIA AND ALLIED AFFECTIONS.

The tender points along the spine mostly disappeared, and after the cessation of
treatment she continued to improve until recovery was approximately complete.
The symptoms were of several years’ standing.

Spinal irritation af two years’ standing—Recovery under spinal galvanization,

Case XXIV.—Miss S., an inmate of the N. Y. State Woman’s Hospital, was
affected, in addition to uterine disease, with severe and persistent spinal irritation of
over two years’ standing,

Spinal galvanization repeated a dozen times during the course of a month effectu-
ally overcame the excessive irritation of the cord, and resulted in greatly increased
strength.

JInsomnia.—Insomnia is a symptom which, with greater or less uni-
formity and severity, accompanies nearly all forms of disease..

It is a symptom of such an indefinite variety and complexity of pa-
thological conditions that it is manifestly impossible to treat it with
anything like uniform success by any one conceivable form of medica-
tion ; but of all the remedies that have yet been tried there is, we be-
lieve, no one which permanently relieves the symptoms in so large a
proportion of cases as electrization. The effects of electricity on the
sleep, whether used in the form of general faradization, or galvanization
of the head and cervical sympathetic, are both temporary and perma-
nent. The ¢emporary relief that appears the night or two following an
application, though usually far less potent than those of bromide of
potassium and hydrate of chloral, are yet very decided ; but it is for the
permanent relief that electrization is chiefly indicated in this symptom.
This comes gradually, slowly, and as a result of the improvement of the
morbid condition on which the insomnia depends.

As has been stated, improvement in sleep is one of the earliest ef-
fects for which we look during a course of treatment by general electri-
zation. In a wide range of diseases sleep, to a certain extent and with
exceptions, may be regarded as a thermometer of health. When all
other bodily functions are well performed, the sleep is usually sound,
calm, and refreshing ; when it becomes painfully and persistently dis-
turbed by dreams, or is long absent, we may suspect actual or approach-
ing disease.

Temporary loss of sleep, that comes from temporary anxiety or from
neuralgia or other pain, is usually relieved with the removal of the
cause, and only demands special medical treatment when it is long con-
tinued.

The ¢reatment of insomnia is really the treatment of all the diseases
on which it depends. For those cases where simple wakefulness exists,
unaccompanied by any other symptom of recognizable disease, we
HYSTERIA AND ALLIED AFFECTIONS. 455

may use either galvanization of the sympathetic or in the head, or fara-
dization of the head and spine, or, better than all, general faradization,
for somnolence is a result of all these methods of electrization. It is
not even necessary to make the applications to the head, the sympathe-
tic, or even to the spine, in order to produce sleep. Simple peripheral
galvanization or faradization will produce this result, and in some cases
to a very marked degree. This must, we suppose, be explained by
reflex action. In case of rheumatism of the hip-joint, which we once
treated by galvanization through the joint, the soporilic effect on the
patient was so marked that he fell into a profound slumber before we
had time to leave the house, in less than ten minutes after the ap-
plication was over. In another case of infantile paralysis the mother
reported that the child slept soundly for two hours or more after each
sitting, although only the limbs were galvanized.

| Persistent insomnia after child-birth—An application of the faradic current to the
head and spine ts followed by sleep of several hours,

Case XXV.—Mrs. A., aged 30, of a highly nervous organizition, gave birth to
her first child after a labor of 6 hours. So great was the disorder of her nervous
system, that for 5 days and nights she was unable to close her eyes in sleep. Her con-
dition was most distressing, and resisted all efforts in the way of medication.

It was agreed that a mild application of the farad:c current should be applied to
the head and down the spine. The result was most decided and gratifying, since a
sleep of several hours, deep and refreshing, immediately followed. It is proper to
say that subsequent applications did not have the same decided effect, although they
evidently strengthened the nervous system of the patient and greatly aided in dissi-
pating the condition of insomnia.

Insomnia af months! standing tmmediately relieved by general faradization,

CasE XXVI.—Mrs, C., a young married lady, was directed to us by Dr. J. Marion
Sims, who was treating her for uterine difficulty. She was suffering acutely from in-
somnia, and it was hoped that some form of electrization might prove beneficial,
more especially since she had previously been relieved by the application of electricity,
although its administration had been without method. We subjected her to the most
thorough form of general faradization, directing especial attention, however, to the
head and neck. The applications were administered on five successive days, and during
each of the following nights the patient enjoyed uninterrupted and refreshing sleep,
As to the permanency of the effects we are not informed.

Tnsomnia of several months duration relieved under treatment by general faradi-
zation and galvanization of the brain.

Cast XXVII.—Mr. J. D., aged 65, was referred to us by the late Dr. J. C. Nott
for the relief of insomnia of such an obstinate character as to threaten serious conse-
quences. He had suffered a few months previously from a severe attack of congestive
chills, From the effects of these he had approximately recovered. His strength and
456 HYSTERIA AND ALLIED AFFECTIONS.

appetite were fair, but as it was sometimes impossible for him to sleep more than an
hour or two during the whole night, he was fast merging into a nervous, excitable con-
dition. ‘The patient was treated by both general faradization and galvanization of the
brain. He very gradually improved, and at the end of a month’s treatment he was
enjoying five and six hours’ continuous sleep every night,

Insomnia following menstruation—General faradization affords immediate relief,

CasE XXVIII.—Mrs. B., aged 40, suffered an unusual loss of blood at each men-
trual period, which was followed by obstinate insomnia during the succeeding two
weeks, (General faradization was essayed for the relief of the sleeplessness, and was
entirely successful. Three or four applications after each period was sufficient to
promote calm repose until the next flow.

Astraphobia (aotponp lightning and poBos fear of ).—Some individ-
uals, especially those of peculiarly impressible organizations, are not
only unpleasantly but seriously affected during thunder-storms -that
are attended by vivid flashes of lightning. They suffer not only dis-
tressing fear, but positive pain in the head or stomach, that leaves them
in a condition of exhaustion that may last several hours, or even two
or three days.

A medical friend informed us of a patient under his care, who during
thunder-storms was attacked by severe nausea, and by convulsive at-
tacks resembling epilepsy. Under treatment directed to the improve-
ment of her general system she greatly improved. In some cases diar-
rhoea is excited.

These symptoms, though most frequent with nervous people, and es-
pecially with women, may also appear in those who are otherwise strong
both in health and in will power.

Hereditary Astraphobia—Reflex paralysis of left forearm—Writer’s cramp—An-
a@sthesis associated with neurasthenia—Improvement under localized galvaniza-
tion and faradization and central galvanization—Spinal cord nerve current
and plexus nerve current, combined with internal medication.

CasE XXIX.—Mrs. R., a widow of 39 years of age, was referred to us July 27th,
1871, by Dr. A. W. Catlin, Eight weeks before that time she had run a.needle
into her right forefinger ; the needle was removed in three hours, but at once loss
of power was experienced in the fingers, and in a week the forearm also had become
very weak, .

The patient supported herself by copying many hours daily and nightly, and the
query arose, whether the affection was reflex paralysis, or writer’s cramp. ‘The his-
tory of the case and the special symptoms seemed to show clearly enough that the
case was one of paralysis, probably reflex, induced by the injury, but that the exercise
of the arm in writing had acted as a predisposing cause. This opinion was strength-
ened by the fact that the patient had had some symptoms of writer’s cramp before the
accident, )
HYSTERIA AND ALLIED AFFECTIONS, 457

Electro-diagnosis.— No loss of electro-muscular contractibility, but volitioned con-
tractility much diminished and considerable anzesthesia, made evident by examination
with the esthesiometer and the electric brush, There was also analgesia, ,

Examination with the dynamometer showed loss of force over the muscles, and the
difficulty of writing was so great that she had acquired the habit of copying with the
left hand. The patient was of a thoroughly nervous constitution and all her life had
suffered from astraphobéa (fear of lightning). Even in her baby-hood the approach of a.
thunde:-storm had markedly distubed her nervous system, and long before she was old
enough to be afraid of lightning she was a victim to the weakness, the distress, the
malaise and after unpleasant nervous symptoms that lightning excites, Her grand-
mother had been similarly affected.

Dr, Catlin treated the patient by localized faradization and strychnine, and the pa-
tient observed that shortly after the electricity was used the fear of lightning was re-
moved. This was the more singular from the fact that only localized faradization of
the arm was used and no general faradization or central galvanization.

We recommended the use of the electric brush, central galvanization, and the in-
ternal administration of Horsford’s acid phosphate. The details of the treatment,
with the exception of the central galvanization, were carried out by Dr. Catlin and
the patient somewhat improved, Subsequently the patient was terribly frightened by
stumbling over the body of a drunken man jn a dark lane of the city, at midnight, and
in an almost unconscious state arrived home, and was next day taken sick. Then fol-
lowed pain in the very spot where, weeks before, the needle had entered the hand, and
the muscles of the hand began to improve.

June, 1872, the patient again consulted us. There was still, as before, local anzes-
thesia, only more profound, anorexia, insomnia, spinal irritation and various symptoms
of the neurasthenic condition.

She was again treated and again improved ; but her recovery was never absolute,

The above case illustrates the complicated variety of symptoms that
so often appear in the nervous diathesis. It further illustrates the variety
of methods of electrization that may be used in such cases.
CHAPTER XVI.
INSANITY,

We have seen that very much has been accomplished in the treat-
ment of hypochondriasis and melancholia by the combined methods of
central galvanization and general faradization, and, reasoning from
analogy, it is probable that.an important future is in store for the scien-
tific faithful use of these methods of electrization in our public and pri-
vate asylunis.

Lt is not as well recognized as it should be that in diseases of the brain
and spinal cord, where the mind is seriously affected, the electrical treat-
ment is also indicated, justas in diseases of the same organs when the mind
és not affected. In some of the asylums of England, United States, and
Germany, electricity is now and for some time has been used as an ad-
junct to other remedies for the treatment of different forms of insanity ;
but with a few exceptions, the treatment is not systematically carried out,
and, partly through ignorance of the methods of application, . partly
through want of sufficient médical assistance to supervise the necessary
details, the results have not been entirely satisfactory, and the cases
have not been fully recorded.

We should except from these remarks the Alabama Asylum for the
Insane, where, under the superintendence of Dr. Bryce, both currents
of electricity have been used in the treatment of the patients for the
past two or three years.

We have corresponded with Dr. Bryce on the subject from the first,
and have at different times given suggestions in regard to the methods of
application, which suggestions have been carried out so far as possible
for the already overworked officers of that institution.

Under date of February 17th, 1873, he gives the general results of
his observations in the following language: ‘We like it: find it bene-
ficial in most cases, valuable in a majority, and indispensable in certain
forms of hysterical insanity, in primary dementia, and neurasthenia.”

The failures in this as in other branches of electro-therapeutics are,
in fact, the logical result of want of familiarity with the management of
INSANITY, 459

batteries, of incorrect ideas on the differential action of the currents,
and the general action of electricity on the body, and deficient techni-
cal skill in the details of the applications.

For those who are beginning to use electricity, or are contemplating
its use in asylums for the insane, the se general suggestions may be
of service: 1. Let it be remembered always that electricity, in any form
reais. Galvanic, or Faradic—when applied to the body, acts as
a stimulating tonic with a powerful sedative influence. It is an agent
for improving nutrition in any condition, local or general, where im-
provement in nutrition is required. It is to be used for the insane just
as bromide of potassium, quinine, strychnine, and iron are used.

The order and degree of its effects depend largely on the method and
mariner of application, and on the constitution and disease of the patient
to which the application is made.

2. That in insanity the brain isnot the only part of the body affected.
Excluding those cases of insanity produced by reflex action from the
digestive and pelvic organs, there are very many cases where the spinal
cord and other parts of the central and peripheral nervous system) suffer
as an effect of the disease of the brain. :

While these remarks’ may seem but commonplace to experienced
psychologists, and while the fact of the relation of diseases of the brain
to diseases of other parts of the body is continually recognized, when
other remedies are employed, still, in the application of electricity, some
experimenters have acted oh the theory that the drain alone should be
treated. Those who act exclusively on this theory will not gain great
victories over insanity by electricity. Some of the applications should
be made in such a way as to bring the whole central nervous system
under the influence of the current, and local diseases associated with
insanity as a cause or effect should receive local treatment.

The central nervous system is best brought under the direct influence
of the galvanic current by the method of central galvanization. The
method may be varied by galvanization of the brain, cervical sympa-
thetic, pneumogastric and spine ; but the method of central galvaniza-
tion is easier, safer, and more effective. In cases associated with
debility, and especially in those forms of insanity dependent on neu-
rasthenia or nervous exhaustion, general faradization answers a good
purpose, and may with great advantage be used alternately with central
galvanization or localized galvanization of the nerve centres.

3. The first tentative applications should be very mild, and the
strength of the current and the time of sitting should be gradually in-
creased as the patient proves himself able to bear the treatment.
460 INSANITY.

In the following case, although no permanent relief was afforded by
the method employed, the temporary effects were so sudden and startling
as to render the history of exceeding interest : ;

Acute mania of the most intense character existing four months—Remarkable
effects of general faradization,

CasE XXX.—Miss R., aged 20, living in Harlem, and a patient of Dr. Joseph
Wooster, of New York, was suffering from acute mania dating from suppression of the
menses, occurring four months before she fell under our care. She had always enjoyed
most excellent health—indeed was remarkble for her vigorous, robust constitution,
and it may be added, the ruddiness of her complexion, While watering the plants in
the conservatory of her sister, her clothes became quite wet ; she neglected to change
them immediately, and the consequence was a suppression of the menstrual flow, She
complained on the following day of severe headache, and on occasions, during the next |
two weeks, was markedly unreasonable in her action and demands.

Finally active delirium set in, but with no decrease of bodily strength. At times
she was intensely violent in her demonstrations—screaming at the top of her voice
and breaking every article of furniture within her reach; as a consequence she
was confined in a room stripped of its furniture, and in her wildest moods the strait-
jacket was applied. For more than two months no sleep visited her eyelids, without
the nightly administration of from 100 to 120 grs, of chloral. During the morning
she was often measurably quiet, but as evening approached she became absolutely

“ungovernable, and when chloral was not given she had been known to pace around
the room with great rapidity and: strength, muttering to herself, with absolutely no
cessation, from sunset to sunrise. She had decreased in weight from 160 to r1o lbs,
On the evening of the 15th of April, she was held firmly in position by several powers
ful assistants, and, after thoroughly moistening the hair of the head, we submitted
her to the most thorough form of general faradization with the very smoothest current
obtainable. The current was of great strength, but evidently in itself caused no dis-
comfort to the patient. That night, and without the use of any drug, the patient en-
joyed five hours of the quietest sleep, and for 48 hours thereafter was perfectly obedi-
ent and tractable. Another paroxysm of violence again showed itself, and the same ‘
form of application was readministered, She again slept quietly, and in the morning
awoke perfectly rational, but extremely weak in body, The day being bright and
sunny, a chair was placed in the yard, where she sat for several hours, and in all her
conversation evinced entire freedom from anything like mental deranyzement. Sud-
denly, however, she arose from her chair and ran around the yard with great rapidity.
She was immediately captured, and, when taken to her room, gave evidence of all her
former derangemeut. She was unusually ‘violent during the rest of the day, but after
the administration of too grains of chloral (and this was effected with great diffi-
culty, owing to her fierce struggles) she passed the latter part of the night in compar-
atively quiet sleep. On the following morning she awoke, somewhat excited, and re-
mained so during the day, while towards evening she as usual became more violent.

General faradization was again tried, and was attended by its previous good effects,
Four or five hours of quiet sleep followed, and on awakening, and for a part of
the succeeding day, the patient was quite calm and in some respects entirely rational.

Not to prolong this description, it may be said that neither general faradization nor
INSANITY. 461

central galvanization seemed to be sufficient to accomplish more than is related in the
above description, and finally it failed to give marked relief. The patient was taken
by her friends to an asylum and passed from under our observation.

Menopause insanity in a married lady—Great melancholy ; constant weeping ; at-
tempts to commit suicide ; attempts at starvation ; loss of flesh ; attacks of numb-
ness ; heaving, tearing, grasping, binding sensation in stomach and abdomen;

" unilateral sweating ; hysterical attacks of cryiug, laughing, and unusual suscep-
tibility to electricity—Gradual and steady recovery under central galvanization of
the cervical sympathetic, combined with cod-liver oil emulsion,

"Case XXXI.—Mrs. S., @ married lady of middle lie, was referred to us, Oct.
19, 1871.

The patient was pretty evidently suffering from menopause mania, of several
months’ standing, and evinced no disposition to recover. She attributed all her
symptoms to the use of the vaginal syringe, but there was no evidence of this, and the
case was pretty clearly one of mania dependent on the beginning of the change of life.

The patient would zever sit down : all day long she walked and walked the floor of
the house, sometimes standing still a moment to look out of the window or converse
or to look vacantly into space; but never would szt for a moment or even lie down
on a lounge; at night only would she go to bed.

She would weep for hours together, and when not: weeping was heavily depressed.
Her ruling desire was to commit suicide, and most resolutely she tried to starve herself
to death, but failed in'the attempt for the reason that she could not resist the tempta-
tion to take a bite now and then, although she did not partake of a regular meal for
several weeks, She wasnaturally very fleshy, and had lost fifty pounds in weight. She
tried to get hold of the batteries that were left at her house in order to drink the acid
solution, and her husband was obliged to take away the bottles after each applica-
tion, The patient had besides many vague, nervous symptoms, such as numbness and
tearing, rolling, heaving, burning, binding sensations in the stomach and abdomen.
Attacks of unilateral swelling on the left side came on at times, and the left side in all
respects was weaker than the right.

We suspected that all the symptoms might be more or less reflex from the uterus,
but the patient would not yield to our ‘suggestion that some gynzecologist be called in
to make an examination.

There was tenderness over the ovarian region, especially on the left side, and also
tenderness on the dorsal and lumbar vertebrze, and at times along the entire length of
the spine.

It seemed probable that the patient would have to be sent to an asylum, but as her
husband was so situated that he could give ‘her close attention, we decided to first ex-
haust treatment by electricity and internal medication.

We used central galvanization varied by galvanization of the cervical: sympathetic
and spine, and prescribed for internal use the cod-liver oil emulsion. | She was found
to he very susceptible to electricity: only gentle currents and short applications were
borne, and when thus used the sedative effect was excellent; but when carried be-
yond a certain point irritation rather than sedation followed. The applications were
made on the average about three times a week, for four months, with at first slow and
almost imperceptible, and afterwards with rapid improvement, and with ultimate and
462 INSANITY.

permanent recovery. A year and more after the treatment was abandoned, the patient
had fully regained and still retains all her flesh, health and spirits.

The above case seems to us to illustrate the following points :

1. The well: known fact of the curability of menopause insanity, even
when the symptoms are of the worst character. In the case of Mrs. S. all
the symptoms were bad symptoms, At times her maniacal attacks were
so violent as to be absolutely alarming, and twice at least we had reason
to be considerably terrified.

2. The advantage of combining medical treatment with various
methods of electrization. Although the patient herself and her husband
attributed the result to the electrical treatment alone, yet in our own
judgment the credit should be ‘divided between the medical and the
electrical treatment, and the elément of time should also be considered.
The patience and perseverance of the husband and his constant atten-
tion should be considered.

3. The fact that electricity, cautiously used, may be of great service
even when it is not well borne. Mrs. S. never could endure a long
or strong application, even when she had been long under treatment,
and by some the case might have been given up as not adapted for
electrical treatment.

4. The principle that, in the treatment of insanity by electricity, the
applications should not be confined to the brain, but should be made so
as toaffect the whole central nervous system, which, primarily or second.
arily, must be more or less involved in nearly all phases of insanity.
CHAPTER XVII.
CEREBRAL AND SPINAL CONGESTION.

AN exceedingly interesting point in the consideration of congestion of
the nerve-centres is, the discrepancy between the observed symptoms
and the authoritative statements, in regard to the necessary and con-
stant relation of certain symptoms with that condition. In pathological
conditions of the brain and: spinal cord, more perhaps than with other
organs of the body, it is difficult, nay, utterly impossible, to associate
a long list of distinct symptoms with some change or tendency
to change of structure, and say that they invariably exist as effects
and cause. What we term distinct variations from the physiologi-
cal conditions of the great nerve-centres, so markedly and undeniably
run into and overlap each other, are so frequently as it were intertwined,
that it is hard for the most careful observer to do more than to arrive
at approximately correct conclusions as to the actual pathology. — Irri-
tation and congestion of the cord may coexist. Congestion of a severe
and chronic character may simulate actual sclerosis, and hysteria asso-
ciated with a mild form of either irritation or congestion may give rise
to symptoms of anzesthesia and such decided impairment of electro-mus-
cular sensibility as to completely mislead the practitioner and suggest
the existence of serious organic disturbance.

These remarks will be more fully appreciated by referring to several
of the illustrative cases that follow.

Prognosis and Treatment.—The relief that is afforded by electrization
in the ordinary forms of passive spinal and cerebral congestion is quite
constant and reliable.

Galvanization of the brain, spinal cord, and sympathetic are of course
to be used and should be attempted with more or less thoroughness ac-
cording to the indications of each individual case.

General faradization, however, should not be neglected. There are
very few cases that will not receive benefit by its judicious employ-
ment,
464 CEREBRAL AND SPINAL CONGESTION,

Sudden onset of congestion of the cord associated with symptoms of irritation— Rapid
recovery follows general faradization.

Case XXXII.—Mr. B. W., a, youth aged 17, but exceptionally mature, both in
physical and mental endowments, was referred to us by his physician, Dr. John J.
Crane,

This patient, who was a student at Harvard, stated that some weeks previously he
had one afternoon walked quite briskly, and for a considerable length of time, and
while in a state of partial perspiration had reclined upon the grass until a sense of
chilliness warned him of his imprudence. During the rest of the day, and on retiring
at night, he observed no unusual symptom, but in the morning the legs were found
to be stiff and weak, associated with a decided loss of co-ordinating power. In shert
the patient was suffering from incomplete paralysis in a paraplegic form. There was
slight but marked tenderness along the spine on pressure, but no exaggeration of
reflex excitability in the limbs, and no appreciable impairment of electro-mus-
cular contractility or sensibility. | Anzesthesia was quite marked in the calves of the
legs and toes, but any sensation of tingling was altogether wanting. Pains in the
back and limbs were not increased by motion, but the patient complained of some
discomfort along the spine that was increased at night by the warmth of the bed,
It seemed sulficiently clear that the case was one of spinal congestion, and our first
thought was to trust to galvanization of the spine, but on futher thought, and taking
into consideration the recentness of the attack, and the remarkable effects of general
faradization in equalizing the circulation, we submitted the patient to a most thorough
but mild séazce of the last-named method, and directed him to call again in the course
of a couple of days. On his return we found that the anzesthesia had almost entirely
ceased to annoy him; his limbs were more supple and stronger, and there was a mani-
fest increase in the power of co-ordination. Substantially the same method was em-
ployed on seven different occasions from May 5th to May 13th, when he returned
to his studies completely recovered. :

In the case above cited, anzesthesia was a prominent symptom, while
there were absolutely no sensations of formication or tingling.

Tenderness on pressure along the spine was decided, and yet we find
various authors stating that in spinal congestion not only is this symp-
tom wanting, but so also is anzesthesia, while the sensations of formica-
tion and tingling in either the toes or fingers are almost invariably
present.

Sometimes the symptoms of one pathological condition may be the
more prominent—sometimes the symptoms of another—and occasional-
ly it may be observed by one whose experience is at all extended that
spinal congestion and irritation occur together as affections, so to speak,
co-ordinate and coequal. In this case congestion of the cord was un-
doubtedly the predominant condition, while the symptom of tenderness
along the spine on pressure rendered it evident that irritation was pres-
ent as well.
CEREBRAL AND SPINAL CONGESTION. 465

Spinal tenderness along the lower portion of the spine on pressure followed by pain
in the bowels and extremities—Impaired motor power, etc.—Improvement under
spinal galvanisation after failure of general faradization,

Case XXXIII.—As an illustration of a very considerable loss of power in the lower
limbs from well-marked spinal congestion, we refer to the case of a married lady aged
35, who was-placed under our care by Dr. J. O. Farrington. Some four years pre-
viously she first began to notice certain symptoms for which she could not account,
but which evidently indicat ed some disturbance of the circulation, and possibly some
slight spinal irritation.

She was then regarded as hysterical, and was really tormented with many of those
vague and various symptoms which accompany this condition. Associated with her
general nervous distress at that time, however, were a number of special symptoms,
which she readily called to mind on being closely questioned. The most prominent
of these was a sensation of tenderness when by any accident or design pressure was
made over the lower part of the spinal cord. She recollected also that this sensation
of tenderness was accompanied by pain in the lower parc of the bowels and in the ex-
tremities, and frequently a disposition to nausea.

These symptoms became neither much aggravated nor decidedly improved, but
continued to annoy her until about five months before she came under our observa-
tion, when a great change for the worse manifested itself.

Quite suddenly she found that the power of locomotion was considerably impaired,
Slight exercise fatigued her more and more, until finally she was unable to walk more
than a few hundred feet without becoming excessively fatigued. There was a sense
of heaviness in the knees and feet, and frequently it required all her efforts to over-
come this feeling of helplessness and move around. There was no anesthesia ; but
she complained of a constant tingling in the fingers and toes,

Pressure, when made over any portion of the spine, caused no feeling of tenderness ;
but at night the warmth of the bed frequently produced a dull aching of the cord,
which effectually prevented sleep. Both night and day she was annoyed at intervals
with paroxysms of shortness of breath, /

Hoping to equalize the circulation, and thus help to relieve the congestion which
was supposed to exist, we made use of the faradic current. We could accomplish
nothing with it, and resorted to the galvanic.current, placing the negative electrode
at the coccyx and passing the positive up and down the spine—spinal-cord current.
The application was administered every other day, and was followed by good results,
The sensation of tingling of which she complained was entirely dissipated.

The annoying shortness of breath was so much relieved that it ‘was only occasionally
and at night that she was troubled by it. Her feet became permanently warmer,
and she was able to increase somewhat her amount of exercise without suffering
fatigue. These results were accomplished in two months, during which time thirty
applications of the galvanic current were made.

The prominent symptom which pointed to spinal irritation as the original difficulty
in the case of this patient was the sensitiveness of the spine to pressure, and the ac-
companying nausea and pains,

The symptoms which indicated the later stages of congestion were:

First—Incomplete paralysis in a paraplegic form.

Second—A constant tingling in the toes and fingers.

go
466 CEREBRAL AND SPINAL CONGESTION.

Third—A dull aching along the spine, caused by warmth.

Fourth—Shortness of breath.

These symptoms, together with the absence of some of the prominent indications of
myelitis, viz., ancesthesia, paralysis of the bladder and sphincter ani, impairment of
electro-contractility and electro-sensinility, and also of tenderness on pressure along
the spine, which does not accompany the graver diseases of the cord when not asso-
ciated with spinal irritation—all these fully confirmed the diagnosis of congestion of
the cord. ‘~

Cerebral congestion in a young girl—Atlacks brought on when working on a
sewing-machine—Great temporary relief under central galvanization, galvani-
zation of the sympathetic, and bromide of potassium—Relapse under the con-
tinuation of the exciting cause.

CasE XXXIV.—E. A , a girl twenty-four years of age, came to us represent-
ing that, for four months, she had suffered from attacks of fulness of the head, flush-
ing of the face, with burning feeling that came on, sometimes every day, especially
in the afternoon and evening, when she had been hard at work on the sewing-machine,
She was employed in a shop where she was expected to work all day on the machine,
The constitution of the patient was excellent, and there were no evidences of uterine
disorder.

We used central galvanization, galvanization of the head and sympathetic, and
prescribed bromide of potassium internally, with immediate and decided relief, but
the symptoms recurred when she returned to hard work on the machine.

 

Cerebral congestion and exhaustion induced by over-toil and worry, following cure
of catarrh and nasal polypi— Terrible insomnia— Temporary numbness—Recovery
under galvanization of brain and cervical sympathetic, and internal use of cod-
liver oil emulsion,

CasE XXXV.—Mr. D——, a gentleman of middle life, a political editorial writer
on one of our prominent Western newspapers, consulted us December 20, 1872, for
persistent insomnia of a very aggravated character, that for one year had forced him
to try all methods of treatment, including hydropathy, homceopathy, severe exercise,
etc,, with but little profit. The condition had come upon him asa result of over-
toil in his profession, combined with mental annoyances of a most serious character.
Formerly the patient had suffered from nasal catarrh (chronic rhinitis) and nasal
polypi: as the cerebral disorder came on, the catarrhal symptoms disappeared,

The insomnia had been most obstinate: for weeks and months it had been neces-
sary to use chloral, else there was absolutely no sleep; and recently the chloral had
lost somewhat of its power.

We gave him a few applications of electricity, using the ordinary methods of gal-
vanizing the brain and cervical sympathetic, and gave the cod-liver oil emulsion. He
was obliged to return to his duties ; but he carried out the treatment faithfully, and
now and then reported his progress. The improvement was constant and permanent,
He got along with less and less chloral. In the course of a few weeks he wrote that
he was nearly well; but he adds: ‘* The catarrh is coming back ; the devil take it!”

One feature worthy of note in the above case was, the relation that
appeared to exist between the constant counter-irritation produced by
CEREBRAL AND SPINAL CONGESTION, 467

the nasal catarrh and the cerebral trouble. We have observed the
same in other cases, but in none so strikingly as in this.

Cerebral congestion associated with vertigo and numbness of the left side—Symptoms
aggravated by faradization —Recovery under central galvanization.

Cas—E XXXVI.—Mrs, H. was directed to us by Dr. A, Brayton Ball, to be treated
for symptoms of cerebral congestion. Her general condition was much below par,
and her menstruation, though regular, was painful and prolonged from eight to ten
days. Severe headaches were frequent, and for two years she had suffered from de-
cided numbness of the whole left side sufficient to prevent much labor or exercise.
Faradization, both general and local, was essayed without good effect ; indeed, the
numbness and vertigo were decidedly aggravated. The second application, three
days subsequently, was made with a current generated from four zinc-carbon cells.
The positive pole was applied to the top of the head, and the negative immediately
below the sternum. A slight increase of numbness was observed even from the weak
current used, but in a few hours this effect passed away, leaving hardly a trace of the
usual anzesthesia, This treatment was continued, at intervals of several days, for
over a month, during which time she was annoyed but little if any by either vertigo
or numbness.

Cerebral congestion—Distressing sense of fulness and heat in the head—Mild cen-
tral galvanization alternated with general faradization, is followed by decided
relief.

Case XXXVIL—On Feb, roth, 1872, we were called to Mrs. , who was under
the -professional care of Dr. Thomas Sabine. For several years the patient had been
an invalid, suffering more or less from ulceration and displacement of the womb, She
was of a decidedly nervous organization, exquisitively sensitive to all external impres-
sions, and yet her general appearance, so far as regards color, flesh, and expression,
was indicative of a fair degree of health. There was great pain and tenderness over
the left ovarian region, while at short intervals severe paroxysms of neuralgia, seated
in the head and left shoulder, occasioned much distress, The attendant symptoms,
however, which more especially interest us, were the constant burning at the top of
the head and an angoying numbness of the extremities, The heat of head was so great
that she felt obliged on nearly all occasions to wear cloths dipped in ice-water,

Mild central galvanization afforded some relief, but the most benefit was derived
by applying the faradic current by means of the moistened hand to all portions of the
head and neck, and extending the applications through sponges to the entire surface
of the body. In the course of a few weeks the patient was not only relieved of the
neuralgia of the head, and coldness and numbness of the extremities, but in a great

measure the distressing heat of head from which she so constantly suffered was dissi-
pated,

 
CHAPTER XVIII.

CHRONIC ALCOHOLISM.

WirHout entering into any exhaustive considerations of the various
symptoms associated with alcoholic poisoning or attempting to define
the possible pathological changes that may appear in the membranes of
the brain and spinal cord, we would here simply call attention to a
certain impairment of motor power in the lower extremities. This loss
of power simulates paraplegia, but as a rule is only partial or incom-
plete.

It is, however, sufficiently distinctive to deserve the term of “alco-
holic paralysis,” and is indicative of a condition more rooted and severe
than the familiar general muscular and nervous debility that afflicts the
habitual drinker. While in many cases of alcoholic paraplegia it is evi-
dent that certain pathological peculiarities must exist, such as chronic
meningitis of the cord on the one hand, and on the other thickening of
the membranes of the brain and spinal cord, together with a wasting of
their substance, it is in other cases as certainly evident that no such
structural change is present. On no other supposition can we account
for the rapidly and permanently beneficial effects that so frequently fol-
low the use of electrization in cases of alcoholic paraplegia. "

Symptoms of paraplegia and trembling, apparently from the ex@ssive use of stimu
lants—Recovery under central galvanization and general faradization—Relapse.

CasE XXXVIII.—Mr, ——, a hotel proprietor, was referred us by Dr. J. J.
Crane, May 4th, 1872,

For many years the patient had been accustomed to drink daily at dinner a quart
or more of champagne, and the only apparent result of this excess was a yradual im-
pairment of motor power and a condition of trembling in his legs.

Otherwise the general health was measurably vigorous. This loss of strength and
power of co-ordination in walking was sufficiently marked to excite the attention of
the casual observer. We submitted this gentleman to central galvanization, alter-
nated with applications of general faradization, and with immediate good effects, In,
six weeks, after having received some twenty applications, he was discharged quite ree
covered. After two years of relief he again complains at this date of certain symp-
toms that seem to indicate a return of his former difficulty,
CHRONIC ALCOHOLISM. 469

Chronic alcoholism, associated with tremulousness, weakness, insomnia and premo-
nitions of cerebral effusion.—The patient improves in all his symptoms under
general faradization and central galvanization,

Cast XXXIX.—Mr. ——, a gentleman of fifty, consulted us at the request of his
physician, Dr. J. O. Farrington. For years he had been accustomed to take daily a
considerable quantity of alcoholic stimulants, although his libations did not, as a rule,
extend to the point of intoxication, Two years before his interview with us he had
suffered from a persistent abscess in one groin from which much pus was discharged,
and which left his nervous system in an exceedingly depressed and shaken Condition,
He was excessively weak and tremulous, and sleep was impossible withcut the aid of
four or five grains of opium, The circulation was unequal, and he was annoyed by
constant flashes of heat and cold over every part of the body.

In addition he had frequent attacks of vertigo, with numbness and tingling in the
extremities, premonitions we inferred of cerebral effusion. .

Without thought of a radical cure, we submitted the patient to mild séances of
general faradization, alternated with central galvanization, and were rewarded by a
decided improvement, as manifested by increased strength and firmer nerves; sleep
became possible and refreshing without opiates, and the premonitory symptoms of
paralysis were much improved.

In the simpler and more frequent form of chronic alcoholism, in which
the patient complains merely of nervousness with the various symptoms
of insomnia, trembling, visual hallucinations, etc., the administration of
tonic remedies, a nitrogenous diet, and a judicious use or an entire ab-
stinence from drink are generally sufficient to insure recovery. Even in
such cases general faradization especially will greatly aid the above
treatment and will sometimes prove of infinite service in those excep-
tionally obstinate cases that resist the ordinary methods.
CHAPTER XIX.
NEURALGIA.

NEURALGIA has usually been classified according to the locality of
the pain, and corresponding special names are given to it.

Without entering on the discussion whether neuralgia is or is not
an exclusively central disease, we may, for the sake of convenience of
description, class all conceivable forms and phases of ‘it under these
four grand divisions :— ,

1st. Constitutional Neuralgias.—Those which arise from constitu-
tional conditions: anzemia, neurasthenia (nervous exhaustion), poison-
ing by minerals and various diseases, as syphilis, mercury, lead, rheu-
matism, gout.

2d. Central Neuralgias.—Those which certainly arise from disease
of the central nervous system : irritation, perverted nutrition, inflamma-
tion, congestion, and atrophy of the brain and spinal cord ; also tumors,
pressure of foreign substances, etc. _

3d. Peripheral Neuralgias.—Those which arise from local diseases
of, injury to, or pressure on, the nerve: neuritis, neuroma, aneurisms,
wounds, bruises, exposure to-cold, etc.

4th. Reflex Neuralgias.—Those which arise from reflex action.
This class embraces a large number of neuralgias that attack all por-
tions of the body. -

Llectro-diagnosis in neuralgia discovers the painful spots that are
detected by pressure in the course of the affected nerve, and may also
discover sensitive points on the spine, or the head, that might, perhaps,
have otherwise escaped observation.

Treatment.—Before attempting the electric treatment of neuralgia,
we should endeavor to diagnose its general character, in order to de-
cide upon the method to be employed. In doubtful cases it is neces-
sary to try in succession central, peripheral, and general treatment.

The treatment of the different varieties of neuralgia is the best test
of skill in electro-therapeutics. There is no disease or symptom in
which the results of treatment in different cases so closely depend on
METHODS OF TREATMENT. 471

the nature and strength of the current used, and the method and fre
quency of the applications. ©

Cases that injudicious treatment might aggravate may, by the exer-
cise of the skill and caution that experience teach, be rapidly cured.

The success achieved by electrization in the treatment of neuralgia
has been brilliant and remarkable, and would be sufficient of itself to
entitle it to a prominent and indispensable .position among modern
remedies. What is more remarkable still, is that this success has been
achieved by very diverse methods of applications, and with imperfect,
indifferent, or incorrect diagnoses. All forms of electricity—statical,
galvanic, and faradic—in all the different methods and phases of elec-
trization, general and localized, centrally and peripherally, by currents,
stable, labile, continuous, interrupted, uniform, and increasing.

The pain is frequently relieved in the midst of the application ; but
in such cases it usually returns in the course of a few hours, and some-
times with heightened intensity. Some cases of a peripheral character
are permanently dispelled by one or two applications.

Electricity is applied for neuralgia in the following forms :—

General faradization and central galvanization.
Localized faradization or galvanization, central or peripheral, or
both combined,
Galvanization of the cervical sympathetic,
Electric brush.
Electric moxa.
Statical electricity.
Electric bands and disks.
- The magnet.

Statical electricity works well in neuralgia, and excellent cures have
been performed by it, but there is no evidence as yet that it is in any
respect superior to the galvanic current when rightly used.

Many of the failures and disappointments with the use of electricity
in neuralgia have been due to the mistake of treating constitutional dis-
eases locally, and the central varieties peripherally.

There is one difficulty in the treatment of neuralgia by electrization,
and that is that, on account of the intensity of the pain of the disease,
patients are sometimes unwilling to give the treatment a fair trial.
This difficulty is further increased by the fact that, during or after the
first two or three applications, the pain may be ¢emporarily aggravated,
especially if the sittings have been long, or with currents of too great
strength. For this reason the initial applications should be made with
472 NEURALGIA.

caution, and the operator should not yield to the temptation to renew
them too frequently. Once a day, or every other day, is about as often
as applications can be made with benefit.

As before remarked, the methods of applying electricity must be
studiously adapted and varied to each case, ever keeping in mind that
all methods of using electricity have been successful in thts disease, and
that no one method is uniformly successful even in the same variety.

Besides the central and general electrization, which is to be con-
ducted on general principles, in ‘order to affect the seat of the disease,
all the varieties of neuralgia may demand more or less treatment in the
seat of the gain. For this purpose we may use either faradic or gal-
vanic currents. Although the faradic achieves excellent results, yet
some of the most striking results have been obtained by the galvanic.
It sometimes relieves the pain when the faradic only aggravates it.*
After the faradic current has been tried a few times without’ effect, we
should never abandon the case without resorting to the galvanic, or the
two currents may be used alternately. As a rule, the applications
should be short and made with a mild current; but this rule has
marked exceptions. There appears to be no special law in regard to the
direction of the current. The strong statements that have been made in
regard to the superiority of one or the other pole in this disease are
not sustained by experience. Either the positive or the negative pole
may be placed over the painful points, while the other pole is applied
near or on the nerve centre. Thus, in neuralgia of the arms, one pole
may be placed at the cilio-spinal centre, and in neuralgia of the legs,
on the lumbar vertebra, and the other on the affected nerve (spinal-
cord-nerve current). :

The electric moxa is sometimes more rapidly efficacious in neuralgia
than any other method of treatment. It is, however, a very painful pro-
cedure, and many patients will not bear it.

It seems to act partly as a counter-irritant. Meyer very strongly
advocates the use of electric moxa in neuralgia, and sustains his position
by a number of cases. Very féw American patients in the higher walks
of life will bear this severe method of using electricity.

General Prognosis.—Take the cases as they arise, without reference
to their pathology, duration, or situation, neuralgia offers a very favor-
able prognosis. The majority of cases will be cured or permanently

* The statements of Niemeyer and others that the faradic current never succeeds
in neuralgia after the galvanic fails, is not true. "We have seen several cases where
relief was obtained by faradization with Kidder’s continuous machine, after galvani-
zation had at least apparently failed.
CASES. 473

improved. Patients who have the neuralgic constitution are liable to
relapse in time, however successful the treatment may have been.

Paroxysmal attacks of a most distressing general neuralgia, associated with menor-
rhagia and anesthesia, treated by general faradization—Recovery,

CasE XL,—A lady about 30, married, but childless, had suffered from several mis-
carriages, and had been treated for a long time for ulceration of the neck of the uterus
that finally yielded to local applications. Up to her twenty-fifth year she had enjoyed
a good degree of health; but after her first miscarriage she began to suffer from pro-
longed menstruation, attended with an excessive flow. This condition had existed
but a few months when the patient began to experience certain wandering pains over
the body, that became more marked at each return of the catamenia, until the par-
oxysms assumed a most distressing character. They were usually ushered in by ten-
derness and a sensation of oppression in the epigastric region, Throughout the whole
attack the most acute pain would be felt over the stomach, and was attended by vomit-
ing. Most of the body was, however, to a greater or less extent, affected by. the dis-
order. The head became tender to the touch, the eyes intolerant to light, and the
tongue and mucous surfaces of the cheek would be affected by a very annoying sensa-
tion of numbness. Several times a year she was prostrated by symptoms that were
very sudden in their onset, and exceedingly alarming in character. The pulse, almost
without warning, would fall to 40 or 45 in the minute, andl become so feeble as to be
hardly perceptible. The power of articulation left her, the anzesthesia of the mouth
and tongue became complete, and her face assumed a deadly color and coldness.
These attacks lasted from twenty minutes to half an hour, and were treated by the
free use of brandy and carb, of ammonia, An application of general faradization,
given one evening during one of her periodical monthly paroxysms, so relieved the
distress that a quiet night was the result. It may be here stated that it was impossi-
ble for the patient to take opium in any form with benefit. Exceedingly small doses
caused sleeplessness and the most intense excitement. Invariably after this we found
that a similar application would greatly alleviate the pain. The main idea, however,
was to strengthen the general system, and so prevent these attacks, For this purpose,
on every other day she was treated thoroughly by general faradization, and it was not
long before its good effects were manifest. In the course of a few weeks her powers
of endurance had increased considerably ; and when the menses appeared they were
of shorter duration, and attended with a much less loss of blood than before. The
neuralgic pains were incomparably less severe, and she rallied to her usual condition
immediately. After remaining under treatment several months she was discharged as
cured, Five years have elapsed since treatment was discontinued, but she has never
suffered since from those occasional attacks of which mention was made. Her men-
ses continue regular and normal; and it is only after great provocation that she ever
experiences paroxysms like those of former days,

Intercostal neuralgia of a malarial origin—Recovery under general faradization
and quinine.

Cask XLI.—A young man, who had been exposed to the hardships and dangers of a

frontier life, was suffering from distressing pains that were confined mainly to the

thoracic region on either side. Several months before we saw him, he was prostrated
474 NEURALGIA. :
by an attack of intermittent fever that recurred several times after being apparently
subdued, :

One of the paroxysms was followed by what his attendant called ‘drow ague”?—
a term not unfamiliar some years ago to the residents of malarial districts.

It was characterized by sharp shooting pains all over the head and face, affecting,
however, especially the forehead and eyes. The neuralgic symptoms soon abandoned
these parts, but in a few days manifested themselves by an unusually severe paroxysm
in the chest and side, For a number of months before he fell under our notice, at-
tacks of intercostal neuralgia occurred at intervals of two or three days,

The patient experienced no distinét chills or marked febrile excitement, but the
neuralgia was almost invariably ushered in by a creeping sensation of cold down the
back and limbs, The exciting causé was undoubtedly a malarial poison, The diag-
nosis of neuralgia was unmistakably confirmed by the presence of that almost pathog-
nomonic symptom, namely, pain on pressure over the spinous process of one of the last
dorsa] vertebree, A gradual improvement took place under frequent general applica-
tions of the faradic current. Quinine was administered at the same time, so that we
cannot state in positive terms the exact amount of credit due electrization. It must
be remembered, however, that quinine had been taken for some time previously, and
was followed by no very marked results, The first application, administered during a
paroxysm of ordinary severity, was followed by a very grateful amelioration of the
pain, and in all subsequent attacks the same result followed.

Ten applications served to break the periodicity of the attacks, and to place him on
a plane so little below the normal, that it could be fairly said of him that he was
approximately cured,

{
Intercostal neuralgia, resulting from exposure to camp life—Spinal Irritation—
Debility—Rapid improvement and recovery under general faradization,
’

CasE XLII.—L. C., aged 28, served in a Nevada regiment for three years during
the war. After his discharge, in the fall of 1865, he was taken with Acute articular
rheumatism, which confined him to a hospital during the whole winter. The spring
found him much better, and in a few months there seemed to be no vestige of the rheu-
matism remaining. His health remained delicate. In July, 1866, he wastaken with
severe pains in the back and side. He was treated by localized faradization a few
times, but with no appreciable benefit. The neuralgia increased in severity, locating
itself between the ribs. In January, 1867, he applied to us for treatment. He was
then extremely weak, and presented a remarkably anzemic appearance. There was
very great hyperzesthesia over the peripheral expansion of the affected nerves, Slight
irritation by the finger-nail, or moderate pressure by the hand, was sufficient to cause
considerable pain. On account of his extreme sensibility he was obliged to substitute
for the coarse red flannel which he had been accustomed to wear, an undershirt of
finer texture. Pressure made upon the first spinous processes of the dorsal vertebrae
caused no uneasiness, but when the sixth and seventh processes were firmly pressed,
the patient loudly complained. We gave him a general application, as is our custom
in such cases. The whole system was brought powerfully under the influence of the
faradic current. The application at once relieved him, and in three days he was
directed to come again. During that time he suffered much less than usual ; his ap-
petite had improved, and for the first thirty-six hours he was much invigorated. He
CEPHALALGIA. , 475

visited us for one month, during which time he received ten general applications. The
improvement was uninterrupted from the beginning.

After the fourth application he suffered no more from the neuralgia. The color,
returned to his cheek ; his appetite became more vigorous from week to week, and{
when he discontinued treatment, we regarded him as comparatively well.

This case called for a powerful constitutional tonic. Hardships in
the army and previous disease had reduced his stock of vitality to such
a degree that our ordinary internal tonics failed to produce their accus-
tomed results. His nervous system had been so shaken, and all his
functions so disturbed, that he could not assimilate the iron and bitters
that were so much needed. It is in such cases that general faradiza-
tion achieves most satisfactory results.

Central Neuralgia.—Under this head we include those cases of

“neuralgic pain that certainly depend on pathological lesions of the
central nervous system.

The neuralgic pains of locomotor ataxia belong to this class.
Those who with Dr. Anstie regard neuralgia as a distinct disease, de-
pendent on atrophy of the roots of the nerves, do net regard these pains
as really neuralgic. Under this class also come certain varieties of
headache and cervical neuralgia.

Cephalalgia (Headache).—Headache should be treated by general or
localized electrization, according to the indications of each case. Dry
faradization with the hand is used successfully. Stable galvanization
or faradization, uniform or increasing, may be employed. Labile ap-
plications with the moistened hand are sometimes of service. General
faradization is more effective than localized, for the reason that in so
large a proportion of cases the pain in the head is so very frequently
symptomatic of disease of other parts of the body, the precise nature
and locality of which we cannot possibly detect. Central: galvanization
is sometimes more efficacious than any other method. Relief not un-
frequently follows galvanization or faradization of the stomach, or
bowels, or spine, or galvanization of the sympathetic, even when the
head is nottouched. Applications to the back of the neck are sometimes
more efficacious than direct applications to the head.

rognosis.—Although headache in this country is even a more
frequent symptom than dyspepsia, yet patients do not usually apply for
treatment for this symptom alone, but only when it is associated with
more special and distinct affections. The immediate effects of electriza-
tion in headache are as variable as the pathology of the symptoms. It
sometimes relieves, sometimes aggravates, and sometimes: gives only
negative results, Sometimes the pain is relieved in the midst of the
476 NEURALGIA.

sitting ; more frequently the relief does not appear for several hours,
There is no reason to be discouraged because immediate relief is not
obtained. In very many of our cases of dyspepsia, of anzemia, chlorosis,
nervous exhaustion, paralysis, headache is a more or less constant
symptom, fram which during the treatment they usually obtain either
relief or cure. In rare cases all other symptoms yield but this.

In many of the cases of dyspepsia, neurasthenia, anzemia, and hys-
teria, headache was a prominent symptom, which was not only tem-
porarily but permanently relieved by the treatment. If we were to judge
from our own observations, electrical treatment is even more efficacious
to prevent attacks of headache, by improving the tone of the system,
than to dissipate the pain after it has once set in.

The Magnet.—The therapeutical results that have been obtained by
the magnet in the treatment of headache are not sufficiently encourag-
ing to entitle it to special notice. Something has been claimed for it,
but, as a rule, it has been found that it is necessary that the patient
should be of a peculiarly impressible organization, in order to be in the
slightest degree affected by it.*

Frequent and severe headaches ina girl of fifteen since the age of four—Approxi-
mate recovery under a month of central galvanization—Subsequent relapse.

Case XLIII.—Miss C., aged 15, consulted us at the suggestion of her physician,
Dr. Everett Herrick. The patient was small of her age and menstruated first at the
age of eleven. In regard to hereditary influences it may be said that her,father had
for many years suffered from periodical attacks of headache, and that her aunts,
sisters of her father, had also menstruated at about the same early age as the patient
herself. The following were the symptoms for which relief was sought: Since the
age of four she had suffered intensely from headaches associated with vomiting, which
latterly had increased in frequency until four out of the seven days of the week was
the ordinary ratio of the sick days to the well days. It may be remarked, however, that
at no time was she entirely free from pain. The general health'and strength of the
patient was fair; but the circulation was feeble and the appetite not very good. Cen-
tral treatment being indicated, we began the use of this method by the application of
the galvanic current from four ordinary zinc-carbon cells, and during the treatment,
consisting of seventeen séances, and extending from May roth to June 16th, we grad-
ually increased the number of cells toeight. It was observed that the attacks greatly
decreased in frequency and severity, and when she left the city for the annual summer
vacation she was but little annoyed by her old enemy. We learned incidentally that
subsequently the patient relapsed,

* Tripier (Annales de I’Electrothérapie, 1863) presents a résumé of some not
very convincing experiments of Abbé Le Noble in the treatment by the magnet of
headache and other nervous affections. The experiments were recorded by Andry
and Thouvet, in ‘‘ Mémoire sur le Magnétisme Médicinal.’? Paris, 1782.
CASES OF CEPHALALGIA. 477

Intense and deep-seated cephalalgia—Permanent relief follows central galvaniza-
tion.

Case XLIV.—A patient from whom a large fibrous tumor of the uterus had been
removed several months before she fell under our observation, complained of such
constant and severe neuralgic pains, which seemed seated in the centre of the brain,
that at times she almost lost control of herself both physically and mentally. Neuralgia
had been a symptom from which she had suffered more or less for years, but far less
acute in degree than after the operation mentioned, From March 12th to 3oth,
1872, central galvanization was applied on five occasions and with excellent results.
The pains, although not entirely dissipated, became far less distressing in character,
and ceased altogether to exert any mental influence,

Throat dysesthesia, associated with severe cephalalgia of twenty years’ standing—
Decided relief under central galvanzization,

Case XLV.—Mrs. T., who was directed to us by Dr. C. R. Agnew, had for 20
years suffered from an almost constant and painful heaviness about the head and eyelids.
Associated with this symptom were frequent periodical attacks of the most intense
cephalalgia. For the last few years the patient had complained of a local neuralgia of
somewhat rare occurrence, noticed by Hanfield Jones as ‘throat dyszesthesia.”’
Dysphagia was present, with a sense of impending suffocation, with heat and dryness,
Inspection revealed no inflammation sufficient to account for the distress.

The treatment consisted of some 25 applications, almost wholly by the method of
central galvanization, and with most decidedly beneficial results. The heaviness of
the head and eyes was much relieved, and the cephalalgia occurred at far greater in-
tervals and with less severity.

The throat difficulty yielded more readily and completely than the other symptoms.

It was a noticeable fact in the history of the treatment of the above
case that at the outset a mild current of say from five cells, when,
applied to the eyes, while it was not unpleasant and produced no aggra-
vation of pain, signally failed to relieve.

A current from three cells was invariably followed by immediate
alleviation of pain.

Persistent and constant cephalalgia of long standing—Aneasthesia of head—No
relief.

Casz XLVI.—Mr. R., a clerk aged 22, was referred to us, April 22, 1869, by
Dr. Hallet, of Brooklyn, The yonng man had been many months a sufferer from per-
sistent pain through the head, in all parts of it, even to the back of the neck. Treat-
ment had been of no avail. His constitution was of the nervous variety, and his
symptom was aggravated by his sedentary mode of life, and by any sustained mental
effort,

Ektctric examination with both galvanic and faradic currents demonstrated a very
unusual lack of sensitiveness to the current on all parts of the head, which in health
can bear only very gentle currents. All the modifications of electrization were em-
478 NEURALGIA.

ployed for four weeks, without making the feeblest impression on the symptoms, No
temporary relief could be obtained either during or after the séance. The most un-
usual fact of all was, that the pain could not be temporarily aggravated or changed
in its character, even by powerful and somewhat prolonged galvanization. The fail-
ure was complete; after four weeks’ treatment the patient was dismissed, no better
and no worse than at the outset of the treatment. ‘

The patient a few years subsequently committed suicide, being driven
to the desperate act by constant and unrelieved pain.

A careful post-mortem examination made by Dr. A. B. Crosby, in the
presence of Drs. E. S. Bunker, S. G. Armor and ourselves, revealed no
pathological lesion that would satisfactorily account for the symptoms
during life.

Sick-headache (Migraine)—The results of our treatment of sick-
headache by electricity have not been quite inconsistent. In some cases
the relief has immediately followed treatment; in other cases some
time after treatment; in still other cases there has been no relief, tem-
porary or permanent.

Sick-headache—Vomiting—WNo relief from faradization,

CasE XLVII.—In the case of a young lady, the onset of the pain is very peculiar.
Without the slightest warning, when at church or walking, at the piano or engaged
in household duties, her vision will become blurred. Objects before her seem to
dance about in every direction, and she is unable to recognize familiar faces, No
barometer is so accurate in indicating storms as are these nervous symptoms in fore-
telling the commotion about to take place in her system. Soon the blur before the
eyes partially disappears, and a most raging headache sets in. The arteries in the
temples swell, and pulsate with great rapidity and force. Sharp lancinating pains

“dart all over the head and through the eyes. Asa rule, vomiting of a grumous-look-
ing liquid, mixed with bile, accompanies the other symptoms. After lasting from 12
to 24 hours, the severity of the attack abates, leaving her in a somewhat debilitated
state, from which she soon recovers, Electrization failed to give any relief. Bromide
of potassium is the only remedy that has any effect whatever. Given in doses of 20
grs. as soon as the eyes become blurred, it will frequently lessen the severity of the
pain in the head.

In the case of a sister of the above the headache is preceded by no blurring of the
eyes, but is accompanied by an excessive and distressing sense of #ervousness, causing
the patient to throw her limbs and body about, and to ‘ feel,’’ to use her own expres-
sion, ‘‘as if she would fly.” A number of applications of the faradic current enabled
her to overcome this feeling of nervousness, and thus relieved her of one very annoy-
ing symptom of her disorder. Generally, though not always, in the cases just related,
these attacks of sick-headache occur just before or during the menstrual period, and
so would seem to be influenced in some measure by this function!

The true principle of treatment is to tone up the system by a perse-
vering use of general faradization and central galvanization, with other
FACIAL NEURALGIA. 479

tonics, so that the paroxysms may be less frequent and less severe; in
other words, to combat the zervous diathesis of which the sick-headache
is but a symptom.

The following case illustrates the advantage of carrying out this prin-
ciple of treatment. :

Migraine of several years’ standing in a lady of a very nervous temperament—Very
great and permanent improvement under central galvanization.

CasE XLVIII.—Mrs. K., a young married lady, daughter of a physician, was of a
specially nervous organization by inheritance, and had suffered from neurasthenia,
spinal irritation, and especially from frequent attacks of migraine. We treated her
during the intervals of her attacks for twelve times by central galvanization, There
was immediate improvement; the attacks became less frequent and less severe. The
improvement advanced after treatment was discontinued, until she was almost entirely
free from migraine.

FACIAL NEURALGIA—(EPILEPTIFORM NEURALGIA—FOTHERGILL’S DIS-
EASE—TIC DOULOUREUX).

Facial neuralgia appears under two forms. The mild form is usually
of a peripheral character, being caused by neuritis, pressure from effu-
sion, or decayed teeth. This form usually yields readily and surely to
electrization. The severe form, to which Trousseau has given the name
epileptiform neuralgia, is probably ofa central character, being caused
by a variety of pathological conditions of the brain.

The symptomis of this form of facial neuralgia are the spasmodical and
very intense character of the pain in the course of some of the branches
of the fifth pair. The spasms are of very short duration—ten to fifty or
sixty seconds—and may be accompanied by convulsive action of the
muscles. The attack may be brought on by any exercise of the jaws,
as chewing, reading, eating, or talking. The pain is so great as to cause
the patient to slap his face, or frantically rub the spot over the seat of
the pain. Sometimes patients who have great self-control stamp violently
on the floor, jump up if they chance to be sitting, pace the room, and
utter piercing cries.

This terrible disease has usually been regarded as almost incurable,
and is so pronounced by Trousseau, who has graphically described its
symptoms.* Section of the nerve, of which so much was once ex-
pected, is now but seldom used, and permanently succeeds only in ex-
ceptional cases, j

By a judicious and varied use of peripheral faradization or galvaniza-

* See his Lectures, Bazire’s Translation, part I, p. 105.
480 NEURALGIA.

e

tion, or by the electric moxa, or by galvanization of the brain or cervi-
cal sympathetic, a certain portion of these terrible cases can be relieved
or cured. Our experience does not yet enable us to say what propor-
tion the failures will bear to the successes ; but if one case out of ten can
be relieved or cured, it is justifiable to try electricity in all, since most
other modes of treatment offer no hope.

We present typical examples of both failure and success in the elec-
-rical treatment of this disease. ~

Epileptiform neuralgia of left side of face, of two years standing, treated with-
out benefit by various methods of electrization.

Case XLIX.—Mr. P., aged— was sent to us, Noy., 1869, by Dr. Willard
Parker, with typical symptoms of epileptiform neuralgia, The patient, though a man
of mild temperament, stamped furiously on the floor, even while telling us his history,
The spasms of pain appeared in one spot, in the course of the lower branch of the
trifacial, The general health of the patient was not greatly impaired, although ghe

had suffered for two years.
We tried, in succession, all means of electrical treatment, with both currents. At

one time some temporary benefit appeared to have been derived ; it was, however, of
short duration, and the paroxysms returned in full force.
After ten applications the patient abandoned treatment, utterly disheartened.

In the above case we made the applications twice a day, as the
patient could stay but a short time in town. It is possible that better
results would have followed if a longer interval had been allowed.

We now turn to the pleasanter side of the picture.

Epileptiform neuralgia of two years standing—Improvement under localized
Saradization ; temporary aggravation by galvanization,

Cask L.—Mr. M., aged 65, of extraordinary vigor of constitution and per-
fectly temperate in every habit, stated that some two years since, in the year 1865, he
first noticed a slight pricking sensation under the lobe of the left ear.

For one year this feeling occurred only occasionally, and annoyed him but little,
At the expiration of this time the attacks became more frequent, were considerably
prolonged, and produced actual pain.

It was a singular feature associated with his condition, that exposure to the sun’s
rays for a few moments would invariably qccasion an attack of pain. About this
time the loss of a large amount of money was a cause to him of great anxiety of
mind, and evidently aided in aggravating his disorder. The paroxysms of pain in-
creased in frequency and severity, until it was his sorrow to suffer the greater part of
every day from the excruciating torture of the worst form of facial neuralgia, At
night he suffered but little, but with the rising of the sun his distress began, The
instant he opened his mouth to speak, darting pains would shoot over every portion
of his face, followed by a profuse flow of saliva,

The act of eating was attended with even greater suffering, and frequently he
would continue hungry for hours rather than make the attempt.
CASES OF FACIAL NEURALGIA. 481

For two years he suffered in this manner, without being able to obtain’ more than
slight temporary relief. Upon applying to us we immediately localized an exceed-
ingly mild and fine faradic current through the different ramifications of the fifth
pair, with immesiate beneficial effect. The pain from which he was then suffering
was subdued, and during the two succeeding days paroxysms of pain were much less
readily excited than usual, A second application resulted in still further improve-
ment; but at the third visit, hoping to accelerate the cure, we made use of a mild
galvanic current from six of Bunsen’s cells,

The effect was most disastrous, The neuralgic attacks returned with more than
ordinary severity, and gave the patient no rest until we saw him again the next day.
An application of the faradic current again relieved the pain as effectually as before.

From this tinie onward, under the exclusive use of the faradic current, the im-
provement was uninterrupted, until, after remaining under treatment six weeks, and
receiving eighteen applications, he was discharged approximately cured. Occa-
sionally, after a long conversation, he feels something like a twinge of the old pain,
but it is so slight as to give him little annoyance,

Neuralgia of the superior maxillary and ophthalmic branches of the fifth pair, fol-
lowed by strabismus convergent and projection of the eyeballs— Treatment by local
ized faradization—Recovery.

Case LI.—In September, 1867, the following quite novel case fell under our ob-
servation, The patient was a married lady (aged 35), who stated that in July, 1866,
she was taken suddenly, during the night, with severe neuralgic pain in the right side
of the face, along the course of the superior maxillary division of the fifth pair. Since
the first attack the pain had been almost constant, and frequently occurred in pro-
longed and acute paroxysms. Before the disease manifested itself, she was of a full
and stout habit, and had enjoyed good health. Her sufferings, however, made alarm-
ing inroads upon her general constitution. When we first saw her she was markedly
frail and anzemic.

She was able to take but little exercise, and her appetite was poor and capricious,
In April, 1868, the ophthalmic branch became affected, and the pain changed its seat,
coursing along this nerve and seeming to spend itself behind the eyeballs. Strabismus
convergent followed almost immediately, and the eyeballs rapidly projected, until it
assumed most unsightly proportions, She had been untiring in her sgarch for relief,
but finally became deprived of hope of any amelioration of her symptoms, when the
use of electricity was suggested. We made an extremely mild application of a faradic
current, and succeeded to a considerable extent in dissipating the paroxysm from
which she was then suffering.

During the two days that intervened before the second visit, she suffered, but not
so severely as before. When she presented herself for the third application, she had
an encouraging account to give. For three nights she had experienced absolutely no
pain, and both the strabismus and the projection of the eyeballs were materially les-
sened. She continued to progress towards reeovery during the succeeding few
weeks, until her neuralgia was entirely overcome, with the exception of a slight un-
natural prominence of the eyeballs. The eyes were restored to their normal appear-
ance and position.

31
482 NEURALGIA.

Neuralgia of the head, accompanied by impairment of sight and vertigo, in a lady
aged 70.— Treatment by localized faradization,—Approximate recovery,

Case LII.—An aged lady, between 70 and 80 years of age, applied to us on one
occasion, by direction of Dr. D. B. St. John Roosa, for the relief of a most
agonizing distress in the head.

The pains were evidently neuralgic in character. They darted over the head in
all directions, from the forehead to the occiput, but were most severe immediately
behind and above the ears. The eyelids were affected to a considerable extent,
seeming constricted and heavy; and sometimes, during a paroxysm of more than
ordinary intensity, the sight would be much impaired for hours, When the severity
of the attack had abated, she would be annoyed by a persistent dizziness, so that she
could with difficulty stand erect. Previous to this attack in the head, she had
suffered from similar pains that extended up the arm to the breast.

A gentle application of the faradic current to the head, during a most severe
paroxysm, greatly relieved her.

Not only was the pain entirely dissipated, and the constriction and heaviness af
the eyes removed, but for many hours after she was entirely free from vertigo.

The applications were continued at intervals of several days, for a number of
times, and accomplished an approximate cure. Occasionally she suffers from a return
of the paroxysms; but they are of a much less severe character than formerly, and
are at once dissipated by the current.

Facial neuralgia of several years standing successfully treated by localized faradi-
zation,

Case LIII.—Mrs. S., a patient of Dr. J. O. Farrington, aged 65, had for a number
of years been a great sufferer froma most acute form of neuralgia of the face, frequently
associated with vertigo and nausea. The point from which the pains radiated and
darted in all directions, to the temple, the ear, and even down to the neck, was
situated close up to the right ala of the nose.,

The patient would occasionally remain a number of weeks comparatively comfort-
able, but as a rule not more than a few days intervened between the attacks,

A mild faradic current was applied through the fingers of the operator during a
season of great distress. This not only alleviated the pain for the time being, but
during the two succeeding days, after which she presented herself again for treatment.
The relief continued complete.

At intervals the patient was treated in this way for about two months. She had.
in this time but one or two attacks, slighter than usual, She discontinued treatment,
and during the following summer was entirely free from them, In the fall she began
to suffer again, and submitted some half a dozen times to the old method of treat-
ment, and to the date of writing, six months subsequently, she has remained free
from the attacks.

It is worthy of remark that in this case the galvanic current, however
mildly applied, seemed only to aggravate the paroxysms.
Peripheral Neuralgia. —Neuritis, neuroma, the continued action of
cold or wind, wounds, or other injuries of the nerve—all these may give
rise to the peripheral form of neuralgia. Neuritis, or rather inflammation
GASTRALGIA. 483

of the neurilemma, must be regarded as one of the most frequent causes
of peripheral neuralgia, and this inflammatory condition may depend
upon'some form of mechanical irritation, as long-continued pressure of
the child’s head in labor on the sciatic plexus, or by the concentrated poi-
son of gout, rheumatism, malaria, or syphilis, acting locally. It may, of
course, be conceded to the advocates of the purely central theory of neu-
ralgia that there may be a constitutional predisposition to neuralgia, but,
on the other hand, it must also be conceded that, in many cases at least,
some exciting cause, acting on the periphery, is necessary to develop it.

Treatment.— The treatment of peripheral neuralgia should obviously
be of a peripheral character ; stable faradization and galvanization, and
electric moxa. In doubtful cases, that refuse to yield to this method
of treatment, it is well also to try central and general electrization.

Cervico-brachial neuralgia of left side, of six months standing, in aman other-
wisein good health—Recovery under localized faradization and galvanization,

Casz LIV.—Mr. Q., a stout, vigorous gentleman, of middle life, was sent to us by
Dr. Jared Linsley, April 1, 1869. The patient complained of cervico-brachial neu-
ralgia in the left side, The pain extended from the occiput down the arm, and was
most severe at night: tender point on the occiput. We judged that the neuralgia
was of a peripheral character, and of a rheumatic origin,

Three mild applications of faradization gave sensible relief. Twice galvanization
was tried, the negative pole being placed on the occiput, over the tender spot, and
the positive on the shoulder, or on the side of the seventh cervical vertebra, After
the sixth application the patient announced that he was entirely well, and discon-
tinued treatment. Although both faradization and galvanization were manifestly of
service in this case, yet the former accomplished the chief part of the task before the
latter was brought into requisition,

Gastralgia.—Gastralgia may perhaps be included under peripheral
neuralgia, although there is room for much discussion on this point.
Our results in gastralgia have thus far been more satisfactory than in
any other neuralgia.

The following case illustrates how utterly futile internal medication
is in certain neuralgias, and what a vast difference there is between the.
remedial power of the faradic and galvanic currents.

A very severe case of chronic gastralgia of a periodic nature—four years’ standing—
relieved by galvanization, after failure of faradization.

Cast LV.—Mr. B., « gentleman from Charleston, S. C., consulted us in Janu-
ary, 1867, The history of his case issubstantially as follows: In the latter part of 1861
he was taken with a severe attack of neuralgia in the back of the head and neck,
Similar attacks recurred, in paroxysms, every few weeks for about two years. In
December, 1863, while suffering from severe pain, colchicum was prescribed, to be
484. NEURALGIA.

taken every two hours. Not understanding the nature of the drug, he took it every
half hour for five hours, This imprudent dosing was followed by persistent vomiting
and retching, which lasted for eleven days and nights, producing excessive prostration,
and, in the end, total unconsciousness.

Acute gastritis supervened, from which he recovered with difficulty, but only to
suffer from neuralgic pains in the stomach, similar in character and severity to the
distress which he had previously experienced in the head. These paroxysms were
finally subdued by quinine and opium, and for three months he was comparatively
well. In April, 1864, the neuralgia in the head returned, for which he took a large
dose of morphia. Excessive vomiting was again induced, followed by gastralgia.

From that time until we saw him, January, 1868, every night had been passed in
intolerable agony. For the first few hours after retiring he would sleep with some
degree of comfort ; but about 2 to 24, A.M., the invariable paroxysm would awaken
him, and banish for the night all sleep. It was his custom to take immediately forty
drops of the tincture of opium, which, for the time being, only aggravated the dis.
tress, By its influence, however, the pain abated in about six hours, and in the in-
tervening time he experienced only a dull aching in the epigastric region. Time and
again he had endeavored, by the advice of physicians, to gradually decrease the dose
of laudanum ; but all to no purpose.

It is a most singular and unaccountable fact, that xxxv. gtt. of the narcotic had
no effect whatever, while xl. gtt. would act as above stated. ‘Without the anodyne
the pain was constant; but he had on several different occasions endeavored to break
off from the use of it altogether.

During one trial he abstained from the opium for nearly a week’; but the agony
became: so intense, and his strength so nearly exhausted, that, notwithstanding a
resolute will, human endurance reached its utmost limit, and he was compelled to
resume its use. Constant suffering had left its impress on his pale and wasted fea-
tures.

He had a wild and vacant look, and his gait was weak and tottering, like that of
an old man on the verge of the grave. For a year past he had been seeking relief at
the hands of some of our most distinguished men, and when we asked him what
remedies he had been taking, he answered that it would be difficult to say what he
had not taken. While he was in Canada his physician had made use of ‘general fara-
dization, but with no appreciable result.

When he came under our care we made use of general faradization, both during a
paroxysm and when he was free from pain; but the faradic current seemed to be
wholly inoperative.

We then made use of a strong galvanic current, placing the positive pole on the
back of the neck, just above the seventh cervical vertebra, and applying the negative
over the region of the stomach, in order to affect the solar plexus and pneumogastric,

The application seemed to refresh him, and relieved in a marked degree the vague,
dull aching which was always present in the interval between the paroxysms. It so
increased his appetite that in a few hours he ate a hearty meal, something which he
had not done before in two years,

At the usual hour on the following night the paroxysm returned, but was most
singularly located between the shoulders, while the stomach was almost entirely free
from pain, After the second application the pain resumed its seat in the stomach,
but was not of such a severe character as formerly. Believing that the tonic pro-
CASES OF GASTRALGIA. 485

_perties of the electricity would enable him to do without the opium more readily than
on previous occasions, we advised that it be discontinued. It wasa most difficult
undertaking ; but, for three weeks, unti! he was imperatively called South, not a
particle passed his lips. He received in all but six applications of the galvanic cur-
rent, and although the cure was by no means complete, yet the relief he experienced
was positive and most gratifying. ~

His appetite remained permanently better, and digestion was performed with more
comfort and rapidity. The regularity of the paroxysms was broken, and their
severity ameliorated.

The wild, wandering look of distress, which was ever stamped upon his features,
gave place to a calmer and more hopeful expression. Unfortunately, circumstances
rendered it impossible for him to remain longer at the North; but sufficient benefit
had been derived, during the brief time that he was under our care, to render it
probable that still further amelioration of his remarkable symptoms would have been
obtained by a persistent use of the galvanic stream. We were the more hopeful,
from the fact that on a previous occasion we had treated successfully, by general
electrization with the faradic current, a lady suffering from this form of neuralgia,
but of a less aggravated character.

So far as regards the treatment of this case, the point of particular
interest lies in the fact that the galvanic current was of value, while the
faradic was wholly inoperative. By the use of the galvanic current the
pain was immediately relieved, the digestion was strengthened, and the
appetite sharpened.

Abdominal neuralgia of an agonizing character, associated with muscular spasms
—Decided temporary relief from local galvanization—Subsequent improvement
which possibly might in some measure have been due to the secondary effects of
treatment,

Case LVI.—Mrs. H., who suffered from most agonizing abdominal neuralgia, was
referred to us in April, 1871. The complications in this case were peculiar.

The paroxysms of pain were associated with spasmodic contractions of the abdomi-
nal muscles of such severity as to necessitate the constant use of subcutaneous injec-
tions of morphia. :

Ten years ago the patient miscarried, and for two years thereafter she was annoyed
occasionally by slight neuralgic pains, Menorrhagia now supervened, and after ex-
isting two years it was apparently cured, and for eighteen months she enjoyed fair
health, During the last two years menstruation had recurred but two or three times,
and her sufferings were terrible. She was taking, by subcutaneous injection, eight
grains of morphine daily, and so persistently had it been admunistered that hardly a
point on her body or limbs could be found that was not of that peculiar hard char-
acter, the result of the repeated operations. There was uterine displacement associ-
ated with local complications, of the character of which we are not informed. Our
treatment, begun Feb. 25, 1871, was external and local, with an occasional general
application of the faradic current. Electrization, on the whole, did not accomplish
‘tlecided permanent good, without the results observed after the cessation of our treat-
486 NEURALGIA.

ment were in a measure secondary to the electric stimulus, The patient certainly
gained immensely during the following year. Temporarily local galvanization was of
much service. It frequently induced sleep, reduced the intensity of the paroxysmal
pains, and often rendered her more comfortable during the intervening periods.

Severe gastealgia of fourteen years standing—Periodical attacks at -night—
Rapid and permanent cure under central galvanization after fatlure of fara-
dization,

Case LVII.—Dr. S. J. H., a physician aged about 36 years, consulted us in the
autumn of 1870. For fourteen years he had suffered from attacks of gastralgia of a
most violent character ; these attacks came on usually at night, while in bed, after
midnight, before or about two o'clock; the attacks would last sometimes several
hours, and the pain was of the most distressing character. Of the various methods
of relief that he had used, alcoholic liquors seemed to be the most efficacious, but the
respite they caused was only temporary. The appearance of the patient suggested
robust health ; nutrition was well maintained, and the functions were generally well
performed. .

Examination gave little information. Disease of the heart had been suspected, but
the careful and repeated examinations of Dr. Thayer established the fact that there
was no disease of that organ. Tenderness of the epigastrium in one spot sometimes,
but not always, existed. We suggested central galvanization. The patient had pre-
viously tried faradization without any benefit. We had little hopes of helping the
patient ; the persistency and fixity of the symptoms and their periodicity gave an
unfavorable prognosis, and only by our urgent solicitations did the doctor allow us to
experiment on him.

Treatment by central galvanization was commenced January 3, 1871, and was kept
up for two months, two or three times weekly. In less than two weeks benefit was
apparent ; the periodicity and violence of the attacks were somewhat modified, and
in a month it was evident that the disease would yield more or less permanently to the
treatment. Occasional relapses occurred, as always in similar cases, reminders of the
former sufferings, showing that the evil spirit was not wholly cast out ; but in three
months from the time the treatment was commenced, the patient regarded himself as
well.

Three years have elapsed, and the patient is still well, although en-
gaged in laborious duties. The features of chief interest in the case
were these :

1. The superiority of central galvanization over faradization.

2. ‘The permanency of the cure of such a long-standing affection.

Sciatica.—In the treatment of sciatica by electrization very much
depends upon the care with which the current is applied. An ill-di-
rected, too prolonged application, or the use of a current the mechani-
cal effects of which are unduly marked, frequently results in more harm
than good. In sciatica, the pain, as a rule, closely follows the course
of the nerve, and, therefore, in the majority of instances the disease is
SCIATICA. 487

typical of true neuralgia. The effects of faradization in these cases are
undoubted, and in our hands have sometimes proved far more effi-
cacious than galvanization.

It cannot be too frequently repeated, that in sciatica the faradic cur-
rent is capable of doing infinite harm if ignorantly used or over-used,
but that if applied with that caution and skill which experience alone
can give it generally relieves.

It isin just such conditions as these that the character of the current
for fineness and evenness is all-important, and these factors are found
combined in a higher degree in Kidder's separate-coil machine than in
any other. On account of the great caution that must be exercised in
the treatment of sciatica by faradization it is probable that beginners may
here achieve greater success through the use of mild galvanic currents.
The muscular atrophy that sometimes follows sciatica may be treated
by localized faradization. Whichever current is used the application
should be made both over the lower part of the spine, to act upon the
roots of the nerves, as well as over the course of the nerve in the leg.

Galvano-Puncture —We have recently attempted the treatment of
sciatica by electro-puncture.

The needle may be insulated or not; should be bayonet-shaped, so
as to go in easily, and may be inserted far enough to touch or penetrate
the nerve. The moment when it so penetrates or even touches will be
revealed to the patient by a tingling or pricking sensation through the
leg.

The needle thus introduced should be connected with the negative
‘pole ; but two to four cells should be used, and the current should
be continued but a few minutes.

Severe and obstinate’sciatica excited by obstruction of the bowels—Relief and slow
improvement under localized gulvanization with moistened sponges, with the
metallic brush, and galvano-puncture.

CasE LVIII.—Mr. K., aged 39 years, was referred to us, March 3, 1873, by Dr.
Conkling. The patient had been occupied by various and complex affairs, and had been
for years bearing the burdens of ten men. His vacations had been few and his hours
of labor many, and he had fallen into a condition of profound neurasthenia. He had
suffered from gastralgia of a most violent character, for which opiates had been quite
freely given ; and constipation and hardened feces had resulted that had caused obstruc-
tion of the bowels, which was relieved only with difficulty and by mechanical means,

The sciatica of one side, from which the patient was suffering when we were called
in, seemed to be of a reflex character from the constipation, The pain was fearful,
and there was, of course, lameness and atrophy of the muscles of the leg. At times
excessive hyperzesthesia appeared over the thigh, eapestellge in the region of the sciatic
nerve, and there was great tenderness, :
488 NEURALGIA.

We tried various methods of electrization ; general faradization, for the patient
was much debilitated; localized faradization with sponges and with the metallic
brush; central galvanization, localized galvanization, and galvano-puncture.

Localized galvanization with currents of medium strength, and continued for an hour
or so just as the patient had retired for the night, seemed to be more efficacious than
any other method or manner of treatment. Almost always it soothed the pain, re-
laxed the stiff and aching muscles, and this relief would last for hours, perhaps give
a good night’s sleep, The proceeding was to place one pole on the spine, and to pass
the other, without regard to the direction of the current, up and down over the region
of the sciatic nerve,

A few times we tried galvano-puncture with insulated and non-insulated needles.
The needles were thrust in quickly and firmly until they came near the nerve, and
sometimes they touched.it, as was evidenced by the tingling and pricking sensations
excited that were felt down the leg. The punctures were made on various points
down the back part of the thigh, No anesthetic was used, but once or twice local
anzesthesia by means of carbolic acid and ether,

We were persuaded that this treatment by puncture did good; that it gave the
patient a start, and enabled the external galvanization to do its work at better advan-
tage. The patient, though a man of strong will and decision, terribly dreaded the
thought of the needles, and we were obliged to abandon their use. The needles were
always connected with the negative pole, the positive being applied externally by a
sponge or cloth cover,

This case was treated off and on for four months, and with slow and
not very steady improvement. It was a long time before the patient
could ride or sit long without causing pain. In a few weeks he com-
pletely recovered.

Sciatica from strain, of several months duration—Immediate improvement under
general faradization and localized galvanization—Subsequent relapse and final
recovery.

CasE LVIX.—Mr, W., aged about 40, was referred to us by Dr, C. E. Bucking-
ham, of Boston, :

The patient had been suffering for several months from severe pains along the course
of the sciatic nerve. He had not been especially exposed to cold, and as the symp-
toms came on suddenly, he could only attribute the disease to'the unusual exertion
of lifting a heavy trunk a short time previously.

The limb had atrophied somewhat, and the general health of the patient was some-
what impaired. He was submitted to general faradization and to galvanization of
the affected limb. A dozen applications resulted in very great alleviation of the
severe pain which had for so long a time distressed him, and we felt hopeful of a speedy
recovery, Unfortunately the patient exercised too freely in walking one day, and in
addition probably took some cold. At all events the neuralgia returned in full force,
and so discouraged the patient that he almost immediately sailed for Europe, where
after a number of months he recovered.

The value of the faradic current is illustrated in the following case :
CASES OF SCIATICA—REFLEX NEURALGIA. 489

Sciatica of several months? duration successfully treated by faradization.

Case LX.—An old gentleman, aged 76, was sent to us by Dr. F. Elliot to be
treated fora condition of general paresis, associated with which was a severe neuralgia
of the sciatic nerve in both limbs which had distressed him for a number of months.

There was a lack of co-ordinating power in locomotion, together with decided anzes-
thesia of both upper and lower extremities. -The left foot and ankle were enor-
mously swollen, and in this limb the pain was far more severe than in the other.

The patient was treated by general and local faradization;.and in the course of
seven applications the swelling nearly subsided, and the neuralgia was quite subdued.
The patient subsequently died from cerebral effusion.

Sciatica following pressure of the childs head at parturition—Localized galvaniza-
tion is followed by alleviation of pain and recovery.

CasE LXI.—Mrs. ——, aged about 40, was confined in March, 1873, and after
great suffering, and by the use of the forceps, she was delivered of a still-born child.
Through the pressure of the child's head the nerves had sustainad serious shock, and
for many days before seeing her she had endured the most severe neuralgic pains in the
left limb.

Nothing seemed to give more than temporary relief, and at the time that we were
sent for by her physician, Dr, Oliver White, the onset of hysterical symptoms ren-
dered the patient a most pitiable object. It was with difficulty that she could be in-
duced to submit to treatment, but finally a mild application of localized galvanization
was administered, and seemed to be soothing in its effects. The total number of ap-
plications given was eight, and, with the exception of one séance which was followed
by increased pain, every treatment resulted in an alleviation of suffering, and finally
recovery was complete.

The pain had not entirely left her when the galvanization was discontinued, but
grew less and less every day for a week or so until her limb was in good condition.

Sciatica—Relief follows seven applications of faradization,

Case LXII.—Mr, F., a patient of Dr. Downs, applied to us by the advice of the Dr.
for the relief of severe pains along the whole length of the sciatic nerve. The suffer-
ing was most acute in the hip, Blisters and other forms of counter-irritation had
been tried, but with no effect. Faradization of the affected limb, repeated on seven
different occasions, approximately relieved him.

Reflex Neuralgia. —The term reflex, as applied to paralysis, is at once
common and suggestive. In the same way it is applicable to neuralgia.

As in children paralysis frequently follows the irritation of teething
or dysentery, and in older persons that of urinary disease, so neuralgia
of distant parts may result from uterine and other disorders. Neural-
gia of the fifth pair, caused by a carious or false tooth, is a common and
well-known reflex result of mechanical irritation. The treatment of
reflex neuralgia is by no means so empirical as that of the, peripheral
variety. If a carious tooth is at the root of the evil it must be removed.
490 “ NEURALGIA.

If the cause can be traced to uterine disease, the skill of the gyna
cologist is called for. Occasionally electrization, through its power of
subduing local irritation or inflammation, effectually relieves the remote
neuralgic pain, of which the irritation or inflammation is the cause.

Neuralgia of left leg, apparently proceeding from ovary—Recovery,

Case LXIII.—In the case of a young lady who had suffered for several months from
the most severe neuralgic pains down the left leg, tactile examination revealed very’
marked tenderness to pressure in the left ovarian region. No other portion of the
body was especially susceptible to the touch. It is proper to state that the patient
was not at all hysterical, that exercise aggravated the.pain, and that the neuralgia of
the limb was in proportion to the tenderness over the ovary. She was immediately
relieved by localized faradization, and completely recovered in the course of six weeks,
after having received twelve applications.

Neuralgia in the ovarian region, over the abdomen, and extending down the limbs,
of several years’ duration— Complete relief under general faradization,
Casr LXIV.—Miss L., about 23 yearsof age, and a patient of Dr. Frederic D.
Lente, had for several years suffered much distress from a neuralgic affection of the ab-
domen and lower extremities. The pain was especially severe and constant in the region
of either ovary. According to.the Dr., uterine difficulty evidently existed ; but as local
treatment was out of the question, and as the ordinary external and internal remedies
had been used without much benefit, we were requested by Dr. Lente to test, in her
case, the effects of electrization. Simple general faradization proved most efficacious.
Some dozen applications sufficed to dissipate completely the pains from which she
suffered and to markedly improve her general condition.

A year subsequently the above patient was annoyed again by the
same symptoms, but a short course of the same method: of treatment
relieved her a second time.

Galvanic belts and disks for the treatment of neuralgia have been
recommended by Hiffelsheim. He applies the belts—either Pulver-
macher’s or Davies’—moistened with vinegar, to the painful locality,
and allows them to remain there for days, weeks, and even months.
Although Hiffelsheim reports some good results from these applications,
yet it must be admitted that there is as yet no sufficient, reliable evi-
dence that they have succeeded where galvanization or faradization
has failed, or that they have any positive advantage whatever, except,
perhaps, for those who are so situated that they cannot receive ordinary
treatment.*

* The therapeutic results obtained by wearing galvanic chains, belts, disks, soles,
girdles, etc., must depend on the manner of their construction and application.
Many of those which are sold in the stores and extensively and indiscriminately used
by the laity, are so arranged that the feeble currents which they may generate fail tc
make a circuit through the body, and recombine in the metals themselves.
GALVANIC BELTS AND DISKS. 491

The objections to and disadvantages of this method of treatment in
neuralgia, as in all other affections for which it has been so widely
employed, are these :—

1. The current which they generate is very feeble and inconstant,
and probably does not, except under peculiarly favorable circumstances,
penetrate far beneath the epidermis. ,

2. They can only be used locally: Many of the symptoms for
which they are used are of a constitutional character, and can only be
permanently dispelled by measures calculated to affect the whole sys-
tem.

3. They are usually, and sometimes necessarily, applied to the
seat of the pain rather than to the seat of the disease. In galvanization
and faradization for local neuralgia, it is found that the best results are
obtained by treating the seat of the disease.

4. They sometimes cause ulcers that leave permanent cicatrices.

The benefit that is derived from them is probably due in part to their
influence on the imagination.

These arguments against the use of galvanic belts would be valueless,
if experience could demonstrate from their use any great utility or any
very positive advantage.

It is not impossible that, in future improvements in the construction
of these belts and chains, and more scientific experiments in their use,
we may develop advantages from them which they have thus far failed
to exhibit, and may accord to them a position in electro-therapeutics
to which, from the results of the past, they are not entitled.

The fact that they have thus far been used almost exclusively by the
laity, and have been made the theme of noisy advertisements, so far from .
discouraging, should rather stimulate men of science who have any faith
in their efficacy to rigidly investigate and interpret their claims to a
position among the appliances of electro-therapeutics.

Those, however, who experiment with these contrivances, should
remember that the mechanically irritating effects of metallic bands
applied to the tender skin are not inconsiderable, and. that the thera-
peutic results which appear to follow their application may not unlikely
be due wholly, or in part, to counter-irritation.

(For further remarks on this subject, see Myalgia.)
CHAPTER XX.

ANAESTHESIA,

Ana@stuesta is derived from a, privative, and aicSdvouc, to perceive,
and therefore literally signifies a deprivation of sensation. It is a symp-
tom of some organic or functional disease of the central or peripheral
nervous system. The kinds of anesthesia are as various as are the
nerve ramifications, and the symptoms that accompany it are modified
by the locality and causation of the disease. All forms of anesthesia,
as of paralysis of motion, may for the sake of convenience of descrip-
tion be classified under these four general divisions: Constitutional,
central, peripheral, and reflex.

There are five kinds of sensibility, all of which are, of course, modi-
fications of general sensibility, and all of which may become diminished
by disease :—

1. Zactile sensibility.—This is the form which is most frequent, and
best appreciated. Diminution or loss of this sense is usually known as
anesthesia.

2.—Sensibility to temperature—heat and cold.

3. Sense of pressure or weight.

4. Sense of pain.—This is quite distinct from tactile sensibility, with
which, on superficial observation, it is often confounded. The loss of
this sense is called analgesia. These different kinds of sensibility may
be very unequally affected by disease. One form may be entirely
destroyed, while the others remain intact. Thus, while tactile sensi-
bility is perfect, the prick of a needle, when thrust into the flesh, is not
felt. In such cases there is analgesia, but not anesthesia.

5. Farado-sensibility.—This form of sensibility appears to be suffi-
ciently distinct to entitle it to special mention. Farado-sensibility may
be quite active when tactile sensibility is much diminished.

The diagnosis of anzesthesia, except in very delicate cases, is suffi-
ciently easy.

The degree of normal sensibility to tacile impressions varies widely
in different parts of the body. It is necessary to bear this fact in mind,
ELECTRO-DIAGNOSIS. 493

and to make experimental trials on persons in health, in order to arrive
at correct conclusions in cases of disease.

The use of the compasses, according to the directions of Dr. Weber,*
will enable one to determine ina very accurate manner the condition
of the sensory functions in health and disease.

Thus, when the two points of a pair of compasses are placed upon
the inner surface of the last phalanx of the finger, they need to be sepa-
rated but one line in order to give two impressions, while, in the middle
of the thigh, the points of the compasses need to be distant from each
other some fifteen to twenty-five lines in order that two impressions
may be received.

Sensation in the tip of the tongue is more acute than in any other
part of that organ, for two impressions are received when the points of
the compasses are separated by only half a line; and it will be founc
that, in the face, this sense of acuteness diminishes as we recede from
the mesial line.

_ Electro-diagnosis.—There is a method of determining the relative elec-
tro-sensitiveness of the two sides of the body that we have found very
convenient and reliable, and sufficiently delicate except for those cases
when the anesthesia has extended over the entire system. This con-
sists in the application of the faradic current by means of a brass ball,
or other metallic electrode, attached to one of the poles of a faradic
apparatus. The other pole of the apparatus may be placed at the feet
of the patient, or at the coccyx, or at any indifferent point, as may be
convenient.

Different points of the body, on both sides, are alternately touched
with the brass ball, perfectly dry, very lightly, and with a mild current.
In order to test the sense of pain, the ball should be covered with a
moist sponge, so that the current may penetrate the epidermis. In
this way a very slight difference of sensibility, especially of the upper
and lower extreniities, can readily be detected. By gradually increas-
ing the power of the current up to the point of endurance, the extent
of the anesthesia can be ascertained with tolerable accuracy. One
great advantage of this method is, that the same apparatus with which
we treat the disease can be used to diagnosticate it, and to mark the
progress from day to day.

Treatment.—When the anzsthesia is very limited in its extent, and the
general health of the patient is otherwise good, localized electrization is of
course indicated. As a matter of fact, however, very many anzesthetic

* De pulsu, resorptione, auditu et tactu, annotationes anatomice et physiologice.
Lipsiz, 1834.
494 ANASTHESIA.

patients, whatever may be the cause on which their symptoms depend,
are more or less debilitated, and are benefited by the constitutional
tonic effects of general electrization. In cases of anzesthesia that are
dependent on lesion of the central nervous system, central galvaniza-
tions is sometimes indicated. Obstinate cases of a localized character
are well treated by the electric brush. Anesthetic patients will gener-
ally bear strong currents in proportion to the extent of the anzesthesia
with benefit and without injury. Some temperaments that do not feel
the current during the application may yet experience unpleasant re.
active effects.

Prognosis.—The prognosis in anesthesia, waiving for the moment all
questions of causation or pathology, is usually very favorable, and be-
yond comparison more favorable than that of paralysis of motion.

One reason for this difference is that anesthesia is an earlier symp-
tom of organic disease of the nervous system than motor paralysis,
and is therefore sooner treated. But we continually observe, even
when the two conditions coexist, as is so frequently the case in cen-
tral, spinal, and peripheral paralysis, that the anzesthesia yields much
sooner and far surer than the paralysis of motion.

The discussion of the interesting physiological questions suggested
by these observations, though somewhat enticing and suggestive, does
not come within the scope of the present work.

Anesthesia of antertor region of right thigh, of traumatic origin, of ten years
standing—Permanent recovery under localized faradization.

Cas—E LXV.—Mr. H., a stout, vigorous man aged 29 years, was sent to us by
Dr. H. Gregory, of Harlem, to be treated for anzesthesia (which had annoyed him for
many years) of the anterior portion of the right thigh. The only possible cause
to which we could refer the symptoms was an incised wound that he had received in
the thigh, near the great trochanter, some ten years previously.

The patient could not positively state that the paralysis of sensation immediately
followed the injury, since the anesthesia was not so noticeable as at a later date.
The part had become so insensible to ordinary impressions, that it was necessary to
separate the points of a pair of compasses some 45 to 50 lines, before two impres-
sions were received. The pricking of a pin caused no sensation, and even when the
point penetrated several lines beneath the surface, no pain was experienced.

Dissipation in eating and drinking, unusual exercise and loss of sleep, invariably
aggravated the disorder. The first application of the faradic current—made down
the spine and to the affected limb—very markedly relieved the anzesthesia, and after
the third application the limb was restored to its normal sensibility. At the fourth
visit he complained that the part had partially relapsed into its former anzesthetic con-
dition, but accounted: for it from the fact that he had spent most of the previous
night at a social gathering.
CASES OF ANASTHESIA. 495

An application again relieved the anzesthesia. We found, as usual in all cases of
anesthesia, that, as the limb progressed toward a cure, it became more and more
sensitive to the influerice of the current.

After receiving ten applications the limb was again restored to its normal sensi-
bility, although occasionally, after unusual exertion and loss of sleep, it became some-
what anesthetic.

In the case of this gentleman, the wound before referred to was over
the course of the external cutaneous nerve, after it passed beneath
Poupart’s ligament, and the beneficial results that followed treatment by
electrization were due, doubtless, to the fact that the nerve had suffered
merely from contusion and not division.

Hysterical hyperzesthesia is much more commonly noticed with us
than anesthesia. The latter condition is without doubt occasionally
overlooked, and again may sometimes be feigned.

Hysterical anesthesia—Diminution of temperature during the attacks—Great in-
sensibility—Gradual improvement and final recovery under general faradization.

Cast LXVI.—Mrs, S., aged 33, was subject to frequent attacks of hysteria, with
intense melancholy. She suffered also from general neuralgic attacks, which were fol-
lowed by almost complete anzesthesia—commencing at the fingers of either hand, ex-
tending up to the arms, the shoulders, and face, and finally involving the tongue, so
that her speech was only in broken utterances.

About the finger-nails the skin assumed a dull leaden color. The pulse was almost
imperceptible, and the temperature of the affected parts was considerably below the
normal, Insensibility to painful impressions, which always preceded the loss of the
sense of touch, was at first incomplete, but gradually increased. During the attack
her memory always became much impaired, so that she was often unable to call to
mind the names most dear to her.

The paroxysms lasted from twenty minutes to half an hour, and were followed by a
severe headache, while a considerable numbness of the arms and hands remained for
several days. Carbonate of ammonia seemed to relieve her more quickly than any
other internal remedy, but nothing she had ever tried had been of any very permanent
benefit. An application of the faradic current, made to the parts affected during a
paroxysm, always shortened the attack; although, while the anzesthesia lasted, the
fingers, arms, face, and tongue were insensible to the influence of a current of con-
siderable power, x

Treatment by general faradization was continued during the interval between the
paroxysms, resulting in a diminution in the severity of each succeeding attack, until
in a few months they ceased to trouble her.

Anesthesia of left side of face, extending to left nostril and internal surface
of cheek, and complicated with paralysis of motion—Improvement and recovery
under faradization. :

CasE LXVII.—Miss A. G., an unmarried woman, aged 28, applied for treatment
for cutaneous anzesthesia of ‘ie left side of the face. She was employed in a bock-
496 ANASTHESIA.

bindery, and her daily Jabor extended over a period of from twelve to fourteen hours,
As a natural consequence, her general health had become somewhat impaire 1.

Ter menstrual function was, however, performed regularly ; and, although her di.
gestion seemed to be vigorous, she was nervous and anzemic.

She gave the following account of herself: Some six months previously, she no-
ticed, at the close of a day of hard labor, and after exposure to a cold biting wind, a
slight feeling of numbness in the right side of the face. This numbness rapidly in-
creased, until in a short time the anzsthesia was complete. On examining the face
it was found that the mouth was drawn somewhat over to the right side, There was
slight ptosis of the left eyelid, and the left cheek was flaccid. The want of expres-
sion was quire marked on the affected side, and contrasted strongly with the gight
side when she laughed, or entered into conversation. She was entirely insensible to
ordinary impressions on the left side of the face, and the anzesthesia extended to the
left nostril and the internal surface of the cheek. e

The sensation and movement of the tongue, and the power of taste, were unim-
paired. Local applications of the faradic current were given every day or two, but
for some little time no impression seemed to be made on the diseased nerve.

It was only after treatment had been continued two weeks, and some eight appli-
cations had been given, that any sensitiveness to the current was manifest along the
course of the fifth pair. The improvement, however, from this time, although slow,
was constant.

In this case the rule that the anesthesia improves more rapidly than
the paralysis of motion was reversed.

The anesthesia improved but little until the face assumed its natural
proportions, when, in a short time, the normal sensation entirely re-
turned. The treatment was continued during two months. In most
cases of anaesthesia. of the trigeminus, related by Romberg, the loss of
sensation was so marked that deep pricking with a needle caused no
pain, while in this case the anzsthesia was limited to the skin and
mucous membrane. Anesthesia of the fifth pair of nerves may be
peripheral or central ; in the latter case there is coincident paralysis of
the nerves of motion and sensation, and hemiplegia, more or less com-
plete, is often present.

The diagnostic symptoms of this variety of paralysis differ, according
as the seat of-the disease is located in the course of the various ramifi-
cations of the fifth pair, after it leaves the sphenoid bone, or in the Cas-
serian ganglion, or at the base of the brain.

Anesthesia—Diminished temperature—The result of a fractured fibula— Decided re-
lief from localized faradization,

CasE LXVIII.—Mrs W., wife of a physician, fell upon the icy sidewalk one winter
evening and sustained a fracture of the fibula, with rupture of one of the ligaments of the
ankle. Recovery was tedious, and after she was able to walk the parts remained per-
CASES OF ANA:STHESIA. 497

manently anesthetic, cold and weak. We made simple local applications of the fara-
dic current to the limb and with beneficial results, The anesthesia nearly disappeared
and the temperature of the part became normal, while the patient was able to use
the foot without pain and to accomplish much more in the way of walking,

General anesthesia—Impaired motor power with great debility—The sequele of an
attack of diphtheria—Dissipated by six applications of general faradization and
central galvanization,

CasE LXIX.—Mr. C. H. G., referred to us by Dr. J. O’Farrington, suffered
from .a severe ‘attack of diphtheria in the month of April, 1873. He was left in a
very weak condition, and with difficulty only could attend to his ordinary duties.

About the 21st of May, the patient observed some numbness and loss of motor
power in all four extremities, which rapidly increased until he could hardly distinguish
anything by the touch, and was most unsteady in his gait. His symptoms were from
week to week increasing in severity, when he came under our observation and was
submitted to the alternate treatment of general faradization and central galvanization.
Six applications administered during the course of two weeks dissipated all anzesthe-
sia, restored the power over locomotion, and left the patient in his ordinary physical
strength,

The symptom of anaesthesia occurs in many forms of paralysis of
motion—hemiplegia, paraplegia, and so forth—and many cases will be
found under those diseases, Anzesthesia occurs also in writer’s cramp
and in locomotor ataxia, where it is a prominent symptom. In all the
diseases where it exists as an incident or complication it is to be treated
on the same principles as where it exists as the sole or leading symp-
tom.

34
CHAPTER XXI.

PARALYSIS.

PaRA.ysis of motion is a condition for which, from the earliest his-
tory of electro-therapeutics, electricity in its different forms has been
used more than in any other disease ; and not until quite recently has
it been demonstrated that there are many other symptoms in which
the results of electrical treatment are much more rapid and brilliant
than in any form of motor paralysis. In hysteria and affections allied
to it, in cerebral and spinal congestion, in chronic alcoholism, neuralgia,
and in certain diseases of the skin, electricity rightly used by the meth-
ods of central galvanization, general faradization, and local galvaniza-
tion of the nerve centres, relieves and cures far more rapidly than in
paralysis.

Paralysis has been especially prominent in electro-therapeutics, for
the reason that oftentimes electricity is the only remedy to which it
yields. ‘Those who have restricted themselves to localized electrization
have always given their chief attention to different forms of motor par-
alysis, but even now the impression yet lingers that it is about the only
disease for which electricity is indicated.

All forms of paralysis, as of neuralgia, may, for the sake of conven-
ience of description of therapeutical indications, be included under one
of these four divisions :—

1. Constitutipnal.
2. Central.

3. Peripheral.

4. Reflex.

Constitutional Paralysis.—This term is applied to those paralyses
which arise from some blood-poison or constitutional degeneration.

Among the more common causes of this variety of paralysis may be
mentioned hysteria and the poisons of certain diseases, as gout, theu-
matism, syphilis, mineral poisons, as lead and opium, etc.

Rheumatic Paralysis.—In the partial but persistent paralysis that
occasionally follows subacute muscular rheumatism, faradization has
proved exceedingly efficacious. The muscles most frequently affected
ELECTRO-DIAGNOSIS AND TREATMENT. 499

by rheumatic paralysis are the deltoid and trapezius (in consequence
of which it becomes impossible or difficult to lift the arm from the side),
the extensor muscles of the forearm, the muscles of the lower extrem-
ities, and occasionally the inter-ossei and lumbricales muscles.

Electro-Diagnosis—Treatment.—The electro-muscular contractility
in recent cases is normal ; in long-standing cases, diminished. General
as well as purely local treatment is frequently required in paralysis of
a rheumatic origin, in order to combat the rheumatism in the constitu-
tion, as well as its local manifestations (see chapter on Rheumatism).

In this, as in other forms of paralysis, atrophy of the muscular tissue
occurs after a certain length of time. Itis extremely important to begin
treatment before the muscles become thus affected. In cases of rheu-
matic paralysis, where the invasion has been sudden and the pain con-
siderable, electric excitation produces pain ; but where the invasion has
been more gradual and unattended by pain, electric excitation causes
very little, if any sensation.

Rheumatic paralysis of deltoid, of several months standing—Kecovery under generat
and localized faradization.

CasE LXX.—A patient, a young lady aged 23, had been unable to raise her hand
from her side for several months. The access of the rheumatism was gradual, and
unattended by acute pain, excepting when pressure was made over the affected mus-
cle, or when she attempted to raise the arm. An application of the faradic current
caused pain only when it was sufficiently intense to produce contractions.

The muscle rapidly became less sensitive to the influence of the current, and
gradually regained its lost power. The restoration of strength was complete in two
weeks.

We have treated quite a number of cases of rheumatic paralysis of
the deltoid, the trapezius, and of the lower extremities, and usually
with the most satisfactory results. Electricity is always indicated in
this condition, and few cases, doubtless, would fail to improve, even if
they do not recover under its influence.

Syphilitic Paralysis.—Syphilitic nervous affections may exist either
with or without appreciable structural change. Paralysis which results
from secondary syphilis may derive benefit from electrical treatment.

The principles and method of treatment are the same as for rheu-
matic paralysis. There is as yet no evidence that general faradization
or central galvanizatien have any special influence over the syphilitic
poison ; they act as general tonics and thus help the system to contend
with the disease.

Lead Paralysis.—In slow poisoning by lead the metal becomes dif-
500 PARALYSIS.

fused throughout the whole system, and exerts its influence, though in
an unequal degree, on every nerve and organ.

As is well known, however, the upper extremities are most frequently
affected by paralysis (more or less complete). The muscles usually
affected are the extensors of the hands and fingers, so that they hang
down by their own weight. It is probable that these muscles are
chiefly affected in this disease, as in hemiplegia, because they are weaker
and operate at a great mechanical disadvantage.

LElectro-Diagnosis and Treatment.—The electro-muscular contractil-
ity of the affected part, in this form of paralysis, is always diminished ;
and frequently it is entirely lost, even in cases where there is little or
no atrophy of the muscles. ‘The electro-muscular sensibility is usually
unimpaired. Diplegic contractions may appear in this disease. Ac.
cording to Hitzig, mobility in cases of lead poisoning is lost before
electric contractility.

If the electro-muscular contractility is completely lost, it is better to
apply a mild galvanic current to the paralyzed part for a few minutes
before the faradic is made use of. The latter current should be used
daily, and not longer than ten or fifteen minutes at each sitting, As
soon as the slightest contractions are produced by the faradic current,
the galvanic may be discontinued. In some cases we have thought that
the galvanic current answered better than the faradic, even when the
muscles respond to the faradic.

Lead paralysis of nine months standing dropped wrists—A pproximate recovery under
localized galvanization and faradization.

CasE LXXI.—F. H., aged 24, afflicted with lead paralysis, gave the following his-
tory: For several years he had worked almost constantly in lead, and about nine months
prior to his application for relief he became obstinately constipated, suffered from vague
pains in the legs, shoulders, and over the body generally, and in a short time he observed
a decided lameness in the wrists. He gradually became worse, until he found it impos-
sible to raise the right hand at all, and over the little finger of the left hand he had
but little control.

No contractions of the affected muscles followed localized faradization; the gal-
vanic current produced slight contractions.

The patient was treated for some weeks by a galvanic current, just sufficient in
strength to produce slight muscular motion ; and subsequently, when the faradic cur-
rent was tried, the muscles reacted appreciably to it.

The treatment was kept up for two months and resulted in an approximate return
of the normal strength to the affected parts.

Paralysis from Opium, Stramonium, Arsenic, etc.—In desperate
cases of poisoning by opium, electricity has been repeatedly used with
HYSTERICAL PARALYSIS. 501

success. The method of artificial respiration may be used (see chapter
on Artificial Respiration).

After recovering consciousness from severe poisoning by opium, or
other poisons, the various limbs of the body are occasionally left in a
permanently paralyzed condition that persistently resists all the efforts
of nature and medicine. Two such cases have fallen under our obser-
vation.

Partial paralysis of upper and lower dimbs, caused by an overdose of opium—Im-
provement under general faradization.

CasE LXXII.—A little boy, some eight years of age, was presented to us suffering
from partial paralysis of the lower limbs, and, in a less degree, of both arms also. He
could walk only with the assistance of another, and then with an uncertain, staggering
gait. His legs were remarkably small and cold, his bowels continually constipated,
and his general condition feeble. When but three years old, his nurse on one occa-
sion administered to him by mistake a teaspoonful of the tincture of opium,

By persistent efforts only was his life saved; but the shock to his nervous system
was so great that, for one year after, both legs were completely paralyzed. Finally
he regained a portion of strength, until he reached the condition already described.

The electro-muscular contractility and electro-sensibility, not only of the limbs, but
of the entire body, was much’ improved. The boy could bear, without pain, a fara-
dic current of sufficient intensity to prostrate a grown person in ordinary health. The
first general application seemed to benefit him,

He felt lighter and better. Six subsequent séances increased his appetite, percepti-
bly augmented his strength, and relieved his constipation, At this time his legs
began to feel somewhat warmer, while he was unable to bear a current of as great
intensity as‘before. The patient was under treatment some two months, and received
about twenty-five applications. The temperature of his legs, and of his whole body,
had very decidedly improved.

His legs had grown larger, and when he discontinued treatment his general health
was fair, and his gait nearly normal.

ffysterical Paralysis.—The hysterical form of paralysis is constitu-
tional, because the entire central nervous system is degenerated into a
condition of abnormal susceptibility (see chapter on Hysteria and allied
Affections).

Llectro-Diagnosis.—In this form of paralysis, the electro-muscular
contractility in recent cases is unimpaired ; in old cases it may be im-
paired or lost, or the electro-sensibility may be very much blunted.
Diplegic contractions sometimes appear in hysteria. The loss of power
is usually incomplete, and sooner or later recovery usually takes
place.

Treatment.—The disease is constitutional and demands general as
well as local treatment. In many instances general faradization pro-
502 PARALYSIS.

motes rapid recovery ; other cases are very rebellious and only improve
up to a certain point. The general treatment may be combined with
central galvanization and faradization of the affected part.

The following case is an example of its influence in the transient
form of this affection :—

Hysterical paralysis of right arm—Attacks frequently repeated—Immediate relief
Srom localized faradization,

Case LXXIII.—A young lady, of an excessively nervous organization, was fre-
quently subject to hysterical attacks, when one of her arms (generally the right) always
became perfectly anzesthetic and almost powerless. As arule, her arm remained in
this condition about an hour, .

On one occasion, immediately after an attack, a powerful faradic current was di-
rected for two minutes through the arm, from the wrist to the shoulder, completely
dissipating the anzesthesia and restoring the lost power. Many similar applications,
during subsequent attacks, invariably produced the samé result.

General paralysis of an hysterical character, with loss of motion of both the upper
and lower limbs, and severe atrophy of the muscles of the upper limbs—Remark-
able symptoms—Very great improvement but not absolute recovery under peripheral
and central galvanization,

CasE LXXIV.—Mrs. S., of Staten Island, aged 41, was the most remarkable illus-
tration of the efficacy of galvanization in paralysis that has ever fallen under our obser-
vation, The patient first came under our care Sept. 25, 1868. Nine months before
she suffered a miscarriage that had left her in a condition of utter helplessness. Both
upper and lower limbs were completely paralyzed, the only power remaining being a
slight limited movement of the fingers. The hands were permanently extended, the
inter-ossei greatly atrophied, and the muscles of the arm and forearm were so much
shrunken that the circumference of the arm was diminished to the extent of between
one and two inches. The lower limbs were absolutely motionless—-not a muscle
gave even the feeblest response to the will. The muscles of the lower limbs were but
little atrophied even below the knee; but the skin presented a peculiar glossy ap-
pearance that is associated with greatly impaired, nutrition, which has been described
by Drs. Mitchell, Morehouse, and Keen.* There was, however, no pain, which
these physicians found to be an invariable accompaniment of glossy skin that resulted
from injury to a nerve. The appearance of the skin may be best understood by com-
paring it to a cicatrized wound. This appearance was most marked below the knees.
Both upper and lower limbs were very cold and very sensitive tocold. There was no
loss of power over the bladder or rectum. Appetite and digestion were good, but
there was some dyspncea. The patient also slept well usually, although compelled to
lie constantly on her back unless she was turned over. The important feature of the
case was the remarkably healthful performance of most of the vital functions, con-
joined with absolute helplessness. As the little motion of her fingers was not sufficient
to enable her to grasp even the lightest object, it was necessary for the nurse to feed

“ Gunshot Wounds, and other Injuries of Nerves, 1864. Pp. 79, 80.
CASES OF PARALYSIS. 503

her. Daily she was lifted out of bed and placed in an invalid’s chair that could be
lowered into a horizontal position. To sit up in an ordinary chair was impossible,
since the flexion of her limbs caused unbearable pains in the joints,

The brain was usually clear, though the memory had been somewhat impaired.
The patient was surprisingly buoyant ; but sustained mental exertion, even the read-
ing of a short paragraph, was followed by sensations of weariness.

The patient was of a nervous constitution, had never been capable of great exertion.
and for a long time before the attack had complained of numbness, tingling, and other
premonitory symptoms.

Electric examination showed, as was expected, absolute loss of electro-muscular
contractility, in both the upper and lower limbs, to the faradic current. A strong
galvanic current produced feeble contractions in the extensors and flexors of the fore-
arms, but none whatever of the muscles of the lower limbs. There was also very
great anesthesia, Analgesia existed in the lower limbs. In the arms, forearms, and
fingers, there was excessive hyperesthesia of the sense of touch, conjoined with decided
analgesia. A tolerably strong current localized in the muscles was not painful, but
the slightest touch on the surface was unpleasant. Two important features of the
case were reflex spasms of the muscles af the lower limbs during electrization, and a
peculiar sensation through the whole nervous ramification after electrization. The
patient compared it to ‘¢ waves of sensation ” rolling up and down the limbs.* This
sensation was sometimes felt one or two days after the application.

Taking into consideration all the facts of the case—the completeness of the paralysis.
the loss of muscular contractility, the absence of pain in the limbs or in the spine, the
absence of any morbid symptoms in the rectum or bladder, or of a feeling of constriction
in the abdomen, the absence of spinal tenderness, or of a sensation of pain when ice or
hot water were applied to the back, and the various and peculiar behavior under elec-
trization, we concluded that the case was one of a hysterical character.

The treatment consisted chiefly in central and localized electrization three times a:
week. Both methods were used at the same sitting. At first the faradic current was
used, but without making any impression on the disease. The first application of the
galvanic current took immediate effect. The next day the patient could raise both of
her lower limbs six inches from the horizontal, as she lay in her chair. The improve-
ment was permanent and progressive. Another singular feature was that, in spite of
her weakness and helplessness, the patient could and did bear with benefit protracted.
applications. In order to bring the whole body under the influence of the current at
one sitting, and at the same time to give the needful attention to the affected muscles
and groups of muscles, the sittings were sometimes double the average length.

Improvement in the upper limbs followed improvement in the lower. The exten-
sors and flexors of the arm and forearm soon began to resume their contractility under
the faradic current.

January, 1869, the patient had steadily progressed from day to day. Although.
healthful contractions were not obtained in the muscles below the knee, even under
the galvanic current; yet the skin had a less glossy appearance, and the power of mo-
tion had greatly increased.

The improvement in the arms, though at first slow, was subsequently more rapid in

* One of the authors has experienced a precisely similar sensation through the brain,
spinal cord, and all the ramifications of the nerves, after an overdose of hasheesh,
504 PARALYSIS.

the upper than in the lower limbs. By Jan. 1, both the arms and forearms had per-
ceptibly enlarged, as was also shown by measurement. The patient could handle
light objects, and was beginning, in an awkward way, to feed herself. She could sit
in nearly a natural position in her chair, and when well supported could stand for an
instant.

Feb. 1, 1869, the treatment was abandoned, because the patient seemed for the
time to remain stationary. At that time she had increased in weight to the extent, it
is just to estimate, of twenty-five pounds, although the patient was not weighed. She
was able to read short paragraphs, and took her book or paper daily.

On account of the weakness of the peronei muscles of the right leg, the foot had
all along exhibited a tendency to turn in. This symptom did not improve,

After the treatment was discontinued, the patient still progressed.

When last seen, August 1870, she had gained from thirty to forty pounds in weight,
had nearly full use of her arms and hands, which had regained their full size, and was
able to step with assistance, and appeared to be prevented from walking alone only by
giddiness. She could read for hours at a time without excessive fatigue.

The improvement in the last few months had been greatly aided by systematic rub-
bing and movements.

In the above extraordinary case the record was never complete, but
the results of treatment were most interesting and remarkable.

Prof. J. L. Cabell has detailed a very interesting case of hysterical
hemiplegia that presented many of the peculiarities of the above case,
and which completely recovered under general and localized faradiza-
tion. *

Ltysterial paraplegia after slight exertion—Complete recovery under general fara-
dization.

CasE LXXV.,—Miss J., aged 25 years. Wasreferred to us by Dr. C. M. Alin,
The patient was of slight build, and her nervous system had from childhood been
unduly excitable. Three years before, after an attack of typhoid fever, she observed
an inability to walk more than a short distance without a sense of decided exhaustion
in the legs. This symptom gradually increased in gravity until, in the course of a
month or so, a minute’s walk would be followed by violent trembling of the limbs, and
such a feeling of loss of power that rendered further effort impossible.

After being thus affected for a year, the patient visited Saratoga, where her condi-
tion very decidedly improved. ‘The gain was, however, but temporary, for soon after
leaving the Springs she relapsed, and for a year and a half every effort has failed to
appreciably benefit her.

On the qth of January, 1872, we began treatment by cautiously submitting the
patient to general faradization, She was so susceptible to the influence of the current
that the most gentle treatment was borne with difficulty. Gradually, from time to
time, the power of the current was increased until she bore without discomfort very
thorough treatment. After the first week slight improvement was manifested, which
steadily continued until the rst of April, a period of nearly three months, when she

* Archives of Electrology and Neurology, May, 1874, p. 49.
CENTRAL PARALYSIS. 505

was able to walk any ordinary distance with perfect ease. The entire number of
applications was forty. No relapse has occurred.

In another case of a young lady whose limbs would give out suddenly
and completely after walking perhaps half a block, the results of treat-
ment were also satisfactory.

Central Paralysis.—Central paralyses are those which depend on
some special and distinct morbid condition of the brain, spinal cord, or
sympathetic,

Hemiplegia and paraplegia, with their complications, are the more
frequent and important manifestations of paralysis of central origin.

Electro-Diagnosis.—In the electrical treatment of cerebral and cere-
bellar paralysis it is of supreme importance to make, so far as possi-
ble, a diagnosis of the precise seat of the lesion, as well as the general
nature of the morbid process. The difficulties in the way of exactly
localizing the seat of the lesion are very great, and our success must of
necessity be at best approximate and relative.

1. When the morbid process is in the large hemispheres, electric
examination indicates a convulsive or exhausted condition. This condi-
tion is also associated with convulsions and contractions. By the aid
of other associated symptoms we may be able to localize the disease
more definitely. .

2. When the morbid process is in the central ganglia, the reaction
may be either normal or increased.

3. Difficulties of swallowing indicate disease of the pons and the
medulla oblongata.

When dizziness is excited by a very mild galvanic current, there is
reason to suspect some morbid process within the brain. The diagno-
sis of the diseases of the brain with which hemiplegia is associated is
much aided by the ophthalmoscope, which frequently reveals changes
in the optic disk, the retina, the choroid, and their blood-vessels. Cere-
bral effusion may be indicated by congestion or infiltration of the optic
disks on the side on which the clot exists ; ¢wmors of the brain by
neuritis, neuro-retinitis, and ischemia; softening occasionally by neu-
ritis or atrophy.

Prognosis.—The prognosis of hemiplegia under treatment by elec-
tricity is in general much better than has been supposed. Manifestly,
everything depends on the nature and seat of the affection as well as
on the age and constitution of the patient.

The prognosis is better in proportion as the symptoms are uncom-
plicated ; better in the young and middle-aged than in the old. Cases
that are so thoroughly cured as to leave no marks behind are exceptional.
506 PARALYSIS.

The improvement, however rapidly it may progress at first, usually stops
at some point short of a perfect cure. The majority of cases can be
benefited, sometimes rapidly benefited, up toa certain point, after which
the improvement cannot be pushed by any amount of treatment. It is
furthermore always necessary to bear in mind the liability to other
attacks ; very many cases are improved at once and rapidly, while with
others the progress is almost imperceptibly slow.

In psychical symptoms (melancholia, hypochondria, etc.), the progno-
sis is often quite favorable. A persistence of these psychical complica-
tions, even when other symptoms appear to yield, we have come to
regard as an unfavorable sign.

In anesthesia, when uncomplicated with other symptoms, the prog-
nosis is remarkably good, even. when variously complicated with paraly-
sis of motion or disorder of the cranial nerves, and the anzesthesia may
yield, even though its associated symptoms are not affected.

In severe disorders of speech the prognosis is not very favorable.
‘They are, however, susceptible of treatment.

In impairment of nutrition—the muscular atrophy that so frequently
accompanies hemiplegia—the prognosis, especially when the cases have
not been too long neglected, is oftentimes exceedingly favorable. After
the affected lower limbs have become much reduced, they may by per-

severing faradization and galvanization be restored to their normal size.

In contractions of muscles and convulsions, the prognosis is unfavor-
able.

In disorders of bladder and rectum, the prognosis is not very favorable.

In affections of the joints the prognosis is not very favorable.

In cases complicated with hysteria or hysterical symptoms the prog-
nosis is better than in cases not so complicated. In very strong and
vigorous persons of coarse organization the prognosis is generally not so
good as in the nervous organization.

Other conditions being the same, the prognosis is much better for
those cases where the arm is not affected ; and when both the arm and
leg are affected, the leg is susceptible of the earliest and greatest im-
provement. The chief difficulty in the hand is usually with the exten-
sors and inter-ossei, which, being very long and weak muscles, and act-
ing as they do at the worst power of the lever, are the greatest sufferers
in hemiplegia, and are very slow to resume their normal functions.

It should always be borne in mind that the tendency of the disease is
toward recovery up to a certain extent, and that the improvement which
takes place in the early stages, sometimes very rapidly, is partly due to
nature and time.
TREATMENT OF CENTRAL PARALYSIS. 507

Electrical Treatment.—Diseases of the brain of the different varieties
are to be treated by both general and localized faradization according
to the indications of each case. General faradization is frequently in-
dicated in hemiplegia as in other manifestations of disease of the brain,
on account of the general debility of the functions that accompanies
and follows an attack of disease of the brain. It improves the general
nutrition. a

Central galvanization with a very mild current is a method of treat-
ment that is of great service in these conditions. The special form and
locality of the galvanization will depend on the supposed locality of the
disease.

It is well to use central galvanization alternately with general or
localized faradization.

There is little doubt that this method of treatment, when not over-
done, acts beneficially. on the nutrition of the brain, directly by the
passage of the current through the brain, and indirectly through the
modification of the cerebral circulation by the irritation of the sympa-
thetic.

It must be confessed, however, that the exclusive use of central gal-
vanization in cranial disorder is far from being satisfactory, and for these
four reasons: First. With all our improved means of diagnosis it is
impossible to fix with anything more than approximate certainty the
seat or even the nature of the morbid process in diseases of the brain ;
hence, all localization of the galvanic current in this or that part of the
head must at best be empirical and tentative. Secondly. It is im-
possible to localize the galvanic current entirely in any small portion of
the brain. Thirdly. Diseases of the brain are usually accompanied
and followed by general feebleness that demands constitutional treat-
ment. And fourthly, the paralysis will not yield to merely central treat-
ment directed to the seat of the disease, but must be treated itself. In
hemiplegia also the spinal cord becomes affected through disease ; hence
the theoretical indication for galvanization of the spine, or, better still, ,
the entire method of central galvanization.

General faradization, thoroughly used, affects all parts of the brain and
the sympathetic at each application, and in addition powerfully and
beneficially affects the entire periphery. The improvement which is
acquired by the extremities and by all the superficial muscles, and by
the viscera ‘especially, under general faradization, we believe, reacts
favorably on the brain and aids the reparative process. Our best results
thus far have been obtained by the combination of localized faradization
of the paralyzed muscles, general faradization, and central galvanization.
508 PARALYSIS.

In the majority of cases of hemiplegia the muscles are not so badly
paralyzed that they will not readily contract during the process of general
faradization. Localized faradization with careful and special reference —
to the motor points is therefore not necessary, and as general faradiza-
tion acts more or less on the spinal cord, which is secondarily affected,
and on the whole system, which in time becomes debilitated, as well as
on the paralyzed muscles, it is well oftentimes to use that method in
connection with localized faradization or in preference to it.

In regard to the comparative merits of central galvanization, periph-
eral and general faradization, and localized galvanization of the nerve-
centres, in hemiplegia, we should say decidedly that the latter method—
localized galvanization of the brain, sympathetic, and spinal cord—is the

least important. By itself alone, unaided by other methods, it will ac-

complish but a little. It comes in very well, however, to supplement
other methods, and may be used in connection with them. The full
method of central galvanization, however, by acting thoroughly on the
whole central nervous system, accomplishes much in hemiplegia, and
may carry on the improvement after peripheral and general faradization
have finished their work and lost their efficacy.

Time of beginning Treatment.—In regard to the time of beginning
treatnient after an attack of hemiplegia, each case must be studied by
itself. Asa rule, it is better to wait two or three weeks, until the active
irritation in the brain has in a measure subsided. The almost univer-
sally entertained idea, that it is better in all cases to wait three, four, or
six months, until the muscles have been long atrophied and contracted,
and the shoulder-joint become perhaps permanently immovable, before
beginning electrical treatment, is one of the most serious errors of electro-
therapeutics. Jf proper caution be used, it is never necessary to injure
the patient at any stage of the disease. Cases that are taken early may
be treated at first by exclusively localized faradization ; and afterwards,
when that has accomplished all that it can and the patient ceases to
progress, it may be well to resort to general faradization and central
galvanization. Electrization of the facial muscles on the affected side
sometimes materially aids the speech, but it may cause unpleasant
symptoms, and in the early stages especially should be avoided. Mild
galvanization may sometimes be used before faradization of the muscles.

Accessories to Electrical Treatment af Paralysis.—The treatment of
paralysis of all kinds by electricity may be greatly aided by observing
the following rules :

1. Thoroughly soak the part with warm water before beginning treat-
ment. When this is done a much feebler current will produce contrac-
TREATMENT OF PARALYSIS. 509

tions and the contractions will be more active, and some muscles will
readily contract which otherwise would not contract at all.

The skin when dry is, as we have seen (Electro-Physiology, p.183), a
poor conductor, and in proportion as it becomes thoroughly moistened
in that proportion does its conductivity increase.

2. Relax the muscles when the application is made. The advan-
tage of the observance of this rule is decided (see Electro-Physiology,
p.158).

In treating paralysis of the extensor muscles of the hand, for example,
flex the hand backward a little and then relax the extensor muscles. In
treating paralysis of the peronei muscles of the leg, raise the foot so as to
relax these muscles and the tibialis anticus. The muscles of the thigh
are most relaxed when the patient is sitting, and most tense when the
patient stands. In treating paralysis of the face, draw back the muscles
of the affected side toward the ear. Dr. C. E. Detmold has suggested
the use of a blunt, curved wire. This wire is placed in the corner of
the mouth and the other end is attached by an elastic to a curved wire
behind the ear. This contrivance may be worn not only during treat-
ment, but at night, if it be not too disagreeable, and an hour or so
during the day.

For keeping the hand raised in lead paralysis, Dr. Geo. Van Bibber,
of Baltimore, has devised a contrivance consisting of Sayre’s artificial
rubber muscle connected by eyelets to elastic bands attached by ad-
hesive plaster to the arm above the elbow at one extremity, and at the
other extremity to the hand and fingers.

Dr. Van Bibber has utilized the same principle in the treatment of
ptosis. In order to hold up the lid he applies a narrow bit of adhesive
plaster to the forehead, and to the lid itself.

3. Enlist the mental co-operation of the patient in the treatment. Let
him try to move the paralyzed muscles at the very moment that the cur-
rent is applied. Concentration of will alone is sufficient to help par-
alysis, as has been proved by actual experiment.

4. Passive movements of the limbs at the joints, massage, and mani-
pulation of individual muscles. The joints should be rotated so as to
combat the tendency to stiffness and the kneading of the muscles should
be carefully and thoroughly performed, massage and passive movements
are usually but half done.

5. Apply dry heat to the affected muscles before the electricity is ap-
plied, or at any time during the intervals. This can be done in various
ways. A good way to bring a paralyzed arm or leg under the prolonged
influence of dry heat is to take a common sewer-pipe as sold in the
510 PARALYSIS.

shops, of a suitable size and curvature, heat it through in an oven, cover it
with cloths and let the limb remain in it until the heat is dissipated. In
this way not only the forearm and leg, but the whole arm, including the
shoulder-joint and the thigh with joint, can be daily subjected to the ef-
fect of the prolonged heat. This treatment not only temporarily increases
the electro-muscular contractility of the paralyzed muscles, but perma-
nently improves the nutrition both of the muscles and of the stiffened
joints. Dr. Charles F. Taylor allows his paralyzed patients to warm
their paralyzed limbs in a hot oven arranged for that purpose.

All the above suggestions will apply to the treatment of every form
of paralysis.

Right hemiplegia coming on gradually, with numbness and coldness in right leg ;
slight anasthesia of right hand, and considerable anesthesia of right leg ; some
diminution of electro-muscular contractility in right leg—Gastralgia, insomnia,
and great mental depression—Important improvement under general faradization
and peripheral galvanization—Subseguent renewed attack,

Case LXXVI.—Hon. Mr. G., aged 52, for many years United States -Senator,
was referred to us Oct. 19, 1868, by Prof. Austin Flint. During the excitement of
the Impeachment Trial the patient, whose constitution was always supposed to be of
the strongest, observed a feeling of coldness of the right leg at night. This coldness,
however, was not very marked, since his attention was first called to the condition by
his wife. One day, while in Congress, and shortly after the delivery of his opinion on
the Impeachment, he experienced a slight attack of hemiplegia, which he endeavored
to walk off.

Before coming to New York, he had received the very pernicious advice to take
vigorous and severe muscular exercise. Acting upon this unfortunate suggestion, he
had seriously injured himself at the exhausting labor of chopping wood. He grew de-
cidedly worse, and became exceedingly depressed. Under the advice and medication
administered by Prof. Flint he had measurably improved, and at the time we first saw
him there was a tendency toward recovery. He complained, however, of persistent
insomnia, considerable gastralgia, with indigestion, pain in the lower part of the back,
and very great mental depression.

Electric Examination.—Slight anesthesia of right hand ; considerable of right leg;
some diminution of electro-muscular contractility in the muscles above the knee on the
right side; no diminution of electro-muscular sensibility ; the volitional power of the
muscles was intact, and the patient could walk a considerable distance.

The case demanded a general tonic as. well as merely local treatment, and-we accord-
ingly used general faradization daily, or every other day, occasionally making use of
galvanization. It was not long before improvement was manifest in all the leading
symptoms. He soon began to sleep and to digest better, and was much relieved of
the pains in the back. At the end of five weeks the patient abandoned treatment, and
so far improved that in the early part of December he resumed his seat in Congress,
and during the entire winter continued in the exercise of his official duties.

While under treatment by electricity, he at the same time continued the use of bro-
mide of potassium and other internal remedies, with special reference to the affection
CASES OF HEMIPLEGIA. SII

of his stomach. Inasmuch, however, as he had been taking these remedies before, and
as the improvement received important and quite rapid acceleration shortly after elec-
trization was commenced, it seems fair to infer that this improvement was mainly due
to the latter.

In the spring following the patient visited Europe, where, as we were
informed, he was engaged to plead in a case at law. The excitement
brought on a new attack, and that again was followed by another, which
left him in a condition of despondency, from which, however, he slowly
rallied. He afterwards died, we believe, of another disease.

The following case illustrates the value of galvanization of the brain
and sympathetic after peripheral faradization seems to have done its
work,

Hemiplegia associated with decided atrophy of the leg—Rapid increase in the size of
the limb following the use of the localized and general faradization and galvaniza-
tion of sympathetic.

Casz LXXVII.—Mr. Y., aged about 60, was sent to us by Dr. De Forrest Wood-
tuff, September, 1869. About six months previously the patient had suffered from a
severe attack of apoplexy, resulting in paralysis of the left side of the body. In four
weeks he so far recovered that he could walk to a carriage, and in three months was
able to walk out at pleasure and unattended. The left leg had, however, decreased
in size, measuring in circumference three-quarters of an inch less than its fellow of the
opposite side.

Fifteen applications of the faradic current increased the circumference of the limb in
one month half an inch,

Subsequently the patient was still more improved by mild galvanization of the brain
and cervical sympathetic. His capacity for work increased and also his motor power.

The power and the limitations of electrical combined with accessory
treatment in hemiplegia depending on cerebral hemorrhage was very
well illustrated by the case of the late Prof. Geo. T. Elliott, of Bellevue
Hospital Medical College.* He was taken down with right hemiplegia,
in the winter of 1871. He was at first unable to move either the right
hand or the right leg. Three weeks after the attack we began localized
faradization of the paralyzed right side—the details of the applica-
tions being carried out a part of the time by Dr. C. C. Lee—and he
gradually improved, so that he was soon able to hobble about. In the
treatment galvanization of the brain and cervical sympathetic was alter-
nated with peripheral faradization. This central treatment seemed to be
of service, for he always felt lighter and better after the séances, pro-

* While under treatment Dr. Elliott repeatedly expressed the wish that his case

might be reported in this book for the benefit of the profession, and much regretted
that it could not appear in the first edition.
512 PARALYSIS.

vided very mild currents were used. Two days before the second attack
came on he was exceedingly hopeful, and said to us that he could walk
two miles. In connection with electricity, massage and hypodermic
injections of strychnine were used.

Hemiplegia of left side, of four months standing, complicated with affection of shoul-
der-joint and atrophy of muscles of forearm and emotional disturbances ; diminu-
tion of electro-muscular contractility and sensibility—Some improvement under
general faradization—Relapse, possibly caused by too severe galvanization of head.

Cas—E LXXVIII.—Mr. D., aged 60, was referred to us Oct. 12, 1868, by Prof,
Isaac E. Taylor. Four months before the patient was prostrated by a stroke of
apoplexy, from the effects of which he had slowly rallied. The attack had been preceded
by severe anxiety, that was supposed to be the leading cause of his affliction. At the
time we first saw the patient he was confined.to bed, his left arm useless by his side,
and only with great difficulty and pain could be forcibly extended. It was a task to
raise him from his bed to the invalid’s chair by its side.

Electric Examination. —Great diminution of electro-muscular contractility and sensi-
bility in the arm, with considerable anzesthesia and slight diminution of electro-muscu-
lar contractility in muscles of leg above the knee ; but very little anzesthesia.

The extensors and flexors of the forearm were much atrophied, and the skin of the
hands presented a dry, shrivelled appearance. The shoulder-joint was moved only
with pain and difficulty, and presented many of the features described in the cases of
Charcot and Hitzig. ,

Psychical and hysterical symptoms were prominent, the patient being excessively
nervous, somewhat irritable, timid, and.so sensitive as easily to be moved to tears,
The conjunctiva of both eyes considerably injected, pain through the brow and in the
side and back of the head on the right side ; very much constipated ; fair appetite; no
difficulty of speech. The prognosis for recovery was not favorable.

Under general faradization the patient was temporarily benefited, and for several
weeks retained considerable improvement. He was able to step with assistance ; felt
more hopeful ; electro-muscular contractility in left leg nearly normal. Dec, 15 we
resorted to localized galvanization of the head, with at first negative and afterwards
apparently unpleasant results. That the galvanic current was used too strong or too
long for the condition of the patient we had some reason to suspect from a relapse
that occurred Dec. 21. The symptoms almost indicated effusion. The patient lay
for some hours in a semi-comatose condition, and the muscles of the affected limb
relapsed into their former condition. He again somewhat improved under treatment.
The following year the patient had a fresh attack.

While hemiplegia in the majority of instances doubtless depends
on some serious anatomical lesion of the brain, it may occur without
demonstrable organic change. It is doubtful whether there can be any
serious disturbance of the functions of the body without corresponding
structural change. Since, however, in many cases science utterly. fails
to detect anatomical lesions, we are under the necessity of clinging to
the old term /unstional, as descriptive of this condition.
CASES OF HEMIPLEGIA. 513

Among others, the following case presented an excellent opportunity
of studying an example of paralysis from the foregoing causes :—

Case LXXIX.—Mr. H., a bank president, aged about 45, after having enjoyed
excellent health previously, and having always led a correct life, was suddenly pros-
trated one morning while dressing, by a slight sensation of vertigo and a feeling of
utter exhaustion. In the course of an hour these symptoms were followed by a partial
paralysis of the right side. He was unable to walk alone, but if allowed to lean on
another for support, he could slowly and with difficulty make his way from one room
to another. In order that the case may be fully appreciated, it will be necessary to
notice his physique and speak biiefly of his past history. He was tall and very thin,
with a tendency to anemia rather than to plethora. He had always enjoyed a fair
degree of health, and for many years there had been scarcely a perceptible variation in
his weight. His present position was not at all onerous, but most of his life had been
spent as head of a business firm that had taxed his energies to their utmost. :

For some months previous to his illness he had’suffered from excessive anxiety
because of. financial embarrassments, but especially because of the inefficiency and care-
lessness of his son, to whom he had intrusted certain details of business of much im-
portance. His mental condition produced insomnia that finally resulted in a sudden
collapse of the debilitated nerve-centre. An application of general faradization cause |
immediate but only temporary increase in the power of the paralyzed members, as may
he so frequently noticed in cases of hemiplegia following effusion. On the su:-eeding
day, however, very marked and permanent improvement was observable, an idea of
which may be conveyed by stating that he was able to do what before was impossible,
viz., put on his pants without assistance.

Treatment was given every other day, and resulted in very rapid progress toward
recovery.

In the course of a month he could walk with such ease and readiness that no one
would have supposed that he was in any way disabled. He could not, however, run
with any ease or comfort ; and although nearly two years have elapsed since treat-
ment was discontinued, he does not feel that he is able to engage in any exercise moré
severe than a rapid walk. ;

Probable cerebellar paralysis of two months" standing ; right leg and left arm most
affected—Approxima’ recovery under general faradization.

Cask LXXX.—Mr. F. H. C., aged about 50, was referred to us by Drs, Purple,
of this city, and Cooper, of Brooklyn. The patient, who for many years had attended to
his business affairs with remarkable diligence, and had uniformly enjoyed most excel-
lent health, stated that during the last two years his strength had sensibly declined.

Some two months previously, while in a stooping position, he war suddenly seized
with vertigo, together with an appreciable loss of power in the right leg and left arm,
and marked anasthesia in the right foot. There was a feeling of heat and heaviness
in the region of the cerebellar. Several recurring attacks induced his physicians to
submit the patient to our care.

Nov. 23, 1869, the patient received his first application of a mild faradic current to
the head, neck, spine, and extremities. At this date he was quite weak and remarka-
bly nervous,

33
514 PARALYSIS.

No special improvement was noticed after the first and second applications, but the
third resulted in a sensible decrease in the intensity of fhe anzesthesia. Every succeed-
ing application imparted strength to his limbs and improved his general condition, and
in two months he had approximately recovered.

Glosso-laryngeal Paralysis (Glosso-pharyngeal Paralysis).—The dis-
tinctive features of this affection are paralysis of the muscles of
the tongue, lips, soft palate, and also of the pharynx and larynx.
‘There is difficulty both in speaking (especially in pronouncing certain
letters) and swallowing. The saliva dribbles. Food is sometimes
forced into the nostrils or larynx. In the last stage there is debility and
difficulty of respiration.

Prognosis.—This disease is believed to be surely fatal in a few
months. Faradization of the pharynx and tongue is, however, of essen-
tial service in uccasionally relieving the difficulty in deglutition, and
also some of the other symptoms.

Glosso-pharyngeal paralysis of nine months standing—Great difficulty in speaking
and swallowing— Temporary and decided improvement under faradization and
galvanization of the affected parts.

Case LXXXIL.—Mr. K., aged 43, a short, stubby, plethoric German, consulted us
May 18, 1867, with marked and typical symptoms of glosso-pharyngeal paralysis. His
difficulty of speech was very great, and any attempt to read was exceedingly ludicrous,
His especial difficulty was in pronouncing certain vowels, as a, u. In eating, particles
of food were thrown up in the upper and posterior pharyngeal space, and liquids some-
times were expelled through the nostrils.

The patient referred the beginning of his symptoms to a very severe cold.

Three localized faradizations were followed by manifest improvement in most of the
symptoms, and especially in the swallowing,

May 29, galvanization was commenced, and was continued with still further improve-
ment both in speaking and swallowing.

Of the issue of the case we have never heard.

Glosso-pharyngeal paralysis, with hemiplegia of left side of three years’ standing—
Chronic pharyngitis—No improvement under a short course of electrization.

CasE LXXXII.—Capt. George H., aged 55, consulted us on Oct. 15, 1866, with
symptoms of hemiplegia and glosso-labial paralysis, Certain letters, as h, p, he could
not articulate, and conversation was a matter of considerable difficulty, He could
walk, but needed assistance in ascending stairs or crossing streets.

The accompanying symptoms were in every way discouraging, The patient was
partially insane. Naturally kind and genial, he had become excessively irritable and
inconsiderate ; was at times impatient and violent.

Localized and general faradization, attempted for a short time, proved of no service,
and the patient was not encouraged to continue treatment. We afterwards learned
that his symptoms gradually became worse, in spite of various hydropathic, equalizing,
and other methods of cure that he attempted, and in three years he died, ;
GLOSSO-LARYNGEAL PARALYSIS. 515

We do not presume to say that the case that immediately follows was
one in which there had been any decided atrophy of nerve tissue, and
yet all the symptoms of which the patient complained were of the most
persistent and distressing type, and seemed to point unmistakably to
structural lesion. If there was zo decided structural change present
in the motor roots of the upper portion of the cord, as the immediate
effects of the treatment would seem to indicate, the case affords an
instructive illustration of those purely functional conditions that occa-
sionally simulate with such exactness incurable diseases of organic
origin.

Rapid recovery of a supposed case of glosso-laryngeal paralysis of three years’ stand-
ing under galvanization of the neck and upper portion of the cord.

CasE LXXXIII.—Mr. P., a gentleman aged 45, was sent to us by Dr. James Ander-
son, Some three years previously the patient had first observed a slight sense of stiffness in
the tongue, associated with a feeling of constriction in the pharynx and larynx. Occa-
sionally his speech became thick and hoarse ; some words were pronounced badly, and
he found it difficult to contract the lips. At such times partial aphonia was present, and
when he attempted to converse, the effort was attended with a degree of discomfort if
not pain, For several months these symptoms had remained stationary, with the
addition only of some little weakness of respiration.

Finally, however, he noticed some difficulty in the act of deglutition, which in the
course of a few weeks so markedly increased as to threaten suffocation. He dreaded
every attempt at eating, and frequently in the place of his regular meal he would take
a considerable quantity of brandy, the stimulating effects of which would often tempo-
rarily seem to restore power to the diseased parts. For more than two years this
patient had suffered in this way. Although he had unceasingly sought relief, every
method that he attempted signally failed to afford the slightest service. On applying
for electrical treatment, we at once submitted him to a mild séance of central galvani-
zation, after which a current of somewhat greater strength was as nearly as possible
localized. in the upper portion of the cord and its motor roots. This accomplished
nothing, and as the patient gave evidence of being decidedly unsusceptible to ordinary
electrical influences, we attempted at the second séance to localize in the supposed
seat of the disease a current from 15 cells, gradually increasing it to 25 cells.

Considerable vertigo with slight spasmodic contraction of the larynx followed, last- .
ing several minutes. On the following day he reported that he was able to eat with
markedly increased comfort, and that during the intervals of eating he felt completely
recovered. Eight similar applications, but with gradually decreasing strength of cur-
rent, were followed by complete recovery. In a few months he suffered a slight relapse
from which he speedily recovered by a short course of treatment. Two years have
elapsed since the treatment, and the patient continues well.

Paralysis of the muscles of the neck and chin with dysphagia—Not treated.

Casr LXXXIV.—Mr. L., aged 60, referred to us by Dr. E. R. Peaslee, was par-
alyzed in the muscles supporting the head and chin; dysphagia was marked, and deglu-
Utiow was so much impaired that eating was attended with much difficulty,
516 PARALYSIS.

Our diagnosis was central lesion, the chief expression of which was atrophy of
the motor roots. We were permitted to use the galvanic current but ‘about three
times.

No benefit was derived, but a further trial might have alleviated the symptoms
somewhat.

Paralysis of Spinal Origin—Paraplegia.—The exact differential
diagnosis of the various morbid conditions of the spinal cord that give
rise to paraplegia is sometimes a matter of considerable difficulty, and
for these two reasons :——

t. All known morbid conditions of the cord have more or less symp-
toms in common. In order that any of them.may be of special diag-
nostic value, it is necessary that they should be taken in connection
with other symptoms.

2. Many of the morbid conditions of the cord are complicated with
each other, and the symptonis must be correspondingly complex. Thus
meningitis may exist with myelitis, and the term myelitis itself is a genus
of which there are several species. It is difficult to draw the line where
irritation ends and congestion begins, and equally difficult to determine
at what stage a condition of hyperzemia or congestion becomes a con-
dition of inflammation.

Llectro-Diagnosis.—In the early stages of spinal paraplegia the gal-
vanic and faradic reaction may be normal, but in the course of a few
weeks or months becomes diminished. In most of the cases that con-
sult the physician there is diminished or destroyed electro-muscular con-
tractility.

Electro-muscular sensibility is usually more or less diminished. Elec-
tro-muscular contractility is usually much more diminished in the severe
forms of paraplegia than in hemiplegia. In cases where the posterior
columns are affected electro-anzesthesia may also exist. ‘

Treatment.—In hemiplegia, as we have seen, the electrical treatment 1s
substantially the same whatever the nature or seat of the cerebral lesion.
Similarly in paraplegia the treatment, so far as electricity is concerned, is
the same, whatever be the nature of the spinal lesion on which the para-
plegia depends. Spinal paraplegia should be treated by galvanization of
the spine, and peripheral faradization or galvanization ; to depend on
one method solely is unnecessary. In paraplegia the electro-muscular
contractility is frequently so much diminished that it is necessary to give
particular attention to the motor points in order to produce contractions.
Whether general faradization and central galvanization be employed
will depend on the general condition of the patient. In the early o1
subacute stage the séances should be short; in the chronic stage the
PARAPLEGIA—ANTERIOR SPINAL SCLEROSIS. 517

séances may sometimes be more protracted. In many incurable cases
the general tonic effects of general faradization alone are of very great
service.

Prognosis.—Nearly all cases of spinal paraplegia can be benefited
by electrical treatment, but very few can be entirely or permanently
cured. We may look for perfect recovery in some cases that are
taken early, andin cases that depend on hysteria, congestion of the cord,
or exhaustion. Cases of myelitis, meningitis, and non-inflammatory
softening are, as a rule, but little benefited, although they may some-
times improve quite rapidly under electrical treatment up to a certain
point.

Paraplegia resulting from anterior spinal sclerosis, with dedility, insomnia, anemia,
dysphagia—Improvement of nearly all the symptoms under general and localized
Saradization and localized galvanization—Relapse, and again improvement under
the same treatment,

Cass LKXXV.—Mrs. D., aged 51, married, was referred to us by Prof. John T
Metcalfe, on Oct. 12, 1868, For two years she had been afflicted with paraplegia,
which was preceded by loss of control over the rectum, and which was brought on hy
exhaustion incident on loss of sleep and over-exertion in attendance in the sick-room,

She could walk a short distance, but ascending stairs was very difficult. Among
the accompanying symptoms were unpleasant dysphagia, insomnia, very feeble appe-
tite and digestion, and poor circulation—in short, general functional debility, The
patient could not walk at all in the dark. There was no pain in the back, but a con-
stant feeling of weakness. No feeling of constriction.

Electric examination showed a considerable loss of electro-muscular contractility in
the affected limbs, but no anzesthesia.

Before consulting us she had teceived positive benefit from general faradization. We

_ employed for three months general faradization and galvanization of the spine, and at
first with benefit. The patient hoped for a complete and permanent cure, In this
respect she was disappointed, Although her sleep improved immediately after the em-
ployment of general faradization, and although her strength much increased, yet the
power of walking was increased only to a certain degree, which under further treat-
ment it seemed unable to pass.

The patient retained her improvement for several months; but in the following
autumn was again somewhat’ prostrated, and again received the same treatment, to-
gether with galvanization of the spine, and with substantially the same result.

In the above case there were three points of interest.

1. General faradization was more beneficial than galvanization of the
spine, although the spine was unquestionably the seat of the disease.

2. The patient seemed in a measure dependent on the tonic influence
of electrization, since it operated more rapidly and more powerfully up

to a certain point than any internal medication which she had faithfully
tried.
518 PARALYSIS.

3. The Case illustrates the limitation of even the most successful elec
trical treatment in many cases of organic spinal paralysis.

Paralysis resulting from anterior spinal sclerosis with severe constipation—Very
- great dyspepsia and debility—Susceptibility to electricity—Slight improvement at
Jirst under electrization.

’CasE LXXXVI.—Mrs. B., a married lady of middle life, had for several years been af-
flicted with paralysis of left leg. The patient was of a nervous constitution, and she attrib-
uted her condition to overwork and anxiety attendant upon keeping house and en-
tertaining company. At the time we saw her, February 14, 1868, she was able to
walk only with difficulty, and her vitality was feeble. The affected limb was very cold,
and was three-fourths of an inch smaller than the other above the knee.

Electric examination showed loss of electro-muscular contractility in the affected
limb. A strong faradic current localized in the spine caused pain and uneasiness in
the knees, which lasted for several days. This phenomenon we have observed to so
marked a degree in no other case.

The patient was exceedingly constipated, and was obliged to depend on alvine in-
jections, At various times there had been a feeling of a cord around the waist. At
the time we saw her there was no spinal tenderness. The patient was at all times dys-
peptic and feeble.

Treatment by general faradization previously administered had relieved her dyspep-
sia and improved her general condition.

On account of the peculiar susceptibility of the patient, we abandoned treatment
after a few trials.

Paraplegia dependent on meningitis and myelitis—Traumatic origin—Loss of
control over bladder—Bed-sores.

CasE LXXXVII.—Mr. C., aged 28, was sent to us March 11, 1868, by Dr. W. C.
Wey, of Elmira. The history of the patient was that in February, 1863, while an officer
in the army, when in the act of swinging an axe, he felt a slight ¢w7tch iz the back.
Shortly after came a diarrhoea, with~pain in the calves of the legs, cold feet, then a
desire to urinate, with inability, then pain and stiffness in the back. He grew weaker
and weaker, and for two years was confined to his bed. There remained large scars
of farmer bed-sores.

Electric Examination,—Great anzesthesia of the bladder, slight diminution of elec-
tro-muscular contractility, and considerable anzesthesia in the lower limbs, The
urine was continually dribbling, so that the patient was obliged to wear sponges and
disks,

_ The patient could walk only with the aid of crutches. He was treated by general
faradization and localized galvanization. After seven sittings he returned very slightly
improved.

' There was no improvement in the condition of the bladder,

In the above case there was, as sometimes happens in traumatic my:
elitis, disease of both the posterior and the anterior columns.
PARAPLEGIA—-SPINAL HEMOKRHAGE, 519

Spinal hemorrhage, resulting in paraplegia, with profound anesthesia of the legs
and absence of electro-muscular contractility below the knees—Improvement and
approximate recovery,

CasE LXXXVIII.—L. F., a gentleman aged about 60, was seen by invitation of
Dr. S. T. Hubbard. The patient was suddenly prostrated while in his office by an
attack of spinal apoplexy, and during the several weeks that had elapsed before he fell
under our observation, the muscles of the thighs and legs had become decidedly
atrophied and. flabby.

Control was partially lost both of the bladder and rectum. The legs were pro-
foundly anzesthetic, and below the knees there was an entire absence of electro-muscu-
lar contractility, \

The use of both the galvanic and faradic currents for several weeks appreciably
relieved the anzesthesia, ‘an approximately restored the electro-muscular contractility.
The electricity was discontinued, but the patient improved in strength, probably as
the spinal effusion absorbed, and in a number of months was able to walk by the aid
of a cane.

Peripheral Paralysis.—A true peripheral paralysis manifestly excludes
all lesions or influences of a central origin. The cause must be sought
for in some portion of the nerve-tract after it has emerged from the
bones that enclose the nervous centres.

The principal causes of peripheral paralysis are :

1. The action of cold on the superficial distribution of nerves.

2. External injuries.

3. Pressure on a nerve from morbid growths, etc.

4. ‘Destruction of a nervesby carious bone, ete.

Facial Paralysis.—The most prominent form of peripheral paralysis is
that of the seventh pair of nerves. The symptoms of facial paralysis vary
not only as its cause is central or peripheral, but also according to the por-
tion of the nerve affected. Paralysis of the seventh pair without coinci-
dent paralysis of an arm or leg seldom results from cerebral hemorrhage.
It may occur, however, but it may be readily distinguished from the
peripheral form of the affection. J complete facial paralysis of peri-
pheral origin the orbicularis palpebrarum muscle is paralyzed, ana
the eye cannot be entirely closed ; while if the cause is central this mus-
cle is, asa rule, unaffected, and the eyelids can be brought together.
In some exceptional cases a certain lesion may paralyze the orbicularis
muscle, while occasionally, in peripheral facial paralysis, the nerves
that supply the muscles of the eye may escape, thus leaving it free to
close, The fact that in facial paralysis of central origin the electro-
muscular contractility is unimpaired, while if the nerve itself is the seat
of the injury the muscles refuse to respond to either current, materially
aids us in diagnosis.
520 PARALYSIS.

Electro-Diagnosis.—In facial paralysis of a peripheral origin, the
farado-muscular contractility is usually diminished or lost; ga/vano-
muscular contractility may be increased or normal; though in some
cases it may be diminished, it is rarely lost. Facial paralysis is one of
the conditions in which the difference between the two currents, in their
power of producing contractions of muscles, is typically shown. The
galvano-muscular contractility sometimes becomes so much increased
that when the farado-muscular contractility is entirely abolished, the
diseased muscles respond to a much feebler galvanic current than is
nécessary to produce contractions on the healthy side. As the muscles
resume their normal condition under treatment, the galvano-muscular
contractility diminishes.

Prognosis.—The prognosis of facial paralysis of a peripheral origin is
generally very favorable. Few forms of paralysis yield so surely as this,
provided the electrical treatment be used with sufficient perseverance.

Treatment.—Facial paralysis should be treated by localized faradiza-
tion and galvanization. When the muscles fail to respond to the fara-
dic current it is of but little worth to use it; it is far better to depend
on the galvanic current. In this disease the current-reverser electrode
is exceedingly convenient. A current just sufficient to produce con-
traction of the muscies is better than stronger currents, and short ap-
plications are preferable to long ones.

Facial paralysis from exposure to cold—Loss of contractility to faradic current—Im-
provement under the galvanic current.

CasE LXXXIX.—Miss P., a stout, vigorous young lady of 15, was sent to us by
Dr. F. Elliott, to be treated for paralysis of the seventh pair, on the left side, caused
by exposure to a draught of air two months previous. The paralytic symptoms came
on suddenly and in full force immediately after the exposure, and at first she experi-
enced considerable difficulty in speaking.

She gradually became so accustomed to the abnormal condition of her lips and face
that she was able to converse almost as clearly as before ; but the improvement in the
condition of the paralyzed muscles was very slow, and at the time she came to us the
affection appeared to be almost stationary, At the time she received the first appli-
cation at our hands (Aug. 1, 1862), she presented most of the usual symptoms of
paralysis of the seventh pair.

Her mouth was drawn over towards the healthy side so violently as to produce con-
siderable deformity when she laughed or conversed, and even when she smiled. When
she attempted to frown, the left-brow remained as smooth as that of a child.

Her left eye rolled up, and when she attempted to close it, the lids would not ap-
proach nearer than one-quarter of an inch to each other. 4 powerful faradic current,
localized in the affected muscles, produced very feeble - imperfect contractions;
while on the sound side a very mild current, applied ws.a the hand, produced active
contractions of all the principal muscles, The patient was so well in all other respects, -
FACIAL PARALYSIS. 521

that we decided to use only partial or localized electrization over all the muscles on
the left side of the face. Two vigorous applications made in this way, one electrode
being placed firmly in front of the ear, and the other passed over the ramifications of
the seventh pair, as well as over the individual muscles, did not seem to increase to any
appreciable extent the electro-muscular contractility, and accordingly we resolved to
adopt an entirely different method of warfare,

The next time we localized the galvanic current through the left side of the face,
and with the best results. Contractions of the paralyzed muscles were at once pro-
duced that were as vigorous and as natural as those caused by the faradic current on
the healthy side, and by a current that had no effect on the healthy side.

The patient began at once to improve, and after ten visits, distributed over a period
of six weeks, she was dismissed as approximately cured. There still remained some
deficiency of action of the muscles concerned in frowning and in winking, but the ex-
pression of her face, both in repose and in conversation, was normal.

The interesting points in this case are these :—

First.—The galvanic current produced contractions and wrought a
cure when the induced or faradic utterly failed.

Second.—The paralyzed muscles were at first brought to contraction
by a galvanic current that had no effect whatever on the muscles of the
healthy side. As the patient improved, however, it became necessary
to use a stronger galvanic current in order to produce the contractions.
Towards the close of the treatment, the muscles of the paralyzed side
began to respond to the faradic current.

That the faradic current may sometimes work well in facial paralysis
is shown by the following case :—

Partial paralysis of the right side of the face, with contraction of muscles following
neuralgia—Approximate recovery under localized faradization,

CasE XC,—Miss J., aged 40, came to usin the early part of September, 1868,
to be treated for a facial paralysis of a peculiar character. Her face was drawn to
the right side, so that her features were very much distorted. We at first supposed,
and very naturally, that the case was one of paralysis of the seventh pair of the left
side, but a more careful examination led us to modify our diagnosis.

Her history was as follows: Several years before, while occupied in a day and night
attendance at the bedside of a sick friend, she was suddenly attacked with severe facial
neuralgia of the rig/d side, that continued to annoy her for two months. The disease
then abated, but since that time she had been frequently harassed by persistent numb-
ness in the right arm and hand. ,

On localizing a strong faradic current through the muscles of the /e/t side of the
face, powerful contractions were excited. On the righz side no such effect could be
produced,

Furthermore her right eye was nearly closed, owing to a partial ptosis, and while
she could easily frown and corrugate the left brow, the right was entirely smooth and
expressionless. It was very evident, both from the history of the case and from symp-
toms at the time, that the vig4t side was paralyzed, and not the left, as at first aps
$32 PARALYSIS.

peared, and that the face was drawn towards the right by the contractions of the mus
cles following the paralysis.

Trousseau has described this condition so accurately that we quote his own language
as it appears in the translation of Bazaire.*

After relating the symptoms of a patient suffering from paralysis, he says: “If
left facial paralysis was thought of at first sight, the depression of the lower lid, and
the less marked expansion of the nostril on the right side, were already sufficient to
cause a modification of the diagnosis. But when the patient attempted to move that
side of her face there could no longer be any hesitation, and it became manifest that
it was the right side which was affected. When she spoke, and still more when she
laughed, her face was pulled with force to the left, the upper lip and the ala nasi on
that side going obliquely upwards, and the labial commissure being drawn with con-
siderable energy upwards and outwards, When she attempted to blow, her left cheek
swelled and her mouth remained closed on that side, whilst her right cheek was flaccid
and her mouth opened out a little on that side. Besides, she could not shut her right
eye, however much she tried.”

In this case we used only the faradic current, localizing the electricity as nearly as
possible along the course of the portio dura and its ramifications. To accomplish this
the small positive electrode was pressed firmly on the point where the nerve emerges
from the temporal bone, while the negative was moved along its various terminal
branches.

No particular results were obtained from the first application, but during the second
visit slight contractions were produced on the right side, and it was then noticed that
the eyelid did not fall so low as before.

In the course of a few days the patient again visited us, when the improvement was
quite marked. There was considerable relaxation of the contracted muscles, and the
electro-muscular contractility was readily demonstrated. At the fourth visit, which
occurred about two weeks from the commencement of treatment, the ptosis was hardly
noticeable, and the power of corrugating the occipito-frontalis on the right side was
perfect. There still remained, however, some distortion of the features, owing to the
obstinate nature of the muscular contractions, and, although she subsequently received
quite a number of applications, the contraction was not so entirely dissipated as were
all the other symptoms, But the amelioration was so complete that the distortion was
little noticed, and ceased to give her any considerable annoyance.

Double facial paralysis—Probably resulting from syphilitic lesion in the course of the
nerves—No improvement under localized faradization,

CaseE XCI.—Mr. M. was referred to us by Prof. A. Clark. In the month of
March, 1862, during the retreat of the Confederate army from Kentucky, this gentle-
man, after prolonged exposure to cold and wet, was attacked with facial. neuralgia,
Previously he had been so unfortunate as to contract syphilis, which had passed into
the secondary stage; but for several years he had been, to all appearances, entirely
free from the disease. This attack of neuralgia was followed by partial paralysis of the
right side of the face. The neuralgia persisted until July, but the paralysis has con-
tinued constant until the present time. In January, 1866, he had a renewal of the
neuralgia, which this time attacked the left side of the face. It wasof an intermittent

* Lectures on Clinical Medicine, Part II., p. 322.
PARALYSIS FROM PRESSURE AND COLD. 523

type, and on the 25th of March, without a premonitory symptom, and when he was
entirely free from pain, the left side of the face became completely paralyzed. He
gradually lost the sense of hearing, andin two weeks was absolutely deaf. When brought
to us for treatment he was suffering from paralysis of the whole face.

He was unable to close either eyelid, could neither elevate the eyebrows nor frown.
He had but little control over the mouth, and as a consequence his speech was very
imperfect. ‘‘The motionless face assumed a peculiar aspect, and looked like a lifeless
mask, on which the impressions of the soul were no longer expressed but by changes of
color.” We had but little hope of benefiting him, nor were we disappointed ; for, after
a month of faithful and hopeful perseverance on the part of the patient, not the slight-
est improvement was observed. The galvanic current was not used. .

Facial paralysis existing three weeks— Approximate recovery foliows three wpplica-
tions of the faradic current.

‘Case XCII.—Mr, C., aged 35, a patient of Dr. Joseph Worster, had been afflicted
for three weeks with paralysis of the seventh pair, of the rivht side,

’ The patient complained of a peculiar tingling and occasional numbness in the hands
and feet that we regarded as an indication of slight central disturbance. In all other
respects his health was excellent. A local application of the faradic current resulted
in immediate benefit, and two more séances were followed by approximate recovery.

The following is one of the very few cases of facial paralysis that do
not recover under persistent treatment by electricity :—

Partial facial paralysis of five years’ standing—No permanent benefit from electri+
zation.

Case XCIII.—Rev. Mr. M., some five years before he fell under our observation,
became completely paralyzed in the left side of the face after long exposure to cold.

The part improved gradually, and in a month’s time he was considered almost well.
The face still continued tu be drawn slightly to one side, but the deformity was hardly
observable without an attempt was made to laugh. The eyelids of the affected side
did not completely approach each other. Nature having accomplished so much, re-
fused to do more, and for five years no advance had been made towards recovery.

Electro-muscular contractility under the influence of both the faradic and galvanic
currents was perfect, and yet their persistent use was of absolutely no permanent ser-
vice,

For a day after the applications the eye could be closed more readily and the cheek
was more flexible, but, as soon as the immediate effects of the stimulus disappeared,
the parts réturned to their usual partially paralyzed condition.

Paralysis from Pressure and Cold.—Paralysis sometimes occurs from
pressure on the nerves of the arm during sleep, and most frequently in
persons who are intoxicated.

Paralysis of the arm may also arise from the pressure of a board or
any other hard object under the arm. It may also be caused, like facial |
524. PARALYSIS.

paralysis, by exposure to cold. Paralysis may arise also from the pres-
sure of the foetus in parturition.

All these forms of peripheral paralysis may be treated by electricity,
preferably by the galvanic current, and with curative results, unless the
nerve be too severely injured.

Paralysis of muscles of right thigh ; apparently produced by exposure to cold—An-
@sthesia—Improvement under galvanization—Increase in size of limb.

CasE XCIV.—Miss F., aged about 20, first observed a slight pain and soreness in

the muscles of the right thigh, that readily yielded to a few applications of the faradic

* current. Five months subsequently, after several hours’ exposure to cold and wet,
she experienced considerable pain in the right limb, and also a marked degree of stiff-
ness, that disappeared temporarily after walking a few times around the room.

In a few days the pain extended to the hip and involved the whole limb, which soon
became completely paralyzed, and for two weeks she suffered excessive pain both day
and night. Three months later, when it was decided that the patient should be
treated by electricity, she was able to move about the house with the aid of crutches,
although the limb remained almost perfectly powerless.

The anesthesia over the quadriceps muscle was very decided, the eee
producing two impressions only when its points were separates four inches, and the
electro-muscular contractility was entirely absent in all the external or surface muscles
of the thigh andin a portion of the leg. The thigh had atrophied to the extent of
an inch and one-half.

Ten applications of the faradic current entirely dissipated the anzesthesia, so that it
was necessary to separate the zsthesiometer but three-quarters of an inch in order
that two impressions might be received.

‘The same current partially restored also the electric contractility of the diseased
muscles ; but it was not until a galvanic current of consid-rable intensity was em-
ployed a number of times, that they responded healthfully to its influence.

The faradic current was again resorted to and persistently used for several months.

The limb gradually increased in strength, so that she was able to walk readily with
the aid of a cane. It increased also in size, so that around the thigh it measured but
one-quarter of an inch less than the sound limb. Time alone can tell whether she
will ultimately regain complete control over the diseased member.

Complete paralysis of the flexors and extensors of the wrist and fingers, caused by
pressure—Cured by three local applications of the faradic current.

CasE XCV.—Mrs. P., aged 30, was suffering from complete paralysis of the exten-
sors and flexors of the wrist and the right arm. Eight weeks before shé had held
her little child in her arms all of the day. The right arm was of course used the most.
In the evening she fell asleep in a rocking-chair, with nearly the whole weight of the
child resting on the right arm. In the course of an hour she awoke, to find the. wrist
and fingers paralyzed. No improvement had been manifest in the condition of the
parts up to the time we saw her.

The tissues below the wrist were decidedly anzesthetic, but electro-muscular con-
tractility was little impaired. Three local applications of the faradic current alone, in
REFLEX PARALYSIS. 525

the course of five days, dissipated the numbness, and so improved the members that
she could with ease move the fingers and wrist in every natural direction. The re-
covery became complete in a week or so without further treatment.

Calorific Paralysis.—Under this head Benedikt records a case of
paralysis caused by the contact of glowing hot iron with the skin, at a
point near the radial nerve. The nerve was not directly injured, but
paralysis with anzesthesia ensued. The patient recovered after a num-
ber of sittings. Both galvanic and faradic currents were employed.*

Reflex Paralysis.—Under this head are included those peripheral
paralyses which arise by reflex action through the central nervous sys-
tem, from some remote part of the body. Some of the cases of general
paralysis of all the extremities are of this nature.

Paralysis that arises by reflex action may remain long after the mor-
bid condition that caused it has entirely disappeared. *

Treatment.—L.ocalized faradization or galvanization is required in
this form of paralysis. This treatment should be directed not only to
the paralyzed muscles, but also in some cases to the diseased part from
which the paralysis is reflected. In doubtful cases, general faradization
and central galvanization may be tried.

frognosis.—This is much more favorable than in paralysis that di
rectly proceeds from organic disease. Everything depends on the na-
ture and locality of the irritation.

Typical case of complete reflex paralysis of the seventh pair on the right side of the
Sace, following severe neuralgia of the fifth pair on the same side.

Case XCVI.—The patient, a lady aged 30, some weeks previously, had experienced,
in the fifth pair, an attack of sharp shooting pains, of far more than ordinary severity,
was followed in the course of twelve hours by symptoms of facial paralysis, which
gradually increased until the loss of power was almost complete.

The muscles responded to the influence of faradization, but there was a manifest
decrease of the electro-muscular contractility. Three applications of the faradic cur-
rent to the affected side completely restored the contractile power of the muscles, and
three similar applications removed the paralysis.

Refléx paralysis of the left arm, apparently from neuralgia of short duration—
Recovery under localized and general faradization.

Case XCVII.—Mrs. W., aged 31, consulted us February 1, 1867. She was suffer-
ing from general neuralgia, which was especially localized in the left arm. Appetite,
digestion, and sleep were all poor.

There was paralysis nearly complete of the left arm. We began treatment by gen-
eral and localized faradization. In one week, after three sittings, the paralysis disap-

* Op. cit., p. 480.
526 PARALYSIS.

peared. Treatment by general faradization was subsequently continued, for the pur.
pose of raising the tone of the system.

Reflex paralysis of five months’ standing—A pproximate recovery under fifteen appli.
cations of the faradic current,

CasE XCVIII.—Miss , aged about 30, an inmate of the N. Y. State Woman’s
Hospital, was afflicted with uterine displacement and finally was prostrated by a severe
attack of cellulitis. ‘

During and after recovery from this illness the patient complained of anzsthesia
and tingling in both feet, together with a decided loss of motor power. These symp-
toms were persistent, and for five months the patient was able to walk but very short
distances and only with great difficulty.

On examination with the faradic current it was found that the electro-muscular con-
tractility was somewhat impaired. Faracization of the lower portion of the back, the
loins and the legs was employed, with the observed effect of at once increasing the con-
tractility of the muscles.

Twelve applications so improved her condition that she succeeded in walking two
miles without suffering extraordinary fatigue.

 
CHAPTER XXII.
LOCOMOTOR ‘ATAXIA—POSTERIOR SPINAL SCLEROSIS.

In regard to posterior spinal sclerosis we have these remarks to
offer :

1. The great exciting causes of the disease are exposure to wet and
cold, mechanical injury, and syphilis. It is a fact not thoroughly ap-
preciated by the profession or by the people, that it is as possible to
take cold in the cord as in the lungs. Cold in the cord manifests itself
just as cold anywhere else manifests itself,—that is, by congestion ; and
if the colds are repeated, the congestion becomes a fixed condition
that is not easily resolved, and in time may go on to the condition
known as posterior spinal sclerosis, or locomotor ataxia.

The connection between this structural lesion of the cord and expo-
sure to wet and cold is not always directly apparent, is but rarely sus-
pected by the patient, and almost never inquired into by the physician,
partly because of its remoteness, and partly because the professional
mind, at least, has been diverted in the direction of sexual excess as
the one great cause of ataxia.

The mechanical injuries that most frequently give rise to sclerosis of
the cord are severe blows and falls, or the shock of accidents cf almost
any kind. It is not necessary that the injury, whatever it may be,
should be received on the spine or head, in order to cause symptoms
of ataxia. A violent concussion from any injury that is directly felt on
the arms or legs may have the same effect as a direct injury to the
back.

2. The cord is predisposed to take cold by any causes that tend to
exhaust it. Among the more prominent of these causes are long
marching or violent and wearying muscular exertion of any kind, espe-
cially of the sort that draws heavily on the lower part of the cord, ex-
cessive intellectual exertion, and sexual excesses, The two latter pre-
disposing causes, excessive intellectual exertion and sexual excesses,
operate far less frequently than the purely physical causes.

3. In regard to the supposed influence of sexual excesses on this
528 LOCOMOTOR ATAXIA.

disease, the vrofession must revise its opinion. That sexual excesses
Constitute an important factor in the causation of nervous diseases
must be admitted, but it is not structural so much as functional diseases
that they excite.

One plausible reason for suspecting that sexual excess is the cause
of ataxia is found in the unnatural sexual desire that so often precedes
the ataxic symptoms. ‘The increase of desire naturally calls the atten-
tion of the patient to the sexual organs, and almost compels a certain
amount of abuse; and when questioned concerning his habits, it is no
marvel that he recalls and confesses his recent experience in this re-
spect. Now, this increase of sexual desire is often, if not always, the
effect of spinal congestion, by which the cord is rendered excessively
active ; It is a sign, not of health, but of disease. It is not, however,
nor is the abuse which it invites, the cause of the degeneration of the
cord into which congestion leads,

The most, then, that can be said of sexual abuse in its relation to
ataxia, is that, by weakening the cord, it may in certain temperaments
prepare the way for colds, mechanical injuries, or perhaps for syphilis,
to enter in and take possession.

4. It is more frequent, so far as we can learn, in the North than in
the South ; cold, damp climates favor its development. In the early
stages, long residence in tropical or subtropical regions is worthy of
trial.

5. It is very often complicated with congestion and sclerosis of the
anterior column. The neuralgic pains, of which so much is said, do
not appear in. much more than half the cases. We are not yet able to
say whether they are a good or a bad symptom. One thing is sure,
the worst and most obstinate cases we have yet seen had no neuralgic
pains. Another point equally true is, all the characteristic neuralgic
pains may exist in those who never have ataxia,

Llectro-Diagnosis.—The electro-muscular contractility, or at least ir-
ritability, may be normal or increased. This fact distinguishes locomo-
tor ataxia from ordinary paralysis of motion depending on anterior or
spinal sclerosis, in which the electro-muscular contractility is usually
diminished. The electro-muscular contractility may, however, be di-
minished in certain forms and stages of posterior spinal sclerosis, or
when complicated, as it may be, with anterior spinal sclerosis or with
hysteria or general congestion of the cord, or of the membranes.

Prognosis.—The prognosis of this disease under electrical treatment
alone, or it combination with drugs, may be thus generally stated: A
very small proportion of cases apparently recover; a considerab.e
PROGNOSIS AND TREATMENT. "529

number are very greatly benefited in all the leading symptoms; about
the same number are but slightly benefited ; and in a few cases abso-
lutely nothing is accomplished.

The proportion of absolute cures is so small that there is a natural
temptation to doubt the diagnosis or pathology of any reported cure.
The cases that are brought on by mechanical injury, especially by con-
cussion, offer the best prognosis ; and this is true, we believe, of other
nervous disorders. The explanation would appear to be that the dis-
ease excited by concussion is of a temporary, and comparatively tran-
sient, character, and the character of the lesion is far less severe than
in those cases that come on slowly, through long years of incubation.
In our observation the most satisfactory improvement has been in
those cases of ataxia that were brought on by concussion. This is also
true of paralysis in general, excepting, of course, those cases where the
spinal cord is directly and seriously injured.

Most of the published statements in regard to the prognosis of the
disease under electricity, as indeed under any other form of treatment,
must be received with great caution. Many of the physicians who re-
port the cases have perhaps never before seen a case where they made
the diagnosis of ataxia, and in the instance that they publish there is
much probability of deception ; and this. probability is increased if the
patient perfectly and permanently recovers. Hysteria comes in to
complicate the diagnosis, and some of the reported cures have been,
without doubt, of an hysterical character. Spinal congestion is very
often mistaken for spinal sclerosis ; the symptoms run into each other,
and the former in some cases leads to the latter. But spinal conges-
tion is relievable and curable, while spinal sclerosis is rarely so. Some
of the supposed cures have been very likely simply remissions in the
course of the disease.

Treatment. —Ataxia may be treated electrically by a combination of
several different methods of electrical application: Galvanization of
the spine, central galvanization, and general faradization when cere-
bral disturbance or general ataxia of the nervous system appear ;
galvanization of the cervical sympathetic, and peripheral faradization
with sponges and the metallic brush. All these various applications
may be made with weak or strong or medium currents, according to
the wants of each case.

We have found good results from simply treating the leading symp-
tom,—the anzesthesia,—without any special reference to the cord. We
do this by means of the metallic brush, or by a finely-pointed metallic
electrode, making the application over the feet, legs, arms, and all parts

34
530 LOCOMOTOR ATAXIA.

of the body that are anesthetic. The end justifies the means. We
have found more good, in some cases, from this method than from gal-
vanization of the spine and all the other methods combined. When
the ‘anzesthesia is profound and permanent, currents of great strength
are sometimes not only not disagreeable, but positively agreeable.

In recommending this method we do not recommend exclusive reliance
upon it; it is to be used in alternation with the other methods of
which we have spoken. It should not be forgotten that the reflex ef-
fect of powerful peripheral faradization on the cord may be of greater
service than galvanization of the spine.

Posterior spinal sclerosis—Concussion of the spine complicated with attacks of apha-
sia and weeping—Very unusual improvement under galvanization of the spine and
nitrate of silver. 5

CasrE XCIX.—Dr. N., amedical gentleman, over 70 years of age, was brought to us
November 9, 1872, by Dr. Corey. About six months before, the doctor undertook to
get ona street-car, but, the iron support being loose, he slipped and fell on his hip and
leg, and for this he was treated surgically. He was laid up with the injury to the leg
and hip for some weeks. Certain nervous symptoms also began to appear after a few
weeks, but they were not referred to any injury of the cord, and spinal sclerosis was,
very naturally, not suspected. Dr. Corey had made the diagnosis of degeneration of
the cord before bringing him to us, and this diagnosis corresponded with our own.
The patient had a stiff and uncertain. gait, and could not turn round quickly without
falling, nor stand still when his eyes were closed. A strange complication was occa-
sional attacks of utter inability to speak, accompanied with suffusion of the face and
shedding of tears. These came on under any special excitement, and lasted from one
to five minutes.

The anesthesia and azalgesia of the lower limbs were profound, and electro-sen-
sibility was but slight ; but there was no loss of electro-muscular contractility, and no
motor disturbance whatever. There was also a deficiency of the sense of pressure,
as indicated by the pzesmeter. At night there was great pain in the back, witha sen-
sation of numbness that often compelled him to rise and walk the room.

As the patient was entirely well at the time of the accident, and as the symptoms
of sclerosis followed or at least began to appear a few weeks after the accident, and
as there was no evidence of exposure of any kind, it was clearly a case of traumatic
ataxia,

The case was subsequently brought into court, in order to collect damages of the
railroad company, and was decided in favor of the patient. Being called upon to tes-
tify, we gave it as our opinion that the disease from which the old gentleman suffered
was of so grave a character that he would never recover, but would be a great sufferer
until he died.

We subsequently treated the above patient by mild galvanization of
the spine, and nitrate of silver, and in the course of a month he began
to improve, and, what is more remarkable, the improvement continued.
He did not fully recover, but came nearer to a permanent recovery than
CASES OF LOCOMOTOR ATAXIA. 531

any other case that we have yet seen. He was able to resume active
labors.

Posterior spinal sclerosis beginning in spinal congestion—Some improvement under
faradization with the metallic brush.

Casz C.—Mr. D., a gentleman 50 years of age, was referred to me March 17,
1873, by Dr. T. M. Markoe. The patient was of a strong build, and of a sanguine
lymphatic temperament ; during his whole life prior to this disease he had known
nothing’ but health. One year before, he had attended a sale of pews in a church,
and for three hours had sat quite still in a cold room. He went there in absolute
health ; he came out with a feeling of numbness in the legs, which extended to the
hands. He was never well again. :

On examining him, we found persistent and profound anzesthesia of the hands and
feet, and even of the arms and legs. Tingling and pricking and stinging sensations
were felt. Sexual power was diminished, but not destroyed. He could stand with
closed eyes, but could not turn quickly round. Tests with the dynamometer showed
good, strong muscular power. At times he had suffered from sharp, shooting, neu-
ralgic pains in the legs. The diminution in electro-sensibility was so great that
very powerful faradic currents applied with the sponge caused /i¢#le or no pain, al-
though the prick of a pin was guickly felt. The patient walked quite comfortably,
and attended to his business. The treatment used at first was galvanization of the
spine, combined with ergot and nitrate of silver internally; but all didno good. We
then tried general faradization, and: last of all faradization with the metallic brush.
The latter accomplished something, —reduced the anzesthesia and relieved a little the
abnormal subjective sensation.

Neuralgic pains that develop into well-marked locomotor ataxia—Deficiency in power
of localization—Some improvement under general faradization.

Casz CI.—The patient was a young man, aged 33, and had served during several
years of the late war as an officer in the Union Army. For several months he
had complained of the severe aching pains in his legs, and ascribed them to the ex-
posure and hardships of his recent army life. His knees were stiff and lame, rendering
him incapable of moving faster than a walk. In treating him by electrization, the ap-
plications were directed especially to the legs, the seat of the supposed rheumatism,
This treatment, continued for two weeks, almost completely relieved the symptoms
which had so persistently annoyed him, and thus in a measure seemed to confirm the
diagnosis. For a short time the patient was apparently well, but in a few weeks the
peculiar symptoms of ataxia manifested themselves, when he once more fell under our
care. His movements then presented the characteristics of an advanced condition of
locomotor ataxia, He found it difficult to rise from a chair, and even more difficult
to start when he had gained his feet. His legs and feet were cold and profoundly
anesthetic. He was deficient in the power of Joca/ization ; without the aid of sight
he was unable to tell where his limbs were. Half a dozen applications of general
electrization with the faradic current succeeded in giving very decided relief to the

anesthetic condition of the lower extremities, and improved considerably the steadi-
ness of his gait.
532 LOCOMOTOR ATAXIA.

Feeling of constriction .in thigh—Neuralgic pains—Anesthesia of feet and fin-
gers—Some improvement under galvanization of spine and general faradization,

CasE CII.—A young Englishman, complaining of symptoms which, at first,
masked the real disease from which he was suffering, was sent to us by Dr, John
Cooper, of Brooklyn. Asjunior partner in a large importing house, and having sole
charge of the books of the concern, he had labored too hard, and had been confined
too close to his desk. Up to the time of the onset of the symptoms, for the relief of
which he was directed to us, he attended as usual to business. Regarding, however,
his method of life as the cause of his difficulties, he immediately dissolved his business
connections, and soon after fell under our observation. When walking or standing
he leaned forward, and on attempting to throw his body into its natural erect position
he complained of a sense of constriction in either iliac region, as if the muscles con-
cerned in flexing the thigh were permanently contracted.

A general application, but directed especially to the lower portion of the abdomen
and the groin, relieved him wonderfully, and another séance overcame completely
this apparent muscular contraction, so that he was enabled to stand without inclining
forward, and to walk with far greater ease. Now that this unusual complication was
dissipated, the true character of his disease became evident. The more, important
symptoms of locomotor ataxia became unmistakably manifest :— /

1. There was inco-ordination of the motor power in the lower extremities, but no
true paralysis of motion there or elsewhere.

2, Characteristic neuralgic pains, of a sharp and shooting kind.

3. Considerable anzesthesia in the feet and fingers.

The patient was treated by galvanization of the spine, alternating
with general faradization, but without perceptible improvement.

Posterior spinal sclerosis— Temporary relief only follows galvanization of spine and
local faradization.

CasE CIII.—Miss W., a patient of Dr. Abram Dubois, complained of anzesthesia
of the right foot and occasionally of the left arm. Around the abdomen she de-
scribed a sensation as of a band tightly drawn. She had in a measure lost control over
the action of the sphincter ani and not unfrequently she was annoyed by slight involuntary
evacuations. The loss of co-ordinating power in the legs was very marked, and, so far
as this symptom was concerned, her condition was typical of spinal sclerosis. The first
symptoms of the disease were observed several years before, and, with the exception of
one or two seasons of temporary improvement had been slowly progressive.

In the treatment of this case by electrization, the most that we obtained was some
amelioration, but no very decided or permanent relief. Faradization of the lower por-
tion of the spine and the loins would, as a rule, increase temporarily the patient’s con-
trol of the sphincter, while galvanization of the cord and faradization of the legs en-
abled her for several hours to use her limbs with more steadiness, and to endure a
greater amount of fatigue.

Posterior spinal sclerosis of six years’ standing—Persistent treatment accomplishes but
little. :

CasE CIV.—Mr. E., a gentleman aged about 50, was sent to us by Dr. John T.
Metcalfe, to be treated for well-marked posterior spinal sclerosis of some six years’ dura-
CASES OF LOCOMOTOR ATAXIA. e335

tion. The patient had been a person of great physical vigor, and when in health had
been accustomed to walk great distances. His gait was very uncertain, anzesthesia of
the extremities quite profound ; bladder impaired in tone, but of the usual neuralgic pains
there were none. This case was treated with persistency by both general faradization
and central galvanization ; but aside from slight improvement in his general condition,
and some increase in the contractile power of the bladder, nothing was accomplished.

Lncipient spinal sclerosis associated with congestion—A pparently permanent arrest of
the rapidly increasing symptoms of loss of power, inco-ordination of movement, and
neuralgia by galvanization of the spine.

CaszE CV.—Mr. W. C., a gentleman aged 36 years, consulted us in July, 1870,
for a condition which we diagnosed as spinal congestion accompanied by a more severe
neuralgia of the legs than is usually associated with hypersemia of the cord. The limbs
were tender to the touch, and circumscribed patches, which were excessively sensitive,
would suddenly appear and disappear in the lower extremities. /

In addition, there was considerable decrease in the power of locomotion, attended
by slight symptoms of inco-ordination of movement. These last symptoms were of
such a character as led us to suspect incipient spinal sclerosis.

In a few months the patient had fallen away in flesh some twenty pounds. We
employed in this case almost exclusively galvanization of the spinal cord, beginning
with five, and as the treatment progressed, using as high as eighteen cells. The treat-
ment was followed by complete relief of his severe neuralgic pains, increase in flesh,
and decidedly more strength in and control over the legs. Before treatment the pa-
tient was rapidly growing worse. The result of the application was not to effect a
perfect cure, since we believe that to be well-nigh impossible, but the disease was at
once arrested, and at this date, after the lapse of two ytars, the patient retains all the
benefit derived from the twenty applications given.

In the above case the spinal cord was clearly passing from the stage
of congestion to the stage of sclerosis. Spinal congestion is usually a
curable disease (see chapter on that subject), and hence it is probable
that if ataxic patients were put under electrical treatment in the transi-
tion stage from congestion to sclerosic degeneration, the results would
be much more favorable.

The above is but one of anumber of cases that were similar both as
regards the recentness of the attack, the apparently progressive march
of the symptoms, and the effects of treatment that have fallen under
our observation. The lesson that they teach is sufficiently plain, and
there can be but little doubt, that if this teaching were heeded and
practically acted upon by the early and judicious use of the treatment
indicated, the advanced stage of spinal sclerosis would become a far
less frequent occurrence.

Locomotor ataxia of years standing—Very great improvement under galvanization
of the spine and general faradization.

Casz CVI.—Mr. S. C. P., a gentleman of 45, and directed to us by Prof. Austin
Flint, had for some four years suffered from symptoms unmistakably typical of a
534 LOCOMOTOR ATAXIA.

somewhat advanced stage of posterior spinal sclerosis. By the aid of a cane and
accompanied by an attendant the patient would venture almost daily into the street, but
the power over the co-ordination of tnovement was so markedly impaired that it was
with difficulty only that he could walk on a level. When he attempted to ascend or
descend the stairs he could execute the necessary movements with assistance only, or
slowly and painfully by grasping the banisters or railing. We submitted him to.
alternate applications of spinal galvanization and general faradization. This method was
continued « number of months, but the patient was irregular in his attendance, and
thus in a scientific point of view rendered the treatment entirely unsatisfactory. The
results, however, were important. He gained in strength and in power of co-ordination
to amarked degree. He ventured into the street alone and could readily walk without
acane. The service rendered was most decidedly manifested when he attempted to
go up or down stairs ; this he could do with ease and entirely alone, and what before
was impossible, viz., turning quickly around, he now accomplished without diffi-
culty.

Marked characteristics of gait—Dificulty of turning around— Tinnitus aurium—

; Neuralgia—Decided improvement under general faradization.

Case CVII.—G. M., aged 49, came under our care in September, 1868. He
stated that his lower limbs were partially paralyzed; but when, at our suggestion, he
threw out either leg violently, it was evident that there was no loss of power in those
members. To illustrate the unsteadiness of his gait, he attempted to walk across the
room. This he accomplished slowly and with effort, his feet coming to the floor
heavily at every step, and: his whole body swaying from side to side. When he essayed
to turn in his course, these symptoms were aggravated and others were presented.
His arms joined in the general commotion, but his feet seemed rooted to the floor, as if
unwilling to obey the order to turn. Finally, by a great effort, the feet were again
called into action, and the patient managed, by making a considerable circuit, to face
about and resume his walk. He complained of a persistent numbness and coldness
in his arms, legs, and feet, and, on testing the cutaneous sensibility of the outer por-
tion of the thigh with the asthesiometer, it was found that two impressions were
received, only when the points of the instrument were separated at least four and a
half inches. He suffered much from acute neuralgic pains in the lower limbs that
frequently impaired his rest, while at the best his sleep was fitful and unrefreshing.
Sight and hearing were somewhat affected, and he was annoyed by a constant “/itus
aurium. While his appetite and digestion continued fair, his power of endurance
had markedly decreased, so that a short walk of a couple of blocks was all that he felt
able to undertake. His method of life for many years had been such as necessarily
to operate injuriously against the healthful performance of the functions of both mind
and body. Asa circus-actor, his whole physical system had been racked and twisted
into every conceivable shape, and as an associate of the dissolute of both sexes in the
‘* profession,” he had indulged freely in almost every conceivable form of dissipation.
Some five years previously he contracted syphilis, and again two years after, when the
secondary form of this disease manifested itself. When he commenced his visits to us
he called attention to several syphilitic ulcers on the left ankle. He had always in-
dulged freely in alcoholic stimulants, and he had also used tobacco to the greatest
conceivable excess, often smoking the whole day, and frequently rising from his bed at
night to light his pipe or cigar.
CASES OF LOCOMOTOR ATAXIA. ga5

After the administration of a dozen applications of general faradization, we summed
up their results as follows :—

1 1. The tactile sensibility of the thigh was increased, so that the zsthesiometer
produced a sensation of two impressions when its points were separated but two anda
half instead of four and a half inches.

2. The neuralgic pains of the limbs were completely relieved.

3. The extremities were sensibly warmer.

4. Sleep was more sound and refreshing.

5. He was able to walk ten blocks with as much ease as he could walk two before,
and the power of co-ordinating his movements was decidedly increased.

He continued treatment until January, a period of about four months, improving
gradually until he was able to accept employment as clerk in the office of a coal-yard.
Nine months after treatment was discontinued, he retained all that he had gained,
and could readily walk a mile. His gait was somewhat unsteady, and he found it
necessary still to carry his cane. Doubtless electrization had accomplished about all
for him that it is capable of, yet it is possible that continued treatment might have
still further benefited him.
CHAPTER XXIII.
PROGRESSIVE MUSCULAR ATROPHY.

Llectro-Diagnosis.—In cases of progressive muscular atrophy the
electro-muscular contractility is either diminished or destroyed. __ Elec-
tro-muscular sensibility is usually diminished. Various changes in
muscular irritability may take place during the progress of the disease.

Reflex contractions occur in muscular atrophy. Diplegic contractions
also appear in this disease. These facts, taken in connection with the
history of the case, the, atrophy, the fibrillary contractions, swellings,
and anchylosis in the bones and joints, the anzsthesia and the neural,

“gia, make up the diagnosis. Diplegic contractions were first observed
in muscular atrophy by Remak; they have since been observed in hys-
teria and other irritable conditions.

The disease does not always exist alone ; it may be complicated with
locomotor ataxia, with paralysis of the cranial nerves and other disorders
of the brain.

Prognosis and Treatment.—Our better and increasing knowledge of
the possibilities of electro-therapeutics fortunately enables us to modify
to some extent the prognosis in this disease. That the prognosis is
grave cannot be denied, but by persistently following out the treatment
that of late years has proved so successful, we confidently assert that
not only may the disease be arrested far more frequently than in the
past, but that in not a few instances the nutrition may be so far im-
proved as to amount to approximate recovery.

In no other forms of disease does it seem to us so important that es-
pecial emphasis should be laid on the electrical treatment as in those
of the so-called progressive character. In many of the phases of pa-
ralysis, in the neuralgias and in most forms of local and constitutional
disturbance where the indications call for electricity, other remedies
as well have their uses, and in many instances are even of greater
service.

When we advance, however, to the consideration of those ominously
progressive disorders, ataxia and muscular atrophy, we recognize the
fact that, with the exception of those cases which depend on a syphilitic
A

PROGNOSIS AND TREATMENT. 537

taint, our ordinary remedies exercise but little control over their prog-
ress. We have therefore almost in despair turned to the therapeutics
of electricity in these diseases, and although it has failed by far to
accomplish all that could be desired, it has yet proved to be more
efficacious than is generally credited. In some cases it certainly arrests
the disease. ’

As a rule we alternately make use of central galvanization in its most
thorough form with, faradization and galvanization of the affected
muscles.

Persistent faradization of individual museles has been alone recom-
mended by Duchenne,* and among others who have reported recover-
ies by this simple and single method might be mentioned Dr. Alex. P.
Fiddian.

The case ¢ that he details was treated by that form of electricity
generated by the old-fashioned magneto-electric machine, and although
the authenticity of the statements cannot be doubted, yet a knowledge
of the combined experience of those who have accomplished most in
electro-therapeutics must confirm us in the assertion that in order to
achieve the best results, both currents must be used and the applica-
tions directed to the nerve centres as well as to the affected muscles.

Progressive muscular atrophy of muscles of the right hand, three years’ standing—
Pain in back—Numbness, and coldness, and neuralgia of the arm— Disease of
the skin—Arrest of the disease under galvanization of the spine and peripheral
Saradization.

CasE CVIII.—Mr. N., a gentleman of middle life, was brdught to us by S. J. Hol-
ley, November 14, 1870. The patient, who had a strong constitution, for three
years had been suffering from atrophy of the muscles of the ball of the thumb of the
right hand. The disease had been ‘gradual in its onset, and very gradual in its
advance, and by various treatment—medicines and faradization of the muscles—had
been more or less modified. The atrophy was preceded by pain in the back in the
region of the third dorsal vertebra. This spot we found to be tender on pressure,
and also tender under the electric current. A galvanic current applied to the tender
spot caused at once a sensation in the affected hand. There were in the hand per-
sistent coldness and great numbness, with anesthesia, and also impairment of the
sense of pressure as determined by examination with the piesmeter, and there was
enfeeblement of the sexual power. The coldness and numbness were first felt six
years before in the track of the ulnar nerve; the pain in the back appeared five
years before, and two years after that the muscles of the hand began to atrophy.
At one time there had been evidences of an acute, or rather subacute, congestion of
the cord, with the symptoms of numbness of half the body on the right side ; anzes-
thesia of the rectum, so that the faeces were passed unconsciously, and severe neu-

* De l’Electrisation Localisée, p. 702.
+ Med. Times and Gazette, July 20, 1872, p. 66.
*

538 PROGRESSIVE MUSCULAR ATROPHY.

ralgia of the arm—these symptoms lasted one month. The first (and not very
strong) application of the galvanic current caused insomnia that night; pain in ab-
domen, and mental depression, and anesthesia of the rectum; one day following
treatment he felt a sensation in his back, as though some one had suddenly and
severely struck him from behind; gradually he became accustomed to the applications,
which were made milder and shorter, and began to get better. There were less in-
somnia and better appetite, less pain and more warmth in the hand andarm. During
the treatment, which lasted several weeks—about twenty applications—a pruriginous
eruption appeared on the back and shoulders, with great itching, with which came
great relief of the pain in the spine. The itching of the prurigo was itself relieved
by the galvanic current. The disease was, to all seeming, arrested, although the
atrophied muscles did not return ‘to their normal condition. Eighteen months after
the close of the treatment we met the patient. He was in excellent health; although
the hand was still considerably shrunken, the sexual power had returned, and he had
but recently married, having previously lived a bachelor, and he was in most excellent
spirits.

The features of most interest in the above case are:

1. It seemed to show the central origin of progressive muscula1
atrophy. Long before the muscles of the hand began to atrophy there
was evidence of spinal congestion at or near that part of the cord
whence issue the nerves to supply the arm. For several years these
symptoms had been existing before the atrophy was observed.

2. The fact that, when taken early, progressive muscular atrophy,
grave as the disease is, may be arrested by galvanization of the nerve-
centres.

3. The apparent relation of the pruriginous eruption and the morbid
state of the cord. When the eruption appeared with severe itching,
the patient at once improved, and then the eruption was itself relieved
by the galvanic treatment (see chapter on Diseases of the Skin).

Progressive muscular atrophy of several years’ standing—Approximate recovery
under persistent treatment by general and local faradization and spinal gal-
vanization.

CasE CIX.—Mr. D., aged 44, came to us with symptoms typical of progressive
muscular atrophy. These symptoms had been developing for over two years. ‘The
thenar and hypothenar eminences of the right hand, together with the mass of inttr-
ossei muscles, were so wasted as to render the hand nearly useless. The outer muscles
of the left hand were also somewhat wasted, so that the little finger of that side was
fast becoming powerless. On localizing the faradic current in the affected muscles of
the right hand it was found that there was some degree of electro-muscular contrac-
tility in all of them.

Up to a few days before, the patient had been unaware of the nature of his com-
plaint, and on learning its true character, he expressed his readiness to undergo pro-
longed treatment. In addition to the symptoms above stated, he complained of
weakness and stiffness of the limbs, together with some want of co-ordinating power.
CASES OF PROGRESSIVE MUSCULAR ATROPHY. 539

Once a week the patient was submitted to general faradization, and three times a week
to galvanization of the spine, and faradization of the affected muscles. Spasmodic
contraction occasionally occurred in the flexor muscles of either arm and hand, and
these contractions were always aggravated if the faradic current was applied to these
muscles, while a mild continuous galvanic current afforded great relief. The above
treatment was continued uninterruptedly for four months, when it could readily be
seen that there was an appreciable increase in the size of the atrophied muscles, espe-
cially those between the thumb and index finger. He was again able to write with
considerable readiness, something which he had not attempted for several months,
His limbs had gained markedly in strength, and he seemed approximately well.

Progressive muscular atrophy with paralysis of the extensor muscles of the hand—
Decided relief under local faradization and galvanization of the sympathetic—
Diplegic contractions.

Case CX.—A gentleman, aged 40, was sent to us by Dr. J. J. Crane. There was
decided paralysis of the extensor muscles of the right hand, with such marked atrophy
of the muscles at the base of the thumb as to cause both the thenar and hypothenar
eminences to stand out in bold and angular relief. Spasmodic contractions of
the flexor muscles occasionally occurred, and he, was annoyed by sharp neuralgic pains
in the affected part. These symptoms were first noticed somewhat more than a year
previously, and the apparent cause was a violent jerk that he had received about that
time. The patient was treated by galvanization of the sympathetic, and faradization
of the affected muscles, and the result, after some twenty séances, was approximate
relief of all pain and tendency to spasmodic contractions ; the grasp became stronger,
and the patient was again enabled to write with some degree of readiness. The treat-
ment was not continued sufficiently long to enable us to test in this case the power of
faradization to increase the muscular tissue.

We were enabled to excite in this patient the so-called diplegic contractions of
Remak.

Muscular atrophy of three years’ standing—Increase in size of the atrophied muscles,
and approximate relief of associated symptoms—The patient still under treat-
ment,

Cask CXI.—In the case of a gentleman of 50, who at the date of writing is still
at our hands receiving treatment, that has already extended over several months, the
benefit ‘derived has been of the most decided character. The first symptoms of the
disease were observed three years prior. When we first saw him, there was very
marked atrophy of the muscles of the right hand and to a less extent of those of the
left ; this atrophy, moreover, was making appreciable progress from month to month.
There was paralysis of the index finger of one hand and the little finger of the other ;
sudden spasmodic contractions of both hands were frequent and annoying, and there
was“an utter inability to write. Up to this time the treatment by central galvaniza-
tion combined with faradization of the atrophied muscles, galvanization of the flexors,
with occasional séances of general faradization, have vastly improved the patient in
every symptom, ‘The nutrition has been so far improved as to show an appreciable
increase in the size of the affected muscles. There has been an approximate recovery
of the paralyzed fingers ; spasmodic contractions no longer annoy him, and he enjoys
considerable facility with the pen,
540 PROGRESSIVE MUSCULAR HYPERTROPHY.

Progressive Myo-Sclerotic Paralysis (Progressive Muscular Hyper-
trophy), Pseudo-Hypertrophic Paralysis.—This disease of childhood
was first described by Dr. Edward Meryon, in a paper read before the
Royal Medical and Chirurgical Society, December, 1851. A case was
subsequently reported by Dr. T. King Chambers, in the Medico Chirur-
gical Transactions, 1854. The disease has been observed in two, three,
and four children of one family. The disease has been systematically
studied by Duchenne, who was the first to set it before the profession
as a distinct disease. The symptoms of this affection in the first stage
are weakness in the lower limbs and flexion of the toes; in the second
stage, increase in size of the muscles of the legs—especially of the calves,
of the back, and of the gluteal muscles ; in the third stage, extension of
the disease, muscular atrophy, exhaustion, and death.

Llectro-Diagnosis.—Farado-muscular contractility usually diminished ;
galvano-muscular contractility may be either normal or exaggerated ;
electro-muscular sensibility is sometimes diminished, sometimes normal.

Prognosis.—The patient is pretty sure to die in the course of a few
years. In the second stage the symptoms may remain stationary for a
long time. Benedikt was able to improve a case of two years’ standing
by galvanization.

| Lreatment.—Faradization and galvanization of the affected mus-
cles, central galvanization, and galvanization of the sympathetic, should
all be tried in succession or alternation.
CHAPTER XXIV.
RHEUMATISM AND GOUT.

RuEUMATISM is a disease for which electricity, by various methods of
application, has been employed, with more or less success, from the early
periods of the history of electro-therapeutics. Next to paralysis, it is
perhaps the disease in which the original experiments of electro-thera-
peutists were most frequently conducted ; and for the reason that (like:
paralysis) it is so frequently obstinate to ordinary remedies.

Treatment.— Being a constitutional disease, it demands constitutional

treatment. The best results are obtained by general faradization, com-
bined with faradization or galvanization of the affected joints. To con-
fine the treatment to the affected joint is unphilosophical, and usuaily
more or less unsatisfactory, for the obvious reason that it attacks merely
a local symptom, which at any time may be transferred to other and
remote parts of the body. The true method is to lay the axe at the root
of the tree by making the applications general, so as to bring the whole
system under the influence of the current. This treatment sometimes
causes increase of the flow of urine, and almost always more or less ex-
hilaration, and relief of the pain. Special attention should be given to
the parts which are chiefly affected, and the swollen joints should be
treated by mild and steady faradization or galvanization. Where in the
acute or subacute forms the immediate effects are agreeable, it is prob-
able that continued treatment will be of service. For the local treat-
ment the galvanic and faradic current may be used alternately.
' The effect of the current on the inflamed joints is to relieve the pain,
reduce the inflammation, and, where effusion has taken place, to cause
absorption. Absorption may be caused by both currents, in some cases
more powerfully by the galvanic. If the currents are used too strong
or too long, the pain and inflammation may be increased. For appli-
cations to very sensitive and painful joints, the Josztive pole is prefer-
able (see p. 281). For rheumatic callosities and anchylosis, very pro-
longed \ocal applications of the galvanic current may be tried.

Prognosis.—In presenting the prognosis of rheumatism great stress

 
542 RHEUMATISM AND GOUT.

must be laid on the distinction between the chronic, subacute, and mus.
cular varieties.

During our earlier investigations in electro-therapeutics we treated
perhaps as many cases of rheumatism as of any one class of disease.
The apparent results of treatment by electrization in many cases of mus-
cular, and in a number of cases of the acute, subacute, and chronic vari-
eties of articular rheumatism, excited our enthusiasm, and led us to hope
that a remedy had been found that would prove very generally and pow-
erfully remedial in all forms of this disease. Further experience and
investigation compel us to declare that we are not to expect such rapid
and decided benefit from electrization in the worst cases of chronie¢ artt-
cular rheumatism as we at first supposed.

The most uniform results are obtained in the muscular form ; the next
best are the subacute and acute, and the least satisfactory of all in the
chronic stages.

A good opportunity to note the immediate effect of electrization is
afforded in those cases where the disease is of such severity as to render
any of the muscles of the body almost if not quite powerless.

Rheumatic paralysis—Decided relief under general faradization.

CasE CXII.—The sufferer was a little boy, who for several months had been afflicted
with both acute and chronic muscular rheumatism. The sterno-cleido-mastoideus,
and the platysma-myoides muscles were very rigid, and frequently contracted violently,
causing acute pain. The patient was unable to bring his jaws nearer to each other than
one-half an inch, while it was impossible for him to turn the head on either side, with-
out at the same time turning the whole body.

The entire head was exceedingly sensitive to slight pressure with the fingers. The
first application was made with an exceedingly mild and fine faradic current, and was
of ten minutes’ duration. With the hand and fingers as electrodes, we carefully ma-
nipulated the head, neck, and individual muscles, until the patient could close his mouth
and turn his head to either side with some freedom, and without suffering pain or incon-
venience.

In about a week the patient again presented himself. He could still close his jaws
firmly, but was unable to turn his head as readily as before. A second application
relieved him as completely as the first. To our regret we saw no more of this case
after the second visit, but learned subsequently, however, that he retained the improve-
ment, and, under internal medication, recovered.

Intercostal rheumatism of long standing —Improvement under general faradization.

Case CXIII.—A gentleman, sent to us by Prof. Austin Flint, was approximately
cured of chronic rheumatism that chiefly affected the intercostal muscles.

For nearly three years he had suffered, from time to time, attacks of more or less
severity, although at no time since the disease first manifested itself had he been
entirely free from it.

It was a singular feature of his disorder that it was aggravated by the warm weather
CASES OF SUBACUTE RHEUMATISM. 543

of spring and summer. He was treated by general electrization with the faradic cur-
rent every other day for six weeks. He gradually improved, and, when treatment
was discontinued, he remained comparatively free from any symptoms of his late dis-
order.

Subacute articular rheumatism—Muscular soreness and enlargement of joints re-
lieved by three general faradizations.

CaszE CXIV.—By the courtesy of Prof. Austin Flint we treated, in October, 1867,
acase of subacute articular rheumatism in one of the wards of Bellevue Hospital. For
three months the patient had suffered from muscular soreness of the back and shoulders,
and a considerable enlargement of the right wrist and ankle and the joints of the first
toes of the feet. Three general applications, with special reference to the diseased parts,
dissipated the muscular soreness, and so decidedly relieved the lameness and reduced
the enlargments of the joints that the patient was discharged from hospital in three
weeks,

Both acute and subacute rheumatism occasionally occur complicated
with neuralgia and nervous exhaustion, and are usually very persistent.

Subacute rheumatism—Right deltoid muscle and several joints and fingers and left
knee affected—Debility—Recovery under general faradization.

CasE CX V.—A gentleman, aged about 40, observed and treated by invitation of Dr.
Howard Pinkney, in October, 1867, was suffering acutely from rheumatic paralysis of
the right deltoid muscle, symptoms of inflammation of the sheath of the right ulnar nerve,
swelling of several of the joints of the fingers of the left hand, anda very painful enlarge-
ment of the left knee, and great debility. It is proper,to state that the patient, as well
as his physician, ascribed his great nervous prostration partly to recent and excessive dis-
sipation. The first application of the faradic current not only greatly reduced the
temperature of the affected limbs, but restored in some degree the lost power of mo-
tion to the right arm. Under the influence of the current, the leg increased in size and
remained in this condition for about a week, when the swelling rapidly subsided. The
heat in the inflamed joints did not again rise to the same temperature, and the paraly-
sis of the arm progressed gradually towards recovery from the first application.

Anesthesia of the deltoid was a marked symptom ; but, as is usually the case, it was
readily dissipated.

Treatment by electrization, together with potass. bromid., was continued from Oct.
21st to Nov. oth, when the patient was discharged as approximately cured.

Subacute articular rheumatism of nine months standing—Approximate recovery
under general faradization and galvanization of the spine, sympathetic, and
solar plexus.

Case CXVI.—Mr. S., aged 40, had for nine months suffered constantly from sub-
acute articular rheumatism. The paroxysms varied in severity, and the seat of pain
and swelling was constantly changing from the finger-joints to the wrist and elbows,
to the shoulders, hips, knees, and ankles. The most constant location of the disease
was in ‘the ankles and wrists, and in consequence incapacitated him from pursuing his
avocation of a book-keeper. He was treated first by general faradization March 17th,
1873, and in a couple of days the galvanic current from ten ordinary zinc carbon cells
544 RHEUMATISM AND GOUT.

was directed along the spine from the sixth cervical vertebra to the solar plexus. This
method of treatment, which was continued for two months, gradually lessened the
tendency to swelling and irritation of the joints, and enabled the patient to resume his
business.

When the treatment was discontinued, he had not entirely recovered, but during
the summer he improved still further and through the. following winter and spring
was so little annoyed by his old enemy as at no time to be compelled to intermit his
duties of writing, even for a day.

Myalgia (Muscular Rheumatism).—This name is commonly applied
to neuralgic or rheumatic pain of the muscles on movement, caused usu-
ally by exposure to cold or dampness. It may be distinguished from
ordinary neuralgia—jirs#, by the fact that the pain occurs chiefly on
movement and not on rest; and, secondly, by the fact that the sore-
ness is diffused through or over the muscles, and not seated or fixed
in certain nerve tracts. It receives different names according to its lo-
cality. In the back it is called Zamdago; in the thoracic muscles,
pleurodynia ; in the neck it simulates torticollis or wry-neck so closely
as oftentimes to be confounded with that affection (see Torticollis).

Treatment.—l.ocal faradization with a mild current, either stable or
labile, usually relieves such cases in a short time. Stable galvanization
also with a mild current may be at once effective. Severe applications
may increase the pain in this affection. The fact that the patient is
not at once relieved, or is worse after the first application, should not
discourage us, since the final result may be satisfactory. Of the large
number of cases that we have treated, nearly all have been relieved by
one, two, or more applications. <A single application, with a mild cur-
rent, prolonged for one or more hours, may sometimes entirely dissipate
an attack of myalgia.

It is in myalgia that the belts, chains, bands, disks, etc., worn on the
body, have obtained the best results. A convenient arrangement for
making prolonged or continuous local applications of very mild galvanic
currents is the electric disk of Dr. Garratt.

    

Fic. 1I4.
Circle Disk, Oblong Button Disk.

These are made of alloy--magnesium and zinc—for the negative, and
silver for the positive pole. The surface of the body forms a moist con-
.

CASES: OF MUSCULAR RHEUMATISM. 545

nection between the pairs, which are insulated by thin rubber. The
disk is made in two general varieties—the circular and the oblong,—
the latter being used for the limbs or back; the former, which is very
flexible, can be applied to almost any portion of the body.* The very
slight galvanic action of these disks, which is excited by the moisture of
the body, may be increased by wetting the skin. beneath them with salt
water. They should only be worn a part of the time, either in the day
or night. They may be used for weeks and months.

That these and other similar contrivances, when scientifically con-
structed, may relieve slight local and superficial pains, there is no ques-
tion. In the treatment of deep-lying affections of the brain, spinal cord,
and viscera, or severe neuralgia, very many important results have not
yet been reported for them. The results that appear under their use
may, perhaps, be sometimes explained in part by their effect on the
imagination of the patient, and by the counter-irritation which they un-
questionably excite when long worn. To differentiate these effects is
quite difficult.

Complete relief of muscular rheumatism of several years standing by a dozen appli-
cations of general faradization.

CasE CXVII.—Mr. F., aged 30, was directed to us by Dr. Thompson. The
patient was of a delicate constitution, and from childhood had been extremely sus-
ceptible to all external influences. A few years-previous to his visit to us, he began to
be severely affected by muscular rheumatic pains having their seat more especially in
both shoulders and the chest.

He became anzemic and suffered much from cardiac palpitations, He was at once
submitted to, and treated only by general faradization in its most thorough form.
The effects were immediate and decided. He suffered less from the first séance, and
in three weeks after the administration of a dozen applications, the relief the patient
experienced was complete.

Muscular rheumatism of the hips and limbs existing a month—Rapid recovery under
faradization of the affected parts.

CasE CXVIII.—Mr. S., an old gentleman of 65, was referred to us by Dr. J.
O’Farrington.

The patient was suffering acutely from pain and lameness across the lower portion
of the back and hips, while both thighs were so exquisitely sensitive as to render him
utterly unable to walk. These symptoms had resulted from exposure to cold a month
previously, and had resisted various methods of treatment. Faradization of the affected
parts one evening just before retiring did not immediately allay the pain and tender-
ness ; but the following morning found him able to take a few steps with comparative
comfort, and by evening he had very perceptibly improved. The same application,
repeated on successive evenings, enabled the patient in the course of a week to walk
with considerable ease, and in a fortnight all lameness had disappeared.

* For sensitive patients, and especially for ladies, the oblong ‘‘ button-disk” is usu-
ally to be preferred, on account of its greater lightness and flexibility.

35 i
546 RHEUMATISM AND GOUT.

Gout.—In the chronic form of gout faradization is sometimes of essen-
tial service. General faradization and central galvanization may be tried
with the hope of raising the tone of the system, and so as to enable it to
better cope with the disease. Temporary relief of the pain may be derived
from either local galvanization or faradization ; but anything like a per-
manent removal of the disease is not to be expected from any form of
electrical treatment.

With some gouty patients the electrical treatment acts so decidedly
that we are disposed to resort to it during the subsidence of each attack,
to relieve the pains and hasten recovery. Galvanization of the affected
joints does not seem to produce the absorbing or catalytic effect that
could be desired, although when judiciously used it accomplishes some-
thing. Whether any benefit can be derived from any form of electriza-
tion during the acute stages, we are unable to say.

Gout of thirty years’ standing in a gentleman sixty years of age—Positive relief
Srom general faradization in the subsiding stage of an attack,

Casz CXIX.—Mr. W » a retired gentleman of 60 years, who had lived in con-
siderable ease for a number of years, consulted us March 20, 1868. For thirty years
he had suffered from attacks of gout, especially during the fall and winter seasons.
When he first consulted us, he was in the subsiding stage of a severe attack. We
gave him four applications of general faradization that relieved his pains and seemed
to hasten his return to his usual condition of health during the intervals. Subsequently
the patient resorted to electrical treatment, with decided benefit. Whether the treat-
ment had the effect to diminish the violence or frequency of the attacks, we have not
been informed.

 

Rheumatic Gout (Arthritis nodosa).—This affection is neither gout
nor rheumatism, but appears to be a distinct constitutional affection.
It occurs most frequently in the delicate and the nervous, and may be
regarded as essentially a condition of debility. It is very apt to affect
the hands, fingers, and toes, and sometimes thoroughly cripples the
patient.

Treatment.—This condition is most successfully combated by tonics,
and electrization, more for its tonic effects on the system than for any
special catalytic power over the enlarged joints. General faradization,
central galvanization, and galvanization of the sympathetic are the
methods that experience has shown to be most useful in this very intrac-
table malady. ;

Prognosis.—The prognosis in rheumatic gout is not brilliant. The
pains can be relieved, the sleep can be improved, and the system can
be in every way strengthened by the electric treatment, and even the
enlarged joints can be made to diminish in size, or atleast to be’ less
RHEUMATIC GOUT. 547

troublesome. As nearly all patients afflicted with rheumatic gout are
in a condition of debility, the improvement experienced at first under
general faradization is such as to lead them to hope for a permanent
eradication of the disease. In this respect they are always disappointed.
The disease may be held at bay, but is never banished. It is doubtful,
indeed, whether the benefit is not entirely due to the tonic effects of the
treatment on the system, and not at all to any special influence over
the rheumatic gout.

Other remedies are so powerless in this affection that electrization
is worthy of a trial for the sake of its general effects. We have treated °
a number of cases by general faradization, central galvanization, and
local galvanization of the affected joints, with palliative and tonic effects
of a most decided character. Dr. Althaus has had similar experience.
CHAPTER XXvV.

SPASMODIC DISEASES.

OF spasmodic diseases this general law holds, that when recent, even
though violent, they yield readily to electrical treatment ; but when
long standing, they are easily palliated, cured with difficulty, and are
prone to relapse.

Writer's Cramp.—This affection is not peculiar to writers. An anal-
ogous condition may attack seamstresses, milk-maids, and others whose
callings compel them to use for a long time a certain set of the muscles
of the hand. It is believed that the affection is not purely peripheral,
but that it frequently, if not always, is connected with disease of the
upper portion of the spinal cord.

Whether found in the artist, rendering him unable to manipulate his
brush—the pianist, preventing him from fingering his instrument—or
the penman, causing his writing to be almost if not quite illegible—the
same general characteristic is observed, viz., the recurrence of spasm
or pain whenever an attempt is made to execute a special movement.

Pains resembling neuralgia or rheumatism so closely as to be con-
founded with those diseases, frequently accompany writer's cramp.

The grognosis in the early stages is sometimes favorable for a perfect
cure ; advanced stages of long-standing cases are usually rebellious ;
but even these may be much relieved. est from the occupation is
almost imperative.

The ¢reatment should be both central and peripheral. ,Galvanization
of the upper portion of the cord and of the median and radial nerves,
spinal cord, plexus, and nerve-currents, and faradization of the affected
muscles and of their antagonists, may be tried, and when anesthesia
exists the wire brush.

Unfortunately, however, those who are most frequently subject to
writer’s cramp are the very ones who are unable to take the necessary
rest.

Although the results of treatment by electrization in this variety of
palsy is by no means uniform, yet it has undoubtedly been followed in
many instances by approximate and even perfect recovery.
CASES OF WRITER’S CRAMP. 549

Writer’s cramp, existing for four years—Improvement under faradization and
. galvanization.

Cast CXX.—For four years the patient, a gentleman aged 35, had observed a cer-
tain loss of power in the thumb and index finger of the right hand, that became more
decided and annoyed him more and more seriously, so that about a year previous to
his visit to us he was enabled only with difficulty to write the few pages daily that
his business required.

The patient was unable to fully extend the thumb and index-finger, and on localiz-
ing the faradic current through the flexor longus pollicis and the adductor pollicis,
there was a marked decrease in the electro-muscular contractility. The flexors and
extensors of the other fingers responded normally to the influence of the current. The
inner surface of the hand was decidedly anzesthetic, while he complained of a constant
soreness of the wrist that at times became quite painful.

We begen with the faradic current, localizing it through the two muscles of the
thumb specially affected, and also making the application more general through arm,
wrist, and hand.

This method completely dissipated the annoying anzsthesia and soreness of the
wrist, but resulted in no other benefit.

A mild galvanic current from six Bunsen’s cells was more effectual. Twelve appli-
cations resulted in a considerable increase of strength in the affected hand, and the
flexor muscles of the thumb and index-finger very decidedly relaxed, so that he was
readily enabled to accomplish two or three times more in the way of writing than
before.

In some cases of writer’s cramp, and especially in the early stages,
anesthesia or numbness is the leading, if not the only, symptom. This
may appear long before the cramp.

Incipient writer's cramp in an editor—Profound local anesthesia—Rapid relief under
localized faradization and galvanization.

CasE CXXI.—Mr. H. C. B., a gentleman over 60 years of age, a prominent edi-
tor, was referred to us, November 20, 1872, by Dr. C. L. Mitchell. ;

The only symptom of which the patient complained was a numbness of the last two
phalanges of the right index-finger. The electro-sensibility was so much diminished
that a strong faradic current, which on the third phalanx and all the other fingers of
the hand was intolerable, was but little felt on the last phalanx, and caused, indeed,
rather an agreeable sensation. The zsthesiometer also indicated great anzesthesia.
The muscles all responded well to the will and to electricity. The symptoms had
existed about two weeks, and. had come on gradually. There was no evidence of
cerebral difficulty or of spinal sclerosis; in all other features, except the numbness,
and a slight feeling of weakness, or rather of nervousness in the arm, the patient is
well, z

At that stage there was no tingling or pricking sensation, no neuralgia, and no
spasms.

_ We made the diagnosis of incipient writer’s cramp, partially by exclusion, and
.Partially by the positive symptoms of numbness and weakness in the parts concerned
in writing. °
550 SPASMODIC DISEASES.

Faradization with sponges and the metallic brush gave immediate relief; the first
sitting did much toward restoring the sensation. In nine days five applications;
only the last phalanx of the index-finger remained anesthetic. This part was obsti-
nate throughout, especially on the very tip of the finger,

The patient now felt that he was well, and closed his visits, still working as usual
with his pen as hard as ever almost all day long.

December 7th he returned, with a return of the symptoms of numbness, compli-
cated with pricking and tingling sensations, neuralgia of the arm, and great debility.
Long writing caused great uneasiness,

Absolute rest from writing was now demanded, and the patient obeyed, still using
his brain, but employing a secretary. Again he began to improve under peripheral
faradization and galvanization, and galvanization of the upper part of the spine and
cervical sympathetic. , :

January 1, 1873, he was very much better—indeed, nearly well. That day he
slipped, and fell down the steps of his house, and struck on the hand and shoulder of
the affected arm. The shock lamed him greatly, and caused for a long time stiffness
and much pain of the shoulder.

The electrical treatment was renewed, January 14th, and continued every other
day during the month, with satisfactory results. The enforced rest—for the patient
was confined to the house—co-operated with the electrical treatment.

Lorticollis (Wry-neck).—This familiar disease consists in a spasm of
the muscles of the neck, by which the head is drawn to one side. The
spasms may be tonic or clonic. ,

Although the pathology of the disease is obscure, it is yet quite clear
that it is of a nervous character. More than by any other cause, it is
brought on by excessive mental labor or anxiety. The symptoms
usually come on gradually ; the muscles of the neck on the side toward
which the neck is turned are sometimes flabby and atrophied, and the
muscles on the other side are hard, lumpy, and enlarged. Frequently
the deeper muscles of the neck are involved, as well as the sterno-
cleido-mastoid and trapezius. The spinal accessory nerve would ap-
pear to be at fault. The condition is really a hind of “ partial chorea,’
analogous to writer's cramp, facial spasms, spasm of the eyelid, and,
like all these, is usually very obstinate, except in the mild form and
early stages. Zhe disease is frequently brought on by excitement or
WOrry.

Diagnosis.—The disease should not be confounded with common
stiff-neck that is caused by rheumatism of the muscles of the neck and
is analogous to lumbago. In stiff-tieck, which usually yields to faradi-
zation like other forms of myalgia, the head is kept from moving by
the pain which movement causes. Diseases of spine and diseases of

ie brain sometimes produce tonic spasms of the muscles of the neck
that resemble torticollis. .
TORTICOLLIS CASES. BSI

Electric Examination. —On the affected side * the muscles sometimes
exhibit increased electro-muscular contractility and sensibility. On
the other side the electro-muscular contractility is sometimes dimin-
ished. ‘

Treatment.—Galvanization of the muscles of the affected side with
mild currents, and faradization of the muscles of the other side, galvani-
zation of the sympathetic and cervical spine, are the methods that
should be tried in this disease. They may be tried simultaneously or
in succession.

Protracted applications are not ordinarily indicated in this affection.
General treatment is only required when the patient is debilitated.

In connection with the use of electricity, the hypodermic injection
of morphine and counter-irritation of the cervical spine by blisters, and
mechanical contrivances for keeping the head in position, may be
tried.

Prognosis.—In the early stages torticollis may be relieved or cured
by electrical treatment alone. After it has been established for a num-
ber of months, it becomes one of the most intractable of diseases.
Even when relieved by treatment, it is much disposed to relapse. No
case should be abandoned until both galvanic and faradic treatment
has been thoroughly tried, since it is the only method of treatment that
offers even any hope; and the physician should not be discouraged if
the symptoms appear to be aggravated by the first few applications, but
should reduce the strength of the current and the length of the séances.
The same remark will apply to analogous diseases, such as writer’s
cramp and facial spasm.

Torticollis of long standing, brought on by over-confinement and anxiety—Some re-
_ lief from faradization and galvanization.

Cask CXXII.—Mr. K-——., aged 40, was sent to us June, 1870, by Dr. Willard
Parker. For several years before the attack appeared he had been in his usual
health, but had been severely confined and much distressed by the cares of business.
The symptoms appeared gradually; they were at first slight, and only developed
their full force after several weeks. When we first saw him he had been suffering
for several months. His face was almost constantly turned toward the left side.
On the opposite side the sterno-cleido muscle was considerably hypertrophied, and
on the other flabby. The position of his face and the violence of the cramp were
much dependent on mental influences, being aggravated by exhaustion or worry.

Electric examination showed increase of electro-muscular contractility in the af-

* It should be considered that the sterno-cleido-mastoid, as it pulls the back of the
head toward the shoulder, turns the face in an opposite direction. The face there-
Sore is turned away from the affected muscle.
552 SPASMODIC DISEASES.

fected side, and diminution on the opposite side (towards which the face was turned)
Careful examination revealed no evidence of disease of the vertebrze.
The patient was ¢reated by stable galvanization of the hypertrophied and hardened
muscle, by spinal-cord brachial pfexus current, by galvanization of the sympathetic
_and spine, by faradization of the flabby muscles of the opposite side, and by
general faradization. In three weeks there was positive but not marked improve-
ment; there was decrease of the hypertrophy of the muscle and some diminution of
the spasm.

As is so often the case, the patient appreciated the benefit of the
treatment after resting for two or three weeks, even more than while
receiving the application. Unfortunately the very sudden death of a
near relative severely shocked his nervous system, and caused a relapse
of the torticollis,

Torticollis of three years’ duration—Great relief afforded by local faradization,

CasE CXXIII.—-Mr. John B., aged 60, a teacher by profession, consulted us in
June, 1871.

Some five years before he had a slight effusion, followed by hemiplegia of the left
side. He gradually improved, and in a year’s time, was able to move about with
ease, and to attend to the ordinary duties of his profession.

About this time he noticed an increasing tendency for the head to turn to the right
side, until in the course of six months, the chin rested permanently on the right breast,
and it was only by a considerable effort that he was able to return the head to its
normal position, and then only fora moment. For three years he remained in this
condition, neither improving nor growing decidedly worse.

The patient was withal much annoyed by involuntary jerkings of the left sterno-
cleido mastoid muscle, occurring even when he was asleep. We applied the faradic
current to both sterno-cleido muscles, treating the left side gently because of its ex-
treme irritability, while currents of greater strength were applied to the contracted
muscle of the other side. After each séance, the patient was enabled to move the
head more readily, and hold it in position with less effort, and was soon able to sleep
comfortably on the right side for the first time in several years. But six applications
were given.

Paralysis Agitans (Shaking Palsy )—There are two kinds of shak-
ing palsy :—

ist. Those with organic lesions.

Sclerosis of some form is the pathological state that usually gives rise
to the symptoms of shaking palsy.

2d. Those where no lesion can be discovered.

These are usually styled functional, although, like hysteria, they may
be supposed to depend on some molecular derangements which are
not revealed tm the microscope.

The disease may be local or general ; it may attack one limb, or the
PARALYSIS AGITANS. 553

lower jaw, or all four extremities. It is most frequent in the aged, but
is sometimes observed in middle life, or in’ the young.

Treatment.—Central galvanization and general faradization, for
general effects, may be used in shaking palsy with benefit. The best
results have been obtained by galvanization of the spine and sympa-
thetic and brain.

Prognosis.—Cases where all the limbs are affected are never cured
by any method of treatment, especially in the aged. Cases in which
only one limb, or one upper and one lower limb, are affected are some-
times benefited, and in rare instances cured. Temporary relief can
sometimes be obtained where no permanent benefit results. The
tremor of the limb is sometimes abated or completely arrested for one
or more hours after the application either of general faradization or
galvanization of the spine, and in rare cases entire recovery occurs.
Dr. Russell Reynolds has reported a cure by the galvanic current. Re-
cently Jules Chéron, of Paris, has published the results of galvanization
in 7 cases. Of these 2 were cured; 2 were much improved; and 3
were much. improved in their general condition, but not in the tremor.

A case of palsy agitans associated with spasmodic muscular contraction and neural-
gic pains—Approximate relief from central galvanization and general faradiza-
tion.

Cas— CXXIV.—Mrs. M., aged 50, applied to us for the relief of a disorder of
which the following were the main symptoms. These symptoms had been almost
constant for more than fifteen months :—

The patient was so exceedingly feeble, that a walk of a few blocks caused complete
exhaustion.

Neuralgic pains in the face, right arm, and side, were constant although varying
in intensity. Sometimes the distress was for hours most excruciating, and then an
interval of rest would occur in which the pain was barely appreciable. Pain along
the spine, but no tenderness to pressure. The most annoying symptoms were frequent
spasmodic contractions of the muscles of the neck, while a constant and incessant
trembling of the hands during the waking hours made with the rest a complication of
symptoms that pointed to structural change of the upper portion of the cord. Cen-
tral galvanization was in this case alternated with general faradization. So far as
the spasmodic contractions of the muscles were concerned, the effect was immediate,
being followed by complete and permanent relief.

The neuralgia was gradually dispelled, and the trembling or shaking in the course
of two months’ treatment so benefited as to be hardly noticeable. During the sum-

mer that followed, the patient was almost entirely free from every unpleasant symp-
tom,

Unilateral paralysis agitans ina man aged sixty years—Very decided alleviation
of symptoms under central galvanization.
Casz CKXV.—Mr. James A,, aged sixty years, Suffering from unilateral palsy
554 SPASMODIC DISEASES.

agitans of the left side. Was placed under our care by Dr. Andrews, of Utica,
August rst, 1870.

The first symptoms of this disease became manifest in October, 1869, and gradu
ally increased in severity until January, 1870, since which time there had been na
appreciable aggravation of his condition. The patient was a mechanic, occupied al-
most constantly in filing saws, and it was his firm impression that the peculiar influ-
ence transmitted to the cord by the steady scrape of the file was an important factor
in the production of the disease. However this may be, it was certain that he was
now unable to use his file a moment without causing most disagreeable feelings.

We essayed a few applications of general faradization, but as it did not seem to al-
lay any of the disagreeable features of the disease, we resorted to central galvaniza-
tion. After a few applications to the brain, sympathetic, and spinal cord, the speech,
which was decidedly affected, so that he stuttered and hesitated, in every effort to
talk, became perfectly normal, and he was no longer annoyed by it. For many
months he had been unable to sleep, unless lying on the back with the arms pressed
to the side. In four weeks he was able to sleep with perfect comfort in any posi-
tion.

The patient remained under observation some three months, and received in all
about twenty-five applications. He improved im his general condition very decidedly ;
the arm and leg became much stronger, and the shaking movements decreased in
severity at least fifty per cent. Further than this we were powerless to assist him,

Asthma.—Asthma is one of the conditions for which it would be sup-
posed, @ prior?, that electrization might be of service ; and yet the published
records of successful treatment are not very extensive. One of the
earliest, if not the very earliest, experimenters in this department was
Dr. Wilson Philip, who began his researches in electricity in the early
part of this century. ‘‘ By transmitting its influence (galvanism) from
the nape of the neck to the pit of the stomach, he gave decided relief
in every one of twenty-two cases, of which four were in private practice,
and eighteen in the Worcester Infirmary. ‘The power employed varied
from ten to twenty-five pairs.” The treatment which is theoretically
indicated is galvanization of the pneumogastric and sympathetic.
Benedikt mentions a case successfully treated by this method.

The methods we employ in asthma are galvanization of the pneu-
mogastric and cerebral galvanization, and usually with temporary,
though not, as a rule, with permanent benefit.

The faradic current is sometimes effective in affording temporary
relief after failure of the constant current. In several cases that have
fallen under our observation persistent faradization of the chest and
neck has been followed by marked relief.

Asthma of three months’ standing—Apparent recovery under localized galvanization,

CasE CXXVI.—Ann M. C., treated at Demilt Dispensary, had her first attack of
asthma three months before seeking electrical treatment. Every few days thereafter
ASTHMA—FACIAL SPASM. gos

a paroxysm of considerable severity would prostrate her. Before the onset of the
attack she invariably experienced a cold sensation between the shoulders. The ex.
pectoration, which so soon as she can throw off affords relief, had the appearance of
boiled starch. The smell of cooking always hastened an attack. The patient was
treated from May 18, 1871, until June 17th, by the method of localized galvanization,
when she was discharged apparently cured.

Asthma of many years’ standing—Decided temporary relief from local faradiza-
tion—WNo permanent benefit.

CasE CXXVII.—June 20, 1871, we treated an old gentleman, a patient of Dr. John
T. Metcalfe, for a chronic asthmatic difficulty of many years’ standing. He was sub-
mitted mostly to galvanization of the great sympathetic, pneumogastric, an1 phrenic
nerves, but the only decided relief obtained was from simple faradization, the positive
pole being placed at the back of ‘the neck, and the negative just above the sternum.
This method caused a most pleasant relief from discomfort on awakening at night.
No permanent benefit, however, was afforded by the treatment.

Muscular Contractions. —These may: arise in hysteria, in myelitis,
meningitis, and spondylitis, diseases of the cerebrum and cerebellum,
or they may be of a reflex character. They exist sometimes in neuritis
or rheumatism. :

The zreatment consists in peripheral galvanization or faradization of
the affected muscles or of their antagonists, with stable currents and
galvanization of the head, spine, and sympathetic, according to the
special indications.

The prognosis is usually unfavorable for all except the rheumatic
cases.

Facial Spasm.—This affection, which is not unfrequent, is usually very
obstinate against all treatment. The treatment is galvanization with
the spinal-cord-muscle or nerve-muscle current. Recent cases may be
cured by the application of the galvanic current to the branches of the
fifth pair. Long-standing cases may be temporarily relieved, but are
rarely permanently cured. Remak reported success even after the con-
dition was very chronic.

Dysphagia from Spasms of the Pharynx.—This symptom, though
sometimes the result of organic central disease, is not unfrequently of
a purely spasmodic character, and as such is amenable to electric treat-
ment, either by external or internal applications. The method we
adopt for such cases is to place one pole on the back of the neck and
- the other just above the sternum, or by the inner border of the sterno-
cleido-mastoid muscle. If this method fails, internal applications may
be made, by means of a catheter-shaped electrode, against the constric-
tors of the pharynx. Some cases yield with surprising readiness to ex-
556 SPASMODIC DISEASES.

ternal treatment. Cases dependent on central disease are usually quite
rebellious.
A case of this kind, in which the food was returned through the
mouth or nose, was cured by Hiffelsheim by galvanization.
Heffelsheim has recorded a case of. excessive and obstinate vomiting
that was cured by five applications of the galvanic current to the
pneumogastric.

Dysphagia from spasmodic action—Recovery from localized faradization, twice re-
peated,

CasE CXXVIII.—An old lady, aged nearly 70, was sent to us by Dr. Fordyce
Barker. She had for some months been annoyed by much difficulty in the act of
swallowing, and was apprehensive of suffocation on account of the tendency of food to
lodge in the cesophagus. Localized faradization, repeated twice, completely relieved
the spasmodic tendency, and enabled the patient to eat without fear of consequences.
So far as we are aware the relief was permanent. ;

Singultus (Hiccough).—This symptom, when it becomes permanently
annoying, may be treated by galvanization of the sympathetic and pneu-
mogastric. We have treated in this way two very obstinate cases with-
out benefit.

Tetanus.—Dr. Mendel has reported two cases of tetanus successfully
treated by the galvanic current. He used various methods of applica-
tion, central and peripheral. Immediate relief followed each applica-
tion.

The conclusions at which he arrives from his cases are that a mild
current should be applied to the affected muscles, without regard to the
direction of the current, although the positive pole should be applied
to the antagonists.

Hydrophobia.—The disease is so rare in its occurrence, and so rapid in
its course, that electrical treatment even by its most imperfect methods,
has had almost no chance to be tested. The suggestions that we have
to offer are therefore of necessity based on theory and analogy, and
experience in the treatment of other and more or less allied diseases.

The best method of using ‘electricity in a case of real or simulated
hydrophobia would be to place the negative pole of the galvanic current
at the pit of the stomach, and apply the positive successively at the
top of the head, the nape of the neck (central galvanization), over the
region of the pneumogastric, and down the spine. If the galvanic cur-
rent cannot be obtained, the faradic (electro-magnetic) might be tried,
although it would probably be less efficacious. Mild or moderate cur-
rents would be likely to do more good than very powerful currents, and
HYDROPHOBIA. 534

there should be intermissions in the treatment. During these inter.
missions ice-bags might be applied to the spine. We should not expect
that this treatment would cure real hydrophobia, but, if faithfully used,
it would greatly relieve the horrible agonies of the disease, and, either
alone or in connection with other treatment, would be likely to prolong
life. Electricity has never yet had a fair trial in hydrophobia. Schi-
vardi, who kept one of his patients alive several days, used only a par-
tial and imperfect method, and no other treatment, so far as is known,
has been so successful.

Hydrophobia is one of the very few diseases in which it is better to
use electricity blindly and imperfectly than not to use it at all. There
are two considerations, however, that are somewhat discouraging :

1. The spasmodic affections that most closely resemble hydrophobia.
and with which it is sometimes confounded—epilepsy, tetanus, etc.—
do not yield readily and permanently to electrical treatment. Great
benefit can be derived from a proper use of electricity in epilepsy, but
very rarely a permanent cure.

2. To get the best results of electrical treatment time is necessary.
Save in the resuscitation of the drowned or asphyxiated, and the tem-
porary relief of pain, electricity accomplishes its great cures slowly.
Hydrophobia runs its course rapidly, and, in its incipience, is not
usually recognized. The only hope that real hydrophobia could be
cured by electricity rests in the possibility that it could relieve the
symptoms and delay death through its powerful sedative influence, so
that there would be more time to act upon the nutrition of the nerve-
centres either by a continuance of the electrical treatment or by other
methods. There is reason for the belief that some at least of the cases
of so-called hydrophobia are of an hysterical character—are brought on
by fright and dread. The only safe course is to treat such cases as
though they were genuine cases of hydrophobia. The most brilliant
results of electrical treatment are obtained in hysteria and allied di-
seases, and notably in hysterical convulsions, and it is quite probable
that the hysterical symptoms of hydrophobia would yield to the same
remedy. The result of the treatment would help somewhat the diagno-
sis. If the patient entirely recovered, the probability that the case was
of an hysterial nature would be strengthened almost into certainty.
Inasmuch as one or two of the recent cases were probably in part hys-
terical, and as the discussion of the subject has caused our sensitive and
highly nervous people to dwell on this dreadful topic day and night, it
is not impossible that other cases of a like nature may occur.

Stammering.—Dr. Althaus succeeded in curing a case of stammering
558 SPASMODIC DISEASES.

of five years’ standing, in a lad nine years of age, by the application of
the galvanic current to the laryngeal nerves. The applications were
made twice a week for two months,

Epilepsy.—Epilepsy is one of the diseases for which electricity in
some form or other has been used for many years, though with rather
uncertain and capricious results. The method of treatment that
promises most in this disease is central galvanization. Another
method is to place one of the poles over the point whence the aura
proceeds, and the other over the nerve-centre.

Temporary relief can be obtained in very many cases of epilepsy by
electrical treatment. The intervals between the attacks can be greatly
lengthened, and in a certain proportion of the cases the results are be-
lieved to be permanent.

Petit mal,_Marked temporary relief from general faradization and galvanization
of sympathetic— Relapse,

Case CXXIX,—In one case of ‘‘ petit mal.,” occurring in a boy some 13 years of
age, the bromide, given in doses of rogrs. three times a day, acted charmingly. The
paroxysms, which for nearly two years had occurred from six to ten times a day, were
immediately reduced to one, two, and three in the twenty-four hours.

This improvement was manifest for nearly a month, when, notwithstanding the
increased doses of bromide, the paroxysms gradually increased in frequency, until the
patient was rendered unconscious by them as often as before. We now resorted to
general electrization with the faradic current, and occasionally to galvanization of
the sympathetic, Singularly enough, the results that followed were substantially the
same as those obtained from the administration of the bromide of potassium. For a
few weeks the frequency of the epileptic seizures was reduced to one and two a day,
when, notwithstanding every effort, there was a second relapse to his old condition,

The boy evidently inherited a very decided nervous diathesis, but the exciting
cause of the attacks was ascribed to a severe fall some weeks before the manifestation
of the first paroxysm.

Epilepsy of eleven years standing—FPeriodical attacks—Improvement in sleep and
mental condition, and diminution of attacks under general faradization—Nothing
Surther gained by galvanization.

Cas—E CXXX.—W. H. V., a lad aged 16, began first to suffer from epileptic
seizures when but five years old,

For the first five years the attacks, consisting of a number of fits in rapid succes-
sion, occurred every five or six weeks. From his eighth to his fifteenth year the
paroxysms increased in frequency and severity, until, at the date of his visit to us,
the attacks recurred every week, :

It was a noticeable fact that for the last year the patient had almost invariably
suffered from these epileptic seizures on Saturday.

The boy had grown sensibly weaker both in mind and body, and was excessively
irritable and capricious.
EPILEPSY—CASES. 559

Treatment was commenced by general faradization, with special reference to the
head and spine.

Under this treatment sleep became more sound and refreshing, and the mind
calmer, while the usual paroxysm was delayed until the Thursday following the regu-
lar time for its recurrence. The general condition of the patient continued to im-
prove, and a second attack was delayed four weeks, He remained under observation
some months longer, having a paroxysm (far less severe, however, than formerly)
about every four weeks. The galvanic current, variously used, seemed to accom-
plish nothing that had not already been obtained by the faradic. The case soon after
passed from our care, and whether relapses have occurred we have not been able to

ascertain,
CHAPTER XXVI.
DISEASES OF THE SKIN.

THERE are several theoretical considerations’ that would lead us to
suppose that electricity might be of service in the treatment of diseases -
of the skin :— j

1. Pain and itching, oftentimes of a very distressing character, accom-
pany many of the diseases of the skin, and of all the known methods of
relieving and curing pain, electricity is one of the most satisfactory. If
the application of the galvanic or faradic current may bring relief in head-
ache, in spinal irritation, in the various forms of neuralgia, in rheu-
matism and in sprains, why should it not afford similar relief in the tor-
menting agonies of psoriasis, eczema, and prurigo ?

2. Ulcers, sinuses, and bed-sores have long been treated by the gal-
vanic and faradic currents, with gratifying success ; and it would be nat-
ural to suppose that the ulcerous conditions of some of the diseases of
the skin might similarly be benefited.

-3. Tumors and morbid growths of various kinds are discussed by the
electric currents, and especially by the galvanic current, andit would be
reasonable to infer that cutaneous indurations and hypertrophies might
be discussed or diminished in a similar manner.

4. Those who hold the theory that some of the diseases of the skin
are of a nervous origin, or are in some way intimately dependent on the
brain, spinal cord, or sympathetic, would find still another theoretical
argument in favor of introducing electricity into dermatology, since
nervous diseases have long been regarded as par excellence the diseases
most amenable to electrical treatment.

The electro-therapeutics of diseases of the skin belongs both to medi-
cal and surgical electricity. The tendency in recent times has been
to transfer dermatology from surgery to medicine, and at present many
of our most eminent dermatologists are physicians more than surgeons.
This tendency is further strengthened by the modern views of the pathol-
ogy of cutaneous disorders, particularly in regard to their relation to the
nervous system. The purely local treatment of diseases of the skin by
METHODS OF APPLICATION. 561

electricity might be regarded as belonging to electro-surgery, while their
general and central treatment certainly belongs to electro-medicine.

Current Employed.—While both currents—the faradic and galvanic
—have proved useful in the treatment of diseases of the skin, the
galvanic appears to act more efficiently and to fulfil a larger variety
of indications than the faradic. The reason of this will be suffi-
ciently clear to those who understand the general differential indica-
tions for the use of the two currents. The peculiar electrolytic
action of the galvanic current, which the faradic current possesses to
but a feeble degree, is indicated in diseases of the skin for the same
reason that it is indicated in the discussion of tumors. For the relief
of the symptoms of itching and pain, the faradic current is frequently
sufficient, especially in prurigo: its effects are also curative, but to a
less degree than the galvanic current. The galvanic current also acts
more powerfully on the central nervous system (see Chapter IV.).

Methods of Application.—Diseases of the skin may be treated elec-
trically in two ways—by applications to the diseased surface, and by
central galvanization. In the first method the disease is affected direct-
ly; in the second method it is affected indirectly through the nervous
system. :

Application to the Diseased Surface.—Our usual method of galvaniz-
ing the affected part is to place an adjustable electrode of from two to
four inches in diameter over the point where the principal nerve that
supplies the part is most superficial,—as the popliteal space, the ante-
rior crural region, the border of the flexors of the arm, etc., while the
negative is applied to the diseased surface by any convenient electrode
with a broad surface. This is the method that we usually adopt in the
treatment of ulcers. We are not able to say how much advantage
there may be in applying one of the electrodes over the nerve. We
suspect that it may be of service in improving the nutrition of the part
that it supplies ; it certainly cannot do harm in that position unless the
séance is very much protracted. One electrode may be placed on some
indifferent point, as the feet, or the hands, or on the thigh, where cur-
rents are borne well and can do no harm, however long they may be
kept there. The electrode is sometimes kept firmly planted on the
skin (stable), and sometimes is slowly glided from one part to another
(labile). When the part is much abraded only mild currents will be
borne, while in the immediate neighborhood a very strong current may
not be felt at all. It therefore becomes necessary to modify the cur-
rent continually according to the sensations of the patient, so that the
treatment’ may never be excessively painful. There is yet no evidence

36
562 DISEASES OF THE SKIN,

that very severe applications have any advantage over mild applica-
tions. The pain of the galvanic current. increases with the length of
time that the electrode is kept in a fixed position without breaking the
current ; for this reason it is necessary, when strong currents are used,
to shift the position of the electrode every minute or so, or as often as
the patient complains of severe pain. We are not able to say whether
the best results are obtained by stable or by labile applications. The
electrolytic action of the galvanic current is most decided when there
is little or no interruption to the current. When the faradic current is
used we generally make labile applications.

Both electrodes may be applied on the diseased surface. The ad-
vantage of this method is that it economizes time and labor where
there are numerous and large patches that need to be treated. Al.
though the electrolytic action of the negative pole is greater than that
of the positive, yet both act electrolytically, as all physicians know,
and both act curatively as-experience shows.

When the body is covered pretty generally by disease, we sometimes
put an electrode on each limb, thus allowing the current to run through
the body.

Local Faradization Generalized.—We have recently applied this
term to a method of using electricity which combines the advantages
of localized and general faradization. Although we first used it in
diseases of the skin, it may be employed to meet the same indications
as general faradization ; but since it requires absolute or approximative
stripping on the part of the patient, it would be called for only ina
limited class of affections.

In this method the operator takes hold of both the electrodes, by
their insulated handles, and passes them, within a few inches of each
other, over all the diseased surface of the body. The electrodes may
be kept stationary over spots where the disease is especially promi-
nent. The method may be modified in various ways. One electrode
may be kept fixed on some particularly bad spot, while the other is
glided up and down the surface adjacent, or both electrodes may be
kept fixed a part of the time. An advantage of this method, which
may be employed with either current, is that it economizes time and
labor, a very important consideration in cases where a large portion of
the surface of the body is diseased.

This method is especially indicated in cases where nearly the en-
tire surface of the body is affected by disease, as in general prurigo and
psoriasis. Either current may be used in this way.

General Faradization.—This method of using electricity is usually
ECZEMA. 563

not indicated in diseases of the skin, and for the reasons already given.
For those cases that are associated with general debility as a result or
cause of the disease of the skin, it may be employed with advantage;
one pole may be applied at the coccyx by an adjustable electrode, or
at the feet by a copper or tin plate, while the other is passed over the »
surface of the body.

Electric Brush.—When the skin is not itching or anzsthetic the
electric brush is very painful, and is therefore to be recommended
chiefly for cases where there is very great irritation, or itching and
anesthesia. We have frequently found it more efficacious than the
ordinary sponge electrode. In some conditions of eczema an applica-
tion, which in health would be unendurable, is positively agreeable.
The distinctively surgical methods of treating certain diseases of the
skin by electrolysis and galvano-cautery will be described in Electro-
Surgery.

Central Galvanization.—This important method of using electricity
we have recently proved to be of great service in the treatment of
certain diseases of the skin, especially of chronic eczema and prurigo.
Under this method of treatment alone, without making any application
whatever to the diseased surface, the itching and burning of these
diseases are relieved sometimes ‘immediately, and under a protracted
treatment permanent cures are obtained. The results obtained by this
method are of the highest possible interest in a pathological point of
view, as showing a kind of dependence of chronic eczema on the nervous
system that had not before been suspected.

Diseases of the Skin for which Electrical Treatment is Indicated.
—Under this head we sum up the results of electrical experience up to
the date of publication.

Ecsema.—This disease we place at the head of the list, for the rea-
son that we have found more rapid, brilliant, and uniform results from
electrical treatment in this than in any other disease of the skin. We
have treated the chronic forms in different parts of the body, and in
nearly all cases thus far with, immediate relief of the distressing pain,
and ultimate cure after a course of treatment. We have used for this
affection, almost exclusively, the galvgnic current, either locally or
centrally. Patients have come into the Dispensary declaring that the
distress is so great that they would be glad to have the suffering part
amputated, and after an application of from five to fifteen minutes have
gone out-entirely relieved. This relief lasts for several hours, some-
times for days, and the pain grows less and less until the cure is accom-
plished,
564 DISEASES OF THE SKIN.

It is in this disease especially that central galvanization alone, without
making any application whatever to the diseased part, has accomplished

such striking results.
The following case illustrates the power of central galvanization in a

most striking manner :—

Severe and obstinate chronic eczema of leg, eight years’ standing—TIntolerable itching
—Failure of various remedies—Rapid relief and permanent cure under central
galvanization.

CasE CXXXI.—Mrs. S. M., an Irish servant-girl, aged 51, was admitted to the
Long Island College Hospital, February 14, 1872, with chronic eczema of the left leg
about the ankle, and extending one-third of the distance to the knee. The itching
and pain were intolerable, and there was much soreness. The patient was in other
respects strong and well, but had suffered from this affection by intervals for eight
years. Four years before she had been under treatment at the City Hospital, and
had been discharged apparently cured, but relapsed.

The case was treated by iodoform, arsenic, bicarbonate of soda, rhubarb, carbolate
of zinc, glycerine, cod-liver oil, iodide of potassium, delcamara, acetate of lead,
wine of colchicum, and acetate of potash. These remedies were variously used in
various modifications, externally and internally. From some of these agents the
patient derived témporary relief of the itching and soreness ; but the average and
ultimate effect was, that on April rst the following record of the case was made in
the hospital book: ‘* Very painful, red and angry, rapidly extending, and now cover-
ing nearly the whole leg below the knee, and most of the dorsal aspect of the foot.”

Arsenic and tincture of cinchon. comp. were now ordered, but April r5th, the
record was: ‘‘ Very much the same.’? At this time, Dr. Davis suggested ocalized
faradization. ‘This suggestion was acted on with gratifying result ; the intense dis-
tress was at once in a measure relieved.

April 16th, the patient was more comfortable than for a long time previous.

April 23d, very much improved and comparatively comfortable.

At this time Prof. A. B, Crosby, the surgeon in charge of the ward, requested us
to see the patient, stating that she had been very obstinate under the various remedies
that he had tried. The patient was suffering greatly from the severe itching and
burning, and the soreness was so great that only with difficulty could she hobble
about the ward. The appearance of the diseased part was red and angry, and some
portions were more or less covered by scales.

We decided to try on the patient the effect of central galvantzation, making no
application whatever to the diseased part. We were induced to make this trial on
the strength of successes in other and milder cases of cutaneous diseases. ‘Our chief
hope was, perhaps, to relieve the itching and pain; a permanent cure we had no
reason to anticipate. As the patient was a good and willing subject on which to
demonstrate electrical applications, she was taken before the class of the Long Island
College Hospital, and treated by central galvanization, the statement being made,
that we did not hope thereby to cure, but simply to illustrate the method of using
electricity.

The details of the applications were entrusted entirely to Dr. Edwin E. Smith,
CENTRAL GALVANIZATION IN ECZEMA. 565

house-surgeon, who carried out the treatment with great faithfylness, and to whom
we are indebted for the full history of the case as here presented.

The relief of the itching and pain was very rapid, although on the 25th Dr. Smith
made the following record: ‘‘ A little more irritable.’’ This result was probably
iue to over-treatment, too strong currents, or too prolonged applications.

April 30th.—Patient ‘* much better.”

May roth, —‘‘ Still steadily improving.” The appearance of the leg was now much
changed for the better. The most obstinate portion was the region about the ankle.

The applications were now made four and five times a week with a 12-cell zinc-
carbon battery of Kidder for about ten minutes at a sJance.

May 25¢h.—A lotion of acetate of lead wash was ordered by Dr. Crosby, to con-
tract the enlarged capillaries. :

Fune sth —* Patient is walking about out-doors with comparative ease, and is
nearly well.’”’

We again presented the case before the class of the College, demonstrated on her
our method of central galvanization, and pointed out the extraordinary and unlooked-
for improvement, The skin of the whole leg, except around the ankle, was well, and
the patient for a long time had been entirely free from itching and pain.

Sune 15th. —The patient was ‘‘ discharged cured.”’

Yan. 13th, 1873.—Dr. Smith informs us that there has been ‘‘ no recurrence of
the difficulty.” Several months after the patient left the hospital we heard that she
was still well.

The above case, taking all the facts into consideration, its long
standing, its inveteracy under manifold treatment, and the immediate
and rapid relief and cure under central galvanization, is certainly most
extraordinary, and it will not subtract from the instructiveness and
brilliancy of the result, if in future years a fresh attack of the disease
should occur. Although the case was not, so far as we know, studied
by any recognized specialist in dermatology, yet among the very many
surgeons and physicians who watched its progress before and during
the electrical treatment, there was, we believe, no difference of opinion
in regard to the diagnosis, and there was no question that the cure was
wrought entirely by central galvanization, acting upon the centrai
nervous system, and thus improving the peripheral nutrition. This
very remarkable experience, which to some has seemed incredible, we
have recently confirmed in a similar case of chronic eczema of the
legs of sixteen months’ standing. ‘The relief of the itching by cen-
tral galvanization alone was immediate, and after a few application
the disease began to improve in appearance, and in six weeks there
Was approximate recovery. At the date of writing the patient is
entirely well, When the patient was about half cured he was seen by
Dr. L. D. Bulkley. Dr. Kinsman, of Columbus, Ohio, writes to us that
he has successfully treated, by central galvanization, a severe case of
inpetiginous eczema of twenty years’ standing.
“566 t DISEASES OF THE SKIN.

Chronic eczema of the legs and feet, one year’s standing—Relief of pain and itching
under localized faradization and galvanization.

CasE CXXXII.—Michael P., aged 64, had suffered for twelve months from chronic
eczema of the legs and feet, accompanied with terrible itching and burning sensations,
The affected parts were but little sensitive to the electric current, either galvanic or
faradic. Localized galvanization and faradization were employed, and some of the
time the electric brush with a strong current was not only well borne, but was most
grateful to the patient. The applications were made from five to twenty minutes.
In all cases there was relief of the distressing pain. Symptoms of relief began to
appear soon after the beginning of the s azce, and at the close was sometimes abso-
lute. This relief lasted at first from two to twelve hours.

The patient continued treatment for three weeks—in all six applications were made.
The intervals of relief were sensibly lengthened, and the patient abandoned treat-
ment. With the relief in the itching and pain there was corresponding relief in the
appearance of the diseased parts. We have no reason to believe that the patiem
was permanently cured.

Lczema of the scalp of three months’ duration in a gentleman seventy-five years of
age—Recovery in two months under local galvanization and general faradization,
CasE CXXXIII.—Mr. L., aged 75, was affected with eczema of the scalp. The erup-

tions extended over the entire portion of the head covered by the hair, and had persisted,

in spite of many external applications, for nearly three months. The diseased part was
covered with thick scabs which tended to coalesce and cover as by one huge mass the
entire surface. The scalp was quite irritable, and at night especially the patient was
annoyed by an irresistible desire to scratch. The bowels were decidedly constipated,
and the general health, although usually good, was at this time considerably below par.

The patient submitted to treatment by both localized galvanization and general fara-

dization, The first application of the former method resulted in a decided relief to

the constant itching.

After two weeks’ trial of both methods, some of the scabs began to dry up and peel
off, constipation was very much relieved, and the general health had improved in
marked degree.

This improvement slowly went on, until in two months from the beginning of
treatment the scalp was quite free from disease. :

Prurigo.—lf electricity could do nothing more than relieve the itch-
ing of prurigo, it would be entitled to an honorable place in the arma-
mentarium of the dermatologist. Dry faradization alone may bring re-
lief in a very few minutes, and, when perseveringly used, may cure.
We have seen immediate relief follow general faradization used in the
ordinary method with wet sponges. In this disease also central gal-
vanization alone has in our hands been very effective.

General prurigo, six years standing—Intense itching—Approximate cure after
Jfteen s ances of central galvanzzation.

CasE CXXXIV.—W. R., 9 years of age, came into the Electro-Therapeutical De-

vartinent of Demilt Dispensary, April 11, 1872. At the age of three the patient had
ANASTHESIA—ACNE—ACNE ROSACEA. 567

scarlet fever; this was followed by general prurigo that had never been relieved:
The disease covered the back, abdomen, and legs. The itching was most severe.
Sleep at night had for years been interrupted by this distress, and marks of scratch-
‘ing were everywhere seen. The disease was at its worst on the back.

Acting on the theory that the disease was of a nervous character, Dr. Woodruff
referred the case tc the Electro-Therapeutical Department, when treatment by cen-
tral galvanization was begun and continued for two months. Towards the close of
the treatment, June 1, little remains of the eruption were seen excepting on the
back, and there was very little itching.

Sune 15.—The patient abandoned treatment ; ‘the recovery appeared to be satis-
factory. We have no further intelligence of the case.

Dr. Sterling gives us the following case, the diagnosis of which was
not fully clear to him :—
General eruption with burning sensation of long standing—Some improvement

under localized galvanization, and galvanization of the cervical sympathetic——
Much greater improvement under central galvanization.

CasE CXXXV.—Mr. G., at the age of twelve, was attacked with an eruption all
over the body, after sea-bathing. Treatment cured the eruption, but a burning, smart-
ing sensation was left in the fore-eye, that always was increased on any excitement.
Drinking a cup of tea or coffee, or entering a heated room, would bring on burning
and smarting in the face, with very decided puffiness. Arsenic and various other
remedies had been used faithfully.

May I, 1871.—-Treatment by galvanization of the sympathetic and localized gal-
vanization was begun, and the result was satisfactory; but relapse occurred, and
some months subsequently he was treated by central gaivanization alone, with very
great improvement. He still suffers from slight relapses that are always benefited by
electrical treatment.

Lichen.—We have had no opportunity to treat a marked case of
lichen ; but there is every probability that electricity would accomplish
as much in this affection as in the other symptoms of the so-called
dartrous diathesis.

Anesthesia.—For the curable cases of cutaneous anezesthesia, faradi-
zation is a specific, if any remedy can be said to be a specific for any-
thing. Even cases that depend on incurable central lesion may im-
prove very decidedly under treatment. In cases of paralysis of motion
and sensation, the sensation may be partially or completely restored
under electrical treatment, even when the loss of motion remains un-
changed.

Anesthesia is a condition for which the electric brush is particularly
indicated (see chapter on Anesthesia).

Acne.—If we were to judge from our own limited experience in the
treatment of acne, we could not speak very encouragingly.

Our assistant, Dr. J. H. Sterling, informs us that one year ago a case
568 DISEASES OF THE SKIN. ‘

of hereditary acne indurata of the face and back, under his care, was
treated by eighteen applications of central galvanization, without any
other treatment, and the disease disappeared. The constipation and
headache, which had been very distressing, were also relieved. Up to
date (July, 1873) the patient was well.

Acne Rosacea.—Whether acne rosacea is different, pathologically,
from ordinary acne or not, it certainly yields better to electrical treat-
ment. On the theory that the disease may depend in some way on
the digestive organs, central galvanization may be tried in connection
with local treatment.

Acne rosacea of long standing—Immediate improvement under localized galvaniza-
tion with sponges and metallic electrodes.

CasE CXXXVI.—A medical gentleman, aged about 60, in April, 1872, requested
us to treat him for acne rosacea that had for some time caused him annoyance. The
blood-vessels were considerably enlarged on both sides of the nose, the color was a
decided red, and there was the usual thickening. The health of the patient was in
other respects pretty good, excepting attacks of indigestion with acidity.

We began treatment with localized galvanization—with wet cloths and sponge,
sometimes using a metal electrode, with a sharp edge. When the metal electrode—
connected with the zega¢ive pole—was used, the dilated capillaries were electrolyzed
under the negative pole, and gases escaped with a sound that could be easily heard,
There was a tendency to reappearance of the dilated vessels, but after a few weeks’
treatment they were entirely destroyed, leaving no scar or trace, and the color of the
nose on both sides had disappeared. There appeared to be also a diminution of the
hypertrophied tissues.

There has been, since that time, some return of the affection, but he is very much
better than formerly. The habits of the patient were never intemperate, but he had
always been accustomed to use more or less alcoholic liquors,

We have since treated another case of acne rosacea by the same
method, and with results which, for the time, are most satisfactory.
This case has been attended with itching that has been relieved, and
the appearance of the nose has very rapidly improved. é

Psoriasis, and Pityriasis, in their relation to electro-therapeutics,
may be divided into three classes : (1) Those cases that are benefited
up to acertain point. (2) Those cases that receive but little, if any,
benefit. Judging from our own observations, we should say that the
latter class (those who do not yield at all) are in the minority. Some
cases progress very slowly, and need months of treatment. The negative
pole of the galvanic current seems to be more efficacious in this dis-
ease than any other method. For the sake of economizing time, how-
aver, we frequently use both poles, with broad electrodes.

The results have not been very satisfactory. Even when decided
HERPES—HERPES FRONTALIS. 569

improvement takes place under long treatment, relapses may occur,
and the cure has never in our hands been complete.

Herpes—Herpes Loster—Herpes Frontalis seu Ophthalmicus.—
Herpes, if not the most persistent, is, without doubt, attended by the
most excruciating pain of the various neuroses of the skin. Whether
its seat be the head, the triink, or the extremities, the associated pangs
are sometimes almost beyond human endurance.

Herpes is now generally regarded as subordinate to the existence of
a neuralgic or rheumatic diathesis, and as originating in any cause
which weakens the vigor of a nerve-trunk or its cutaneous branches:
hence it would not be unreasonable to suppose that electricity in some
one of its forms might prove of service.

The teachings of experience clearly attest its value in this complaint.
The disease, it is true, runs an acute course, and, as a rule, recovery
more or less complete follows in the course of a few weeks, but it is
none the less incumbent to relieve, so far as possible, the acute suffer-
ings that attend it.

The first two cases which we briefly record occurred in that part of
the body—viz., the trunk—which is said to be the most frequent seat
of the disease. The succeeding three of Herpes frontalis seu ophthal-
micus ave of somewhat greater interest, because of the comparative in-
frequency with which such cases are met, and of their great importance
to ophthalmologists.

. Herpes thoracicalis—Treatment by the faradic current.

Case CXXXVII.—Jane A., a dispensary patient, aged 7 years 6 months, had suf-
ered for several weeks from febrile symptoms and anorexia, and finally an herpetic
eruption appeared on the chest and right side. The eruption increased and rapidly
extended, until the thorax was nearly encircled. The pain from which the child suffered
was very severe, and for forty-eight hours it had been continuous. We employed fara-
dization (mildly), and were rewarded by an immediate relief of the neuralgic pains.

Four similar applications were subsequently given,—one on each alternate day;
but there was no return of pain, and within ten days the eruption, which resembled
ahorted vesicles, had quite disappeared.

Herpes sacralis—Treatment by the faradic current,

Cas—E CXXXVIII.—We were called, December 3, 1873, to see a gentleman, aged
24, who was suffering from an herpetic eruption over the region of the sacrum. The
vesicles extended from the hip to the sciatic notch on the right side, and covered a
narrow tract along the outer portion of the thigh, with clusters here and there to the
external malleolus. The accompanying neuralgic pain was quite as severe as in the
preceding case, and simulated actual sciatica. We placed the foot of the patient on

@ copper plate, to which the negative pole was attached, and with a mild faradic cur-
570. DISEASES OF THE SKIN.

rent brought the whole hip and limb under the electrical influence. The effect was
most grateful, and the relief afforded immediate.

The same method was repeated a number of times, and although the patient occa.
sionally experienced twinges of pain, they were of little severity, and within a week
ceased to annoy him.

Of Herpes frontalis seu ophthalmicus we have treated six cases by
electricity, and always with the result of relieving the pain, and in three
cases the course of the disease even was apparently modified.

Herpes frontalis— Treatment by the galvanic current,

Cas—E CXXXIX.—A lady, aged about 60, and sent to us by Dr. C. R. Agnew, had
suffered long and severely from hetpes of the forehead and face. Acute and persistent
neuralgia supervened, resisting all attempts at permanent alleviation. The galvanic
current was locally and centrally applied, and resulted, in a few séances, in relieving
in a good measure the neuralgic pains. Ptosis of the right eyelid remained, how-
ever, in spite of the treatment by galvanization. Three local applications of the
faradic current approximately restored the lost muscular power.

Herpes frontalis—Alleviation of pain by the galvanic current, after failure of the
Saradic current,

CasE CXL.—Mrs. L., aged 39, consulted us on June ro, 1874, and gave the follow-
ing history of her case. ‘Iwo weeks prior her attention was called to a small vesicu-
lar eruption on the left forehead, directly over the course of the supra-orbital nerve.
Similar eruptions quickly followed, thickly studding the side of the head and face,
and accompanied with much pain. A homceopathic physician had had the case in
charge, and had succeeded in temporarily relieving the neuralgia only by the ad-
ministration of morphine. When the patient fell under our observation she. was suf-
fering more than at any previous time, and, rather because of convenience than
choice, we gently applied the faradic current to the affected and surrounding parts.
It did not cause, either during the application or subsequently, any special modification
of the distress. On the following day we resorted, as we should have done at first,
to the galvanic current, making the applications locally, centrally, and in less than ten
minutes the intense agony of the patient was almost completely relieved. She passed
avery quiet night, but in the morning complained of some distress over and in
the right eye and temple. She was immediately relieved by a second application,
after which she was subjected to treatment several times, although she suffered
but little, if any, and rapidly progressed towards recovery.

Herpes frontalis— Treatment by the galvanic current—Immediate relief of pain—
The course of disease apparently modified,

Case CXLI.—A third case of zoster frontalis, in the person of a female, aged about
35, fell under our observation on the 2d of June, 1874. The lady, who wasa patient
of Dr. Oliver White, first observed a slight eruption over the right eye. This
rapidly spread over the whole side of the forehead, and the angle of the mouth
was involved. The associated neuralgia was of the most excruciating and intolera‘le
character. Dr. L. D. Bulkley wascalled in consultation, and advised the galvanic cur-
RINGWORM—SCLERODERMA. 571

rent, a few applications of which rapidly and effectually relieved the patient of all
pain, and greatly hastened recovery after failure of various local applications. The
treatment was continued for some time subsequently, in order to make the scarring
as slight as possible.

It will be observed that of the above cases the first two, in which
the eruption was confined to the body, were relieved by the faradic
current; and that the three following (herpes frontalis) yielded to the
galvanic current.

From these and other cases the following conclusions seem to us
legitimate :—

1, That the pain of herpes, no matter where the seat of the eruption
may be, is generally susceptible of speedy and effectual relief by the
use of the galvanic or faradic current.

2, That when the eruptions take place on the head—/erfes frontalis
—the galvanic current has greater power to relieve the pain than the
faradic.

3. The electric treatment, besides relieving the pain of herpes,
seems to shorten somewhat the acute stage, to break the force of the
disease, and to modify the scarring.

Ringworm.—Common ringworm may yield to the galvanic current.

Tinea circinatus (ringworm) of more than two years’ standing—Recovery follows
one application of the galvanic current,

CasE CXLII.—A lady patient, aged 30, called our attention, casually, toa common
ringworm, circular in shape, an inch and a half in diameter, and situated at about
the junction of the shoulder and neck. The disease made its appearance more than
two years prior in the shape of a slightly elevated spot which gradually enlarged to
the above-named size. The part had begun to heal in the centre several times, and
as often the process of repair would be almost complete, when the disease would take
a sudden start and become as marked as ever. Finally, however, the centre of the
eruption permanently disappeared and left a circular spot of clear skin, surrounded
by a wide erythematous ring. This condition had remained stationary for more than
ayear. We applied to the diseased part a metallic disk sufficiently large to cover it
completely, and passed for a few minutes a galvanic current of slight tension, but suf-
ficient to create a decided burning sensation, and to appreciably affect the eruption.
This was the only application, as immediately after the patient left the city. A
month afterwards, however, she presented herself, but with no vestige of the ring-
worm, It began to disappear almost immediately after the treatment, and within
two weeks the skin was quite clear. To this date, two and a half years since the ap-
plication, there has been no reaj,) earance of the eruption.

Scleroderma. —\his disease of the skin, usually so obstinate to recog-
nized methods of treatment, may be treated by strong localized galva-
nization with considerable benefit. Fieber, of Vienna, records a case
572 DISEASES OF THE SKIN.

where peripheral galvanization combined with galvanization of the sym-
pathetic were very effective. In a case that we saw with Dr. Piffard,
and for a time treated with him, a very persevering use of the galvanic
current had a decidedly beneficial effect.

Chromatogenous Diseases—fLeucoderma, Melanoderma——The chem-
ical or catalytic action of the galvanic current is theoretically indicated
in chromatogenous or pigmentary diseases. With leucoderma or white-
ness of the skin and ephelis or sun-burn, and in lentigo or freckles, no
experiments, so far as we know, have yet been made. Dr. Wm. R.
Fisher, of Hoboken, has treated a case of melanoderma of the face by
the galvanic current, and gained a complete cure. The spot, which
was about half an inch in breadth and: three.quarters of an inch long,
looked like a spot of mud on the cheek. Through the courtesy of Dr.
Fisher we had opportunity to see this case both during the process of
the treatment and after recovery.

Elephantiasis.

Elephantiasis of the legs, over two years standing, attended with ulceration and
great pain—Relief of pain—Removal of the elephantine skin and very remarkable
reduction in the size of one leg under localized galvanization—S: ubseguent death of
patient from exhaustion.

CasE CXLIII.—Mr. P., an Englishman of middle life, a man strong and vigorous
beyond the average, a distiller of oils by occupation, returning from his daily duties
on the evening of February 22d, 1870, observed, on removing his socks, a small blis-
ter on the inner side of the left ankle. The next day he called on his physician, Dr,
Rotton, under whose care he remained for one year and more.

The disease spread over the Zef¢ foot and ankle, and in about two months the right
foot was similarly attacked. The blisters as they ruptured left inflamed and angry
surfaces in their track. The disease involved the surface of the feet, and both legs
up to the knees, The treatment carried out by Dr. R. was mainly of a tonic and
alterative character, with local applications of glycerine, carbolic acid, and lead wash,
At one time Dr. Johnson saw the case, confirmed the diagnosis of elephantiasis, and
rendered a diagnosis positively unfavorable.

We first saw the case by request of Dr. R. in May, 1872. At that time the right
leg below the knee measured ¢wenty-five inches in circumference, and it was covered
all over with elephantine skin, excepting an ulcerating surface below the ankle.
This ulcer was treated with charcoal poultice and discharged freely. The left leg
was not greatly enlarged, but was red, angry, and inflamed, and kept up an incessant
discharge from the surface.

The patient suffered horrible agonies, so that at night the neighbors were disturbed
by his howling. He was unable to move from the sofa on which he sat, and where
he worked at his newly-learned trade of cleaning gloves,

By our request Dr. E. Mann at first undertook the experimental treatment of the
case by electricity. We had never known of elephantiasis being treated electrically,
ELEPHANTIASIS. 573

and gave an unfavorable prognosis, and were indeed inclined not to attempt it ; only
by the earnest request of the patient and his physician we decided to try and see
whether we might give him some relief. Localized faradization, at first tried, accom-
plished nothing, and, so great was the anesthesia, was not felt by the patient.

 

Fic, 116.
Elephantiasis of legs before treatment by electricity,

Localized galvanization, by means of wet sponges, and both poles with zinc-carbon
battery of sixteen cells, was appreciably felt, and very soon began to relieve the pain.

The applications were from ten to thirty minutes in length.

After two months’ treatment the elephantine skin on the left leg was removed, the
pain had ceased, and the leg was reduced in circumference from ¢wenty-five to seven-
teen inches. The ulcerated portion below the ankle was also nearly well.

The electrical treatment was then discontinued for several months. During the
latter part of this time there were evidences of relapse and reappearance of ulcers and
pain. The case was seen at various stages by a large number of the profession.

The patient subsequently relapsed somewhat on a discontinuance of
the treatment; was again treated, though with less benefit, by our as-
sistant, Dr. Sterling. Among other methods central galvanization was
tried, but without perceptible effect. In the course of a year the pa-
tient died exhausted.

Alopecia.—In this condition, local galvanization has been used with
some benefit. Our own observations in this particular affection have
not been very extensive.

The question that has been often asked us, whether parasites on the
skin can be killed by a current that the patient can easily bear, we are
unable to answer.
574 DISEASES OF THE SKIN,

Permanence of the Results.—The very natural question, whether the
results obtained by electricity in diseases of the skin are.more perma-
nent than those obtained by ordinary methods, the future must answer.

That relapses may occur after a cutaneous disease has even yielded to’

electrical treatment, already has been demonstrated. To what extent
central galvanization and general faradization combined with local treat-
ment.can control the diathesis must be ascertained by patient and per-
sistent experiment.

That the results of electrical treatment are, to say the least, as per-
manent as those derived from the accepted~ methods, and that after the
accepted methods have partially or entirely failed, electricity, either alone
or in conjunction with the accepted methods, may succeed, we have sat-
isfactorily established.
CHAPTER XXVII.
DISEASES OF THE ORGANS OF DIGESTION.

Amonc the diseases of the organs of digestion for which electricity
has been successfully employed, are dyspepsia, jaundice, constipation,
chronic diarrhea, gastralgia, abdominal neuralgia, vomiting or regur-
gitation, flatulence, and sea-sickness.

Elettro-Diagnosis.—Irritable conditions of the stomach, liver, and in-
testines are sometimes revealed by their sensitiveness to the electric
current. Pains must be taken to distinguish the sensitiveness of the
skin from that of the internal organs.

An anesthetic condition of the liver is sometimes exceedingly marked.
In several of our cases the whole power of the faradic apparatus was
not painfully felt, when localized through the liver by large sponge
electrodes. Irritability or ulceration of the large intestines is some-
times indicated in a very marked manner. For the diagnosis of the dis-
eases of these organs, the faradic current, on account of its superior
mechanical effects, is preferable to the galvanic.

In nervous dyspepsia there is frequently a peculiar and very unpleas-
ant tenderness in the epigastric region, so that only a very mild current
can be borne. In some cases a thrill, with a sinking sensation, is felt
when the electrode with a strong current is passed down the spine; in
other cases the application of a strong current at the cilio-spinal centre,
or on the crown of the head, causes a feeling of nausea. The spinal
irritation, on which nervous dyspepsia so frequently depends, is indi-
cated by tenderness of the dorsal vertebrae, as revealed by pressure or
application of the current.

General Principles of Electrical Treatment.—Electrical treatment
is serviceable in the diseases of the organs of digestion in two ways:
First, by improving the nutrition of the tissues of the organs ; Secondly,
by improving the nutrition of the brain, spinal-cord, sympathetic, and
entire nervous system. The tonic influence on the nervous system may
be obtained by central galvanization, and by general faradization.

The mechanical influence on the tissues of the viscera may be ob-
576 DISEASES OF THE ORGANS OF DIGESTION,

tained by general or localized faradization. A fundamental fact of

great importance in the treatment of disorders of the digestive tract is
this, that for applications to the abdominal viscera, stomach, spleen, liv-
er, intestines and uterus, the faradic current is usually preferable to the
galvanic. The reason for this is that the faradic current. acts more
vigorously on the muscles than the galvanic, and therefore produces
more powerful mechanical effects, with passive exercise of all the deep
tissues. It may be safely said, then, that we know of no treatment more
sure to relieve the leading and concomitant phenomena of dyspepsia as
general faradization and central galvanization. In connection with

this we sometimes use galvanization of the sympathetic, the pneumo-
gastric, and spine. General faradization relieves nervous dyspepsia,
not so much by the virtue of its influence on the stomach—although
it directly affects the stomach—as by its influence on the nervous condi-
tion of which the dyspepsia is a symptom.

The number of our cases in which dyspepsia was the only symptom
was comparatively small; the number in which it was a prominent ac-
companying symptom was quite large. Most of the cases of hysteria,
nervous exhaustion, and hypochondriasis, and very many of the cases
of neuralgia and paralysis, were more or less complicated with dyspep-
tic symptoms. Relief of dyspepsia is one of the earlier signs of im-
provement under electrization, even when treating cases in which it is
merely an incidental condition. :

The stomach and liver may be indirectly galvanized through the
pneumogastric in the neck; the stomach, liver, spleen, kidneys, and
intestines may be directly faradized by applying large electrodes with
very fine pressure over the back and abdomen, so as 1o pass the cur-
rent directly through the organ that we wish to affect. Except in cases
of disease, these organs will bear strong currents without severe dis-
comfort. Either stable or labile applications may be used, without re-
gard to the direction of the current, from three to ten minutes, or even
longer. ,

Prognosis.—F¥or the temporary or permanent relief of nervous dys-
pepsia, the prognosis under the treatment above indicated is exceed-.
ingly favorable, and the reszlts obtained by general faradization and
central galvanization alone are some of the most remarkable in thera-
peutics, Cases of nervous dyspepsia, with their manifold complications,
are on the whole the best tests that can be offered for this method of
treatment. Not only are the purely dyspeptic symptoms relieved, ‘but
there is great improvement in sleep, and in strength of muscle and
brain, and in some cases very marked increase in weight. Relapses
DYSPEPSIA—CASES. 577

are not unfrequent in this disease, especially under bad hygiene; for
with many the tendency to nervous dyspepsia is hereditary, and is con-
tinually liable to manifest itself.

Dyspepsia, accompanied by a voracious appetite and a constant burning in the stom-
ach—Approximate recovery under treatment by general faradization,

CasE CXLIV.—The case of Mr. S., aged 31, presented symptoms of the old-fash-
ioned variety of indigestion. His appearance did not indicate any special or annoy-
ing disease. :

A year previously he began to experience an uneasy feeling in the epigastric region
after eating a hearty meal. This symptom gradually became more aggravated, until
it was a source of serious annoyance.

He had been advised to limit himself to a spare diet, and had attempted to regu-
late the quantity and quality of his food. In this he failed on account of another
symptom, which before had escaped his observation. We refer to boulimia—in
other words, a voracious appetite, which refused to be controlled, The enormous
amount of food which he devoured at every meal was but partially digested. A con-
siderable portion was occasionally vomited. When his meals were withheld a short
time, he experienced an ‘indescribable sinking” at the stomach, impelling him to
seize voraciously oti articles of food. He complained especially of a constant sen-
sation of heat, or « burning pain in the epigastrium, which was aggravated by the
ingestion of food. We ascribed this symptom to an excessive vascular irritation of
the mucous membrane of the stomach. ‘ :

An unequal circulation was manifested by cold extremities during the day, and hot
feet-at night. 4

Derangement of the hepatic function was evident by the light clay-colored stools,
while the urine was invariably almost colorless. The patient was accustomed to the
habitual use of alcoholic stimulants, but never to the point of intoxication, He had
used strong coffee and tea to excess, but had for some months abstained from them
altogether. The faradic current was acutely felt over the stomach. Over the body
generally, however, he bore a current of more than ordinary intensity. Three appli-
cations given in the course of a week appreciably lessened the irritation of the dis-
eased organ. This effect was evinced by a decrease in the burning sensation, which
was mentioned as a disagreeable and marked symptom, The vomiting was effectu-
ally controlled after two weeks of treatment. Twenty applications administered
during a period of two months resulted in an approximate cure.

The voracious appetite was in a great measure subdued, and it was only.after some
indiscretion in diet that any of the old local symptoms returned sufficiently to annoy
the patient,

A case of indigestion and excessive vomiting associated with anesthesia and weak-
ness of right side—A pproximate recovery of indigestion, etc., under galvanization
of the sympathetic, pneumogastrie, and relief of the anasthesia under general
Saradization.

Cas—E CXLV,—Miss C., aged 23, came to usin October, 1870, with the following
history : She suffered during childhood for several years from chorea of the right
side, which at the age of twelve entirely disappeared.

37 \
578 DISEASES OF THE ORGANS OF DIGESTION.

She then enjoyed fair health until the age of 21 years, when a condition of indiges.
“tion supervened that was fearful in its effects, Hardly anything could be retained
upon her stomach, and during the winter she wasted almost to a shadow, and her
life was despaired of. Under galvanization of the sympathetic and pneumogastric,
her dyspeptic symptoms improved, and the vomiting became decidedly less, After
two months of this treatment, she had increased in weight to her normal standard,
ahd when we last saw her, she was able to retain the greater portion of ‘the food
ingested. Since the digestion began to improve, however, the left side of the body
became markedly anzesthetic, cold, and greatly deficient in strength. The opposite
side was slightly affected. General faradization repeated six or eight times almost
completely relieved these symptoms.

Dyspepsia of many years’ standing—Great improvement under general faradiza-
tion, and increase in weight of thirty pounds.

-CasE CXLVI.—Mr, T , a bookseller, aged 31, stated that for a number of
years he had suffered from chronic dyspepsia, which had rendered his life miserable.
He had lost much in flesh. Although 5 ft. 8 ins. in height, his weight was but about
one hundred pounds, He complained of regurgitations from the stomach of an in-
tensely sour liquid, and on rising in the morning he was often troubled with pyrosis,
Tympanitis was a frequent symptom, and oftentimes the accumulation of gas within
the stomach embarrassed the respiration and disturbed the action of the heart.
Treatment was commenced about the middle of October, 1866, and continued for
four weeks, general faradization being applied three times each week. The daily re-
gurgitations, the tympanitis, and pyrosis gradutlly ceased to annoy him; and after
the tenth application, he informed us that during the month he had increased in weight
some fifteen pounds,

About the beginning of January, 1867, he called upon us, stating that his health
was excellent, and that his total increase in weight, since he first commenced treat-
ment by electricity, was some thirty pounds, He said that he did not feel that his di-
gestive organs were as strong as they had been before he was attacked with dyspep-
sia, but they had ceased to give him any considerable annoyance,

 

Nervous dyspepsia, associated with periodical attacks of headache and vomiting—Ap-
proximate recovery and rapid increase in weight follow general faradization,

CasE CXLVII.—A young man consulted us in the fall of 1866 for a persistent
form of nervous dyspepsia.

He was of a weak nervous organization, and presented a remarkably anzemic and
emaciated appearance. Every month or six weeks he was prostrated by a severe at-
tack of headache and vomiting, from the effects of which he would not recover for
several days. In administering a general application of the faradic current, it was
found that the liver was relatively the most sensitive to its influence. So exhausting
was the sensation produced by the electricity in ‘this organ, that very decided symp-
toms of faintness followed. He soon rallied from its effects, and when he visited us
two days subsequently he expressed himself as having experienced very marked and
grateful relief. At each sitting he was able to bear a more intense current over the
digestive organs and body generally. The beneficial effects of the applications were
soon manifest by a more natural and lively appetite, relief of constipation, by greatly
CONSTIPATION AND: CHRONIC DIARRHGA. 579

increased vigor of mind and body, and by the non-recurrence of his usual paroxysm
of headache and vomiting. The first application was given October 24, and the fif-
teenth and last in the early part of December. During the treatment the weight of
this patient increased from 106 to 115.

A number of cases in which nervous dyspepsia was a symptom will
be found under hysteria and allied affections, neuralgia and paralysis.

Constipation, Chronic Diarrhea, and Jaundice.—Constipation, asso-
ciated with and constituting a part of nervous dyspepsia, is, like dys-
pepsia, disposed to yield rapidly, and often permanently, to electriza-
tion. Next to insomnia, it is the symptom first to yield, after general
faradization is used, even though there may be subsequent relapse.
Very many of the cases related under dyspepsia, hypochondriasis, hys-
teria, and nervous exhaustion, were to a greater or less extent troubled

‘with constipation, even when this symptom was not specified; and in
the majority of cases there was important relief.

The relief is sometimes merely temporary ; relapses are most likely
to occur in those cases that are of a hereditary, or at least life-long
tharacter.

‘It not unfrequently happens that a strong application is followed the
next or even the same day by a freer alvine discharge than usual.
Constipation, much more frequently than is supposed, depends on an
irritable, exhausted, or congested condition of the spinal cord. That
myelitis and the more serious lesions of the spinal cord are accompa-
nied by a deranged condition of the bowels, either constipation or
diarrhoea, is fully recognized; it is not, however, so well understood
that spinal irritation, even in its milder degrees, may have constipation
for one of its symptoms, and that this symptom will disappear with the
removal of the cause, by treatment directed to the spine. For those
cases that result from incurable disease of the brain or spinal cord only
temporary relief can be obtained. In such cases relapse usually occurs
as soon as the treatment is discontinued. Very obstinate and life-long
cases of constipation sometimes are not benefited by any form of
electrical treatment.

Electrization may be said to relieve constipation in several different
ways :—-

1. By its general tonic effects ‘on the system at large, on the same
principle that it relieves nervous dyspepsia.

2. By its tonic effects on the central nervous system, and especially
on the spinal cord. On account of the fact that very many cases of
constipation depend on a morbid condition of the cord, special atten:
580 DISEASES OF THE OKGANS OF DIGESTION.

tion should be given to the spine, whatever may be the method of elec-
trization employed.

3. By its direct effects on the organs of digestion. The mechanical
action of the faradic current especially gives tone to the stomach, liver,
and intestines, markedly increases the hepatic and intestinal secretions,
and aids the peristaltic action of the intestines. _

In jaundice the results of our limited experience have been more
favorable than the reverse. In chronic diarrhea we have succeeded in
a number of striking instances.

The treatnfent of all these conditions is worthy of far more attention
than it has thus far received from electro-therapeutists.

Habitual constipation for fifteen years—No permanent benefit from medication—
Rapid improvement under general faradization—Relapse.

Casz CXLVIII.—Mr. N., aged 30, a printer employed in the office of the New York
Times, was sent to us by Dr. St. John Roosa. For fifteen years he had suffered from
constipation. So persistent were the symptoms, that neither well-directed medica-
tion nor such hygienic measures as he could command were of any avail.

The appetite was good, and the sleep moderately sound and refreshing. The patient
complained of a sense of weight or oppression in the abdomen, of flatulence, and oc-
casionally of a slight feeling of nausea,

The evacuations often came away in knotty lumps, after much straining and an
unpleasant distension of the anus, As aconsequence of this torpor or want of sus-
ceptibility of the intestines, his health had become considerably impaired. He com-.
plained of a general feeling of malaise and a disclination to engage in any active effort.
Above all, however, he suffered continually from most painful mental depression.
The monotony and confinement of his occupation, together with the unnatural
method of life of working at night and sleeping during the day, doubtless served to
aggravate the character of his disorder. He received only three applications of the
faradic current, which resulted in an extraordinary improvement in his general symp-
toms. After the first séance the bowels moved freely, and continued to do so every
day while he visited us. He was completely relieved of his mental and physical de-
pression, and in every respect was more vigorous than for many years before.

The bowels continued regular for several months, when the old symptoms gradually
returned, The patient again applied to us for treatment, and was relieved as effec-
tually as before.

Obstinate constipation relieved by a few applications of the faradic current.

CasE CXLIX.— Through the kindness of Dr. Howard Pinckney we treated an obsti-
nate case of constipation ina lady aged about 30, who also suffered from severe
menorrhagia and nervous exhaustion, A few applications of general faradization—
the current being directed more particularly, however, to the intestinal tract—relieved
this condition so decidedly, that it was unnecessary to continue the treatment. A
year subsequently a single application relieved the patient on « return of the old
fymptom. 7
INTERNAL APPLICATIONS FOR CONSTIPATION, 581

In some cases of very obstinate constipation it is of advantage to
localize the current by internal applications. This may be accom-
plished by means of a rectal electrode (Figs. 117 and 118). This may
either be non-insulated, or insulated up to a point near the tip, and
may be double or single. A very powerful current may be borne in
the rectum without discomfort. The other pole may be applied at
different points over the abdomen,

With the double rectal electrode, as with double. electrodes of all
kinds there is so small a portion of the body interposed that the resist-
ance is very feeble and only a slight current will be borne.

  

Fie x11

Rectal Electrode—non-insula-
ted (Kidder), Double Rectal Electrode

(Galvano-Faradic Mfg. Co.)

 

Fic, 118,

In a case of obstinate constipation following parturition we tried
in succession external and internal faradization and external and in-
ternal galvanization with strong currents without effect.

Ileus (Invagination).—Althaus reports two cases where powerful
faradization availed to cure constipation when the ordinary remedies
had been tried in vain. The negative pole was applied to the spine,
582 DISEASES OF THE ORGANS OF DIGESTION.

and the positive passed over the abdomen in the region of the large

intestine. In three minutes a very abundant evacuation appeared.

The second case was severe, but not as long standing as the other.
The patient passed much blood at stool, and was fast becoming ex-
hausted The same application brought relief, though not so speedily
as in the preceding case. In two cases of ileus that we treated in this
way there was relief.

Dr. Clemens, of Frankfort, states that he has successfully treated
invagination by first administering one or two tablespoonfuls of metallic
mercury, which settled down to the seat of the invagination. The nega-
tive electrode was applied over the supposed seat of the disease, and
the positive in the rectum. Voltaic alternatives were used.*

Chronic diarrhea of six months standing, associated with general neuralgia—
Marked tenderness over the transverse colon—Treated by general faradization,
with special reference to the tender spot—Kecovery in three weeks,

Case CL.—A lady, aged 35, sent to us by Dr. H. H. Gregory, for a general
neuralgia, from which at times she suffered excessively. The faradic current was applied
over the whole body, and produced no discomfort, excepting when it was sent through
a certain part of the intestinal tract.

This tender spot was located on the right side, directly over the transverse colon,
Over no other portion of the abdomen was she at all sensitive to the electricity, but
at this point a very moderate current produced a disagreeable, sharp, burning pain,
similar to that caused by making the application to a raw surface, Upon inquiry,
the patient stated that for six months she had been annoyed by a diarrhoea, which
persisted in spite of persevering and judicious medication. She was obliged to exer-
cise the utmost caution in her diet, for the least indiscretion in eating was certain to
aggravate her disorder.

We now directed the applications more especially to this ¢ezder spot, and soon ob-
served some amelioration of her diarrhoeal symptoms. The stools assumed a firmer
consistency and a more healthy color, and in proportion as she improved in these
respects the tender spot became less sensitive to the influences of the electric current.
Eight applications, extended over a period of three weeks, resulted in ‘complete re-
covery,

Diarrhea of several months standing in a lad of twelve years, caused by exposure to
cold—-Recovery under ten general faradizations—Increase in weight,

CasE CLI.—J. W., aged twelve years, was annoyed by an excessive looseness
of the bowels, which had persisted for several months in spite of every form of
medication that had been tried. He was of a delicate constitution, but until this
attack of diarrhoea he had always enjoyed a good degree of health. His mother at-
tributed his disorder to exposure during a cold, damp day, at a time when his system
was a little below par from too close confinement in the school-room.

A moderate amount of food caused no discomfort, but his power of assimilation

* Althaus, op. cit., p, 603.
CASES OF CHRONIC DIARRHGA, 583

was considerably impaired, as shown by the great quantity of aliment that passed his
bowels daily. Ordinarily he had five or six evacuations during the twenty-four
hours; but if he indulged to ahy extent in athletic exercises the symptoms became
more urgent,

On one occasion, after indulging for an honr in a game of ball, he was annoyed
during the night by nearly a dozen evacuations, which were attended with consider-
able pain, As might be inferred, this constant drain upon his system had still further
decreased his limited stock of vitality, and he had lost within three months some
twelve pounds in weight.

The first four applications worked no important change in his general condition.

After the fifth visit there were manifest signs of improvement. During the twenty-
four hours following he was compelled to evacuate his bowels but three times,
instead or five or six. The improvement continued after each subsequent applica-
tion, until the number was reduced to one daily. The foeces were of a firm consis-
tency and unmixed with undigested food. The evacuations caused no suffering, and,
more than all, he had gained nearly six pounds in weight. He could indulge in all
the ordinary sports of his school-fellows without any evil consequences following.

The patient was under treatment nearly a month, and the number of applications
administered was ten.

Chronic diarrhea with excessive pains in back and abdomen—Great debility—Very
great improvement from general faradization.

Case CLII.—Miss I., a lady 30 years of age, was referred to us by Prof. J. T.
Metcalfe, Oct. 21, 1869, to be treated for chronic diarrhoea of four years’ standing,
alternated with some anemia and muscular weakness. The discharges, sometimes
several daily, were frequently followed by.severe pain. Debility was so excessive
that she was over-fatigued.by a walk of a quarter of a mile. Ler appetite was capri-
cious and digestion imperfect, and the condition of her bowels made necessary con-
stant caution. The patient referred her difficulties to exhaustion caused by attend-
ance on an invalid sister.

Electric examination revealed a marked tenderness over the transverse colon, which
varied at different times,

The patient was treated by general faradization, at first cautiously, but soon as
she proved able to bear it, with greater freedom, by intervals, for three months, the
applications being made every other day. Improvement began early, and its march
was continuous and mostly uniform. The discharges were gradually reduced in fre-
quency, with relief of the accompanying pain, though two slight relapses occurred
from imprudence at the table. The excessive pain in the back was relieved tempo-
rarily with each application. From week to week her strength improved, and at
the close of the treatment she could walk two miles with pleasure, The increase in
size and hardness of the muscles of the upper and lower limbs was palpable. Occa-
sional attacks of looseness of the bowels annoyed her even then, but they were not
accompanied by the severe pain, and were quite readily checked before they had time
to impair nutrition or reduce the system.

A letter received f:om the patient in September, 1869, reported that in the main
she had retained the improvement derived from the treatment.

In this case very strong and quite protracted applications were given, and with
584 DISEASES OF THE ORGANS OF DIGESTION.

considerablé thoroughness. Only the faradic current was employed, since it seemed to
meet all the indications. The temporary effects of general faradization—relief of
pain, with a feeling of warmth and exhilaration—were strikingly observed after each
application.

That the opposite symptoms—diarrhcea and constipation—are treated -
successfully by electricity need surprise no one who thoroughly com-
prehends the fact that electrical treatment improves nutrition and so
may be used to combat any diseases that depend on depraved nutri-
tion, whatever the symptoms by which the depraved nutrition manifests
itself.

Faundice with debility of six months’ standing—Rapid recovery under ge eral far-
adization,

Case CLIII.—Mr. B., aged 28, had suffered at intervals from jaune assoclated
with excessive physical prostration for nearly six months,

His bowels were obstinately constipated, and had been so during all a period of
bodily derangement. He had been physicked at various times, and most thoroughly
by calomel podophyllin and other cathartics, and had been constantly undpr the influ-
ence of tonic remedies. These efforts had resulted only in temporary relief, and at
the time he applied to us for treatment the patient’s appearance was typical of an
aggravated case of jaundice.

We submitted him on alternate days to general faradization with rapid and decided
effect. The constipation was first relieved, and then followed an increase of appetite;
at the same time his skin became clearer, and he increased both in sea and
weight. .

The result was complete recovery within a month. {

\

(For Gastralgia see chapter on Neuralgia.)

Regurgitation and Vomiting.—For those cases of vomiting that are
of an obviously nervous character, galvanization of the sympathetic and
pneumogastric, or strong faradization through the stomach, is sometimes
of important service. Successful results have been obtained by Pepper
and Bricheteau. The latter treated with success three cases of vomit-
ing of pregnancy. His method of application was to place the electrodes
on the epigastrium at the commencement, middle, and close of the
meal.

It is well in such cases, especially if they are obstinate, to try a va-
riety of methods: galvanization of the sympathetic and vagus, and of
the spine, faradization through the stomach with a strong stable current,
and general faradization.

Dr. F. D. Lente, of Cold Spring, informs us that he has met with ex-
cellent success in the treatment of vomiting by faradization. In some
cases the effects are immediate.
FLATULENCE—SEA-SICKNESS. 585

Fiatulence.—Flatulence is a symptom of disorder of the digestive or-
gans that very readily yields to electrical treatment. It demands the
same treatment as dyspepsia and constipation. Those very frequent
cases that depend on spinal irritation and congestion, and on hysteria,
need central galvanization or general faradization ; cases that depend
on an attack of acute indigestion may be advantageously treated by in-
ternal applications, one pole being applied to the rectum by the rectal
electrode, and the other to the spine or abdomen.

Flatulence was a symptom in very many of our cases of dyspepsia,
hysteria, and spinal irritation, and almost uniformly it temporarily or
permanently yielded.

Sea-sickness.—In October, 1869, Mr. Le Coniat, a French surgeon,
, presented a method of treating sea-sickness, before the New York Med-

ical Association. Subsequently a detailed account of the method
was published by Dr. Dwinelle,* who had experienced the good effects
of the treatment on his own person in a passage across the Atlantic.

His method was to first apply a quantity of solution of atropine—one
grain to the ounce—to the epigastrium, then to apply a flat disk, con-
nected with a faradic apparatus, over the pyloric extremity of the stom-
ach, while a moistened sponge connected with the pasitive pole was
passed over the surface, from the cardiac to the pyloric orifice.

Vigorous contractions of the muscles appeared during the applica-
cations, which were followed by agreeable repose.

I.e Coniat claims to cure by this method ninety per cent. of his cases.

The statements made by Coniat and Dwinelle lose much of their sci-
entific as well as of their practical value, from the fact that the atropine
was combined with the faradization.

There is little doubt that the passage of the electric currents through
the body facilitates the absorption of liquids, placed beneath the elec-
trodes ; moreover, it is well known that the skin is capable of absorbing
liquids without the aid of the electric currents. The quenching of thirst
by bathing is a very familiar illustration.

Then again, atropine is a remedy so powerful that 4, or even yty
of a grain is sufficient to powerfully affect the nervous system, when ad-
ministered hypodermically. Futhermore, it is a remedy for sea-sickness
and sick-headache, as has been shown by experiments of ourselves and
others who have employed hypodermic injections of this remedy com-
bined with morphine. A dose containing z4, of a grain of atropine

-and 4 of a grain of morphine is sufficient in certain cases to relieve the

* New York Medical Journal, 1869, p. 390.
586 DISEASES. OF THE ORGANS OF DIGESTION.

nausea and vomiting, and produce sleep—the same effects that are pro-
duced by the operation of Le Coniat.

From all these considerations, taken in connection with the further
consideration that sea-sickness is probably not a disease of the stomach
alone, but of the central nervous system, of which the nausea and vomit-
ing are frequent but by no means necessary symptoms, we are strongly
inclined to the belief that the results obtained by Le Coniat’s procedure
could have been obtained with much less difficulty by hypodermic injec-
tions of atropine.

The true way to settle the question experimentally would be to treat
a large number of patients by all three different methods—some by the
procedure of Le Coniat, others by the same method without the atro-
pine, and others by hypodermic injections of atropine.

Electricity must be proved to have some very potent influence over
sea-sickness, in order to persuade patients and physicians to attempt its
use on shipboard. A surgeon in the United States Navy reports to us
that he has had good results in the treatment of sea-sickness by faradi-
zation,
CHAPTER XXVIII.
DISEASES OF WOMEN.

Tue diseases of female sexual organs for which electricity has been
proved to be of service are the symptoms of amenorrhea, dysmenorrhea,
menorrhagia, and leucorrhea, although some important results have
been obtained in irritation and inflammation of the ovaries, chronic
metritis, enlargements, displacements, and atrophy of the uterus.

Amenorrhea, dysmenorrhea, menorrhagia, and leucorrhea.—These
symptoms of disease are of course most amenable to electrization when
they are not dependent on any severe or incurable pathological condi-
tion, but are merely indications of functional derangement. The in-
consistency and uncertainty of the results of the treatment of these
symptoms by electricity is entirely explicable to all who are conversant
with uterine pathology ; cases that are indiscriminately treated by any
method must, of course, frequently result in a manner very disappoint-
ing. While thisis true of all the so-called functional diseases of all parts
of the body, it is especially so with regard to the diseases of women.

Treatment of Diseases of the Uterus.—Local, central, and general
treatment may be employed. The local treatment may be either ex-
ternal or internal.

External Method.—¥xternally, the uterus and its appendages may
be electrized by placing one pole with firm pressure over the hypogas-
tric region, and the other over the lumbar region of the spine.

This method is sometimes as effective as internal applications, and,
in virgins at least, should always be tried at first. In this method
benefit is derived partly from the effect of the current on the lower part
of the spinal cord and the abdominal ganglia of the sympathetic.

Internal Method.—Electric currents may be localized in the female
organs of generation in a variety of ways. One pole may be applied
to the os by means of an insulated electrode with a metallic bulb
(Fig. 121), while the other, with a broad electrode, is applied to the back,
or on the hypogastric region, or over one of the ovaries. Instead of a
metallic bulb the uterine electrode may be composed of branches to
588 DISEASES OF WOMEN.

clasp the cervix. A much stronger current can be borne at the cervix
than would be supposed. ‘

 

Fic. 120.

FARADIZATION OF THE UTERUS.—One of the poles is connected with a bifurcated
electrode, one branch of which is placed on the lumbar, and the other on the
hypogastric region. The other pole is applied in the cervix (or at the os) by an
insulated uterine electrode, (The normal position of the uterus is after Wieland
and Dubrisay.)

A method of faradizing the uterus is represented in the accompanying
cut (Fig. 120).

For intra-uterine faradization we have devised an intra-uterine elec-
trode which is represented in the cut. The basis of the instrument is
similar to Sims’s sound. This is insulated with varnish up to within
three inches of the extremity ; the handle is of hard rubber, and is pro-
vided with a hole and screw for fastening the connecting wire of the
apparatus, and a button connected with a spring, by means of which the
connection of the current can be made or broken at pleasure. The
manifest advantages of the interrupter, which 13 similar to that of the
universal electrode holder (Fig. 122), is that it dispenses with the
necessity of waiting until the instrument is iz situ before connecting
it with the apparatus, and that it makes it convenient to give rapid
INSTRUMENTS-——LOCAL APPLICATION. 589

interruptions and to instantaneously suspend the treatment when re-
quired.
When properly curved, this electrode nay be used for the larynx.
Fig. 123 represents a double intra-uterine electrode which allows one
pole to act on the uterine canal and the other on the os externum.
Fig. 124 represents the double ulerine electrode of Duchenne.*

   
 

G.TIEMANN-CO.

  

Fic. 121.

Uterine Elec-
trode (Kidder),

 

Fic. 122. Fic. 123.
Beard’s Intra-Uterine Double Intra-Uterine Elec-
Electrode (Tiemann trode (Galvano-Faradic
& Co.), Mfg. Co.).

This is composed of two plates, connected with flexible wires, which
pass through a sound, but are insulated from each other.

On pushing in the wires slightly at the point where the connection
with the apparatus is made, the poles separate as in Fig. 124. On again

* De l’Electrisation Localisée, p. 89.
590 DISEASES OF WOMEN.

drawing them in, they close as in Fig. 125. The instrument, which is the
same in principle as the double’ vesical electrode, is introduced while
closed, as in Fig. 125, and opened so as to clasp the neck of the uterus.
One of the insulated wires is connected with the positive and the other
with the negative electrode. By this means the current is very closely
localized in the neck of the uterus.
Sasa Concerning these internal applications
 g ED of electricity to the uterus, it may be re-
. marked :—

First—That in those cases where lo-
cal treatment is indicated, applications
to the cervix or in the uterus are fre-
quently much more efficacious than ex-
ternal applications, even with the strong-
est currents. For this reason it is ne-
cessary, even with virgins, to insist on
internal treatment, especially after ex-
ternal treatment has failed. The uterine
electrode (Fig. 121) can usually be intro-
| duced into the vagina as readily as the
Fic. 124. Fic. 125. finger. The intra-uterine electrode can-

Duchenne’s Double Uterine Elec- not well be introduced without the aid
trode,

  

of a speculum.

The other pole may be applied to the back or abdomen by means of
a flat metallic surface or plate covered with moistened sponge.

Secondly—AInternal electrization is not so painful as external. Power-
ful currents can be borne at the cervix and in the uterus for a long time
without inconvenience. Patients usually complain more of the pain
beneath the electrode which is applied on the back or abdomen, even
when the negative, which is the stronger and more painful, is applied
internally.

Tripier,* who has carefully studied the subject of localized faradization
of the uterus, is accustomed to place one pole in the bladder by means
of a vesical insulated electrode, or in the rectum by a rectal electrode.

In somé cases he connects one of the poles with a bifurcated elec-
trode, a branch of which is placed on each iliac region, while the nega-
tive pole is connected with an insulated rectal electrode in the rectum.

Fourthly—Either current may be used. Vhe galvanic as well as the
faradic current may be localized in the uterus, and sometimes it is much
more effective. The danger that the chemical action of the galvanic

* Annales de I’ Electro-Thérapie, 1863, p. 205 et seq.
GENERAL AND CENTRAL APPLICATIONS. 59g!

current will injure the lining membrane of the uterus is but slight, pro-
vided too strong currents are not used, or the pole is not allowed to
rest a lohg time without breaking the circuit.

In all these methods of application either direction of the current may
be used. (See p. 281.) In the treatment of uterine congestion and
engorgement, the positive pole is slightly preferable to the negative
pole, for the reason that it has amore powerful contracting influence on
involuntary muscular fibres.

The vagina may be treated by a metallic vaginal electrode (Fig. 126),
with which either the positive or negative pole may be connected. This
is useful in vaginal Zeucorrhea and prolapsus.

For these local applications either the galvanic or faradic currents
may be used; but the faradic is usually preferable, because in the
majority of cases for which electricity is applied to the female sexual
organs, mechanical more than chemical effects are indicated. Especially
is this the case in amenorrhcea. Furthermore, the currents may be sta-
ble or labile, ‘uniform or increasing, according to the indica-
tions. Local applications to the uterus, whether external or
internal, may be continued for from five to fifteen minutes.
Several methods may be tried at each sitting.

General and Central Treatment.—But very many, per-
haps the majority of cases of functional disease of these or-
gans, require general as well as localized electrization.
There is no department in which so many mistakes have
been made by too exclusively local treatment as in that of
gynecology. Vo case of functional disturbance of the uterus
should be abandoned by the electro-therapeutist until he has
faithfully tried general as well as external and internal
localized electrization. To treat symptoms of central
or constitutional disturbance by merely local electrization
is illogical in theory and unsatisfactory in practice. All
the organs of generation in woman as well as in man
can be affected by galvanization or even faradization along
the spine. A strong evidence of the beneficial results of
general faradization in these cases is the fact that patients oo
undergoing treatment frequently remark that their menses (Kidder, }
are in some way affected. In some cases they are brought
on before their time, in others much increased in quantity. So fre-
quently does this happen that we prefer on the whole to suspend the
treatment during the menstrual periods in those cases where no thera-
peutical effect is desired on the sexual organs.

 
592 DISEASES OF WOMEN.

The ¢ime of making the applications is not unimportant. It is an
advantage, in amenorrhoea at least, to concentrate as many applications
as possible during the few days that precede the appearance of the
menses. And yet the advantage of this is hardly as great as has been
supposed. ‘The great thing in all but recent and temporary cases is to
remove the anzmia or chlorosis, or nervous exhaustion with which the
menstrual disorder is associated, and of which it is a prominent factor.
Another suggestive consideration is that the menstrual flow may be
brought on or increased through reflex action by localized electrization
of other and distant portions of the body, as the hands, feet, chest, etc.

Statical Electricity (Franklinization) has been used for amenorrheea,
and with varying results. The very successful results of Dr. Golding
Bird, in Guy’s Hospital, have been indefinitely quoted, but have not
been yet repeated to an extent sufficient to show that this form of elec-
tricity is superior to galvanization or faradization in the treatment of
this affection. Others, however, as Holsbeck, Bitterlin, Taylor, Her-
vieux, and Graves, have reported cures by this method.*

Prognosis in the Symptoms of Amenorrhea, etc.—Whatever method
is used, ¢zme is required to insure results. While it is true that a
single application, especially internal, may bring on the menses,—
may even cause the blood to appear during the sitting,—yet in the
majority of instances treatment must be more or less protracted in
order to insure permanent relief. The very general impression that
the object of electrization of the functionally diseased uterus is merely
to stimulate the organ to its duty, is a great mistake. Electrization
cures these diseases as much by its permanently tonic effects on the
system, as by its temporarily stimulating effects on the organs them-
selves.

In nervous dysmenorrhcea the prognosis is more uniformly good
than in amenorrhoea. In amenorrhoea the results, though often brilliant,
are quite capricious, some. cases yielding at once, others only after
long treatment, and others not at all. In these remarks on prognosis
it is assumed that no severe pathological state is the cause of the symp-
tonis.

Amenorrhea associated with Anemia—Recovery under general faradization,

Case CLIV.—Miss ——, aged 20, was suffering from a condition of excessive
debility and anzemia. She was hysterical to the last degree, and it was with the
greatest difficulty that she could be persuaded to submit to electrization. These
symptoms had annoyed her for about six months, during which time the menstrual
flow had decreased in quantity and had become irregular until, some two months

* Meyer, op, cit., p. 451.
CASES OF AMENORRH@A. 593

before we saw her, it liad altogether ceased. She was at once submitted to generai
faradization, and, although an exceedingly mild current was used, excessive faintness
was produced, which lasted nearly twenty minutes, Subsequent applications were
borne much more kindly, although the strength of the current was decidedly increased,
Her menses returned after the eighth application, and during the treatment, which
was continued for six weeks, the color returned to her cheeks, her step became firm
and strong, her hysterical condition was entirely corrected, and at the very least it
may be said that she was approximately restored to her usual health.

Amenorrhea of four years’ standing, associated with slight anasarca and marked
obesity—Menses restored and other symptoms relieved by general and localized ex-
ternal faradization.

Case CLV.—Miss H., 25 years old, was directed to us by Dr. T. Cock, of New
York,

For four years the patient had menstruated sometimes three times, sometimes but
twice a year. She had increased enormously in size, her weight being 180 pounds,
and there was some effusion of the legs and feet, as manifested by the indentations
remaining after pressure with the finger. The patient was very plethoric, and suf-
fered much from fulness and oppression about the head. It is proper to remark that
Dr. Cock, before submitting the case to electrization at our hands, had for some
time faithfully made use of the internal remedies that seemed most suited to it. The
patient was annoyed by cold feet and hands and by sudden flushes of heat. As in
our experience general faradization haS been more successful in equalizing the circula-
tion than any other form of electrization, we determined to employ this method. In
this as in the former case, extreme susceptibility to the current was manifested, but
depending more on an excited mental condition than on any real sensitiveness of the
nervous system,

The patient was under -treatment from March 20, 1871, to May 25, 1871, and
received’ twenty applications. A part of the time external localized faradization
was employed, After the fifth séance the courses appeared and lasted two
days, At the proper time during the course of treatment they reappeared and
lasted some four days. The patient presented herself a few months after the cessation
of the séances, and reported that not only the menstrual function continued to act
regularly, but that she remained permanently better in every respect. The tendency
to flushes of heat disappeared after the first menstruation, her extremities became
warmer, and after the second menstruation she was entirely relieved of the watery
effusion in the legs and feet.

An interesting but not altogether unusual result of the treatment was a marked
decrease in flesh. During the administration of the first ten applications she lost
some twenty pounds, and after the séances were discontinued she submitted to the
Banting system, and was rewarded by a still further decrease in weight.

Amenorrhea of a year’s standing, associated with vertigo and debility—Recovery
under general faradization.

Cask CLVI.—Miss E. S., a schoolegirl aged 18, was suffering from suppression that

hadexisteda year, The resulting symptoms were periodical attacks of distressing vertigo,
and a condition of nervous exhaustion that unfitted her for the slightest mental or phys-

38
594 DISEASES OF WOMEN.

ical exertion. The faradic current was alone used, and, as in the two preceding cases,
the applications were partly general, The menses reappeared after the twelfth séance,
resulting in approximate relief of the vertigo and a decided increase of nervous strength.
At the present time, two years since the function was restored, she continues regular.

Amenorrhea associated with hysteria—Spasmodic contractions of the muscles con-
trolling deglutition—Recovery follows two applications of internal faradization
after failure of general faradization.

CasECLVII.—Mrs. H., aged 35, a patient of Dr. C. P. Tucker, of New York, had
for several years suffered excessively from a form of nervous prostration, partly hys-
terical in character, and which seemed in a measure to depend on an almost complete
deafness which occurred suddenly after a season of excitement while she was yet an
invalid from confinement, General faradization had, during the early part of 1870,
very materially lessened these symptoms, and she had remained permanently better.
In March, 1871, her menses ceased, resulting in a return, although in a less degree, of
her old nervous symptoms, In October she began to be afflicted with vertigo and
spasmodic contractions of the muscles controlling deglutition, which latter symptom
progressively increased in severity until at times the patient could with difficulty take
sufficient nourishment to satisfy hunger. We employed general faradization on two
or three occasions, but, becoming satisfied that it was impossible to obtain any im-
mediate result by this method, we resorted to internal faradization, using a cup-
shaped metallic electrode, and thus localized around the os a powerful current of
negative electricity. On the following day we repeated the operation, and in a few
hours after the patient was rewarded by a flow somewhat scanty, and of a darker
color than normal. It was attended also by considerable pain in the uterus and
excessive itching all along the course of the vagina, The distressing spasmodic symp-
toms about the throat ceased immediately and completely, and have not yet shown any
evidence of returning, General applications were continued every other day for a
month, markedly relieving her nervous condition. At the next menstruation the flow
was quite normal, and to the present date the patient continues regular.

Amenorrhea existing two and a half years—A copious flow follows twelve internal
applications of the faradic current,

Case CLVIII.—Miss E,, aged 23, suffered from cold hands and feet, and a feeling
of great fulness about the head, with vertigo, which symptoms depended, doubtless,
on long-continued absence of the menses,

Aside from the above-mentioned symptoms, her general health and strength were un-
impaired. As general electrization and galvanization localized externally gave no
evidence of being of service, with the consent, and in accordance with the desire, of
both thé patient and her mother, we applied the current directly to the os by means
of an exeedingly small ball-shaped electrode. Four such applications repeated at in-
tervals of three days resulted in a copious flow, lasting forty eight hours, Greatly to
my surprise, the associated symptoms were not relieved to any very great extent, and
as the patient ceased her visits before the time for the second return of the catamenia,
we were unfortunately not able to judge concerning the ultimate effects of the treat-
ment,
CASES OF MENORRHAGIA AND DYSMENORRHGA. 595

Amenorrhea existing five months—Recovery under peripheral galvanization (exter-
nal) after failure of faradization,

‘Cask CLIX.—Mrs. S., a widow, aged 30. The patient suddenly ceased men-
struating five months previously, and, accompanying the cessation, there was an an-
noying sense of fulness about the head with vertigo. When she applied for treat-
ment, she stated that these abnormal symptoms had continued without abatement,
and had rather increased in severity. A number of internal applications of the fara-
dic current having been given without appreciable result, we localized as nearly as
possible a galvanic current from twelve small-sized zinc-carbon cells through both ova-
ries and the uterus itself.

The catamenia returned twelve hours after the second application, which was given
the day following the first. Just before the next menstrual period, the application
was repeated, and was followed by the usual flow. The menses appeared the third
time, preceded by no application of electricity, As to further results, we are unin-
formed.

Amenorrhea by intervals for several years—Relief of suppression by intra-uterine
faradisation with a powerful current after fatlure of external applications to the
os by the uterine electrode.

Case CLX.—Miss S., aged 23, was sent to us by Dr, Fordyce Barker, July 6,
1870, During all her menstrual life she had been more or less irregular.

At various times she had been relieved by faradization of some kind, and had found
by experience that it was necessary to use internal applications. Her general condi-
tion was not of the best, and suppression always brought general nervous derange-
ment, We treated her at first by the uterine electrode (connected with the negative
pole) against the os, and the positive either on the abdomen or lumbar region.

This treatment, repeated four times, brought on some appearance of blood, but
not the free menstrual flow. One application, with the same strength of current,
with the intra-uterine‘electrode for about the same time (ten minutes), brought on a
profuse flow on the day following.

In regard to the foregoing cases, it is not to be understood that we
present them as in any way typical of the results to be expected in
every instance, even under the most judicious and correct methods of
electrical treatment. The failures are sufficiently frequent, as every
one who has had much experience in this direction will readily testify.

’

Dysmenorrhea and Menorrhagia—Anamia—Debility—Remarkable sensitiveness
to the current—Entire recovery under general faradization,

Cass CLXI.—A married lady, aged 33, was sent to us in the early part of 1867.
Some ten years previously her husband had been the proprietor of a large boarding-
school, and the care and labor which devolved upon her as matron proved too much
for her strength, Her health finally became so much impaired that the business was
given up, and from that time she had been vainly seeking for permanent relief
There was prolapsus of the uterus of the first degree, and during the menstrual period
she suffered from general neuralgic pains of a severe character. What she chiefly
596 DISEASES OF WOMEN.

complained of and regarded as the principal source of ill-health, was the excessive
dysmenorrhcea and menorrhagia, which occurred regularly every month.

The catamenial flow continued seven days, during which time, and immediately
afterward, she presented a remarkably weak and anzmic appearance.

In the intervening time and under favorable circumstances, she regained a portion
of strength and color, only to be again prostrated at the menstrual period. Her
previous medical advisers had given her tonics and other remedies most suited to her
case, but what seemed to have given her greater temporary relief than anything else
was a course of localized electrization, to which she had submitted in Boston. The
menorrhagia and dysmenorrhcea seemed to be but a consequence of general debility ;
and indeed the symptoms of which she complained were so many and varied, that it
was impossible to point out any one to which treatment should be especially directed,
We immediately commenced general applications of an exceedingly mild and fine, or
rapidly interrupted current. She was so susceptible to the influence of the electricity,
that only the most gentle current could be borne ; and, contrary to our general experi-
ence in such cases, she was, at the completion of her course of treatment, as little able
to endure the sensation as at the beginning. :

The applications were given from two to three times a week, and were continued
about two months, :

In her case as in many others, the first séezce was followed by considerable ner-
vousness and some soreness, but as she was instructed to expect such a result, it caused
no uneasiness,

After two weeks of treatment her courses came on, and were as long continued and
the loss of blood almost as great as ever. Her other symptoms, however, were con-
siderably ameliorated, and the pain from the neuralgia was hardly noticeable. Dur-
ing the succeeding three weeks she appeared a different person.

Her appetite was exceedingly keen, her sleep refreshing, and she had the desire
and strength to exercise daily in walking, to an extent which before would have ex-
hausted her. We looked for a pleasant result as the time for her courses drew near,
nor were we disappointed. The flowcontinued but four days, and the dysmenorrheea
and menorrhagia were so trivial as hardly to deserve notice, and the general neuralgic
pains were wanting. Another result of the treatment was to restore the slightly pro-
lapsed uterus to its normal position, This condition was evidently associated with
relaxation of the vaginal walls, and the beneficial result that followed was due to the
direct tonic effect of the current upon those walls, as well as to the general influence
which was exerted over the whole system, She has had no relapse.

The points of particular interest attending the foregoing case were
as follows :— 2

1st. It was absolutely impossible in making the applications to use
effectively the sponge or any artificial electrode. From even the very
finest and mildest current she would shrink, when it was passed through
the sponge, while a current of much greater strength (making all allow-
ance for the resistance of the body of the operator) was borne without
much discomfort when it passed through the person of the operator, and
was applied directly by means of the moistened hand.
CASES OF DYSMENORRH@A. 597

As is generally the case, we expected that she would become inured
to the passage of the electricity, so that the amount could be increased,
but at each succeeding sitting she seemed to feel its influence as muct
as at the first. But even this patient could bear, and needed more of
the electric influence along the spine and over the vital organs, than
could be given by any one not accustomed to the direct passage of the
current through his own person.

2d. The second point of interest consists in the fact that she had
previously been treated by /ocadized faradization, and with some benefit,
although not sufficient to encourage her to hope for a complete or even
an approximate cure. We made use of general faradization only, and
although the applications were directed to particular parts, longer and
harder than to others, yet the main idea was to bring the system gen-
erally under the influence of the electric current.

Dysmenorrhaa from congestion of uterusin a lady of twenty-two-—Anemia—Im-
provement under general faradization and localized galvanization— Relapse,

Case CLXII.—Miss M——, a young lady of 22, was sent to usin August, 1867, by
Dr, Moreau Morris, to be treated for a dysmenorrhcea of an unusually distressing
character, She was of a frail nervous organization, and was decidedly anemic. In
the opinion of Dr. Morris, the dysmenorrhoea was caused by congestion of the womb,
brought on by repeated colds and chills during the menstrual period, years before,
From her girlhood she had been an invalid. Her appetite was exceedingly delicate,
and there was great impressibility to disease in all her mucous membranes, It would
indeed be difficult to conceive of a more disheartening case of dysmenorrhcea, for any
kind of treatment.

Very doubtful encouragement was given. General faradization and localized
galvanization (external) were chiefly employed.

It was not long before she began to improve in her general condition, and experi-
enced a greater relief from her severe neuralgia and dysmenorrhcea than she had ever
secured from internal medication, At one of her monthly courses she was almost
entirely free from pain; and at most of the others that have occurred since she began
treatment, she has suffered less than formerly. She is now far from being strong, but
retains in a measure the benefits she received.

Neuralgic dysmenorrhea and menorrhagia—Constipation—Permanent improve-
ment under general faradization.

Case CLXIII.—Miss D,—, aged 21, came to this city from Auburn, to be treated
for the variety of dysmenorrhcea termed neuralgic. The treatment by ordinary in-
ternal medication was continued some two months, but, as the neuralgic pain seemed
to be but little relieved, and as her general condition did not improve, she was induced
to try the effects of general faradization before returning to her home. She com-
menced to menstruate at irregular intervals when about fifteen years of age, and from
the first had suffered more or less at each menstrual period. Her general health began
598 DISEASES OF WOMEN.

to fail some three years before she visited this city for treatment, and when she came
under our observation she presented the following symptoms :—

She was decidedly anemic, and the general appearance of lassitude and ditpours
agement which she presented at once betrayed the disturbance of her vital forces,
While in many instances of neuralgic dysmenorrhcea the pain seems to be confined
solely to those nerves that supply the sexual organs, in this case the disorder extended
to the whole system, The constant recurrence and terrible paroxysms of pain from
which she suffered rendered life a burden, Even in the intervening time, anticipation
of the agony that she again must so soon undergo, caused her to suffer from great de-
pression and melancholy.

In addition to these distressing pains she suffered from profuse menorrhagia, so that
what little strength she regained after her sickness was almost immediately lost on the
return of the catamenia. Her bowels had been for a long time obstinately constipa-
ted, and unless this state were frequently relieved by aperients she was annoyed by
considerable vertigo and headache, She began to despair of ever obtaining relief,
She received the first application of general electrization in November, 1866. A very
mild and fine current was used, and the application was extended from the neck down
the spine and over the vital organs.

Although she was submitted to the influence of the current for but five minutes,
yet during the application she showed symptoms of faintness, and on the following
day she suffered from considerable soreness and nervous prostration. She visited us
on three different occasions when her courses appeared, and were as long continued
and attended with as great loss of blood as before. There was, however, considerable
amelioration of pain. Before the cessation of the flow we renewed the operations,
and continued the treatment uninterruptedly for nearly four weeks. She received an
application every other day, and was soon able to bear a current of ordinary strength.
The improvement in her condition was exceedingly rapid. The capricious appetite
became less exacting, and constipated bowels more regular. After a very few applica-
tions had been given and the influence of electrization began to manifest itself, she ap-
peared a different person both in mind and body, When her menses again appeared
she suffered but little more pain than is usual, and the general neuralgic distress was
quite wanting,

The menorrhagia, which before was such a prominent and debilitating symptom,
was now so slight as scarcely to deserve the name. Shereceived subsequently three
more applications, when she returned to her home. We were of course anxious to
know if this favorable state of things continued, and have been gratified to learn by
direct information that since she discontinued treatment there has been no return of
any prominent distressing symptom. She moreover continued to improve in her gene-
ral condition, until she became robust,

That the pathological state on which the symptoms of uterine dis-
eases depend, have not been sufficiently considered is very evident from
a study of the history of the electro-therapeutics of these diseases.
There is need of accurate diagnosis, and especially of careful measure-
ment, before, during, and after electrical treatment in order to
know just how much it accomplishes. These measurements should
be made by experts in gynzcology. The future will show that very
ATROPHY AND DISPLACEMENTS OF THE UTERUS. 599

much can be done for congestion, atrophy, and engorgement of the
womb, by careful localized electrization.

Atrophy of the uterus—Scanty menstruation—Sterility—Increase in the size of the
organ and in the amount of the menstrual flow under internal faradization
and central galvanization and general faradization,

\

CasE CLXIV.—Mrs. P., a young married lady, was referred to us, January 17,
1872, by Dr, Fordyce Barker, for the symptom of sterility, According to Dr. Barker’s
diagnosis there was atrophy of the uterus, and he was in the hope that electrization
might, by improving the nutrition of the uterus, perhaps remove the sterility. It was
supposed also that there might be atrophy of all the generative organs, since the men-
struation was defective, though regular, and the patient was withal quite anemic. We
treated the patient for six weeks by internal faradization of the uterus, with our
intra-uterine electrode, through the speculum; external faradization over the back
and the region of the ovaries; general faradization and central galvanization occa-
sionally. The patient came every other day, Internally she took iron and strych-
nine.

At the first menses after treatment the patient remarked an increase of quantity,
and the courses were on her one day longer than usual. By the 1st of March, after
six weeks’ treatment, Dr. Barker found on examination that the uterus had increased
in length one-quarter of an inch. The patient after an interval was again treated,
but without any local improvement,

The modification of nutrition caused by electricity may have two op-
posite effects; it may cause increase or it may cause diminution in the
size of a part or organ. Where the part is abnormally large it causes
it to grow smaller ; where it is abnormally small or atrophied, as in the
above case, it causes it to grow larger. In these opposite results there
is nothing inconsistent; they are readily explained by the change in
nutrition caused by the current.

Congestion, Enlargements, Displacements, and Atrophy of the
Uterus.—Tripier, Beauvain, Seiler, Fano, Beau, and ourselves have
treated engorgements and flexions, prolapsus and atrophy of the uterus,
by electricity. Both the galvanic and faradic currents are employed.

The occasional results obtained in prolapsus uteri are to be explained
partly by the chemical and mechanical effects of the current on the
structure of the uterus, and partly by its tonic effects on the liga-
ments and vaginal walls.

Treatment.—In the treatment of the various displacements of the
uterus, the application must, of course, be varied with the morbid con-
dition. Special rules cannot be given in any detail; each case must be
studied by itself.

According to Tripier,* chronic metritis and enlargement of the uterus,

* Loc, cit., p. 38 et seq.
600 DISEASES OF WOMEN.

is best treated by applying the uterine electrode against the os, and
connecting the other pole (bifurcated) with an insulated rectal electrode
in the rectum and a sponge electrode over the abdomen.

Prolapsus uteri the same author treats by applying the uterine elec-
trode against the os, and connecting the other pole (bifurcated) with
two sponge electrodes, one on each groin.

For anteversion and anteflexion he introduces the negative pole into
the rectum, where it can act more powerfully on the posterior part of
the uterus, and the positive in the vagina.

For retroversion and retroflexion he applies the positive pole in the
bladder or over the abdomen, while the negative is applied to the os,
by the uterine electrode, an air pessary having first been put into the
rectum to elevate the fundus.

By properly insulating the electrode, the current—faradic or gal-
vanic—can be localized in any restricted portion of the uterine canal.

The treatment may be regarded as an important adjuvant in all re-
bellious cases of engorgement and atrophy of the uterus or of its ap-
pendages, and of uterine displacement, and especially of those that are
associated with general debility. The contracting influence of the elec-
trical currents over involuntary muscle is a strong physiological argu-
ment in favor of the use of this remedy in uterine engorgement (see
chapter on Involuntary Muscles in Electro-Physiology).

Tripier* details thirty cases of various phases and complications of
uterine disease treated by localized faradization.

Of anteflexion and anteversion, four cases recovered, two were im-
proved and in one case no result was obtained.

Of retroversion and retrofiexion, one case recovered, one was im-
proved, and in one case there was no result.

Of engorgement, two cases recovered.

Tripier further observed very marked effects on the general system,
and severe symptoms of hysteria, neuralgia, and nervousness were
greatly ameliorated. If general faradization and central galvanization
had been employed, these constitutional effects would have been much
more marked.

Prolapsus uteri—Leucorrhaa and menorrhagia—Loss of tone in vaginal walls—
Recovery under faradization of uterus and general faradization,

CasE CLXV.—Miss T., an unmarried lady, aged 30, applied for treatment for fall-
ing of the womb of the second degree, from which she has suffered for nearly six months.
Previous to the first symptoms of prolapsus, persistent leucorrhcea had annoyed her

* Annales de I’ Electro-Thérapie, p, 202 et seq. 1863.
IRRITATION: AND CONGESTION OF OVARIES. 601

for some time, and had continued up to the day she came to us. She complained
also of some menorrhagia. These conditions, however, were evidently associated with
no organic uterine disease ; but her general health was quite feeble. If it were a case
for electricity at all, it was plain that she needed its tonic influence. We commenced,
therefore, with mild general applications, increasing the strength of the current at
each visit as she was able to bear. At each sitting, also, the electrode was applied
for a few minutes against the os and the vagina. The beneficial results of this course
of treatment were soon observable, Her appetite, which had been capricious, became
more rational, and her strength increased with marked rapidity, The vaginal walls
seemed to gain torie day by day, until after the sixth application the uterus was re-
stored to its normal position.

Lrritation and Congestion of the Ovaries.—Irritation and neuralgia
of the ovaries accompanying hysteria are treated electrically with advan-
tage. Congestion of the ovaries is also similarly treated with excel-
lent result—at least for the relief of the symptoms.

Intra-Uterine Galvanic Pessaries.—The attention of the profession
was called to the use of galvanic intra-uterine pessaries by Sir J. Y.

‘Simpson. The instrument which he employed was composed of a piece
of zinc and a piece of copper fastened together into a shape and
size suitable for entrance into the uterine cavity.

As thus constructed the instrument was stiff and
unyielding, and was not adapted for the various states
of uterine flexion. This form of pessary Prof. T. G.
Thomas * has greatly modified by substituting for the
single pieces alternate beads of zinc and .copper, which
are arranged on flexible wire inserted in a rubber bulb TiitraxUterine
(Fig. 127). This instrument we will still further improve Galvanic Pessa-
by insulating the wire on which the beads of zinc and TY
copper are strung, except at the extremities, where it makes metallic
connection at one end with the zinc, and at the other with the copper
bead, thus forming a miniature voltaic pile, with a completed circuit.

When this contrivance is closely embraced by the lining membrane
of the uterus, and thoroughly moistened by the uterine fluids, a feeble
current is unquestionably generated.

When, therefore, such a galvanic pessary is iz stfu it is probable
that the very feeble current, as it passes through the metallic beads,
way traverse, to a limited extent, the folds of the lining membrane of
the uterus, which presses between them.

The question whether the very slight current thus produced, com-
bined with the necessary mechanical effect of the metals in such case,

 

Fic. 127.

* A Practical Treatise on the Diseases of Women. Second edition, p. 500.
602 DISEASES OF WOMEN.

is capable of important therapeutic results, can only be answered by
extended experience and discriminating observation.*

Dr. Thomas assures us that in amenorrhcea positive therapeutical
results have been obtained by the use of this pessary ; but is unable to
say whether the results are due to the mechanical effect of the metals
or to the action of the current.

Dr. Peaslee also has seen favorable results from the use of the same
pessary.

The question whether the therapeutical effects are due to the press-
ure of the foreign body or to the action of the current might be settled
by substituting glass beads for the metals.

Dr. Murray, quoted by Althaus,f has used Simpson’s intra-uterine
galvanic pessary with success in cases of sub-involution of the uterus,
where the os is open, the lips thickened, and the whole organ flabby
with excess of menstruation and disagreeable discharge. In one marked
case a fortnight’s use of this instrument reduced a flabby uterus “nearly
to its normal and healthy condition.”

An important practical difficulty in using these pessaries is that they
will not always remain in position. To meet this difficulty springs have
been attached to the handle which fall against the walls of the vagina,
and thus keep the pessary from slipping out.

* The white coagula that are observed after this application of this pessary are
caused by the chentical action of the current on the intra-uterine fluids.
t Op. cit., p. 631.
CHAPTER XXIX.
DISEASES OF CHILDREN.

Tue diseases of children in which electricity has been found of ser-
vice are the following :—

Chorea, Marasmus and General Debility,
Whooping-Cough, Incontinence of Urine,

Cholera Infantum, Vomiting,

Laryngismus Stridulus,* Infantile Paralysis.

Treatment.—Chorea has been successfully treated by a variety of
methods of electrization—by frictional electricity, peripheral faradiza-
tion,t and galvanization of the spine,} and in our hands general faradi-
zation and central galvanization. Successful results have been gained
by all these methods. We have found general faradization and central
galvanization alone so successful in cases of general chorea, that we
have but rarely had occasion to experiment with other methods.

Our success with general faradization in chorea is probably to be
accounted for partly by the muscular exercise that is derived from this
method of treatment, as well as by the tonic. action of the current on
the nervous system. Choreic patients do not usually bear strong cen-
tral galvanization or protracted sittings ;“the milder influence of the
faradic current is preferable to the galvanic, unless the latter is used
with considerable caution. ° Benedikt claims to have been uniformly
successful in more than twenty cases of chorea by galvanization of the
spine. He used, however, but a small number of elements, and the
length of the sittings was not more than one and a half minutes. Other
‘observers have not been so successful with this method. Meyer reports
unsatisfactory results with galvanization of the spine in two or three
cases.§ It is probable that the success of Benedikt with galvanization
of the spine was due to the very great caution which he exercised in
regard to the strength of the current and the length of the sittings, as

* This affection is considered under Diseases of the Larynx,
+ Duchenne and Becquerel. + Benedikt, § Op. cit., p. 364.
604 DISEASES OF CHILDREN,

he himself declares that the symptoms were aggravated if the number
of elements were much increased. For hemi-chorea Benedikt recom-
mends galvanization of the head. We prefer for all cases of chorea
general faradization, occasionally varied by central galvanization, with
very mild currents, and believe that this method of treatment faithfully
used will do all that can be done for this disease through electricity.

Prognosis.—In regard to the prognosis of chorea under electrical
treatment there has been considerable skepticism, even among those
who are friendly to electro-therapeutics. This skepticism has been due
to the fact that the majority of cases of chorea recover spontaneously
in time, and because their improvement under electricity is, in some
cases, quite slow. d

Aside from the well-known fact that many cases recover spontaneously
in the course of a few weeks or months, direct and positive results of
treatment can be appreciated in this disease more uniformly than in any
other spastic condition. Cases of failure after protracted treatment by
electricity are exceptional. The worst cases, when recent, sometimes
seem to yield better than those which are comparatively mild.

Partial chorea, affecting the eyelid, the muscles of the neck, or a sin-
gle limb, or group of muscles, is more obstinate than a much worse
form of general chorea. The explanation of this inconsistency is that
patients affected with partial chorea are apt to delay weeks, months,
and years before taking treatment. Recent cases we have found to
yield almost uniformly. All long-standing choreic cases need to be
treated perseveringly—from one to several months being usually neces-
sary to complete a cure. In some cases no apparent improvement
takes place at the outset of electrical treatment, and the friends of the
patient become discouraged ; but if the treatment be continued, a per-
manent cure may be obtained. Symptomatic chorea—dependent on
cerebral or cerebellar disease—offers an unfavorable prognosis.

General chorea, with inability of the patient to walk, feed himself, or distinctly
speak—Recovery under central galvanization, after the failure of general fara-
dization and medication,

Case CLXVI.—Master S., a little boy about ten years old, came to us through
Dr. J. O, Farrington.

The patient had for some time suffered from general chorea of a decided character,
but during the last few weeks it had so increased in severity that he was unable to
walk, or even feed himself. All his extremities as well as the face were in constant
motion; his utterance was indistinct, and in weight he had decreased very much.
There was no hereditary tendency of this character in the family, and the only cause
to which the symptoms could plausibly be attributed was a fall from a horse, which
severely jarred him, some weeks before the disease manifested itself,
CASES OF CHOREA. 605

The treatment was varied. Fowler’s solution and certain other remedies, which we
do not now recall, had been faithfully tried, but without benefit, We began with
mild general faradization, but, as the results did not accord with our expectations, we
abandoned it and essayed very gentle central galvanization,

During the first week of this treatment no appreciable benefit“seemed to be derived,
except an improvement in sleep,

Soon after this, however, the effect observed was decided. His appetite became
better, resulting naturally in increased weight ; co-ordination of movement rapidly
became possible, the utterance distinct, and in a few weeks recovery was complete.

Treatment was discontinued in February, 1871, and to this date there has been no
evidence of a return of the disease.

Chorea of ten months standing, of the left side and right arm, in a girl of eleven~-
Recovery in ten weeks under central galvanization.

Case CLXVII.—M. R., alittle girl, aged eleven, was directed to us by Dr. H. H.
Gregory, of Harlem. Some ten months before, the mother first observed slight con-
vulsive-twitchings of the left hand, which gradually increased in severity until in a few
weeks the member was quite useless. In two or three months the left leg became
choreic, and soon after the disorder extended to the right arm. It was one of those
cases which obstinately resist ordinary internal medication, and was hence considered
a fair opportunity to test the virtues of central galvanization, The treatment was
given every other day, but for three weeks no apparent impression was made upon
the disease,

During the fourth week the symptoms somewhat abated, and from this time forth
the improvement was uninterrupted, until, in ten weeks from the beginning of the
treatment, recovery was perfect.

Choreic disturbance of the head of five months’ duration—Recovery under less than.
twelve applications of general faradization,

CasE CLXVIII.—Minnie V., aged 8 years, had been affected for five months with
severe and almost constant nervous twitchings of the head, They were evidently choreic
in character, occurred without the consciousness of the child, and during sleep were en-
tirely wanting. The patient was somewhat depressed in health and decidedly anzemic,
and we therefore submitted her to general faradization, Under the influence of less
than a dozen applications she gained in appetite and strength, The choreic disturb-
ance became decidedly less marked, and after the cessation of the treatment, for the
purpose of allowing the secondary effects to be manifested, it was not more than ten
tlays before recovery was complete,

Chorea of a year’s duration—Improvement during treatment, and rapid recovery
after its cessation,

Casr CLXIX.—A little boy of a delicate organization was sent to us by Dr. Geo.
Peters, The child had been affected with general choreic movements of a decided
though not severe character for a little more than a year. The mechanical effects of
the faradic current seeming to disagree with the patient, we submitted him to mild
séances of central galvanization. Some fifteen applications were administered during
the month which resulted in some improvement. At this stage the treatment was
necessarily interrupted, but the improvement continued, and in a few weeks the
Tecovery was quite complete.
606 DISEASES OF CHILDREN.

In not a few cases of chorea the beneficial effects of electrical treat-
ment became manifest—as in the above—after cessation of the applica-
tions.

.

Severe chorea ina girl seven years of age—Less than usual sensitiveness on the head
—Recovery under ten general faradizations,

Case CLXX.—L, J., a girl seven years of age, was brought for treatment by gen-
eral electrization in September, 1868. She was pale and slender, but quite tall for
her age. For eighteen months her growth had heen remarkably rapid, and
to this fact the mother was inclined to attribute the disease, The parents first
noticed some twitching of the left hand in the fall of 1866, but did not at the time
give it particular attention. The choreic symptoms rapidly increased to such an ex-
tent, however, that they became alarmed, and applied for medical treatment, But
in spite of persistent internal medication, the want of power to co-ordinate her move-
ments grew more marked, and the symptoms extended to her limbs and organs of
speech. At the time that the patient came under our notice the choreic movements
were quite violent, The left side was considerably more affected than the right, and
her articulation was so indistinct that it was impossible for a stranger to understand
what she said. We found no difficulty in inducing the child to submit to the treat-
ment, but the involuntary agitation of the legs was so great that it was found neces-
sary to hold the feet upon the plate to which the negative pole was attached.

The current was very sensitively felt over the stomach, but not over any other
portion of the body. It may be remarked, however, that over the head could be
borne without discomfort a current much more intense than is the case in the normal
condition,

The first and second applications resulted in no appreciable change in her symp-
toms; but atthe fourth visit, about ten days after the first, a perceptible improve-
ment was noticed. As is usually the case when a favorable result follows any
method of treatment, the diminution of the choreic movement was first manifested in
the lower limbs, The progress towards recovery was very rapid.

At the fifth visit she could retain her feet upon the plate by her own unaided efforts,
while the application was being made, This improvement had also extended to the
arms and face, and the tenth application, administered about a month after the first,
dissipated every choreic symptom. There was one peculiar and well-marked feature,
which we observed in this as well as in several other cases, We refer to the in-
tensity of the current used when applications were made to the head. As the disease
advanced toward recovery, such applications became more and more painful, so that
it was necessary to gradually decrease their power.

Chorea of face and arms in a lad twelve years of age, dependent on mental influ
ences—Recovery under localized faradization.

Case CLXXI.—In December, 1866, a lady brought to usa little boy, aged 12 years,
to be treated for symptoms that were somewhat anomalous, yet not of a character
sufficiently marked to enable us to say positively that St. Vitus’s dance proper existed,
While in perfect repose, and even when engaged in play, study, or conversation, if
there was nothing to excite or alarm, he exhibited nothing unusual in his movements,
If, however, he failed in his recitations, was scolded by his parents, or if he became
CASES OF CHOREA. 607

excited in his play, or was abashed by the notice of a stranger, some peculiar symp-
toms became immediately manifest. The muscles of the face became convulsed, and
at times the twitching was quite violent, so that his appearance was grotesque in the
extreme. Rapid contractions of the muscles of the arm also occurred, These were
most noticeable in the biceps and flexors of the hands and fingers.

The child was to all appearance perfectly healthy, and was of a lively and genial
disposition,

This disorder of the nervous function had existed some four or five months, so that
considerable uneasiness was excited in the minds of the friends of the patient. As he
lived a considerable distance from the city, applications were given only occasionally,
as his attendant found it convenient to bring him. During the course of a month the
boy visited us some five or six times, and as he was suffering from no debility, we
judged it to be sufficient to make the applications only to the parts affected, and not
to extend them over the whole surface of the body. The result of this irregular
treatment was successful, since all the abnormal movements to which he had been so
readily liable on exposure to any excitement became less and less marked, At the
end of the month he left us cured.

An aggravated case of chorea resists the action of the galvanic, but yields to general
electrization with the faradic current—Relapses, and again recovers under the
same treatment,

Case CLXXII.—A little patient, aged 10 years, under the professional care of Dr,
J. O. Farrington, presented the severest symptoms of chorea,

Prof. George T.. Elliott was called in consultation May 18, 1868, and by these gen-
tlemen electrical treatment was advised.

Some two months previous to the consultation certain abnormal movements—such
as starting suddenly to his feet; throwing out a hand or a foot, etc.—were observed
by the teacher of the boy. Two weeks subsequently, the patient was seized with well-
marked choreic symptoms of the right side of the body, and in two days the disturb-
ance extended to the opposite side. So constant and violent were the movements of
his arms and legs that it was impossible to keep him on a bed or sofa, It was neces+
sary to place him on the carpet, surrounded by inflated rubber bags. Intelligence
seemed to be perfect, but the power of speech was lost and the sufferer made known
his wants by impatient cries and ill-directed motions,

Sleep was impossible without the nightly administration of an opiate. Contrary to
our judgment, but by suggestion, we commenced treatment by the use of a mild gal-
vanic current directed especially to the base of the brain and the spinal tract ; but
this method served only to aggravate the child’s condition. We then resorted to the
faradic current by the method of general electrization, but so violent were the invol-
untary movements in the limbs and body of the patient, that it was with difficulty
that he could be held in a sitting posture and his feet kept on the copper plate to
which the negative pole was attached, The applications were genera/—every por-
tion of the body, from the’head to the feet, being influenced on each occasion,

Improvement was manifest from the very first. He was at once enabled to sleep
soundly, although his opiate was reduced one-third, and after the fourth application
it was dispensed with altogether. In the course of three weeks, during which time
fifteen applications were given, the case was so far improved that the patient was able
608 DISEASES OF CHILDREN.

to utter distinctly words and sentences, The choreic symptoms were so much dimin-
ished that the boy could readily sit quiet and alone, and during an application was
able to command the movements of his body and feet. Improvement continued dur-
ing the administration of a few more applications, when the child was taken to the
sea-shore, where in two weeks he quite recovered. After having enjoyed excellent
health for a year and a half, the boy suffered from a second attack. He was imme-
diately subjected to the influence of electrization, and recovered even more rapidly
than before,

Marasmus and General Debility.—In the treatment of marasmus and
general debility of children, Dr. Beard has recently made a series of
experiments at the Sheltering Arms Institution in Brooklyn, which is
under the medical charge of Drs. Jerome Walker and Frank Rockwell.
In addition to this hospital experience, Dr. Rockwell has, in private
practice more especially, had very many opportunities of testing the
efficacy of the various forms of electricity in the diseases under consid-
eration. In these investigations a number of marasmic cases and of
cases of debility of various kinds, some of a most serious character, were
treated by general faradization, and with most pleasing results. The
remarkable improvement in nutrition that the young of animals may
derive from general faradization has already been described (see chapter
on Nutrition, in Electro-Physiology).

Two important facts were brought out and confirmed in these exper-
iments :—

1. That very young children—under one year—could bear as large
doses of general faradization as adults.

2. That the recognized tonic effects of general faradization—improve-
ment in sleep, appetite, and in rapidity and vigor of growth—are appre-
ciated by infants even more rapidly than by adults.

Cases that were fast failing were restored, and in one or two instances
life was apparently saved by the treatment.

Marasmus ina child aged four—-Recovery under general faradization after failure
y of the accepted methods of treatment.

Case CLXXIII.—F. C., a little boy aged 4, had been prostrated for some time with
diarrhoeal symptoms with fever. These symptoms became modified under treatment ;
but the child continued excessively weak, with no appetite, with paroxysms of fever-
ishness, sleeplessness, profuse night-sweats, and progressive emaciation, No form of
medication seemed of much service ; and as the condition of the patient had assumed
a chronic character and clearly pointed to disease of the mesenteric glands, electricity
was advised by both Drs, H. H. Gregory, the attending, and the late Geo. T. Elliot,
the consulting physician.

We submitted the little patient to general faradization carefully but thoroughly
applied. In one respect its effects were immediately and decidedly evidenced,
MARASMUS AND WHOOPING-COUGH. 60¢

The sleep was bettered and the profuse perspiration very markedly checked. For
six weeks this treatment was repeated every night, and while there was no rapid prog-
ress towards health, yet from the beginning of treatment the improvement was gradual
and uninterrupted until the recovery was complete,

Whooping-Cough.—In the institution mentioned on the preceding
page, and in private practice, sixteen cases of whooping-cough in various
stages of the disease have been treated, mainly by central galvanization..
The result was improvement in every case. The paroxysms were
diminished in frequency and violence, and in some instances the
length of the distressing stage of the disease was shortened.

In cases complicated with debility there was improvement in general
nutrition. In. one case where great debility, resulting from congenital
syphilis existed, the improvement in general nutrition was most striking ;
and in that case general faradization was mainly used. In most of the
cases treated, the usual medication in wide variety, including quinine,

“had been tried. All medication was stopped shortly after the electri-
cal treatment was adopted.

Lneontinence of Urine.—This very distressing infirmity will sometimes
yield to local or central galvanization, but the uniform results that are
obtained by these methods of treatment are not always permanent. °

In conjuction, however, with other tonic remedies, it is undoubtedly
a valuable aid in the treatment of this disease.

In cases where there is an almost absolute want of control over the
bladder, the local application of the faradic current is strongly indicated,
and will frequently alleviate the symptoms.

The following case is illustrative of the good effects that may occa-
sionally follow the use of electricity :

Lucontinence of urine since birth in a child aged sixn—Recovery in six months under
local favadtzation,

Cask CLXXIV.—Willie » a little boy, aged six, had been annoyed, more or
less, by this want of control over the bladder since his birth, He invariably wet his
bed at night, and it was not unusual for him to meet with accidents by day. He wasa
fe healthy boy, and therefore he was submitted to simple localized faradization.
The treatment was not kept up very regularly, but once or twice a week, as he hap-
pened to visit the office. In about a month, his mother observed a very decided. im-
provement. The improvement slowly continued, and in the course of six months the
patient seemed to have gained ordinary control over this function.

 

Vomiting and Cholera Infantum.—Both vomiting in children and
cholera infantum are treated with advantage by bromide of potassium
and by the tonic influence of sea, mountain, and country air.. It would
therefore be just to suppose that these affections might be successfully

39
610 DISEASES OF CHILDREN.

treated by electricity. Dr. Lente, of Cold Spring, informs us that he
has nad excellent results in the treatment of vomiting in children by
faradization. Dr. O’Reilley, of Louisville, Ky., reports good results
from faradization in cholera infantum.

Infantile Paralysis.—Paralysis in infants, though often of a reflex
character, is so frequently dependent on some morbid condition of the
spine, that it might properly be included under spinal paralysis. Like
paraplegia in adults, it depends on a variety of diseased states of the
spinal cord and its membranes. There is, probably, no one patholo-
gical lesion that is pathognomonic of this disease.*

The symptoms of the disease are paralysis of motion, with loss of elec-
tro-muscular contractility, some anesthesia, great diminution of temper-
ature, and muscular atrophy.

In some cases the muscular atrophy is accompanied by fatty degen-
eration.

Duchenne, with the aid of the microscope, has investigated the con-
dition of the muscles in muscular atrophy. For this purpose a trocar

 

      

GTIEMANN=UILAY.

[SESS

Fic. 129—Noeggerath’s Trocar.

is necessary. Duchenne’s trocar, Fig. 128, is introduced into the muscle
open. When iz sifu, a piece of sharp steel is pushed, by means of a
button, against the barb of the trocar. A piece of muscle is thus
caught, which, on the withdrawal of the trocar, can be examined.
Microscopie Examination of Muscles.—Noeggerath’s instrument,
Fig. 129, is introduced as a simple trocar, and when iz sifu, the wire con-
‘ tained in it, being pushed forward, causes the prongs or clasps on its
extremity to emerge a little separated. When the wire is pulled out the
prongs come together, bringing with them a piece of the flesh.

* For a valuable résumé of the present state of our knowledge of the Pathogeny of
Infantile Paralysis, see the paper on that subject by Dr. Mary Jacobi in the Am,
Journal of Obstetrics, May, 1874.
INFANTILE PARALYSIS. 611

We present the cuts of Duchenne, with condensed explanations.

Normal fibre. ———First degree. ——_,
‘

 

Fie. 130. Fic, 131. Fi. 132.

Fig. 130 “represents the normal fibres, with the transverse stric,’”
Figs. 131) 132.—‘‘ The transverse strice are less distinct; they are frequently
broken ; the longitudinal fibres are more and more marked.”

Second degree,

 

Fic. 133. Fic. 134.

Fig. 133.— The muscular fascia is composed entirely of longitudinal fibres, the
transverse strize having completely disappeared.’?

“* By the side of the muscular fibre adipose tissue is observed, composed of cells
that are either (2) round or longitudinal ; there are little drops (4) of fat deposited in
the muscular fil:re.”

Fig. 134. The muscular fibres have still preserved thvir contractility, ard are
undulating,”
612 DISEASES OF CHILDREN.

Third degree.

 

Fic. 135+ Fic, 136.

Figs 135, 136.—‘‘ The longitudinal fibres have become less distinct. ‘The moles
cules of fat are more and more abundant—again cover the figure almost entirely.”

Fourth degree.

 

Fic. 137 Fic. 138. Fic. 139.

Fig. 137.—‘‘ The longitudinal fibres have disappeared. We see only fatty
molecules very close together and little distinct, especially towards the axis of the
fascia ”

Fic. 138.—‘ The fat becomes more abundant and difficult ; the muscular fascia is
more transparent.”

Fic. ‘139.—‘‘ Distinct molecules of fat are no longer perceptible ; the fascia is com-
posed of a shapeless mass,

“‘ Each degree of fatty transformation corresponds to a degree of decoloration of
muscular fibre,””

Electro-Diagnosis.—In infantile paralysis there is diminution or utter

loss of electro-muscular contractility. In patients so young the con-
dition of the electro-muscular sensibility cannot of course be ascertained.
TREATMENT OF INFANTILE PARALYSIS. 613

The tactile sensibility is in some cases much diminished ; in other
cases it does not appear to be affected.

A slight degree of anzesthesia cannot be ascertained in very young
patients. An important feature of infantile paralysis is that the muscles
exhibit contractility under galvanization when they are not at all affected
by faradization. In this disease especially both currents are necessary
in the diagnosis as well as in the treatment, and careful regard must be
given to the “ motor points.”

In making an examination of the’condition of the muscles of infants
it should be remembered that, on account of their flabby character and
the relatively large proportion of adipose tissue by which they are sur-
rounded, they do not respond as readily nor as perceptibly to electriza-
tion as the muscles of adults.

Treatment,—Galvanization of the affected: limbs is the method of
electrization that is principally indicated in infantile paralysis. In those
cases that fail to respond to the faradic current, the galvanic is indis-
pensable. When the muscles have regained their contractility under
‘the faradic current, faradization may be used either alone or alternately
with galvanization. ‘

Children will bear as powerful currents and as protracted localized
applications, without apparent injury, as adults (see p. 608). No stronger
currents should be used, however, than are just sufficient to produce
full muscular contractions. Zhe most frequent mistake is to overdo the
treatment—to use too strong currents, and too long applications, and thus
weaken rather than strengthen the muscles.

Galvanization of the spine is also indicated, and in connection with
the peripheral treatment should not be neglected.

In infantile paralysis the general health is not necessarily impaired.
Those cases that are accompanied with general weakness should be
treated by general as well as localized faradization and central galvani-
zation. Treatment by electrization is greatly aided by passive move-
thents systematically and skilfully used, shampooing, frictions, and the
application of dry heat and hot water to the affected limbs. (See re
marks on Accessory Treatment under Hemiplegia.)

' Prognosis.—The prognosis must depend on the cause, the probable
nature of the lesion, the length of time that the disease has existed, and
the condition of the muscles, especially as ascertained by electric and
microscopic examination. If fatty degeneration is much advanced the
prognosis is less favorable than when no degeneration exists.

Cases of 4 reflex or functional character may recover speedily with-
out special treatment. Cases of organic character, which constitute
614 DISEASES OF CHILDREN.

the majority, and which have gone on to atrophy, recover only slowly
and under faithful, persistent treatment. It is rarely indeed that pa.
rents or guardians have the patience or the means to persevere and
obtain the full benefit of which electrization is capable.

Frequently the improvement rapidly advances to a certain grade and
then halts, or advances so imperceptibly as to discourage the parent.

Paralysis of left arm ; atrophy of deltoid—No response at first to faradization—
Lnprovement, but not recovery, under galvanization.

CasE CLXXV.—A boy aged 14 months, was suddenly taken with complete paralysis
of the left arm after exposure to cold. He came under our observation about a week
after the seizure. We found it impossible to produce the slightest contractions of
the muscles with the faradic current. After two applications we resorted to the
galvanic current.

Immediate contraction of all the paralyzed muscles followed its use, and the natural
power was restored somewhat, so that the child was enabled to slowly close and open
the hand. After another similar application, the faradic current was as efficacious in
producing marked contractions as the galvanic.

When treatment had been continued about a month the child could use the hand
and forearm perfectly well. The upper arm was considera'ly improved, so far as
power of movement was concerned ; but the deltoid muscle had atrophied, and no
subsequent treatment sufficed to greatly improve its condition,

Paralysis of left arm, with atrophy of deltsid, caused by exposure to cold—No
response at first to faradizatisn—Improvement under galvanization.

CasE CLXXVI.—A short time before we saw the child he had been exposed (with
bare arms and shoulders), while riding in the horse-cars, to cold draughts of wind. A
few hours subsequently the mother first noticed that the child used the right arm alto-
gether, and upon further examination she discovered that the left arm was perfectly
powerless. Previous to the attack the little patient had been suffering considerably
from the irritative process of teething, which had somewhat reduced him in health
and flesh. The deltoid was atrophied. No intensity of the faradic current which we
felt justified in applying to the affected arm produced the slightest effect ; but when a
galvanic current of moderate power was made use of, the muscles of the paralyzed limb
responded almost as readily as those of the healthy side. The improvement under the
use of the galvanic current was for a time quite marked. He very soon regained full
power over the hand and forearm, but was unable for a long while to move the upper
arm, and when treatment was discontinued after some twenty applications had been
given, it was impossible for him to raise the arm readily from the side, Notwithstand-
ing the approximation to a perfect cure, the faradic current would produce only
feeble contractions, while under the influence of the galvanic current the electro-muse
cular contractility was vigorous.

Piralysis of right leg following diarrhea—Rapid recovery under general fara-
dization.

CasE CLXXVII.—A girl aged 14 months was brought to us in September, 1867, to

Le treated for an attack of paralysis that occurred six weeks before. During the sum-
CASES OF. INFANTILE PARALYSIS. 615

mer she had suffered from a diarrhoea, which had considerably reduced her in strength
and flesh, and just a week before the leg became paralyzed she ex: erienced a severe at+
tack of cholera infantum. The mother of the child first observed some lameness of the
right leg, that followed shortly after a fall from a chair, In two days the leg was
without the slightest power of motion, The limb wascold. The improvement follow-
ing electrization was in this instance unusually rapid. Two applications with the
faradic current resulted in some progress; but after the third visit, when the galvanic
current was used, the improvement was very marked. The muscles below the knee
contracted vigorously for the first time under its influence, and in the course of three
weeks, under the alternating use of the two currents, a perfect cure was effected.

Paralysis of right leg in a child eight years of age, from scarlet Sever—Atrophy—
Approximate recovery under faradization.

CasE CLXXVIII.—E. A., aged eight years, lost the use of the right leg and foot
during illness from scarlet fever,

For about a week the paralysis was complete, but as the fever abated he seemed
to regain some power over the affected limb, and when convalescent he was able to
move it quite freely, After some weeks, when he had gained a good degree of
strength, the little patient found it possible to move slowly about by the aid of a
crutch.

His limb ceased to progress now that he had entirely recovered from sickness, and
when his parents applied to us, a year subsequently, the boy still continued unable to
move about without artificial support.

He was unable to flex the right foot or raise the limb from the floor without flex-
ing the leg.

The muscles of the thigh and leg had atrophied to a considerable extent. By
measurement the calf of the paralyzed limb was found to have decreased in size one
inch.

The parts were cold and flaccid, and it was almost impossible to distinguish the
pulsations of the posterior tibial artery, which in the healthy limb were full and strong.

As the general health was good, we made the application of the faradic current to
the paralyzed muscles only, Their electro-muscular contractility was very much im-
paired, and the current was much less acutely felt than on the corresponding portion
of the sound limb. Applications were administered twice a week for one month,
resulting in a complete restoration of the electro-muscular contractility, and a very
decided increase in his sensitiveness to tactile impressions and in the warmth of his
limb,

At the end of another month of treatment the leg had increased in circumference
one-half an inch, and the patient was able to walk with comparative ease without the
aid of any artificial support.

A case of paralysis with atrophy of one arm and leg ina boy aged sixteen, exist-
ing from childhood—Local faradization somewhat improves nutrition and increases
the strength and bulk of the limbs.

Case CLXXIX.—Master C, E. P., aged 15, was sent to us by Dr. Lewis A. Sayre,
for the relief of an aggravated case of deformity. At the age of eighteen months the
patient suffered from convulsions which left him paralyzed in all hislimbs, He gradu-
ally regained the strength of all his muscles excepting those of the right arm and left
6160 DISEASES OF CHILDREN.

leg. These remained permanently atrophied, and when the boy fell under our obser-
vation the limbs referred to were utterly useless, although his general strength and
health were unimpaired.

The effects of electrization were noticeable only in a somewhat improved nutrition
and increased development. The results, such as they were, are worthy of record.
The treatment was mostly confined to local faradization, but before applications were
begun, the limbs were accurately measured.

After three months of treatment, a second measurement resulted as follows :—

In the arm, the circumference at the biceps had increased from 7% to 84 inches ; be-
low the elbow, from 8 to 8}; at the wrist, 54 to 54; while in the leg the following
is the result: Five inches below the knee, the size increased from 13 to 134 inches;
at the calf, from 10 to 10$ inches. The leg gained slightly bu‘ perceptibly in strength.
CHAPTER XXX.

DISEASES OF THE GENITO-URINARY ORGANS.

Tue medical diseases of the male genital organs, for which electri-
city is chiefly indicated, are spermatorrhea, seminal emissions, impo-
tence, incontinence of urine, and paralysis of the bladder.

As it has been doubted whether the resources of the electro-
therapeutics are capable of affording any decided and lasting benefit in
these diseases, we here record not only as the result of our own ex-
perience, but from a knowledge of the experience of others, that no
case in which there have been reasonable grounds for hope can be
said to have been fairly treated, until the proper application of elec-
tricity has been attempted.

It should be remarked that of spermatorrhoea, seminal emissions, and
impotence, the latter, taking the cases as we find them, yields the most
uniformly and readily to electrical treatment. These three conditions
are, however, very frequently associated, and the symptoms of each
may be so intermingled as to render it difficult to decide which presents
the most prominent indications.

Spermatorrhea.—There can be no auestion that frue spermatorrhaa
is much less frequent than is generally believed. It consists of an in-
voluntary discharge of semen without erection, and as there are several
secretory glands besides the testicles, the secretion from which lubri-
cates the urethral canal, and may even appear externally in a healthy
condition of the parts, the activity of charlatans has had a fair field in
which to excite alarm among the credulous.

Seminal emissions consists in an involuntary discharge of seminal
fluid with erection, and demands treatment only when it becomes ex-
cessive,and is associated with, is dependent on, or is the cause of
constitutional disturbance.

Treatment.—In regard to the treatment of spermatorrhcea and semi-
nal emissions, it is hardly necessary to say that no one method of
electrization will answer in all cases. The applications may be local-
ized externally or internally, and in addition we frequently use with

*
t
618 DISEASES OF THE GENITO-URINARY ORGANS.

advantage general faradization and central galvanization. ‘There is one
method of procedure concerning the ill effects of which we have posi-
tive convictions. We refer to strong galvanization of the ejacalatory
ducts, or the parts in their immediate vicinity, by means of the insulated
catheter electrode.

It is true that if employed with great caution, and with a current of
very feeble power, no harm may result. Currents of considerable
electrolytic power even may frequently be borne without any after ill
effects; but it is equally true that these same applications, whether
weak or strong, have in numbers of instances been followed by pro-
found and lasting irritation.

Deaths have been known to result from the effects of the porte
caustigue. From the history of one of our cases, it seemed sufficiently
clear that this- treatment had laid the foundation of an obstinate
stricture and in another case of complete destruction of the virile
power, it was evident that the symptoms were in a measure due to a
most severe and ill-advised cauterization of the ejaculatory ducts.

Electrolytic action is of course more completely under control, and
although its action is different from that of the caustic, it is yet
occasionally followed by substantially the same results, and we hesi-
tate to make use of it in the irritable conditions that we are con-
sidering. ,

In lieu of this procedure, however, and in addition to the external
methods of treatment, we are highly in favor of the direct application
of the faradic current to the urethra, and on the same principles, and to
meet the same indications, that the occasional introduction of the ordi-
nary catheter is attempted. Mechanical pressure alone tends to unload
th congested capillaries, and to very decidedly lessen the sensibility of
the urethral nerves, and when combined with the vibratory action of
the faradic current, we are convinced that its good effects are marked-
ly : creased. ;

inpotence.—The mildest and most frequent form of impotence mani-
fests itself by a premature ejaculation of semen, with no special diminu-
tior of sexual desire, but with some impairment of the power of erection.
A somewhat more persistent condition is shown by an appreciable
diminution or capriciousness of the sexual appetite, with a marked de-
crease of the power of erection, and again there is not unfrequently an
entire absence of sexual desire and power of erection. Another form of
img vtence may be termed psychical, The unfortunate subjects of this
con ition, ignorant of what the normal sexual appetite should be, often-
times suppose that in their case it is deficient. Depressed and distracted
| WLECTRO-DIAGNOSIS AND TREATMENT OF IMPOTENCE. 619

by self-brooding, they sometimes fulfil their own dark forebodings, and
fail in their preliminary attempts to accomplish the sexual act through
the very intensity of their desire.

We shall not attempt to enter into any consideration of the causation
of these symptoms, further than to say that the vast majority of cases
of this character are brought on by the same general causes, mastur-
bation, or suddenly breaking off the habit of masturbation, excessive
sexual indulgence, prolonged continence, or by any influence that
debilitates the system.

Not only in its incipient but in its more advanced stages, impotence
not unfrequently is the result of organic disease of the nerve-centres,
and its treatment by electricity is of importance only so far as it serves
as an illustration of the extraordinary stimulating or tonic influence
of the remedy. We have had patients suffering from incurable
chronic hemiplegia, progressive muscular atrophy, locomotor ataxia,
etc., where there has been, under local and general electrization, a
most extraordinary increase in the desire and capacity for sexual inter-
course.

Electro-Diagnosis.—Anesthesia of one-half, usually the left, of the
penis, is a condition not unfrequently observed in diseases of these parts.
This may be detected by an electric examination or by the zsthesiom-
eter. This peculiarity, which was first pointed out by Schulz, we have
observed in a number of instances. With anesthesia there may be
coldness and blueness of the sexual organs.

Occasionally the anzsthesia is quite profound, and as a rule the sex-
ual weakness is in proportion to the degree of the anzesthesia.

The numbness in these cases is more than an accidental association ;
it would indeed appear as if it were, to a certain extent, a cause; for by
the application of the ordinary electric brush to the parts in the same
way that we treat any case of local anesthesia, the numbness is often
removed, and the integrity of the sexual function restored.

Hy peresthesia of the urethra is a condition that is sometimes ob-
served, especially in patients otherwise nervous and irritable.

In the worst stages there may be atrophy of the testicles and the
penis, anda diminution of temperature that is at once perceptible to
the hand.

Treatment.—In the consideration of the various degrees of impaired
sexual power, the question at once arises, What are the indications, and
how are these indications to be fulfilled? In the milder forms of impo-
tence, where there is simply premature ejaculation of semen, with some
diminution of the power of erection, as well in the more advanced
20 DISEASES OF THE GENITO-URINARY ORGANS.

tages, where the desire is capricious and the power of erection pretty
ell destroyed, it is evident that there must be a degree of paralysis at
ie root of the disorder, dependent on structural changes in the nerve-
entres, or else this impaired power or tone in the muscles and erectile
ssue may be of a purely local character. In the latter case, the indi-
ations are clearly the same as in other forms of local paralysis, and by
wadization of the ischio-cavernosus and bulbo-cavernosus muscles
uch may be accomplished. In recent cases of impotence, where
iere is considerable power remaining, as well as in a more advanced
age, where the power is approximately lost, we not unfrequently
nd that the seminal secretion is markedly reduced, not only in
uantity but quality; and, reasoning from analogy, it would seem
vat in such cases there were undoybted indications for the use of elec-
‘icity.

The galvanic current especially has the power of exciting to increased
ctivity the secretory function of various glands, and not seldom ac-
elerates physiological mucous discharges. The salivary and lachry-
ial glands, as well as the liver, are susceptible to stimulation by elec-
‘ization, and it is undoubtedly true that the lacteal secretion has been
ugmented by passing the current through the breasts of nursing
‘omen. (See chapter on Nutrition in Electro- Physiology.)

It is highly probable, then, that a deticiency in the secretion of semen
‘hen it is dependent on local paralysis or exhaustion of the nerves con-
‘olling this function, and not on pathological changes of a structural
haracter, may be successfully remedied by galvanizing the spermatic
erves and testicles. We cannot, however, in all cases, depend on
yeal treatment alone. Not only may impotence be associated with,
ut it may result wholly from disorders of a general character. The
xcessive use of sedative narcotic remedies, sedentary habits, and gen-
ral malnutrition from any cause, lead to the condition under consider-
tion, and demand the general constitutional tonic influence of general
iradization.

‘The vesiculee seminales and the testicles may be affected, and in
ome patients very powerfully and sensibly, when one of the poles is
pplied to the lower part of the spine, and the other to some point on
he thigh or against the perineum. <A very good way to affect the
aale reproductive organs is to apply one pole firmly against the peri-
weum, and the other upon the testicles.

Faradization of the genital organs should not usually be protracted
onger than five to ten minutes; galvanizdtion from two to eight min-
ites. The faradic current would appear to be preferable. Impotence,
ASPERMATISM. - 621

like seminal emissions, may sometimes be treated by connecting the
steel sound introduced into the urethra with one of the poles of the
faredic current, thus combining the toning effect of pressure with the
toning effect of electricity on the relaxed parts.

-Aspermatism.—Impotence, as before remarked, may man-
ifest itself by many symptoms, and in various degrees; but
there is one phase of it that is, we believe, not very com- |
mon, It consists in an inability to ejaculate semen while
the power of erection remains vigorous, and to this condi-
tion the term, aspermatism, was first proposed by Roubaud
in 1855.

Dr. Wm. H. Van Buren, in an article published in the
New York Medical Journal for November, 1868, suggested
that the difficulty in ejaculating the semen was caused by an
exaggerated spasmodic contraction of the muscular fibres of
the walls of the ejaculatory ducts, leading to their occlusion
under extreme excitement. On this theory it would seem
that the indications called for galvanization of the ejacu-
latory ducts; but in two cases that have come under our
observation, and that might fairly be placed under the head
of this affection, the treatment failed to afford relief.

   
 
 
  
  
 
 
 
 
 
 
    
  
   

Spermatorrhaa associated with profound mental and physical depres-
sion— Rapid recovery under general and localized faradization and
central galvantzation, —

Cast CLXXX.—Mr. T—, a youth aged 17, came under our care
April 23d, 1873, for the relief of spermatorrhcea associated with pro-
found mental and physical depression, The patient was
of a highly nervous organization, and attributed his symp-
toms mainly to the vice of masturbation, which he had
practised for a number of years, The muscles were in
a flabby condition; there was marked anzmia, and his =
strength hardly permitted him to walk half a dozen Fic. 140.
blocks without the onset of a paroxysm of cardiac pal- Insulated Catheter Electrode.
pitation with utter exhaustion. The mental faculties
were weakened, and at the same time his feelings were in such a condition of hypochon-
driacal depression that he would allow no hope of recovery to enter his thought.
Emissions of semen occurred regularly two or three times a week. ‘The patient was
immediately submitted to general faradization with alternations of central galvan-
ization and localized faradization, At the end of a month’s treatment it was found
that there had been but three seminal emissions, and during the last two weeks none
at all, He had become decidedly hopeful, and could exercise both mind and body to
a far greater extent than for six months before, ‘The treatment was discontinued,
and the patieut left the city for his home, As is the usual course known under simi-
622 DISEASES OF THE GENITO-URINARY ORGANS.

lar conditions, the improvement continued uninterruptedly, and before the close of
the summer a perfect recovery was complete.

Spermutorrhea associated with extreme nervous exhaustion of three years’ stand
ing—Improvement under general faradization and central galvanization,

Case CLXXXI.—G. H. W., a young man aged twenty-five years, came to us Sep-
tember roth, 1871, complaining of a persistent spermatorrhoea, associated with great
physical and mental depression. Three years before, he first observed a decided
weakness of the eyesight, together with occasional nocturnal emissions of semen. It
should be stated that these symptoms immediately followed a severe attack of inflam-
nation of the bowels, with enlargements of the mesenteric glands, All his life he had
ndulged in masturbation to a considerable extent. His nervous system had been so
-ompletely upset that for three years he had been unable to study or to work, and as
nedication and the influences of travel and change had failed to benefit him, he began
:0 despair of recovery, and became tenfold more despondent, and was so reduced
physically that he was unable to walk more than two or three short blocks without a
sense of utter exhaustion and a soreness and ‘‘drawing down” in the abdomen that
was absolutely painful. Seminal emissions occurred almost every night, and added
mmensely to his misery, both mental and physical. As an evidence of the exces-
sively sensitive condition of the central nervous system, it may be stated that a faradic
current of moderate strength applied to the sacrum and lumbar region produced by re-
lex action a decided tingling sensation in several remote parts, and especially on the
srown of the head. The patient was submitted to general faradization, and under
che influence of a dozen applications improved considerably in strength of mind and
sody. Subsequently many similar applications accomplished nothing more for him.
‘zalvanization of the brain, sympathetic, and spinal cord was then resorted to. A
iew impetus seemed to be immediately imparted. The emissions became less frequent,
ind finally occurred so seldom as to occasion little remark. The power of continuous
chought returned, and at the end of another month, he left us apparently recovered

Failure of the sexual power and spermatorrhea associated with hypochondriasis—
Recovery under central galvanization and localized faradization.

Cask CLXXXII.—Mr, —-— came to us by the advice of Dr. John Byrne. For
several years he had been affected with an excessive irritability of the genital organs,
it consequence of which he had become both physically and mentally depressed. In-
voluntary ejaculations of semen were frequent, and occurred generally during sleep at
1ight, while the ability to perform satisfactorily the act of coition seemed almost
nert.

The patient was treated by central galvanization and by faradization localized
lirectly through the genital apparatus,

The beneficial results of the treatment were soon most decidedly manifested. The
nvoluntary emissions ceased in the course of a month almost entirely, and the sexual
ower returned in full force, Asa natural result, the mental balance was restored,
ind the patient left us quite hopeful and happy,

Congenital impotence, with the sexual instinct unimpaired—No improvement.

Casr CLXXXIII.—A very interesting case of congenital impotence fell under our
»bservation in February, 1872,
CASES OF SPERMATORRHGA AND IMPOTENCE. 623

The patient was a young man aged 30, and although the sexual instinct was fully
developed, and a strong feeling of sexual desire had been manifested from his earliest
manhood, yet he had never at any time been able by artificial means to excite any
orgasm, or the slightest ejaculation of semen.

Actual intercourse had never been attempted.

He was subject to occasional nocturnal emissions, that were accompanied, however,
by no pleasurable sensations, Structurally the parts seemed,to be in every way per-
fect, and the fault undoubtedly lay in some original imperfect condition of the nervons
supply. ‘

No benefit was derived from treatment.

Almost complete impotence in a patient aged 45—Perfect recovery under localized
Saradization and galvanization of the spine and sympathetic.

Cast CLXXXIV.—Mr. X., aged about 45, was directed to us by Dr. James An-
derson, in the spring of 1872, The patient was a stout, vigorous man, and the father of
several children, but for some years he had observed a gradual but decided decrease of
sexual power, and at the date of his application for treatment he asserted that he was
almost completely impotent. We submitted him on alternate days to localized fara-
dization and galvanization of the lower portion of the cord, and occasionally extended
the galvanization to the neck in order to bring more or less completely under the in-
fluence of the current the sympathetic system. This method was faithfully followed
out for some six weeks, Week by week the patient observed increasing sexual capa-
city, and at the close of the treatment, when he departed for Europe, he claimed to
possess perfect sexual vigor.

He has-suffered to this date, 1874, no relapse.

Diminution of power of evection in a married man in the prime of life—.Cephalagia
and debility—Recovery under general faradization.

Case CLXXXV.—Mr. , a merchant in the prime of life, and to all appear-
ances enjoying excellent health, consulted us for inability to perform satisfactorily the
act of coition, This inability did not involve an absence of sexual desire, but simply
a want of power to obtain and retain anerection. This gentleman had a family of
several children, and since his marriage, many years before, had led, according to his
statement, a correct and regular life. He attributed this premature decline to early -
excessive indulgence and abuse of the generative function, His outward appearance
belied his general condition, for he suffered much from headache, and oftentimes, on
rising in the morning, from considerable enervation.

General electrization was decided on and given, together with local applications,
He continued treatment for three weeks, receiving an application every other day.
The result was entirely satisfactory. His general condition was so much improved,
and the vigor of his sexual organs was so much increased, that he was enabled to
complete the marital act as satisfactorily as in his youth.

 

Impotente of twenty years standing caused by local paralysis—Numbness and colds
ness of the parts—Deficient power of erection—Slight seminal secretion—No im-
provement under galvanization and faradization,

Case CLXXXVI.—Mr. , aged 44, was sent by Dr. Jerome Smith to be treated |
. for impotence of nearly twenty years’ standing. When but 17 years old he contracted

 
624 DISEASES OF THE GENITO-URINARY ORGANS.

gonorrhoea, and at the age of 25 w1s attacked by syphilis. At that time he led 9
very dissipated life, and no sooner was an attack of this disease apparently cured than
he forthwith subjected himself to another, During the last attack the solid caustic had
been introduced into the urethra, This cauterization produced excessive inflamma-
tion and pain, and was followed by complete impotence, associated with a feeling of
numbness and coldness in the penis, He had tested nearly all remedies, and at one
time, by the advice of Dr. Brown-Séquard, he had used hot and cold douches, but
all without avail, When he came to us the penis was quite cold, and much below
the natural size, Erection was occasionally possible, but he was never able to ac-
complish the marital act. The testes were of an almost natural size,.and when the
penis was artificially excited, 4 small amount of semen would appear. The penis
was apparently paralyzed, and the impotence was manifestly due to that cause more
than to the want of seminal secretion. The patient was a stout, hardy, vigorous
man, of a full habit, and quite a free liver; and neither in his countenance nor
in his general bearing betrayed the slightest effects or even consciousness of his
affliction,

Four applications of the faradic current were given, with the effect of temporarily
increasing the warmth of the penis, and nothing more. The galvanic current
was then tried. It increased the circulation in the penis, and consequently height-
ened the temperature more than the faradic current, but no permanent benefit
resulted, Our patient then discontinued the treatment, owing to the pressure of
his business engagements. He would have persevered; however, if we had felt war-
ranted in holding out reasonable chances of a successful restit from a Jong course of
electrization,

Premature discharge and deficient secretion af semen, caused by excessive sexual
indulgence—Recovery under external and internal galvanization and faradization
combined with medical treatment.

CasE CLXXXVII.—Mr. , aged 27, formerly a gymnast, and latterly a printer,
consulted us in May, 1870, for sexual weakness brought on by abuse of the organs. The
discharge was premature, and with less excitement than usual, and there was a mani-
fest deficiency of secretion. The patient was exceedingly muscular, and his general
health was almost perfect. For that reason only local treatment was employed,
The organs were faradized in the various methods twice a week, and once a week
internal galvanization. was employed, the metallic extremity of the catheter electrode
being directed as near as possible to the orifices of the ejaculatory ducts, At the
same time the patient was directed to take a mixture of bromide of potassium and
wine of ergot. Under this combined treatment the recovery was complete in twen-
ty-five applications.

During the latter part of the treatment the patient observed, during sexual inter-
course, a very great increase tn the quantity of semen discharged,

Diseases of the Bladder.—The diseases of the bladder for which elec-
trization is chiefly employed are incontinence of urine and paralysis.

Incontinence of urine depends on an irritable condition of the neck
of the bladder. While it largely sympathizes with other diseases and
the general health, being frequently associated with hysteria and spinal

 
PARESIS AND PARALYSIS OF THE BLADDER. 625

irritation, it is yet oftentimes a purely local affection. There are vari-
ous grades of the disease, from simple irritability that makes it neces-
sary to pass the water with unusual frequency, to utter inability to sleep
through the night without unconsciously “wetting the bed.” The for-
mer condition exists mostly in adults—especially in the hysterical and
the aged ; the latter is peculiar to the period of childhood. It is pro-
bable that the pathological condition in children who nightly void their
urine in bed, is not necessarily worse than that in adults who only com-
plain of being obliged to pass the water with abnormal frequency. The
unpleasant results in children are due to their profound sleep or defi-
cient self-control. That the pathological condition in children is not
always of an important character is proved by the fact that it sometimes
yields to purely moral influences.

In the treatment of incontinence of urine, both external and inter-
nal applications may be used. In the
majority of cases the internal applica-
tions by means of the catheter electrode
(p. 625) are not required. It is needless
to say that in young ,children the intro-
duction of the catheter electrode is at-
tended with difficulty. The treatment
we prefer is furadization with strong cur-
rents through the neck of the bladder.
In males one pole may be placed over
the symphysis pubis, and the other at the
perineum ; in females one pole may be
applied over the symphysis pubis and the
other at the lower part of the sacrum,
Cases associated with hysteria, or de-
pendent on spinal disease, need central
and general electrization.

Prognosis.—The prognosis of young
and recent cases is usually good. Long-
standing cases also yield, but need cor-
respondingly longer treatment, and are
liable to relapse. Cases complicated with
constitutional or central disease, which
are, of course, mostly found in adults,
have either a favorable or unfavorable
Prognosis, according to the nature of the lg ces

* Double Vesical Excitor or Elec-
malady with which they are complicated. trode (Duchenne),
40

 

CLOSED. OPEN,
626 DISEASES OF THE GENITO-URINARY-ORGANS,

Paresis* and Paralysis.—Paresis and paralysis of the bladder so
frequently depend on incurable diseases of the spine, that the prog-
nosis is, as a rule, unfavorable as regards a complete cure. Relief and
improvement, even in very bad cases, may be gained by faithful treat-
ment, but entire recoveries are exceptional.

The ¢reatment should be external and internal, with both the galvanic
and faradic currents, combined with central galvanization.

External applications may be made, placing one pole, the negative,
over the symphysis pubis, and the other on the back, or at the nape of
the neck, and passing very strong faradic currents with interruptions.

Internal applications may be made either with the insulated catheter
electrode, or with Duchenne’s double vesical electrode (Fig. 141).

The catheter electrode may be connected with the negative pole
while the positive is at the hypogastric region or back. By means of the
double exciter of Duchenne the current can be more exclusively local-
ized in the muscles of the bladder than by any other method.

Gonorrhea.—It would not be unreasonable to suppose that gonor-
rhoea in its subacute stage might be treated by electrization with at
least as satisfactory results as subacute inflammations of the mucous
membrane.

We have had opportunity to test faradization in three cases of gonor-
rheea while the inflammation was in quite acute stages.

Gonorrhea— Temporary increase of secretion under faradization—Recovery.

CasrE CLXXXVIII.—A gentleman requested us to try on him electrical treatment
for an attack of gonorrhcea that he had recently contracted. We consented to do
so, with the understanding that the treatment should be considered as experimental,
inasmuch as we had treated but one case of gonorrheea by electricity. .

We employed local external faradization through the penis, without regard to the
direction of the current. After four applications he represented that he was cured.
In this, as in another case, there was some temporary increase of the urethral secre-
tion after the first two applications,

These cases may be taken for what they are worth; they are the
only cases of the kind in which we have ever attempted electrical
treatment.

Chronic urethris (gleet) we have treated by mild galvanization with
the catheter electrode and sounds, and with encouraging results.
Electricity thus tised acts well as an adjuvant to the other treatment,
just as in catarrh of the nose, granular lids, chronic inflammation of the
middle ear, and analogous conditions.

* From mapeovs, exhaustion.
ENLARGEMENT OF THE PROSTATE. 627

Syphilis.—The severe pains of secondary syphilis are to a certain
extent relievable by general and localized faradization, as we have de-
monstrated in a few instances; concerning the permanency of their
effects we have as yet no positive evidence.

(For the treatment of syphilitic ulcers, see W/cers.)

Buboes may be discussed by external faradization, and have been
so treated by Hassenstein.* Chovstek has used galvanization.

Orchitis—The electric treatment of orchitis has been particularly
studied by Drs. Jules Chéron and Moreau-Wolf.t

They give the results of the treatment in nine successful cases.
Their method of treatment was to direct a galvanic current from ten
to twenty-four cells of Remak, through the tumor, from two to eight
minutes. Sometimes the positive pole was placed on the most pain-
ful point of the swelling, and the negative on the spermatic cord. The
authors regard the ascending current (up the cord) more effective than
the descending. :

Most of their cases were cured by a few (from four to ten) applications.

The great advantage which the authors claim for this method of
treatment in orchitis is; that the patient is mot obliged to suspend his
daily duties, since absolute repose is not necessary.

Chronic orchitis of six months’ standing in u syphilitic patient—Approximate re-
covery under external galvanization and faradization.

Casz CLXXXIX.—Mr. W., aged 28, consulted us in October, 1870, for an enlarge-
ment of the left testicle that had troubled him for six months. It was about twice the
size of the right testicle. There was no pain, but a constant sense of weight. The
patient was suffering from secondary syphilis, and had, in times past, repeatedly expe-
rienced attacks of gonorrhcea, Stable galvanization with a current that was com-
fortably borne was employed for ten minutes, the positive pole being applied over the
testicle at different points, and the negative pole over the spermatic cord, The patient
stated that the testicle felt less disagreeable. In two days there was an apparent
diminution in size, Three more similar applications and one faradizatron produced
an almost complete recovery.

Enlargement of the Prostate.—Yhe electrical treatment of hyper-
trophy of the prostate has been studied by Tripier,{ who has demon-
strated that the effect of faradization of this organ when enlarged is to
cause resolution. The rationale of the treatment is substantially the
same as for analogous conditions of the uterus. Thé. subject is one

* Chemisch-Electrische Heilwerke, Leipzig, 1853.

+ Du Traitement de ?Orchite, par application tes courants continus constants,
Paris, 1869... ; .
¢ Manuel d’Electrothérapie, p. 567.
‘

628 DISEASES OF THE GENITO-URINARY ORGANS.

that deserves investigation. Either the galvanic or the faradic current
may be employed. One pole may be applied internally by means of
an insulated catheter electrode or sound, and the other in the rectum
against the prostate, by means of a rectal electrode. We have treated
one case of enlarged prostate by internal and external faradization.
The patient, a medical gentleman about sixty years of age, was seen and
examined by Dr. Gouley, who confirmed the diagnosis of enlarged pros-
tate. We treated him a number of times by external faradization—
one pole on the symphysis pubis and the other on the perineeum—and by
internal faradization, one pole in the rectum—insulated except at the
point where it came near the prostate—and the connection made in the
prostatic portion of the urethra, by a flexible sound, passed through a
gum elastic catheter, according to the suggestion of Dr. Gouley. Applied
in this way the electrodes were very near to each other and in sensitive
localities, and only very feeble currents could be borne, and sometimes —
slight hemorrhage followed the treatment in spite of all the caution that
was exercised. It was found impossible to use sufficiently strong cur-
rents by this method to produce any effect, and again we returned to
partly external faradization. ‘his treatment, which seemed to aggravate
a cystitis that existed, was abandoned.

Dr. Mittendorf, of this city, informs us that he has obtained decided
results in enlargement of the prostate, in two cases. He used external
faradization—one pole over the symphysis pubis and the other at the
perineum. ,

Diseases of the Rectum.—Electrization has been used for prolapsus
ani, paralysis of the sphincter, and hemorrhoids.

The current can be very well localized in the rectum by means of a
rectal electrode (see p. 581), which may or may not be partly insu-
lated. The rectum is but little sensitive, and will bear strong cur-
rents. The rectum may also be treated by a double rectal exciter,
analogous to that which is used in the bladder. When a single electrode
is used, one of the poles should be placed on the spine.

Prognosis.—Paralyses of the sphincter that depend on local disease,
like paralysis of the bladder depending on the same cause, rarely offer
a perfectly favorable prognosis.

In prolapsus ani Benedikt * claims a few mostly good results. We
have treated one. long-standing case without benefit.

Hemorrhoids.—Piles, external and internal, may be treated by both
currents applied internally. Relief of itching, pain, and permanent im-
provement in the tone of the parts are derived from this treatment.

* Op. cit., p. 482.
CHAPTER XXXI.
DISEASES OF THE LARYNX.

Tue disease of the larynx, for which electrization has been almost
exclusively used, is afhozia, a condition which arises from many morbid
states.

Anemia and Inflammation.—External electrization of the throat is of
service as an adjunct in the treatment of inflamed and irritable con-
ditions of the larynx, but only in rare cases has it been thus employed.
We have found that faradization of the neck, for from two to five
minutes, has an appreciable and agreeable effect in diminishing the
irritation produced by cauterization, and when continued exerts a tonic

-influence on the organ. In cases of diseases of the larynx, connected
with hysteria or anaemia, the local treatment is materially aided by
general faradization.

Subacute and chronic inflammations of the pharynx are also treated
with some success in the same way, and on the same principles.

Method of External Electrization.—The larynx may be electrized ex-
ternally by various positions of the electrodes. One pole may be placed
at the back of the neck and the other just above the manubrium sterni,
or the poles may be pressed against the larynx by the inner border of
the sterno-cleido-mastoid muscle, or one of the poles may be in the
hand of the patient. These methods are best adapted for the pur-
poses of producing a sedative or tonic effect on the inflamed and irrita-
ted membranes. We have frequently used this treatment, for about
five minutes after the application to the larynx of irritating caustics,
with satisfactory results. There is no question that the faradic current,
employed perseveringly by these methods, and in cases of anzemia and
general debility, by general electrization, will alone accomplish some-
thing in anzemia, subacute inflammations, and nervous debility of the
larynx.

Aphonia.—There are few local disorders that yield more uniformly or
readily to any method of treatment than aphonia to electrization. In
order, however, to form a correct idea of its value in these cases, or to
630 DISEASES OF THE LARYNX.

intelligently communicate the results of electrical treatment, it is neces-
sary to have not only a knowledge of the general nature of the disease
but to appreciate, so far as possible, the exact pathological condition
of each individual case. Above all, it is necessary to decide whether
the symptom is of an organic or of the so-called functional character.
Mackenzie, who has had an extended experience in nervous affections
of the larynx, and their treatment by electrization and otherwise, adopts
the following nomenclature of the paralyses of the muscles acting on
the vocal cords : *

Bilateral paralysis of the adductors,

Unilateral paralysis of the addyctors.

. Bilateral paralysis of the abductors.

Unilateral paralysis of an abductor,

. Paralysis of the tensors.

. Paralysis of the laxors,

AYP -

The first of the above-mentioned pathological conditions of aphonia is supposed to
depend most frequently upon hysteria and debility, and readily yields to treatment.
In these cases, however, which are too frequently but the local manifestation of a con-
stitutional disorder, it has been our custom to rely on general as well as localized
electrization.

Central difficulty is rarely a cause of bilateral paralysis of the adductors, but it is not’
uncommon in certain stages of phthisis. In 37 cases of phthisis, examined by Macken-
zie, it which the voice was affected, he found that in 26 there was thickening or con-
gestion of the mucous membrane of the larynx, while in 11 the affection was purely
functional. Aphonia, then, coexisting with pulmonary tuberculosis, may often be
readily relieved by local treatment alone.

Hysteria and debility are not so frequently the cause of unilateral paralysis of. the
adductors as of the first-named condition, This second cause of aphonia, however,
may be due not only to phthisis, but to toxzemic poisoning, to syphilis, to cold, to
muscular strain, and even to cerebral disease. We would naturally infer that this
form of aphonia would be more persistent than the first-named,

Clinical experience has confirmed this inference.

Bilateral paralysis of the abductors of the vocal cords has, unfortunately, for its
causation, in the majority of cases, some central difficulty.

The prognosis is of course most serious, but fortunately this condition is very rarely
met with, Unilateral paralysis of an abductor, although depending on the same gen-
eral cause as the bilateral form, yet, more frequently than the last-named, it is excited
by some peripheral irritation, as pressure on the pneumogastric nerve, or upon one

, recurrent nerve, by an aneurism of the arch of the aorta. The prognosis in these
cases is also unfavorable.

Paralysis of the tensors and laxors (both the bilateral and unilateral form) are sup-
posed to result, in the majority of cases, from a too prolonged or violent use of the
voice. Both are said to be quite amenable to treatment.

* On the Laryngoscope, etc., p. 183. Also Hoarseness, Loss of Voice, and Strid-
ulous Breathing, in Relation to Nervo-Muscular Affections of the Larynx, 1868,
TREATMENT OF APHONIA. 631

Spasm of the muscles controlling the vocal cords is an additional
cause of aphonia.

Treatment.—Mackenzie’s method is to make the application directly
to the cords by means of laryngeal electrodes (p. 632) devised by him.
He uses the faradic current.

The direct application of electricity to the vocal cords is undoubtedly
more efficacious in restoring loss of voice than simple external appli-
cation. This latter method is, however, underrated when it is said that
it “ seldom restores the voice when it has been lost any length of time.”
Several cases that we have treated at various times illustrate very deci-
dedly the beneficial results that may follow external applications, even in
cases where the disorder has persisted several months. We are the
more gratified to be able to make this statement from the fact that the
external is much more readily performed by the operator than the inter-
nal application, and is far more agreeable to the patient. It is far better
at first, in all ordinary cases, to make use of the external method ; and if
it does not succeed, it is time enough to resort to the direct application.
The instrument of Mackenzie is thus described in his own words:

“Tt consists of two parts, viz., the necklet, which the patient wears,
and to which one chain of the battery is attached, and the laryngeal
electrode itself, which is connected with the other conductor. ‘The
electrode is so constructed (see cut) that the current does not pass
beyond a certain point until the pole is seen, in the laryngeal mirror,
to be upon the vocal cords, when the operator touches a little spring in
the handle, and the current immediately passes through the laryngeal
muscles, The necklet should be worn rather low, so that it covers the
sides of the cricoid cartilage, and the space between it and the thyroid.
In this way the lateral adductors of the cords (crico-arytenoidei laterales)
can be most easily reached ; and the arytenoideus proprius, or central
adductor, may be electrified by placing the pole on the posterior sur-
face of the arytenoid cartilages.

“T generally keep the pole in the larynx for three or four seconds
each time it is introduced, and pass a succession of short, rapid shocks
through the larynx ; and at each sitting I apply the pole to the interior
of the larynx three or four times.”

Mackenzie is of the opinion that the effects are of a reflex as well as
direct character.

Meyer * reports successful results in the treatment especially of hys-
terical aphoaia by the electric moxa, applied to the larynx.

* Op. cit., p- 436 et seq.
DISEASES OF THE LARYNX.

632

thers a

in o
Tobold speaks favorably of the

ication ; i

le appl

Ing

by a si

is cases were cured

Some of h
course of treatment was required.

tnat

 

 

 

 

 

g
¢ a

A s

3 Sp *

_— 2 me “a
@ . NS 5

3 a)

f o

Na a

' vu

: 3

5

a

wn

oh

=

 

Fic. 143.

Laryngeal Electrode and Necklet.

A represents the electrode (No. 1). The instrument is connected with the electric apparatus by the connecting wire
at @ When the insulated handle ‘is pressed upon, the circuit is closed by the junction of ¢ and 4, and the current passes to
the metallic point f. The wire ¢e and the handle of the electrode are insulated. JZ is the necklet.

Mackenzie has also devised another form (No. 2) of electrode, in which the two poles are united in the same instru-
ment, after the manner of Duchenne’s double vesical electrode.

in hysterical aphonia any form of irritation, external or internal, elec-

electric moxa in hysterical aphonia.
PROGNOSIS IN APHONIA,. 633

trical or otherwise, may cause instantaneous cure. Some of the most
brilliant achievements of mesmerizers and of those who practise laying
on of hands and other flummeries, have been made in hysterical aphonia.
Kind of Current to be Employed.—For electrization of the larynx,
externally and internally, both currents have been used with success.

IRRITATION OF THE MUSCLES OF THE LARYNX.*

Crico-thyroid.—This muscle may be caused to contract by applying
pointed electrodes by the conoidal ligament. The effect of the con-
traction is to cause the annular and thyroid cartilages to approach
each other.

Arytenoid Transverse, at the posterior surface of the arytenoid carti-
lages. The effect of the contraction of the muscles is to cause the
cartilages to approach each other.

Crico-arytenoid and Thyro-arytenoid muscles, in the sinus pyriformis,
between the posterior border of the thyroid cartilages and the plate or
surface of the cricoid cartilages. :

Crico-arytenoid Posterior (dilator of the glottis), downward and back-
ward froni the sinus pyriformis.

Crico-arytenoid. lateralis, in the sinus pyriformis on the exterior
border of the surface of the annular cartilage. Contraction of these
muscles produces rotation of the cartilages of the larynx, with move-
ment of the vocal cord toward the median line.

Thyro-arytenoid, beneath the anterior superior border of the crico-
arytenoideus lateralis’ Contraction of this muscle brings the cartilages
of the larynx forward and downward, and narrows the glottis.

Thyro-epiglottic and ary-epiglottic muscles, at the border of the epi-
glottis.

Prognosis in Aphonia.—The prognosis in aphonia depends entirely
on the pathology. In functional (bilateral paralysis of: the adductors)
aphonia the prognosis is more favorable than in almost any other dis-
ease that is known to science. The majority of cases will recover,
whether external or internal applications are used, although Mackenzie
contends that the recovery is much surfer and speedier than when only
internal applications are used. He says, out of more than /¢wo
hundred such cases he has succeeded’ in all except four. In some
of these cases the aphonia was of six, seven, and even eight years’
standing.

* The subject of direct electrization of the laryngeal muscles has been studied by
Ziemssen, Elektricitét in der Medicin, 1866.
634 DISEASES OF THE LARYNX.

In unilateral paralysis of the adductors the prognosis is good when
the origin is local, and bad when it is central.

In bilateral paralysis of the abductors and umilateral paralysis of the
wbductor the prognosis is unfavorable.

In paralysis of the tensors of the vocal cord the prognosis is usually
favorable.

In paralysis of the laxors of the vocal cord the prognosis is on the
whole favorable, but much time is required.

Aphonia of four months standing, caused by exposure to cold—Recovery after three
external faradizations,

Case CXC.—Miss F., a robust young lady of 18, consulted us in October, 1868,
‘or a persistent and an almost complete aphonia, from which she had been suffer-
ing without any relief for four months.

She stated that on the evening of the attack she was enjoying a sail with a party
of young friends on one of our rivers, She had for some time previously complained
of slight irritation of throat, but it caused but little annoyance. The evening was
somewhat damp, and the patient carelessly uncovered her head during the whole time
the party remained in the boat, While singing, and endeavoring to strike a very
iigh note, she felt as if something in her throat had ‘‘relaxed or suddenly given
way.’? For one week she remained so completely aphonic that she could not utter
in intelligent word, In the course of another week, however, she could speak at
‘imes so as to be understood, but only with considerable difficulty, and not above a
very feeble whisper. At this point all improvement ceased, and no form of medica-
ion, or external or internal application, seemed to be of any benefit whatever.
Laryngoscopic examination revealed the following condition of the parts affected:
On attempting to speak the right vocal cord remained almost if not quite motionless,
while its fellow approached the median line, It was evident from the feeble and
mperfect working of the left cord, that it also was considerably involved and doubt-
ess had been completely paralyzed. The surrounding tissues were considerably
congested,

The negative electrode was placed upon the spine, between the shoulder-blades,
ind, using our fingers as electrodes, we passed a steady current through the neck
or about ten minutes, At the conclusion of the séance, the patient could speak
n quite a loud whisper, and a second examination with the laryngoscope revealed
the fact that the right vocal chord perceptibly approached the median line during the
ict of phonation. The voice of the patient gained strength rapidly, until, in four
lays, and after receiving but two similar applications, she was able to speak as loud
ind sing as vigorously as ever.

Aphonia following diphtheria—Rapid recovery under direct faradization of the
muscles of the glottis.

Cast CXCI.— Miss G., aged 22, and suffering from functional aphonia subsequent
© a slight diphtheritic attack, consulted us in the spring of 771. Her inability to
speak above a whisper had existed some two weeks,

Examination with the laryngoscope revealed bilateral paralysis of the muscles, clos-
SPASMUS GLOTTIDIS. 635

ing the glottis, with a slightly congested condition of the surrounding tissues. The
patient was anzemic, and excessively nervous, and in the treatment we alternated gen-
eral faradization with direct faradization of the muscles of the glottis,

The tonic effects of these applications were soon manifest, not only in the laryngeal
muscles, but upon the system generally as well.

She gained rapidly in nervous vigor, and within two weeks her strength of voice
entirely returned.

Dr. F. J. Knight,* of Boston, has reported a case of complete paralysis
of one recurrent laryngeal nerve, and partial paralysis of the other, that
-was benefited by the galvanic current locally applied.
"The following case we transcribe from Mackenzie’s work :

Dysphonia of a year’s duration, from paralysis of the laxors of the right vocal cord
cured by electricity.’

‘‘Madam C——,, aged 34, a professional singer, consulted me in May, 1865, on
account of a difficulty she had experienced during the last year in forming her lower
_ notes. Her voice in the ordinary way extended from d above the line to a below. A
year ago she first experienced slight difficulty in forming the lower a, and in January
she could not reach beyond 4. During the last two months she had not been able to
sing at all, even in private. She broke down directly she attempted even a few
notes. She attributed the loss of power to a strain, as she first noticed the difficulty
after the performance of a long and trying cantata, which had been twice encoréd.
At the time she had experienced ‘a stinging sensation, extending from the right side
of the throat up towards the ear,’

‘‘She had been constantly under treatment since her voice first became affected.
The only thing which had seemed to do her good was a solution of caustic applied to
the throat with a piece of sponge at the end of a whalebone rod. But though this
treatment always gave temporary relief, there was no permanent improvement. On
making a laryngoscopic examination, the parallelism between the vocal cords was seen
to be lost, the right cord curving away in the centre from the median line.

‘¢The treatment (direct electrization of the right vocal cord) was long-and tedious
in this case. At the end of six weeks there did not appear to be any improvement,
and I should have given it up had not the patient most earnestly begged of me to
continue a little longer. I was glad thatI did so, for a fortnight later the patient
perceived a marked improvement in the voice. In order to test the voice I used to
allow the patient to sing a few notes once a week, but at no other time. At the end
of three months the voice was decidedly improved, and the following autumn the

voice was so completely restored that the lady was able to accept an engagement
in Madrid.”

Spasmus Glottidis (Laryngismus Stridulus—Spasm of the Glot-
tis. )—In this affection, which is acknowledged to be of a nervous char-
acter, electrical treatment is indicated on the same principles on which
it is indicated in ¢orticollis, writer’s cramp, and facial spasm.

The disease is caused by any influences that depress the system. |

* See Archives of Electrology and Neurology, May, 1874.
536 DISEASES OF THE LARYNX.

[n children it may arise by reflex action from the irritation of teething
or of worms ; in adults it is often an accompaniment of hysteria, and
arises from diseases of the sexual organs.

Treatment.—General faradization and galvanization of the sympa-
thetic, and external galvanization and faradization of the larynx by any
of the methods previously described.

Tobold reports success with peripheral and central galvanization in
this disease. A strong maiden, 23 years of age, who was attacked regu-
larly every night with severe spasms of the larynx, was entirely cured
in four weeks by galvanization.

Nervous Cough.—Electrical treatment is. sometimes excellent for
nervous coughs of various kinds. External faradization or galvaniza-.
tion or central galvanization are indicated.

The following unique case may as well be inserted here :

Spasmodic cough, unique in character, and of unusual persistency and severity-= ;
Recovery under central galvanization.

Case CXCII.—Miss H., aged 16, was transferred to our care by the family physi-
cian, Dr. H. H. Gregory. The case is an example of an unusually susceptible nervous
organization, and is a good illustration of the readiness with which many so-called
nervous symptoms change their seat and character. The distinct and positive features
that stand so boidly relieved in the progress of this particular case, may serve to ex-
plain the more subtle and less marked changes of symptoms that so often occur in
certain nervous diatheses, only to'perplex and to set at naught the resources of thera-
peutics, The patient was a lively, impressible girl, prone to physical indiscretions,
and careless of consequences, She had suffered for a number of years from frequent
and unusually severe attacks of sick-headache, but as soon as the paroxysm had passed
away, she regained her usual strength and buoyancy. The sudden and unexpected
death of a sister, naturally enough, stirred up her emotional nature to its depths, and
together with an imprudent exposure of her person to cold and dampness, seemed to
be the exciting cause of a most remarkable, persistent, ard distressing cough, which,
slight at first, reached its height in severity in the month of March, 1872. Amid the
numberless efforts that were made by both internal medication and inhalatioris, but
one remedy seemed to be of the slightest service, For a time the paroxysms seemed
to abate somewhat under the influence of chloral, although no permanent benefit was
derived from its use. When, during the latter part of July, we first saw the case,
through the kindness of Dr. Gregory, the following was the prominent characteristic
of her paroxysmal attacks: Every one will instantly recognize the peculiar harsh or
grating sound which is so often elicited by the downward thrust of a saw that is im-
properly handled or insufficiently oiled. The cough of our patient exactly simulated
this sound, and, when it first fell upon our ears, we supposed that some one was saw-
ing in the adjoining room.

During a paroxysm, the expiratory efforts were just one a second in frequency, and
from a dozen to sixty in number.

The violence of the attack would rack her terribly, and, when prolonged, was fol-
HYPERASTHESIA. . 637

lowed by considerable exhaustion. The paroxysms themselves occurred so often,
some twenty or twenty-five times during the twenty-four hours, that she was neces-
sarily obliged to give up all attendance at places of public resort, and confine her-
self mostly at home.

On account of our absence from the city most of the month of August, the pa-
tient was not fairly submitted to our treatment until September. We then submitted
her to'a thorough laryngoscopic examination, and found nothing abnormal, with the
exception of*a slight tendency to congestion of the local chords. To dissipate any
doubt in regard to the existence of pulmonary disease, the patient was thoroughly ex-
amined by Dr. Austin Flint, who pronounced the lungs to be in a healthy condition,
and agreed as to the essentially nervous origin of the symptoms,

In the treatment of the case by central galvanization we were gratified to observe,
after the first few tentative applications, an appreciable improvement in the charac-
ter of the cough. Instead of that harsh and painful sound, resulting, as we believed,
from the exceedingly tense condition of the vocal chords, the cough assumed a softer
or looser character, and was much less disturbing ; this we conceived depended on
the decreased local spasmodic action, Freed from wearisome details, the subsequent
shistory of the case is included in the simple statement that the patient improved from
time to time, until, after two months of treatment, and the administration of some
thirty-five applications, the recovery was perfect.

Two years have now elapsed since recovery, but the patient remains well,

In the case of a young girl sent to us by Dr. Leaming, there was a
nervous cough that perfectly resembled the barking of a dog. Laryn-
goscopic examination revealed nothing to account for the strange symp-
tom. Electrical treatment accomplished nothing.

LHyperesthesia of the Larynx.—Cases of this disease have been re-
ported by Gerhardt and Hanfield Jones. They may be either constant
or intermittent. The following case is quite remarkable:

Hyperesthesia of larynx with nervous aphonia of one year's standing—WNo visi-
ble lesion, but slight tuberculous deposit on lung—Great pain from talking—
No Relief under central and local galvanization.

CasE CXCIII,—Miss B——, a young lady from Chicago, was referred to us by
Dr. Johnson, of that city, December 16, 1871.

The patient was of a delicate, thoroughly American type, but no more nervous than
thousands of our countrywomen.

For one year she had suffered from absolute aphonia. The laryngoscopic examina-
tion of Dr. Johnson, her physician in Chicago, and of others, indicated no ‘local lesion
that could well account for her symptoms, although a slight tuberculous deposit of a
passive and stationary character was detected by Dr. Clark in one lung. All the
accompanying symptoms pointed toa nervous origin of her disease. The hyperzesthesia
was very remarkable. The patient said the pain from whispering was so great that,
‘*when I try to whisper I suffer terribly, become dizzy, and have pain in my ear.” ‘I
often feel,’ she continued, ‘‘as if every word I whispered grated on the vocal cords,
and to laugh would make the cords ache.’ Almost continually there was pain in the
throat, and on this account her nights were wakeful,
638 : DISEASES OF THE LARYNX.

The evidence was pretty clear that the nerves supplying the larynx were in a con-
dition of great hyperssthesia, producing a condition analogous to vaginismus,

In Chicago Dr. Johnson had used electrical treatment, with a view to excite the
action of the cord, without benefit. Stable galvanization was used, mainly with the
view of calming the irritability and reducing the hyperzesthesia, but without success,
In about a month the patient went South for the winter, and we have not’ seen her
since that time.

One amongst other interesting points in this case is the clinical proof afforded of the
nervous connection of the vocal cords with the meatus auditorius and membrana
tympani. The anatomical explanation of the phenomenon recorded here is to be
found in the direct communication existing between the auricular nerves (first described
by Arnold) and the sensitive fibres which enter so largely into the composition of the
main trunk of the pneumogastrics.

Anesthesia of the Larynx.—This is an affection but rarely observed.
It would be most likely to occur from injury of the pneumogastric
nerves of their laryngeal branches.

It is rational to suppose that anzesthesia of the larynx might be suc-
cessfully treated by electrization in its various forms, on the same prin-
ciples that this morbid condition is treated in other parts of the body.
CHAPTER XXXII.
DISEASES OF THE EYE.

For two reasons the diseases of the eye are not quite as amenable tc
electrization as corresponding or analogous diseases in some other parts
of the body.

First. The anatomical position of the eye is such that the current
cannot be directly localized in some of its parts ; ‘and secondly, the ap-
plication of a very strong current is sometimes contra-indicated by the
sensitiveness of the conjunctiva, and the possible injury that may be
done to the brain.

For these reasons paresis and paralysis of the muscles of the eye—
the conditions of the organ that are most frequently treated by elec-
tricity—cannot be as successfully subjected to electro-diagnosis or
therapeutics as the same conditions of many other muscles, although
therapeutic results in many instancés of a decided character are obtained
from electrization of the paretic or paralyzed muscles.

The principal diseases of the eye for which electricity has been em-
ployed with more or less success are :

Paralysis of the Muscles, Ptosis,

Asthenopia, Opacities of the Cornea,
Retinal. Hyperesthesia, Photophobia,

Amaurosis and Amblyopia, Myosis and Mydriasis,
Spasm of the Lid, and Neuro-retinitis.

Electrization of the Eye.—The electric current affects the eye both
directly and through reflex action from the fifth pair, and also through
the sympathetic. As has been stated, the anatomical position of the
eye within its bony cavity makes it impossible to reach all its parts as
directly as could be desired ; while the exceeding delicacy of its struc-

‘ture makes it at least very difficult to make the applications imme-
diately to the conjunctiva.

The eye may be electrized in a general way, in asthenopia, for ex-
ample, by pressing one large positive electrode over the closed eye,
and the other at the occiput or by the side of the head above the clieek-
bone ; or one of the electrodes may be held in the hand. When it is
desired to produce chemical changes in the eye this stable method of
540 DISEASES OF THE EYE.

upplication may be used for some time. Placing the positive pole on
che forehead or in the auriculo-maxillary fossa, the superior obligue may
de excited with the negative pole on the upper and inner part of the
orbit ; the inferior obligue and rectus internus near the inner angle of
che eye on the side of the nose; the rectus externus at the outer angle
of the eye; the rectus superior at the upper part, and the rectus in-
ferior at the lower part of the eyeball. Galvanization of the eye with
interrupted currents to affect the muscles should usually be short, but
stable or labile faradization with large electrodes may sometimes be
made for a much longer time—three to ten minutes.

Paresis (exhaustion) or paralysis of the muscles of the eye may arise
trom cerebral lesions, or may be of a peripheral character. Locomotor
ataxia is frequently preceded or accompanied by disorders of the mus-
cles of the eye.

For the purpose of affecting the muscles of the eye the galvanic cur-
rent is usually superior to the faradic. A small number of cells, from
ten to fifteen, are usually sufficient. Galvanization of the sympathetic
should also be tried in those cases that are supposed to be of cerebral
origin. -Short treatments, from one-quarter of aminute to one or two
minutes, are preferable to longer applications. In these conditions
protracted séances, not unfrequently do injury.

Here, as elsewhere, the sensitiveness of the patient and the results in
each case are perhaps the best guide. And yet it is always well to be
cautious in the first application. In diseases of the eye, as of other
parts of the body, we meet with exceptional cases that will bear and
be benefited by very protracted applications of mild galvanic currents.

The unfortunate accident that happened to Duchenne—total de-
struction of the sight of a patient immediately after galvanization—did
much for a time to retard the electro-therapeutics of the eye. The
accident, however, has never been repeated, although the electro-thera-
peutists of the present day galvanize the eye and the brain with great
freedom.

Localized faradization has been somewhat successful in the treat-
ment of paralysis of the muscles of the eye in the hands of Meyer,*
Soelberg Wells,t and Althaus.{ Althaus has succeeded with the fara.”
dic current after failure with the galvanic. The current reverser elec-
trode is very convenient for the treatment of paralysis of the muscles of
the eye.

Prognosis in Paralysis of the Muscles of the Eye.—The prognosis of

* Op. cit. p. 378. + Diseases of the Eye, 1869, p. 568 fOp. cit., p. 495.
PARESIS AND PARALYSIS OF MUSCLES. 641

paralysis of the eye that depends on cerebral lesions is usually unfavor-
able. Cases that arise in the early stages of disease of the brain or
spinal cord, as locomotor ataxia, and early syphilitic cases, offer a good
prognosis, though they are disposed to relapse.

Peripheral cases, when taken in the early stages, have a very favor-
able prognosis, but not so with cases that are long standing.

Benedikt, speaking of the prognosis in cases of paralysis of the eye,
declares that of eight cases, from various causes, that were sent to him
by Wecker, of Paris, in seven there was immediate improvement.*
The same writer states that when the absolute excursive capacity of
the pupil is little altered, but double vision is present in a great part of
the visual field, the prognosis is unfavorable.

In some cases improvement follows early, after one or two sittings,
or during the midst of the sitting; in other cases not until ten or
fifteen.

The tendency with patients and physicians is to abandon treatment
in paralysis of muscles of the eye, without giving it a fair trial. They
certainly demand as long treatment as analogous affections in other parts
of the body. |

Paresis of the left internal rectus muscle—Immediate improvement under localized
Saradization. |
' Case CXCIV.—Mr, M.B., with paresis of the left internal rectus muscle, was sent
tous by Dr. C. R, Agnew for electrical treatment. The first symptoms of the difficulty
dated some months back, just after his return from the West, where he had been
subjected to unusual fatigue. A powerful current (faradic), localized as nearly as pos-
sible in the affected muscle, very markedly relieved the heaviness of the eyelid, and
immediately improved the sight. :
For over a month the patient had been able to read only imperfectly and with dif-
ficulty, while an hour previous to the electrical treatment it was found, on trial, at
Dr. Agnew’s office, that he was utterly unable to decipher newspaper print.
Immediately after one application the patient could read the fine print of the
Herald with ease, and in a day or so a note from Dr. Agnew informed us that the
vision of the patient had increased from one-tenth to one-half, and that the internal
rectus had gained seventy, tested by prisms.

Paralysis of the abducens of both eyes—Double vision ten months standing—Possible
syphilitic origin—Recovery under localized galvanization and iodide of potassium
—Relapse.

CasE CXCV.—Mr. R., aged 46, was referred to us, May 1, 1874, by Dr. Rushmore.
Patient complained of double vision—health otherwise good. Dr. R.’s diagnosis
was, paralysis of abducens on both sides, and as the patient had suffered from
syphilis sixteen years before, iodide of potassium was given.

* Op, cit., p. 292.
41
642 DISEASES OF THE EYE.

For three months this treatment was kept up with but little improvement. We
began treatment by localized galvanization, using strong interrupted currents—one
pole at the external angle of the eye, and the other on the temple, or at the back of
the neck and continued this treatment twice «+ week for one month without any im-
provement. About June 1 improvement began, and by June 22 the recovery was
emphatic, so far as double vision was concerned; dimness of vision remained.

The patient continued the iodide of potassium at the same time with the electrical
treatment, and it is clearly impossible to differentiate with certainty the effects of the
two remedies; but inasmuch as the iodide of potassium had been used before, and
very faithfully, without effect, it is exceedingly probable, to say the least, that the
recovery was largely due to the electrical treatment. The patient subsequently relapsed,

The following are some of Benedikt’s * cases :—

“* Burggraf, Johann, aged 23 (Arlt’s clinique, April 22d, 1864), had been suddenly
seized with double vision fourteen days previously. Paralysis of the right abducens,
preceded by violent pains in the head for eight days. Recovety through local treat-
ment in six sittings.

‘* Meyer, Antonia, aged 55, laborer (Arlt’s clinique, Sept. 18, 1866), had suffered
for three days from doubie vision, paresis of the right abducens. The excursion was
deficient by one line. There was double vision in the larger half of the visual field.
After nine sittings the excursion was normal. Double vision in the extreme portion
of the visual field. Entire recovery after twenty sittings,

“*Mako, Barbara, aged 24 (Arlt’s clinique, Jan. 29, 1863), suited for six weeks
from complete paralysis of all the branches of the oculo-motorius. After three
weeks the paralysis was removed, and the patient, although he had yet some double
vision, left the hospital. ;

“* Isolated Mydriasis.—Rentier, aged 40, suffered from mydriasis and paralysis of
accommodation on the left side. After two local treatments the mydriasis diminished.
It relapsed after a coitus, but was finally entirely healed in twelve sittings, and re-
mained healed for several years.”

Asthenopia.—Asthenopia may depend on an absolute or relative de-
ficiency of energy in the muscle of accommodation ; or of the internal
recti. It is accompanied by hyperesthesia of the retina and ciliary
nerves.t Of these two forms, the accommodative and muscular, the
accommodative is the more frequent. The marked effects in improving
the tone of exhausted muscles in other parts of the body, produced by
electrization, would lead us to suppose that asthenopia might he bene-
fited by passing either the faradic or galvanic current through the eye.

In quite a number of cases of weakness of eye with hyperzsthesia,
that have not been accurately recorded, we have obtained positive and
rapid results. For those very numerous cases of eyes that ache

* Op. cit., p. 297 et seq,
+ Stellwag, Treatise on the Diseases of the Eye, translated by Drs, Hackley ané
Roosa, p. 622,
ASTHENOPIA. 643

severely if used even for a little time before breakfast, or at twilight,
or in reading fine print, or doing fine needlework, or from exposure to
glaring light; that perhaps are annoyed by musc@ volitantes and by
neuralgic pains in or near the eye, and yet in which ophthalmoscopic
examination reveals no lesion—for such cases mild labile faradization
for five or ten minutes through the eye with the positive pole, either
with a moistened sponge or the hand of the operator, while the nega-
tive is at the back of the neck or in the hand of the patient, is certainly
a most agreeable and efficacious remedy. Stable galvanization is also
useful in the same condition. Cases of this kind that are associated
with general feebleness, with hysteria and dyspepsia, are sometimes
niuch benefited by general faradization even when the eye receives no
local treatment whatever. The ¢éred, aching eye is both temporarily
rested and relieved after each sitting, and permanently strengthened by
continued treatment. In such cases electrization does for the eye what
it does for the stomach, or larynx, when they are in a condition of
fatigue.

We believe that electro-therapeutics promises more for asthenopia,
with hyperasthesia of the retina, than for any other disease of the eye.

From the known effects of electrization on neuralgic and muscular
weakness of other parts of the body, it would certainly appear that
asthenopia, even in its severe phases, might also be successfully treated
by the same agent. The subject is worthy of the earnest attention of
ophthalmologists.

Asthenopia of two years’ standing—Rapid improvement under localized faradizatione,

Case CXCVI.—Mr. L., a student, aged 25, was referred to us by Dr. Loring,
The patient had for two years been afflicted with exceeding weakness of sight, and
for a long time was unable to read more than a minute or two without discomfort.
Time and rest had afforded slight relief, so that he now found it possible to read
by daylight some eight or ten minutes}; by gaslight he could not read at all. A mild
séance of localized faradization was essayed, with the result of markedly increasing
the strength of vision. Similar applications were repeated some dozen times, with
the most happy effect, and when last seen the patient was able to read an hour with-
out serious discomfort.

A second case, sent soon after by Dr. Loring, received equal benefit.

A case similar to the above—Improves more readily under galvanization than
Saradization.

CasE CXCVII.—A case similar in its symptoms to the above, and of as long

standing, that was sent to us by Dr. Roosa, was submitted to localized faradization,

with some benefit, Localized galvanization, however, with an exceedingly feeble
644 DISEASES OF THE EYE.

current, proved of greater service, and after a month of treatment the patient was
able to read ordinary print for over an hour continuously, without experiencing any
discomfort,

Asthenopia of an aggravated character and of two years’ standing Complete recov.
ery under twelve applications of localized faradization,

Case CXCVIII.—The most satisfactory result that we have to record in the treat-
ment of asthenopia was in the case of a lady aged 60. For two years she had observed
a constantly decreasing strength of vision, associated with a local irritability, that pre-
cluded any attempt at continuous use of the eyes. Finally, so weak did the organs
become that she found it utterly impossible to read or sew, or in any way concen-
trate her sight for a moment without suffering pain and obscuration of vision, She
was treated wholly by localized faradization—the tips of the fingers alone being used
as electrodes.

But about twelve applications were given, with the result of complete and per-
manent. recovery. During the three years that have elapsed since this treatment the
eyesight has remained perfectly strong.

Amblyopia and Amaurosis.—Amblyopia is now understood to be a
disorder of vision dependent on disturbance of the circulation, while
amaurosis is to be regarded as a symptom of atrophy of the optic
nerve.

For some of these conditions electrization may be tried with ad-
vantage.

A strong encouragement for a faithful trial of electricity in these
cases is that. various degrees of impairment of vision, from complete
blindness through the lower grades, have been sometimes most success-
fully treated by physicians and charlatans, with diverse methods of appli-
cation. De Saussure cured a case of amaurosis by statical electricity.
Lesueur, Magendie, and Person, successfully used faradization in the
same cases,

What is now needed is a careful and persevering trial of galvaniza-
tion and faradization in cases of amblyopia and amaurosis, after accu-
rate ophthalmoscopic examination.

Spasm of the Lid (Blepharospasm).—¥For spasm of the levator palpebra
and orbicularis palpebrarum, faradization or galvanization is indicated
for the same reason that it is indicated in torticollis, facial spasm, and
spasm of the glottis.

The method of application is the same as that prescribed for asthe-
nopia,

Prognosis.—Recent and mild cases recover rapidly. Long-standing
cases are sometimes very obstinate, but even these are frequently re-
lieved for a limited time after each sitting.
OPACITIES OF CORNEA AND VITREOUS HUMOR. 645

Slight spasmodic twitchings of the lid—Recovery under faradization,

CasE CXCIX.—A iady had been troubled with an affection of the left eye that
required surgical treatment ; was taken with slight but disagreeable twitchings of the
lid of the other eye. The twitching was so slight that it could be seen by an observer
only with difficulty.

Under faradization with a mild current, the negative pole being held in the hand of
the patient, and the positive being applied by gentle passes over the lid, recovery
took place in a short time,

\
Spasm of the orbicularis palpebrarum of long standing—Some temporary but no
permanent benefit from faradization and galvanization,

Case CC.--Rev. Mr. B, was referred to us by Dr. C. R. Agnew with severe
spasms of the orbicularis palpebrarum of the right side; the general health of the
patient was otherwise good. Faradization and galvanization, faithfully used for
number of sittings, in the manner described in the case preceding, were only of
temporary benefit.

Opacities of the Cornea.—The electric currents have been employed
with more or less success for opacities of the cornea for many years.
Cases have been reported by Isiglio, Quadri, Willebrand, Tiirck, and
Graefe. Recently this method has been but little employed.

The galvanic current would be more indicated than the faradic. Ex-
ternal or internal applications may be used.

In a case of opacity of the cornea, resulting from herpes ophthalmi-
cus, sent to us by Dr. Prout, there was a very decided clearing up
under a protracted use of the negative pole of the galvanic current
applied to the closed lid, and a part of the time directly to the conjunc-
tiva, which had been rendered anesthetic by the herpes.

Opacities of the Vitreous Humor — Keratitis——Le Fort and Carnus
report interesting and remarkable results in the treatment of opacities
of the vitreous humor by the galvanic current. The applications were
made with one pole over the closed eyelid, and the other in the auri-
culo-maxillary fossa, to affect at the same time the nutrition of the eye
through the sympathetic. In some of the cases the opacity was asso-
ciated with or resulted from keratitis. .

Photophobia.—Photophobia is a symptom of so many different patho-
logical conditions, that the cases of cure or relief obtained in it by the
electric currents are of comparatively little value. It very frequently
depends on the diseases of the conjunctiva and cornea. Hewson
reports the cure by galvanization of thirty-two cases of photophobia de-
pendent on scrofulous inflammation of the corneain children. From
ne to three applications were sufficient.
646 DISEASES OF THE EYE.

The positive pole was applied to the face and the negative to the
supra-orbital foramen.

Ptosis.—This affection, which consists in paralysis of the elevator of
the upper lid, is to be treated like spasm of the lid, but with a stronger
current.

Plosis following herpes—Rafpid recovery under galvanization,

CasE CCI,—A lady patient was referred to us, who had suffered long and severely
from herpes of the head and face. This was followed by acute neuralgic pains that
were most persistent and resisted all attempts at alleviation,

The galvanic current was here applied, and so successfully as in a short time to dis-
sipate in good measure the neuralgia. The eyelid of the right side, however, was
left drooping, a condition which had been present some weeks. Three applica-
tions of the faradic current to the affected part, of a strength as great as could be well
borne, were repeated on several occasions and readily resulted in a complete restoration
of the lost muscular power.

Mydriasis and Myosis.—In these conditions the electric treatment
is sometimes of value, although in many cases they depend on some cen-
tral difficulty that in its very nature is incurable.

The ¢reatment consists in local galvanization and galvanization of the
sympathetic.

Neuro-retinitis.—On the theory that neuro-retinitis may depend on
some morbid condition of the sympathetic, which in its turn may be
connected with various cerebral affections,* it has been treated by gal-
vanization of the sympathetic, and of the brain.

Indeed, from our experiments in galvanization of the sympathetic
(see p. 136), it would appear that in neuro-retinitis, and, indeed, in all
affections where we wish to affect the vascular condition of the retina,
galvanization of the sympathetic would very properly be indicated in
‘connection with other remedies directed to the disease. The subject is
certainly worthy of investigation.

Strabismus.—In strabismus, dependent on merely transitory causes,
faradization or galvanization may be of service; but the results yet
reported are not of great importance.

That temporary relief of strabismus may be derived from faradization
we demonstrated in several instances. The method of application is
the same as that for paralysis of the muscles.

From among many failures in the treatment of strabismus that we
find recorded.in our case books, we briefly note the two following
as illustrative of the benefit that occasionally accrues through electri.
zation,

* Benedikt, op. cit., pp. 252, 253, 254.
STRABISMUS. 647

Cas CCII.—A little girl, aged 8, had for two years been afflicted with strabismus
divergent.

The faradic current was as nearly as possible localized in the faulty MITECIES, and at
the sane time the body of the eye was submitted to gentle treatment,

Improvement became manifest after a few applications, and in the course of two
months ended in recovery,

Case CCIII.—In the case of a babe of 18 months who had shown symptoms similar
to the above some three weeks previously, it required but a single application of the
faradic current to dissipate the trouble.

Cataract.—The attempt to dissolve cataract by galvano-puncture has
been made by Crussel, with the result of inflammation and destruction
of the eyeball. It is stated, however, by Graefe* that applications of
the negative pole of a galvanic current have been successful.

Among other diseases of the eye in whieh electricity may be tried
experimentally with the hope of greater or less success, are anesthesia
optica, and nystagmus.

* Deutsche Klinik, 1852, p. 445—quoted by Althaus.
CHAPTER XXXIII.
DISEASES OF THE EAR.

Tue diseases of the ear are less amenable to treatment by electricity
‘than analogous diseases in most other parts of the body. By its ana-
tomical position the internal ear is even more inaccessible than the eye ;
and even the parts which can be brought more directly under the influ-
ence of electrization, as the middle ear, the membrana tympani, and
external auditory canal, can bear only feeble currents. Hence it is that
there is no branch of electro-therapeutics where there has been such gen-
eral disappointment both among aurists and electro-therapeutists as in
diseases of the ear.

The morbid conditions of the ear for which electrization has been
found of some service are subacute and chronic inflammation of the
drum and middle ear, nervous deafness, and tinnitus aurium:

Experiments on the ear were made quite early in the history of elec-
tro-therapeutics. :

Brenner * gives the following bibliography. of this department in the
early part of the present century :—

AuGustTIN— Versuch einer Geschichte der galvanischen Elektricitat und ihrer
medicinischen Anwendung, Berlin, 1801 (this work contains a quantitative distinction
in the working of-both poles on the nerves of hearing) ; also, Von Galvanismus una
dessen Anwendung, 1801, by the same author.—MERZDORFF—(Behandlung des
Ohrensausens durch den Galvanischen Strom,) bei GRAPENGIESSER, 1801, pp. 131
and 132.—FLIEs—(Galvano-therapeutische Versuche,) Ebendas., 1801, pp. 241,
252.—STELLWaG— Ueber Galvanismus, Hamburg, 1802 (this work contains cures of
deafness). —-STRUWE—System der Medicinischen Elektricitaét mit Riicksicht auf den
Galvanismus, 1802.—WOLKE—WNachricht von den xu Fever durch die Galvani-Vol-

taische Gehirgebehunst beghickten Taubstummen, etc. Osnabriick, 1802.—MArR-
TENS’ Therapeutische Anwendung des Galvanismus, 1803.

It was natural that attempts to cure diseases of the ear should be
made thus early in the history of electro-therapeutics, because at that
time there was scarcely any other method of treatment.

* Untersuchungen und Beobachtungen auf dem Gebiete der Electrotherapie, 1 Band,
1 Abth., 1868, p. 40.
METHODS OF APPLICATION. 646

There are two general methods of electrizing the ear—internal and
external.

 

Fic. 144,

Internal method of electrization of the ear (Duchenne), A, auricle; B, external
auditory canal; C, handle of electrode; D, flexible wire; E, rubber speculum;
F, ossicula in middle ear; G, mouth of tube; H, auditory nerve in inner ear; I,
inferior half membrana tympani; J, external muscle of hammer ; K, internal muscle
of hammer,

The flexible wire can be pressed in toward the drum and then al-
lowed to spring back. The external auditory canal is very sensitive,
and only mild currents, or currents quickly interrupted, will be borne.
The other electrode may be placed in the hand of the opposite side, or
at the mouth of the Eustachian tube, by means of a metallic-pointed
insulated catheter. It is an advantage before making the application
to partly fill, or at least to moisten, the ear with warm salt water, since
thereby the conduction is much increased. Thé water should be warm,
because cold water is not well borne in the ear.

Y
650 DISEASES OF THE EAR.

External Method.—The best external method of electrizing the ear
is to press the electrode firmly on the tragus, the other electrode being
held as before, in the hand of the opposite side. The ear should be
filled with warm salt water, although this is not necessary.

We have used this method for several years with both the faradic and
galvanic currents, and prefer it for all cases except when it is desired to.
act directly on the inflamed surfaces of the drum, or middle ear. It is
far less painful and more satisfactory than the internal method. It may
be used on the most sensitive children, who would rebel against the in-
ternal method, however skilfully performed.

The sitting should not usually be more than five or ten minutes, and
in some cases much shorter applications should be used, especially
when the galvanic current is used.

The electro-physiology of the ear has already been described in the
section on Electro-Physiology.

Electro-Diagnosis.—The electro-diagnosis of diseases of the ear has
been specially studied by Brenner.

The leading idea of this observer * is hat the reaction of the auditory
nerue to the galvanic current is variously changed. by pathological con-
ditions.

The normal formula has already been given. (See Electro-Physiol-
ogy. p. 143).

The difficulties in the practical application of this method of electro-
diagnosis are very great. The normal formula can be obtained only in
a certain proportion of cases, and then oftentimes by painful currents.
Even when we obtain apparent deviations from the normal formula,
we are not always sure just what such deviation indicates, either in
special pathology or in therapeutics.

Changes in the Reaction of the Auditory Nerve in Pathological
Cases.—In pathological cases the normal formula may undergo various
changes.

These changes in the reactions that appear in diseases of the ear may
be embraced under the following heads : +

1. -Hyperesthesia of the nerve, so that it reacts to a milder current
than normal, or reacts longer or more powerfully. This may be either

* Zur Elektrophysiologie und Elektropathologie des Nervus acusticus, Petersburgh
Med. Zeitschr., Bd. 4, p. 286. 1863. Also, Weitere Mittheilungen zur Elektro-
otratrik, Petersburger Med. Zeitschr., Bd. 5, p. 35, 1863. And more recently in
his published work, Untersuchungen und Beobachtungen auf dem Gebiete der Elek-
trotherapie. Leipzig, 1868 and 1869,

{ Brenner, op. cit., Band i., p. 181 et seq.
PATHOLOGICAL REACTIONS. 651

simple or complicated with qualitative change in the formula, or with
paradoxical formula in the ear not experimented on, or with morbid
subjective sensations of hearing.

2. Change in the formula of reaction without hyperesthesia. "These
changes are either in inversion of the normal formula, or deviations of
various kinds.

ka Torpor of the nerve (anesthesia), so that it does not react, or only
to a stronger current than normal.

Illustrative Pathological Cases.—Brenner gives the following illustra-
tion of hyperzesthesia in a case of chronic catarrh of the middle ear, on
both sides, with difficulty of hearing, much “zni¢us.

The reaction was as follows:

, XX go Ka.S.K’.

Ka.D.K. @ 7
Ka.0.—
AS. —
A.D. —
A.O.k.>

In another case, where there was great difficulty of hearing, with
tinnitus, that had existed for three years, and demonstrable anatomical
changes, but in which a central disease was suspected, the reaction was
as follows :*

XX so Ka.S.K’.
Ka.D.K. oo
Ka,0O.—
A.S.—
A.D.—
A,O.k, >

Other cases, illustrative of changes of various kinds, we give below :—

Qualitative change.—A Hyperesthesia with in- Hypereesthesia with pa-
laborer, 30 years old; in- version of the normal radoxical sensations in ear
telligent ; deafness and tin- /formula.4—A lady of 60; not treated.t

 

nitus on both sides from absolute deafness in left ear ; Ear treated. eer not
childhood; drum cloudy drum depressed, thickened XX 100 Ka.S.K" ;
and thickened. and opaque, Ka, D. K. 2 —
X 100 Ka.$.K'. 6 El. Ka,— ia, O. _ K.>
Ka.D.K. 0 Ka, D,— AS. Ke.
Ka.O,—Rattling. Ka.0.PE£. > A.D. k.>
AS. ¢e An.S. Pf. A.O.K.> ——
A.D. & & An.D.Pf. 00 *
A.0.K.> An.O.—

“Op. cit., pp. go, 191.
+ Erb in Archiv Ophth, and Otol., vol. i, No. 1, p. 272.
¢ Brenner, op. cit., Band i., p. 205.
652

Illustrative and typical case of in-
version of the normal formula,* — An
officer, 26 years old; from his childhood
completely deaf in left ear ; no tinnitus ;
no demonstrable change in drum; only a

DISEASES OF THE EAR.

Modification of the normal formula
without hyperesthesia.—A woman, 45
years; old difficulty of hearing in both
ears; no tinnitus; some dulness of the
drums,

pale color ; right ear normal. RicHT Ear :—
XX 500 Ka.S.—‘* Chirping.”
Electric examination of Electric examination of Ka. D. 66 short,
right (healthy) ear left (diseased) ear Ka.O.
aS ae normal oe inverted A.S, —Roaring.
1X Ka.S.K’, IX Ka.S, — A.D. “short.
Ka.D.k > Ka, D, — A.O, —Indefinite sounds,
Ka.0, — Ka.0.K. Left ear gave same formula, except
GY ait A.S.K'. that Ka.O. gave a short and slight roar-
A.D. — A.D.K. > ing.
A.O.k. A.O. —

The above case of the officer Brenner regards as of a special nature.
The patient was examined by a number of aurists, and the inversion
of the normal formula in the diseased ear was decided.

The following experiments were made by one of the authors of this
work on himself. The right ear, on which the experiment was made,
has for twenty-five years been affected with chronic inflammation of
the middle ear. The drum is cloudy, the tube pervious, and the hear-
ing distant ; at times he had been troubled with tinnitus, but not at the
time of the experiment. The objective examination of the ear was
made by Dr. D. B. St. John Roosa. The experiments are given
in detail, because they illustrate a number of the peculiarities in regard
to the galvanic reaction of diseased ears, and the difficulties and com-
plications that attend the investigation.

The internal method was used :

1o Stohrer’s El. Ka.S.—No reaction. 12 El. Ka.S.—No reaction.

Ka.D.—-Some rumbling, Ka.D.—“
made evidently by Ka.O.—
pressure of electrode. + AnS.—*

Ka.O. An,D,—‘* *

An.S.—No reaction, An.O.—“

An. D.— “ -
An.O.— ‘ ae

Feeble flashes of light were observed.
The rumbling of a distant carriage for a
moment was mistaken for the cathode
closing reaction,

* Brenner, 1. c., p. 219.
+ In order to prevent deception on this point, the finger was pressed on the tragus,
and found to produce the same apparent sensation of rumbling. The apparatus
¥
PATHOLOGICAL CASES. 653

16 El., Ka.S.—No reaction. .
Ka. D.—Hissing in the other ear ; (paradoxical reaction),
Ka,O.—Same for a moment,
An.S.—Hissing.
An D.—Same. >
An.O.—No reaction, but hissing in other ear.
Stronger flashes of light 5 dizziness ;»subjective sounds in ears for some minutes
after treatment.

20 El. Ka.S.--Slight roaring, Rheostate—600--Same roaring.
Ka.0.> yoo— < as
Ka.O.—No reaction. 800-- ‘ ef
An.S.—Loud hissing (seething), goo— ‘ «© still pain.
An, D,—Same, > 1,000—Much less roaring, and
An,O.—No reaction. hissing in other ear much
Considerable pain in ear; much less,
stronger flashes and dizziness; metallic Ka,O.—No reaction.
taste; burning in wrist of the hand The anode reaction with the resis«
holding cathode, _ tances of the rheostate was as follows:
The rheostate was now brought into An.S.—Very loud hissing.
use, _ An,D. © and flow of saliva,
24 El. K.8.—Low rumbling and hissing Rheostate—1oo—Very loud hissing,
in other ear; very great pain; 2oo— * ‘“s
perspiration on forehead, and 3o0— “ #6 ae
muscular contractions, 400—Loud _
Ka, D.—Same, oo 500— ‘* as
Rheostate--100o—Same roaring. 600—Less sf
200— ee “a 700— cé oe
300—Less sé 8c00— «6 “
400— * “ goo— ** ‘6
500— ** less pain. 1,000—Much less‘

Concerning the above case it may be remarked :

1. The deviation from the normal formula was unmistakable. The
anode reaction was very decided, there was no possibility of a mistake.
The chief difficulty was with the cathode. A low rumbling or roaring
was all the reaction that could be obtained with Ka.S. or Ka.D. and
that only when many elements were used.

2. The accompanying phenomena—dizziness, pain, contractions of
the facial muscles, metallic taste, flow of saliva, perspiration on fore-
head, burning and contraction of the muscles of the hand holding the
electrode—were present, but did not interfere with thé observation of
the reaction of the nerve. It is just, however, to remark that this in-

used in this experiment had no current reverser, consequently it was necessary to con-

tinually move the electrode to and from the tragus, }
654 DISEASES OF THE EAR.

dividual has been accustomed for many years to experiment on himself
with electricity, and therefore would be little liable to be annoyed or
distracted by their incidental phenomena; yet even he was deceived
momentarily by the rumbling of a distant wagon. Constriction of the
throat, of which some complain, was not experienced.

The following pathological case is of double interest, since benefit
to the hearing seemed to result immediately after the galvanic exami-
nation.

Case CCIV.—G. K. B., aged 18, had from his early boyhood suffered from chronic
ulceration of the membrana tympani with discharge, In the left ear the drum had
disappeared, The watch could be heard only on pressure. There was no tinnitus,
The Eustachian tube was pervious,

Three years before the right ear had been siuailarly affected, and had entirely re-
covered under the influence of treatment, so that the discharge ceased and the hearing
was normal, At that time Dr, St. John Roosa saw the case in consultation and con-
firmed the diagnosis.

August, 1820. The patient again consulted us for his right ear, which we found in
the condition described, and which was similar to that in which we had found it three
years before. At this time we decided to test the galvanic 1eaction, which we were
able to do without difficulty, by the external method.

The result was as follows:

8 El: Ka.S. Some rumbling.
Ka.D. sf se
Ka.O, No sensation,
An.S. Rumbling,
An.D. ee
An,O, No sensation,

With ten and twelve elements there was the same, but louder, and with eighteen
elements a sound like the ringing of a large bell, reaction. When sixteen elements
were used, the patient experienced a sensation of hissing with An.S. and An.D.

After various changes of the current, a less number of elements brought a decided
reaction, In order to see whether the patient deceived himself, or whether the
sounds were produced by the agitation of the water in the ear, we applied the electrode
to the tragus, when disconnected from the battery.

Immediately after the sitting the patient said that he could hear conversation better.
The week following the same experiment produced the same result, During the in-
terval magnesia had been blown into the ear in considerable quantities, so as to in-
terfere somewhat with the hearing power ; for that reason it was impossible to deter-
mine whether the improvement was permanent.

Dizziness in this patient was very marked and lasted by terms for several days,

General Therapeutical Results of Electrical Treatment of Diseases
of the Ear.—In the United States, cures of deafness, without regard
to the pathology on which the symptom of deafness depends, have oc-
TINNITUS AURIUM. 655

casiuuatly been accomplished by uneducated empirics, who have treated
all farms of disease of the ear, from inspissated cerumen to disease of
the auditory nerve, by some unscientific and uniform method of faradi-
za’ion,

Duchenne reports one case by faradization of hysterical deafness
ef many months’ standing; one caused by quinine; one consecu-
five to an eruptive fever; one following measles; one of twenty
years’ standing. Several cases of nervous deaf-muteism were also
ymproved.

The conclusions to which he arrived are as follows: *

1. “That nervous hysterical deafness is generally caused by elec-
trical excitation of the chorda tympani and movements of the chain of
little bones.”

2. “That cases of nervous deafness consecutive to eruptive and
continued fevers have been cured by the same treatment, even though
they have been of long standing, and, from the fact of their resistance
to ordinary remedies, have appeared to be incurable.”

3. ‘That probably the thérapeutical action of the process of fara-
dization is chiefly due to the undulations of the labyrinthine liquid
produced by the movements of the chain of little bones, and conse-
quently of the fezestra ovali.”

4. “That electric exploration of the ear furnishes no pathogno-
monic sign which permits the prognosis of incurability of the deaf-
ness.”

Subacute and Chronic Inflammation of the Middle Ear.—As far
as we can judge from our own observations, old cases of chronic
inflammation of the middle ear, where the hearing power is so much
impaired that a watch can be heard only on pressure, offer an un-
favorable prognosis.

The best results are obtained in those cases that are just passing
from the subacute to the chronic stage. We are inclined to the belief
that these results, when they do occur, are brought about by the
mechanical action of the faradic current, on the adhesions within the
middle ear.’ In some even long-standing cases of chronic inflammation
of the middle ear temporary improvement of hearing unonediaiely fol-
lows faradization or galvanization.

Tinnitus Aurium.—The very frequent and very distressing symptom,
tinnitus aurium, and which accompanies so many of the morbid processes
in the auditory apparatus, is not relieved by electrical treatment as uni-

* Treatise on Diseases of the Ear. Translated and edited by Dr. B. St. John
Roosa. “Second American edition, 1869, pp. 1,013, 1,030.
656 DISEASES OF THE EAR.

formly as d griori reasons would lead us to expect. The capriciousness
and uncertainty of the results in such cases are partly to be explained by
the fact that ¢innitus aurium isa symptom of such diverse and sometimes
undiscoverable pathological conditions. Local galvanization by the
external method, or galvanization of the sympathetic, sometimes avail
for the temporary relief of this affection, and in some cases a more or
less permanent cure is obtained.

Galvanization of the cervical sympathetic affects the ear just as it
affects the retina, through modification of the circulation in the brain.
Dr. Rumbold, of St. Louis, reports two cases of tinnitus aurium, in
which local galvanization was of great service.*

With reference to the therapeutical value of the galvanic current,
especially in the treatment of diseases of the ear, Brenner ¢ and Ha.
gen{ substantially agree to the following propositions :

1. The galvanic current is indicated not only for those cases where
no morbid changes can be diagnosticated, but also in all cases, however
complicated, in which the abnormal reaction to the current shows that
the nerve participates in the disease.

2. The galvanic treatment may aid in the absorption of morbid
deposits.

From our survey of the literature of the subject, and from our own
comparative observations, we are justified in these two conclusions :

_ First. The galvanic current is on the whole of greater service, and is
of greater promise in the electro-therapeutics of the ear than the faradic.

Second. The results obtained in the electric examinations are not uni-
form or always reliable guides to the special method of treatment that
it is best to adopt.

Reasoning d priori, it would be inferred that the reaction of hyper-
esthesia would call for treatment by the azode, and the reaction of Zor-
por (anesthesia) for treatment by the cathode; but experience shows
that there is no uniformity to this law.

Moos, § in the remarkable case to be hereafter cited, found that
the cathode at one time exercised a temporarily beneficial influence on
the subjective symptoms, which usually disappeared only under the
anode.

Erb || also, in case of “ sémple hyperesthesia of the right auditory

* Archives of Electrology and Neurology, May, 1874.

t Op. cit., Bandi, p. 262,

} Praktische Beitraige zur Ohrenheilkunde, Leipzig, 1866, p. 29.
§ Archives Ophthal. and Otol., vol. i., No. 2, p. 488.

| Archives Ophthal. and Otol., vol. i., No. 1, p. 28.
HYSTERICAL DEAFNESS. 657

nerve,” with “inversion of the normal formula,’ found that the tinnitus
was quieted by the closing of the cathode (Ka.S.) and not by the closing
of the anode, as would have been expected.

Still further, it is not demonstrated that in many of the cases of
hypersesthesia that were successfully treated by the anode, or of torpor
(anesthesia) that were successfully treated by the cathode, the results
might have been equally or more successful if the poles had been re-
versed. The conclusion is, therefore, that while the general law laid
down on page 281, that the positive pole is on the whole the more calm-
ing and the negative the more irritating, applies to the auditory nerve
as to other parts of the body, yet it is always liable to many real or
apparent exceptions, and in the present state of our knowledge the rule
can never be made an absolute or uniform guide in the electro-thera-
peutics of the ear. ‘

Brenner * details eleven cases of diseases of the ear treated by the
galvanic current.

In one case of thickening of the drum, the current caused ab-
sorption.

In one case of hyperzesthesia, with tinnitus aurium and anatomical
changes in the middle ear, the tinnitus was rapidly cured.

In one case of hyperzesthesia, after the use of quinine there was
recovery.

In one case of hyperzsthesia, with tinnitus aurium and catarrh of the
middle ear, the tinnitus was cured.

In one case of obstinate subjective symptoms of: various kinds there
was improvement under great difficulties of application.

In one case of noises in the head and ears, of ten years’ standing,
with important anatomical changes in the ear, there was improvement.

Of deafness, two cases were improved, one was much improved, and
one was cured. The case which recovered was one of facial paralysis,
with anomalous reaction of the auditory nerves.

In all the cases there were anatomical changes.

In some cases the treatment was quite persistent.

fy sterical Deafness. —When deafness depends on simple hysteria the
results of electrical treatment may be very brilliant.

Dr. Moos, of Heidelberg, has published a case of recovery from
deafness under the influence of the galvanic current, which is the most
remarkable of any which have been scientifically reported.

* Op. cit. Band i., 2 Abth., p. 233 et seq. Brenner also mentions the fact that
he failed in seventeen cases of tinnitus, Loc. cit., p. 235.

42
558 DISEASES OF THE EAR.

Casz CCV.—The patient, a lady of nineteen, after an attack of acute articular
rheumatism (Feb. 9, 1869), was taken with symptoms of acute intercranial disease of
an hysterical character, She became completely deaf for noises, musical notes, and
speech, and for several weeks it became necessary to communicate with the patient by
writing. This deafness was preceded by abnormal sensitiveness of the ear, and dis-
tressing acuteness of hearing. Two weeks afterwards, the ninth week of her sick-
ness, the sensitiveness had diminished, and her deafness was absolute. In the eleventh
and twelfth weeks of the disease, she began to suffer from hysteria or epileptic attacks,
lasting from a half to one and a half hours, from one to three times a day. These at-
tacks were accompanied by loss of consciousness, tetanus, clonic cramps, and pains in
the back and abdomen. There was also unilateral hyperesthesia of the scalp and face.

‘These symptoms were variously treated by the galvanic current. The patient was
treated with the galvanic current ; at first daily, from May roth to July 27th,

At first there was, as has been stated, a feeble reaction to the current. This was
followed, in a few days, by simple hyperesthesia, combined with a paradoxical re-
action in the ear not treated, and lastly hyperzesthesia w7th gualitative change,
When the cure was complete the normal formula of Brenner appeared.

On the eleventh day of the treatment the patient heard her own voice in the left
ear, immediately after the galvanic treatment. Noises in the ear appeared which
wee treated by the anode. On the 18th and 24th of June, conductibility of the
‘ones was noticed for the first time. July 12th, two months from the beginning of
the treatment, the patient could hear-the watch on the right side 10 feet, on the left 9
feet. The treatment now caused dizziness, which made it necessary to give longer
intervals during the séances, and it was found necessary to use very weak currents.
The patient was now sent to Black Forest, where in six weeks she fully recovered.

On the 2gth of April, Dr. Moos, an experienced aurist, who had once before ex-
amined the patient, came to the conclusion that there was perfect paralysis of both
auditory nerves. The electric examination, made on the gth and roth of May, gave
the following result :— ,

Ricut Ear. 10 El. goocR* K.S. —Lively whirring sound.
K.D, —Same gradually disappearing. ‘
K.O. —No result.
An.S.— “ *
An. D,— «6 ee
An.O.—“
Lert Ear. 10El, goocR KS. —Scratching of a violin.
K.D. —The same, lasting a short time.

K.O, —None,
An.S.— *
An.D.— «
An,O.— §

The ears were differently affected. On the right side there was ‘ paralysis of the
auditory nerve, paralysis of the sense of touch, as well as paralysis of the trophic
nerve, decubitus of the right concha.” On the left side there was “paralysis of the
nerve of hearing, long-continued hyperzesthesia of the nerves of touch,”

* Resistances of the rheostate,
CHRONIC SUPPURATION OF THE MIDDLE EAR. 659

Concerning this case we may remark :—

1. It was unquestionably a case of Aysteria, of which the rheumatic
affection was the exciting cause. Very likely some of the cures of
deafness obtained, now and then, by electrization, are of a similar
character.

2, Although the element of time should not be ignored, yet the re-
covery was mainly due to the electrical treatment. This is proved by
the immediateness and rapidity of the results.

3. The case establishes, so far as a single case can, the substantial
correctness of the main propositions of Brenner.

4. It is not demonstrated that the exclusive use of either pole was
necessary to obtain the result, and it is entirely probable that the
faradic current might have been of more or less service.

Deafness following Cerebro-Spinal Fever.—Our own experiments in
the electrical treatment of deafness, following cerebro-spinal fever, have
been entirely unsatisfactory.

Moos * relates a case of cerebro-spinal meningitis that was followed
by complete deafness, that gradually improved so that he could hear
one or two feet. The patient was troubled with tinnitus aurium and
also with headache and vertigo. With the right ear he heard nothing ;
with the left ear could hear the voice two feet. Temporarily the anode
produced a diminution of thé subjective noises. After twenty-two sit-
tings the hearing power was raised to eighteen paces ; the noises and
giddiness were much diminished.

Chronic Suppuration of the Middle Ear.—We have experimented
somewhat in the treatment of chronic ’suppuration of the middle ear by
the local use of the galvanic current. The experiments were made both
in private practice and at the Brooklyn Eye and Ear Hospital in con-
nection with Drs. Matthewson, Newton, and Prout. The theory on
which the experiments were based was that ulcerous conditions in the
ear might be treated electrically just like similar conditions in other
parts. Ulcers on the mucous membrane do not yield as readily to elec-
trical treatment as ulcers on the surface of the body, and do not bear
electricity as well; they are, however, somewhat susceptible of elec-
trical treatment, as is shown by experiments in chronic urethritis and
granular lids,

The method of treatment adopted in these experiments was to insert
an electrode with a long narrow extremity, covered with a little cotton,
into the auditory canal, through a rubber speculum ; the canal being filled
with tepid water. The electrode is usually connected with the negative

* Archives of Ophthalmology and Otology, vol. ii, No. 1., p. 332.
660 DISEASES OF THE EAR.

pole of the galvanic current, though sometimes with the positive pole.
The circuit is completed by the hand of the patient holding a sponge
electrode or resting on a stationary electrode. Only very weak cur.
rents and very short applications are borne, and it is almost inudis-
pensable to have some kind of rheostate, so that the current may be
gradually shut on or off.

Under this treatment the character of the discharge changes, and in
some cases the recovery was certainly more rapid and satisfactory than
it would have been without it.*

* Vide Dr. Roosa, Treatise on Diseases of the Ear, p. 377+
CHAPTER XXXIV.

MIDWIFERY.

Tue use of electricity in midwifery was first tecommended by Ber-
tholon and Herder (1803). Kilian afterwards used “galvanic obstetri-
cal forceps,” made of two metals.* Faradic currents were first used
for bringing on labor-pains by Heeniger, Zyly, and Jacoby, of Neustadt,
in 1844. Since that time the same agent has been used for this purpose
by Frank, Dempsey, Barnes, Mackenzie, Tyler Smith, Radford, and
others.

The indication for the use of the current in midwifery is declared to
be an adynamic condition of the uterus, when other conditions are
favorable for or necessitate immediate delivery. Dempsey records a
case where, after ergot in large doses had failed, faradization for forty
minutes produced uterine contractions that resulted in the delivery of
the child.

Frank reports a case of miscarriage, from a fall, in which faradization
produced contractions of the uterus, and stopped the very profuse
hemorrhage. Mackenzie succeeded in stopping the hemorrhage in two
cases of placenta praevia. In one case the current was applied for six,
and in the other for three hours.t+

These observers claim that electricity acts more quickly, more uni-
formly, and with less injurious effects than ergot.{

Both M. De Saint Germain and Tripier are highly in favor of fara-
dization in the last stages of delivery. When the labor has fairly begun,
the pains coming on at intervals of about a quarter of an hour, Tripier
faradizes the lumbar region.

Uterine contractions soon follow and occur more frequently, while the
dilatation of the neck takes place rapidly. In cases of confinement M.
Tripier always faradizes the lumbar region by means of two electrodes,
and sometimes he applies one pole directly to the uterus. According

* Meyer, op. cit., P 452.

t Quoted by Meyer, op. cit., p. 452.

¢ Simpson and Scanzoni, on the other hand, deny the utility of electricity in mid-
wifery,
662 MIDWIFERY.

to his account the placenta is expelled immediately after the foetus, and
although it was evident that the child felt the current, not the slightest
injury has ever been inflicted.* During the last two or three years
there has been a revival of interest in the use of faradization in mid-
wifery. Quite a number of observers in different countries have
reported good results.

Dr..A. Murray, of this city, informs us that he has treated eighty-
two cases of izertia uteri, in second stage of labor, by external faradi-
zation, and always with good results.

He states that it acts much more speedily than ergot. His method
is to piace one pole on the sacrum and the other. over the abdomen.
The applications are continued for from eight to ten minutes.

Post-Partum Hemorrhage.—Faradization has also been used with
good effect in post-partum hemorrhage. It rapidly produces contrac-
tion of the uterus, and thus may save the life of a patient.

It is to be applied the same way as before delivery.

Some obstetricians always have a faradic apparatus on hand, in case
of parturition.

Diseases of the Mammary Gland— Deficient Lacteal Secretion.--
Secretion of milk may be increased by electrization. Two methods
of faradization have been proposed, one by means of moist electrotes
on the gland, the other by dry electrodes, with a view to excite the se-
cretion of the gland by reflex action.

Successful cases have been reported by Aubert and Becquerel.t
Aubert cured one of his cases by dry, the other by moist electrodes.
In the first case the patient had no milk three weeks after parturition.
After a delay of seven months the treatment was applied. The third
application brought on a milk-fever ; after the fifth, milk appeared. In
the other case the mother was attacked by pneumonia 114 months
after confinement. As a consequence the lacteal secretion ceased.
Four faradizations with moist electrodes filled the breasts.

In Becquerel’s case recovery was obtained by three applications.
Similar results have been obtained by other observers.

Dr. Skinner, of Liverpool (quoted by Althaus), reports a case of a
lady who, while nursing her fifth child, suffered complete suppression of
the lacteal secretion, which the Doctor attributed to the tincture of iron
she was taking. He applied the current (probably the faradic, which,
on account of its greater mechanical effects, would be more indicated
in such cases) to the left breast. The patient felt a rush of milk to the
breast, and in a few hours a full supply appeared.

* Journal de Médecine. - + Quoted by Meyer, op. cit., pp. 451 and 452.
DEFICIENT LACTEAL SECRETION. 663

The right breast had not been used for some time, on account of a
previous abscess. As a new experiment, the Doctor made two applica-
tions of five minutes each to this breast, and brought on as much milk
as in the other.

Permanent increase in the lacteal secretion under general and localized faradization,

Case CCVI.—Mrs, , who was nursing her second child, submitted to faradi-
zation for the relief of nervous prostration and insomnia.

The flow of+milk was scanty ; quite insufficient for the proper nourishment of the
child. Under the influence of general faradization the patient soon stated that she
thought her milk was somewhat more abundant, and in subsequent séances we invaria-
bly ended by localizing the current in both breasts. These attempts resulted in such
a decided increase in the amount of milk secreted, that the infant found sufficient
nourishment from the breast without resorting to artificial food.

It is worthy of comment, that the left breast, which was almost dry at the begin-
ning of treatment, finally secreted more abundantly than the right.

 

Dr. A. Murray informs us that he has tried faradization as a galacta-
gogue in thirty-seven cases. He found it efficacious in about two-thirds
of the cases.

Sore Nipples—Sore nipples, like ulcers and fistule in general, may
be treated electrically by either current, but the galvanic is preferable.

Different forms of galvanic nipple-shields have been devised. ‘These
act like the electric disks, and other body batteries.

Dr. A. Murray, of this city, has devised a galvanic nipple-shield,
which he finds very valuable. It is composed of silver and zinc. It is
of the shape of a percussion cap, and the size of a small thimble. This
shield is kept z sit by strips of adhesive plaster. The
milk trickling down the breast may offer sufficient moist-
ure to excite galvanic action; or a small piece of moist-
tened lint may be interposed between the nipple and the
shield. Dr. Murray claims that when this shield is worn Fic. 145.
for several hours, the excoriations rapidly heal. Miurcay’s Gal.

He also uses this shield as a prophylactic, and for this vanic Nipple-
purpose recommends it to be worn two or three hours shield.
daily for two weeks or so before confinement.

Rohland, of this city, has devised a galvanic nipple-shield of a differ.
ent construction.

 
CHAPTER XXXvV.

ARTIFICIAL RESPIRATION BY ELECTRIZATION IN CASES OF APPARENT
DEATH FROM DROWNING, OR SUFFOCATION THROUGH POISONOUS
GASES, OR IN ASPHYXIA OF NEW-BORN INFANTS.

THE process of exciting artificial respiration by faradization * is as
follows :

1. Let an assistant put the head, shoulders, and arms of the patient in
a fixed position, while another stands ready to assist the expiratory
movements by pressure.

2. Graduate the current to a strength sufficient to produce vigorous
contractions of the muscles of the ball of the thumb, and then press ‘the
sponge electrodes (which should be of large size and well moistened)
firmly over the phrenic nerves at the outer borders of the sterno-cleido-
mastoid muscles and at the lower end of the scaleni muscles,

3. Interrupt the current (either by removing one of the electrodes, or
by an interrupter ), about three times a minute, while the assistant presses
firmly on the abdomen, pausing occasionally to observe the effect. *

4. Lf after a number of interruptions no inspiratory movements ap-
pear, increase the strength of the current.

In some cases it is sufficient to put one electrode over the phrenic
nerve and the other in the seventh intercostal space.

Large electrodes are used so as to affect the other muscles which
have a share in inspiration (scalenus-anticus and sterno-cleido-mastoid)
simultaneously with the phrenic nerve. The object of holding the
arms and shoulders in a. fixed position is to prevent the interference
which may arise from the contractions of the muscles of the arms, and
at the same time to obtain the co-operation of the serratus and pectoral
muscles.

Prof. Ziemssen, who first proposed this method of producing artificial
respiration, advises the trial of the galvanic current in those cases

* The faradic current is usually employed for this purpose, although the interrupted
galvanic current might answer the purpose,
IN OPIUM POISONING. 665

where the irritability is lost to the faradic. The same writer presents
a number of successful results in cases of poisoning by carbonic acid
gas with this method of treatment trom his own and other experience.*

In opium poisoning artificial respiration by faradization may be tried
either alone or in connection with other methods. Dr. Iram has re-
ported a case of opium poisoning, which recovered on the application
of one pole to the neck and the other to the perinzeum, after tannin,
coffee, and tartar emetic had been unsuccessfully employed for several
hours.

Those who attempt to produce artificial respiration in emergencies
are frequently unfamiliar with the motor point (see p. 168) of the phre-
nic, and therefore apply the pole in the neck indiscriminately. A
medical acquaintance informs us that an attempt of this kind which he
made in a case of opium poisoning proved instantaneously fatal to the
patient. Under ordinary methods the patient was recovering, but in
order to expedite the progress, faradization was tried. One pole’ was
placed on the ribs, and the other somewhere in the neck, in order to
find the phrenic nerve. Immediately the patient ceased to breathe, and
no further treatment availed to resuscitate her.

This case, so far as we know, is unprecedented. It is explicable only
on the theory that the shock of the sudden closure of the current near
the nervous centre destroyed the waning life by concussion.

This unique and unfortunate case should not deter any physician
from resorting to the electric method of artificial respiration in all cases
where it is indicated, any more than the equally unique case of blind-
ness produced by the galvanic current (recorded by Duchenne) should
deter us from galvanizing the eyes and face.

Meyer records a'successful result ina case of threatened death from
exhaustion after diphtheria.+

Friedberg ¢ succeeded in restoring a child of four years, asphyxiate
by chloroform, by this method, combined with compression of the dia-
phragm.§

Many failures have been made in the attempt to produce artificial
respiration by faradization, because the operators were ignorant of the
true method of application, or were not sufficiently persevering.

Dr. Beard has twice failed to resuscitate dogs that were narcotized by

* Die Electricitat in der Medicin, 1866, p. 174 et seq,

t Op. cit., p. 431.

t Quoted by Meyer, op. cit., pp. 431, 432.

§ Irritation of the phrenic nerve might be readily combined with Howard’s method
vf artificial vespiration.
666 ARTIFICIAL RESPIRATION BY ELECTRIZATION.

chloroform, although the applications were begun in less than a minute
after the heart ceased to pulsate.

He failed also in a case of opium poisoning in an infant six weeks old.

Some remarkable results have been reported where life was saved by
faradization around the neck and chest, kept up by intervals for many
hours.

Dr. Allan McLane Hamilton, from a number of interesting experi-,
ments undertaken to test the utility of electricity in asphyxia, concludes
as follows :—

st. That it is useless to expect good results if five minutes have
elapsed since life appeared extinct.

2d. That the current should be applied faithfully and steadily, one
pole being placed on the ensiform cartilage, the other on the base of
the skull or over the tracks of the great nerves of the neck.

3d. That the faradic and interrupted galvanic currents are the best.

4th. That the current should be applied some time after respiratory
movements have become regular.*

Resuscitation of New-born Children.—Successful experiments in the
resuscitation of new-born children have been made by Schulz and
Pernice. The latter succeeded in three out of five cases. In one of
his cases the child was born to all appearance dead. Restoration was
accomplished in half or three-quarters of an hour by the alternate use
of the warm bath and faradization of the phrenic nerve.

Legros and Onimus + have experimented on animals—rats, dogs—
with a view to bringing on resuscitation during syncope from loss of
blood. They used the galvanic current, placing the negative pole in
the mouth and the positive in the bowels.

Dr. Rockwell has treated ‘several cases of suspended respiration. A
new-born babe was to all appearances dead ; faradization of the phrenic
nerve resulted in decided manifestations of life for a few moments
only. In the case of a lady who was in a state of asphyxia—from a
subcutaneous injection of morphine—faradization of the phrenic nerve
excited respiratory movements which were repeated some twelve or
fifteen times after the current ceased to pass. He did not succeed in
saving the patient.

* Electricity as a Means of Resuscitation. American Practitioner, Oct., 1872.
+ Gaz. des Hép.,, No. 53.
CHAPTER XXXVI.
DISEASES OF THE HEART AND LUNGS.

Palpitation of the Heart.—That galvanization of the sympathetic
and general electrization have a positively accelerating or sedative
effect on the action of the heart, we have demonstrated by a large
number of experiments. (See Electro-Physiology.) This effect is pro-
duced by the action of the current on the sympathetic or the pneumo-
gastric in the neck, or in general electrization it may also result,
secondarily, from the influence that the system at large receives from
the application.

Cases of functional disturbance of the heart, associated with dyspep-
sia and hysteria and anzemia, we have found to yield to general faradi-
zation in a large variety of instances, even when no special attention
was directed to the sympathetic or the pneumogastric

Fliess experimented with the galvanic current in twenty-four cases,
nineteen of which were functional, and five of an organic character.

All-the cases were more or less relieved, even those dependent on
structural lesion, while the majority of the functional cases were perma-
nently cured.

His method of treatment was the daily application to the pneumo-
gastric in the neck of mild, descending, galvanic currents, for one or
two minutes. Temporary abatement of the symptoms followed each
application.

The treatment of functional palpitation of the heart is certainly
worthy of more attention than it has thus far received from electro-
therapeutists.

Palpitation of the heart assoctated with dyspepsia—Unusual susceptibility to the
current—Great improvement under general faradization,

CasEz CCVII.—Mr. B., of New Jersey, applied to us March rst, 1867, with the
symptoms of weakness of the stomach and liver, and also of functional derangement
of the heart. He was tall, somewhat spare, but of fair muscular development. His
Occupation was that of a farmler, but for some time before he visited us he had been
unable to make any protracted exertion. He had tested various kinds of internal
medicines, and with unsatisfactory results.
568 DISEASES OF THE HEART AND LUNGS.

During the first application he was momentarily overcome by a feeling of faintness,
out at once rallied, and went away feeling stronger and brighter. He continued to
risit us two or three times a week; for nearly two months, The improvement was
low, but very positive, with occasional temporary relapses, The cardiac symptoms
rradually diminished, and his strength increased to such an extent that he was able to
‘esuume in part his daily avocation.

When he left us his digestive functions were well performed, and he had made ar-
‘angements to enter upon an active and pleasant out-door employment,

Angina Pectoris.—The treatment of angina pectoris has ever been
satisfactory. The cases that have fallen under our observation were
nostly of a chronic character, and turned to electro-therapeutics as a
ast resort. As illustrative of the best result that we have been able
-o obtain in the treatment of this remarkable disorder, the following
case is presented :

Angina pectoris—Probably of an idiopathic character—Recovery unaer general
Saradization,

CasE CCVIII.—The patient was a stout, vigorous man, aged 48, and for eighteen
nonths he had been the victim of violent, sharp, shooting pains, under the sternum, in
she left shoulder and arm. Frequently the neck would suffer, and occasionally the left
eg. Physical exploration gave no evidence of organic disease; and as it was impos-
sible to find any external exciting cause, we attributed the symptoms to idiopathic
zauses, When he moved more rapidly than usual, or over-exerted himself in any
way, he was liable to be seized with a violent sense of constriction in the chest, which
caused him to feel as if about to die. In a moment the radiating pains described
rbove would follow, and compel him to stop perfectly still. His appetite and diges-
sion were but little, if any, impaired; yet, from the first, the frequency and severity
of the attacks had gradually increased, Asa rule, a paroxysm occurred every day,
and frequently several times during the twenty-four hours, Occasionally, however,
a week would pass without an attack.

We made use of general faradization when he was entirely free from any uneasi-
yess. Three days elapsed before he again came to us, but during this interval the
nalady had not manifested itself.

Before administering the second application, the patient purposely brought on a
raroxysm by violently swinging his arms and bending his body. In the midst of the
dain the positive pole was suddenly applied ouer the nipple, and a very intense cur-
rent sent through the body. With the rapidity of the passage of the electricity itself,
che pain left him, and after the séance had closed, he found it impossible, by any
>ffort he could make, to bring on another attack. At the next visit, three days sub-
sequently, he was able, by very violent efforts, to bring on a paroxysm, but of far
ess severity than before, Similar treatment, by localized faradization, immediately
velieved him, A few more applications were given, but during his visits to us he
aever succeeded in exciting another attack, that we might have the pleasure of sub-
Juing it. For several months after he was discharged as cured, he had no return of
the angina, :
CASES OF ANGINA PECTORIS. 669

Angina pectoris—Decided relief under central galvanization—Relapse.

Case CCIX.—Mr, H. M., aged 35, referred to us by Dr, Leaming, had for twenty
years heen a sufferer from cardiac palpitations, with some of the symptoms of angine
pectoris. The cardiac palpitations seemed to have a relation to the condition of the
stomach, being associated with and apparently dependent on attacks of indigestion,
attended with regurgitation and pyrosis. It was one of those cases where it was diffi-
cult to determine precisely in what organ, or nerve, or nerve plexus, the symptoms
took their origin. The patient was not remarkably intelligent, but so far as could
be gleaned from his history, the attacks involved both the heart and the stomach, for
it was certain that anything that excited indigestion often ushered in paroxysms of
great severity, Organic disease of the heart had been suspected, but Dr. Leaming,
a skilful and practised auscultator, decided that there was no such lesion, Medicine
had accomplished but little for the patient, and we decided to use central galvaniza-
tion, The first application was mild and brief, but it caused much dizziness, and for
the moment alarmed and worried the patient. In a few days, however, he began to
improve in his symptoms, and began also to bear the current better. For about two
months the patient persevered in taking the treatment, and with most decided im-
provement.

While the cure was not perfect, yet all his symptoms were so alleviated, that life
became, in a measure, enjoyable, instead of a heavy and constant burden. Subse-
quently he relapsed.

We may have, as illustrated by the following case, a retrocession of
the rheumatic or gouty diathesis to the heart, and, according to some
writers, to the lungs also, producing an incurable organic lesion that
may result in this neurosis. A metastasis to the stomach, of either of
the two diseases just mentioned, may give rise also, according to others,
to symptoms of cardiac neuralgia.

Angina pectoris following repeated attacks of gout—Aggravated temporarily by
strong galvanization—Relieved by mild general faradization,

CasE CCX.—Mr. B., aged 52, was referred to us by the late Professor Geo. T.
Elliott. The patient was a stout, plethoric man, somewhat advanced in years, beyond
the middle period of life. He was perhaps what might be called a ‘‘ high liver,’’ and
for years he had indulged in wines freely, although not to great excess.

He had on two or more occasions suffered quite severely from attacks of gout of
the great toe, and very soon after recovery from the last attack, he began to experi-
ence slight symptoms of his present difficulty. The pain generally commenced in
the chest, behind and a little to the left side of the sternum, and extended to the
shoulder and down the leg.

Occasionally, the symptoms would first manifest themselves in the leg, and then ex-
tend to the heart.

The paroxysms were never severe, so long as a quiet posture was maintained, but
the exertion of ascending one or two flights of stairs, or walking a few blocks, almost
invariably excited much pain, accompanied with a very distressing shortness of breath.
The patient remarked, as a singular fact, that while such slight efforts readily caused
570 DISEASES OF THE HEART AND LUNGS.

cardiac distress, it was possible for him to exercise quite violently with light dumb-bells,
and yet suffer from none of the evil effects that might from analogy be expected to
follow. The first two applications, given in November, 1867, were followed by no
special results,

Treatment with a powerful faradic current, on a third occasion, considerably ag- |
gravated the symptoms. The fourth application, given with a milder current, worked
an immediate change for the better.

The pain was immediately dissipated, and for two days, until we saw him again, he
was far better than he had been for months. ‘He walked a long distance without
being at all oppressed in breathing, and at night he was quite comfortable, although
heretofore his symptoms were, as a rule, much aggravated at this time. On the left
side of the neck, the application excited pain that proceeded toward the chest. On the
right side, no such effect was noticed. Without detailing farther the incidents con-
nected with this case, we will simply say that treatment by both currents, together with
persistent medication, accomplished merely occasional and temporary amelioration of
his distressing symptoms, It is true that physical exploration gave no evidence of or-
ganic lesion, but in consideration of the undoubted gouty diathesis, together with the
persistent character of the symptoms, there could be no hesitation in declaring the
existence of some irreparable structural disease. It is impossible to account for the
temporary but marked amelioration that on different occasions followed the applica~
tions, without we refer it to the mild anzesthetic effect of the faradic current.

Diseases of the Lungs.—For diseases of the lungs electrization has
accomplished less than in any other department. The recognized
gravity of phthisis, together with the @ préord improbability that it could
be directly cured by any known methods of using electricity—these
two causes have deterred electro-therapeutists from making even experi-
mental applications to diseased lungs. One author—Bastings,* of
Brussels—kowever, has reported most astounding results from faradiza-
tion of the muscles of the chest. If we accept in good faith the state-
ments of this author, even the second stages of phthisis may be cured
by this method, which seems to affect the lungs not directly, but in-
directly, through the muscular development which it causes, and the
greater amount of oxygen which it enables the lungs to breathe.

The amazing statements which the author advances, concerning the
cure of consumption, are entitled to more consideration than they
would otherwise receive, from the fact that the fundamental idea on
which his treatment is based, namely, that faradization of the muscles
—electro-muscular gyninastics —- markedly increases their size and
strength, and also improves the general nutrition, is eminently sound
and thoroughly demonstrable, as we have shown during all our investi-
gations in electro-therapeutics.

* Die Lungenschwindsucht und ihre Heilung durch Electricitit. Translated from
the French by Dr, Silbermann. Erlangen, 1866.
CONSUMPTION. 671

Vaust * has experimented with the method of Bastings—electro-mus-
cular gymnastics—in growing children, who were not affected with any
special diathesis, but who ‘presented the appearance of debility, lan-
guor, and lack of force so frequently found among the poorer classes.”

The results were “ wonderful.” Not only were the muscles of the
chest greatly increased in size after a number of applications, but their
“ breathing was deeper, their appetites better, and they were more
cheerful and lively.”

After six months’ treatment the increase was still more marked in
some of the cases. According to our experience, the growth of the
muscles under faradization is at first quite rapid, but subsequently
much slower, and in afew months becomes stationary,

Bastings has used these electro-muscular gymnastics in consumption,
not with a view 4o directly affect the tuberculous deposit at all, but, by’
strengthening the muscles of the chest, to so improve the respiratory
power that more air can be inspired, and so benefit result to the healthy
portion of the lung, and indirectly, through better oxygenation of the
blood, to a certain extent on the diseased portion and on the whole system.

The method and principles of treatment in all his cases was substan-
tially similar—electro-muscular gymnastics: about half a minute was
given to each muscle, and about five minutes to each sitting. Pro-
longed treatment was found to be injurious.

The general statements of the author were confirmed by Dr. Bougard,+
who affirms that the patients remain cured for one, two, or three years.

Dr. Crocq also speaks favorably of the method of Bastings, although
in the treatment under his own direction of the very severe cases of
consumption in the St. John Hospital he obtained no positive results.

Although the beneficial effects of muscular exercise in consumption
have long been conceded, yet, in the present state of the professional
mind on the' subject, the statements of Bastings will need more numer-
ous indorsements before they are accepted.

We would suggest a method of treating pulmonary tuberculosis,
which, so far as we know, has not been used, but which is surely worthy
of atrial, This method would consist in external galvanization of the
diseased portion of the lung with a mild stable current. The electric
current might thus act on the diseased lung, as it acts on inflamed and
ulcerated surfaces elsewhere.

* Medicinisches Journal, vol. 38, Juni 1864, p. 599. Sitzung der Gesellschaft fur
Medicin und Naturwissenschaften zu Briissel, vom 2. Mai 1864. This paper is pre-
sented in the work of Bastings, above quoted, p. 119 et seq.

t Op. cit., p. 147. Loc. cit., p. 142 et seq.
CHAPTER XXXVI.
MISCELLANEOUS MEDICAL DISEASES.

Sequelae of Sunstroke and Cerebro-spinal Fever.—During seasons of
protracted and excessive heat, such as have been notably experienced
during the past few summers, a very large number of persons, especially
in our cities, are more or less injured, either by the general depressing
influence of the continued high temperature, or by some special exposure,
without being, in the ordinary sense of the word, suzstruck. Those whose
nervous system has been exhausted or disordered by the excessive use of
stimulants and narcotics, by debilitating diseases, and especially by over-
labor or excitement of the brain, are most liable to be thus affected.

Injuries thus produced may be manifested by every variety of ner-
vous disorder—spinal irritation, insomnia, neurasthenia, neuralgia, epi-
lepsy, nervous dyspepsia, hysteria, paralysis, and not unlikely positive
insanity.

The majority of such cases never know the exciting cause of their
symptoms until, perhaps, it is indicated to them by the physician who
inquires into them. In a number of cases that have been under our
care for the above symptoms the solar heat was a prominent if not a
principal cause.

The symptoms may appear and reappear for months and years after
the original attack. There is little doubt-that there are through society
thousands of such cases of various grades, many of whom have never
suspected the nature of their malady. The solar origin of the symp-
toms which we have mentioned may be suspected not only when, as is
very frequently the case, they can be traced to some definite exposure,
but also when they are observed to be peculiar to the summer, remit-
ting wholly or partially in winter, or to be especially aggravated by
exposure to the sun, and to be experienced only during the daytime.

Our best results with electricity have been obtained in these cases
by a combination of the two methods of electrization, general faradi-
zation and central galvanization, varied in some cases by galvanization
of the pneumogastric and cervical sympathetic. Excepting those cases
SEQUEL# OF CERERRO-SPINAL AND THERMIC FEVER. 673

which, by some peculiarity of temperament, or as a peculiar result of the
disease, cannot bear electricity, the electrical treatment works admi-
rably, whether used alone or: in connection with internal medication.
Arsenic we give in the form of granules, ~y of a grain each, before
meals. We use also zinc in the form of oxide or phosjhide, and fat
in the form of cod-liver oil emulsion.

Partial paralysis—Physical qnd mental depression—The sequele of sunstroke—
Rapid recovery under general faradization and central galvanization,

CasE CCXI.—Mr. W., aged 55, consulted us in the autumn of 1872. —_he
patient was connected with one of the prominent firms for the manufacturing of safes
in this city; and while in a Western city, endeavoring to negotiate certain sales, he
was suddenly overtaken with faintness, profound vertigo, and almost complete uncon-
sciousness. This attack occurred on an oppressive July day, some four months prior
to his visit to us, and ever since he had been in an exceedingly nervous, excitable con-
dition. Any considerable exercise in walking was invariably followed by unusual
fatigue, and he was not only incapacitated from engaging in any business enter-
prise, but an attempt to read even the morning paper resulted in mental disquietude
and real exhaustion. There was a decided loss of power in both lower extremities,
associated with a considerable degree of anzesthesia. We submitted him, on several
different occasions, and at intervals of a day, to general faradization, with the effect of
improving greatly his motor power, and of dissipating all numbness. After a time
central galvanization was alternated with the above treatment, and in the course of
six weeks the patient had so far improved in his other symptoms as to be fully able to
again engage actively in business,

In the following case the peculiar susceptibility to stimuli caused by
sunstroke was strikingly illustrated :

Case CCXII.—Mr. W., a gentleman about 35 years of age, was referred to us,
Oct. 16, 1872, by Dr. A. B, Ball, While ascending a mountain during ‘his summer
vacation, he was overcome by the excessive heat. He was not unconscious, and after
a short rest he resumed his walk, The thermometer at the time was about 90°.

The attack Jeft him with a feeling of sensitiveness in the head, which, instead of
diminishing, had increased until the time that he called upon us, During several
weeks, at intervals of a few days, he had several attacks of loss of motor power.

* A prominent feature of his case was his exceeding susceptibility to stimuli, A tea-
spoonful of wine or a whiff of a cigar caused him to feel wretchedly.

We found him on trial similarly sensitive to electricity. Mild faradization or gal-
vanization caused a heightening of the evil symptoms, and the electrical treatment
was abandoned, Subsequently the patient was rapidly benefited by a short trip to
the sea-side. The first breath of the ocean air seemed to act on him with the force
of a specific,

The sequelee of cerebro-spinal fever present symptoms quite similar,
and are to be treated on the same general principles ; that is, by gen-
eral faradization and central galvanization, just as we treat hysteria
and allied affections:

43
674 MISCELLANEOUS MEDICAL DISEASES.

Intermittent Fever.—According to Tripier * the electric bath and
statical electricity have been used in certain cases of intermittent fever,
both in England and Sweden, and occasionally with satisfactory results.
The efficacy of the preparation of quinine in malariai disease has,
however, destroyed most of the interest that might otherwise have at-
tached to electricity in its therapeutic relation to fevers.

In certain chronic conditions of intermittent fever, where quinine
and other internal medication have proved ‘unavailing as a means of
permanent relief, we have seen undoubted benefit arise from general
faradization. It undoubtedly acts in this case like any other stimuia-
ting tonic without any special infiuence on the malarial poison.

Intermittent fever— Temporary relief from quinine—Recovery under general fara-
dization,

CasE CCXIII.—Rev. Mr, L, applied to us for treatment in October, 1867. His
general appearance presented all the marked -characteristics of malarial influence,
while he complained of obstinate constipation, loss of appetite, and a considerable
degree of insomnia. One year previously he was prostrated by an attack of chills
and fever, but soon recovered his usual health under the influence of quinine. In the
following July he suffered another and more severe attack of the tertian, which soon
changed into the quotidian type of the disease. During the first ten days of his ill-
ness he took 100 grs. of quinine, but with little apparent benefit. Still further treat-
ment by quinine interrupted the severity and regularity of the paroxysms, but by no
means effected a cure, For some time before he fell under our observation (Oct. 14,
1867), he suffered every few days from what is commonly termed *‘dumb ague.” We
immediately resorted to the most thorough form of treatment by general electrization
with the faradic current. He was remarkably susceptible to its influence, and over
the region of the stomach and liver especially only a very slight current could be
borne. is
This treatment was repeated every other day for two weeks. His bowels soon
became regular, his appetite improved, and after the third application the attack
eeased altogether. For several months, at least, after the cessation of treatment he
continued free from any indications of returning symptoms. Subsequently he passed
from under our observation.

A second and third case, in which the symptoms were less severe,
but fully as persistent, yielded promptly and completely to the same

method of treatment.

Intermittent fever associated with anesthesia, insomnia, and great debility—Ap-
proximate recovery in two weeks by general faradization,

Cask CCXIV.—Miss C. S., aged 23, was placed under our care by Dr. Geo.
Steinert, .of Harlem.

* Manuel d’Electrothérapie, etc., 1861, p. 581.
ADDISON’S DISEASE. 675

The patient had all her life been somewhat feeble in health, but at this time, and
‘or a month previously, she had suffered from a very decided impairment in her
general condition,

Every afternoon at 4 o’clock she experienced a very decided sense of chilliness, fol-
lowed by a feyer which lasted until 5 o’clock the following morning. The hands
were at all hours exceedingly tremulous, and at night especially her fingers became
quite anzesthetic, Her strength was so far exhausted that she could walk but a few
blocks without great fatigue. Notwithstanding these unfavorable symptoms her
lowels continued regular and her appetite good,

She suffered much, however, from insomnia, and was rarely able to sleep before 2
AM,

A single general application of the faradic current resulted in marked relief of the
condition of trembling and numbness. Her sleep rapidly improved ; the periodical
chill and fever became less and less marked, and soon disappeared ; her strength de-
cidedly increased, and seven applications given during two weeks resulted in an ap-
proximate recovery.

Malarial fever, more or less persistent, for ten months—Benefit is derived from
general faradizsation and galvanization of the sympathetic.

Casz CCXV.—Minnie H., aged 20, came for treatment in August, 1871. Since
October, 1870, she had suffered more or less from chills and fever. She had lost flesh,
was weak, anzemic, and irregular in menstruation, She was submitted to six applica-
tions of general faradization, which resulted in a decided improvement in her general .
condition, and for three weeks there were no evidences of a return of the malarial
symptoms. After this the chills again annoyed her, when she returned, and was
treated by galvanization of the sympathetic. The applications were followed by a
cessation of the paroxysms, after which she passed from under our observation,

Disease of the Supra-renal Capsules (Addison's Disease).—Our know]-
edge of the pathology of Addison’s Disease is very incomplete. Ina
large proportion of cases the bronzing of the skin, and the peculiar
sachectic condition of the affection, are preceded by organic lesion of
the supra-renal capsules.

Cases are not wanting, however, in which fost-mortém examinations

_ have revealed no anatomical lesion of the capsules, notwithstanding
the previous existence of the most marked and severe characteristics
of Addison’s disease.

Dr. Wilkes states, “That after some years’ attention to the subject,
I repeat, with much confidence, that the disease of the capsules in
Morhus Addisonii is uniform and peculiar. In all the examples which
we have now in our museum, amounting to thirty-three, the disease is
of the same nature in all.”*

Of one hundred and ninety-six cases reported by Dr. Greenhow, the

* Guy’s Hospital Reports, Vol. xi., 1865. Quoted from Aitken’s Practice of
Medicine. Vol. ii, pp. 113.

‘
676 MISCELLANEOUS MEDICAL DISEASES.

supra-renal capsules were found to have undergone the characteristic
morbid change in one hundred and twenty-seven.*

In consideration, therefore, of these facts, it is extremely probable
that certain organic changes in the capsule of the kidney, and the pecu-
liar symptoms of the disease under consideration, are directly related to
each other as cause and effect. If the affection be recognized before
the bronzing of the skin has taken place, it may possibly be arrested.

‘Unfortunately, however, it is, as a rule, impossible to diagnose the
disease before the discoloration of the skin commences, when it is
generally acknowledged to be incurable.

In regard to this bronzed discoloration of the skin, microscopical
examinations by Dalton and others, have demonstrated that it is due
to pigmentary granules in the rete mucosum, similar to those in the
skin of the negro.

We give the following details of the remarkable effects of electricity
in a case of Addison’s disease exactly as they appeared in the first
edition of this work. After the patient had approximately recovered
his strength, he was presented before the New York Medical and
Library Association, by Dr. Rockwell, as an illustration, not as a cure,
of a case of disease of the supra-renal capsules, but as one of the very
best illustrations of the extraordinary tonic powers of general faradization.

Most of those present acknowledged the amelioration of the man’s
symptoms to be the result of the treatment, but doubted whether there
was or had been disease of the capsules. For two years afterwards the
patient lived and enjoyed during the- time all the vigor that had resulted
from the use of electricity. Suddenly, and without apparent cause, his
strength failed him, and within twenty-four hours he died. A_ post-
mortem was obtained which substantiated the original diagnosis. The
capsule of one kidney had entirely disappeared, leaying in its stead
some calcareous remains. The other capsule was situated on the in-
ternal border of the kidney a little below its normal seat, and was com-
posed of a cheesy-like substance—characteristic of the disease.

The specimen was presented by Dr. Rockwell before the members
of the New York Pathological Society.

Disease of the supra-renal capsules—Dark skin—Deficient secretions—Faralysis of
the left arm—Loss of sexual power—Very great improvement under general far-
adization—Slight further improvement under galvanization of the sympathetic,

CasE CCXVI.—The patient, aman aged 45, was referred to us by Dr. H. H.

Gregory, of Harlem, and the diagnosis of disease of the supra-renal capsules was con-

firmed by Prof. Austin Flint.

* Clymer in Aitken’s Practice of Medicine. Vol. ii., pp. 110.
REMARKABLE CASE OF ADDISON’S DISEASE. 677

Until November, 1867, the patient enjoyed perfect health,

About this time he began to observe slight symptoms of exhaustion. Soon his
appetite failed him. He became anzemic, and suffered from excessive fatigue after the
slightest exertion.

He was confined to his bed during the month of January, when he first observed
some slight discoloration of his face and hands.

During the succeeding months, until August, 1868, his general health seemed to
improve somewhat, so that he was enabled to engage in moderate labor. At this
time. he suddenly relapsed into a state of utter exhaustion, His skin became several
shades darker, and his general appearance was that of an ordinary mulatto.

His bowels became distressingly constipated. Sleep was fitful and unrefreshing.
His mouth and throat were excessively dry and parched; indeed, the function of the
secretory organs generally was markedly impaired.

The skin was shrivelled and dry. The finger-nails were brittle, breaking on the ap-
plication of a very slight force. The left arm was stiff and almost powerless. It
could not be bent beyond a right angle, nor lifted more than a few inches from the
side. Lastly, the sexual power and desire were entirely lost.

All of these symptoms persisted, with but slight variation, notwithstanding an un-
interrupted tonic treatment, until June, 1869, when the case fell under our observa-
tion, As the most prominent and distressing symptom of which the patient com-
plained was the excessive debility that unfitted him for the slightest exertion, the
results of treatment by general electrization illustrate more forcibly than in most other
instances its remarkable constitutional tonic power. A general application of the
faradic current revealed not only a profound anzesthetic condition of the whole body,
but also an unusual general impairment of the electro-muscular contractility. By
placing the negative electrode at the pit of the stomach, and the positive on the
neck, a little above the seventh cervical vertebra, distressing nausea was invariably
produced,

The patient began to amend from the first day of treatment, and, after having re-
ceived thirty general applications of the faradic current, his condition at that date
may be thus summed up:

ist. He had long been completely cured of his constipation.

2d. Sleep was perfectly sound and refreshing.

3d. The dry and parched condition of his mouth and throat was entirely relieved,
and all the secretions of the body had increased in quantity and quality.

4th, His finger-nails were restored to their usual elasticity.

5th. He had approximately recovered the use of his arm. This improvement was

* manifest after the third application.

6th, The sexual organs had been very decidedly strengthened,

7th. Above all, his strength and power of endurance had progressed with the
above changes, At first he was barely able to crawl a single block ; he could after-
wards walk a couple of miles without suffering unpleasant fatigue, and could readily
engage in any light labor.

8th. In regard to the bronzing of the skin, the change was not, as yet, very marked.
The discoloration seemed to be a shade lighter, and had sensibly receded on the
sides of the fingers and hands.

We have referred to the nausea excited by the electric current. In
678 MISCELLANEOUS MEDICAL DISEASES.

view of certain theories that have been advanced concerning Addison's
disease, this fact is of considerable interest.

The semi-lunar ganglion and solar plexus, and also the pneumo-
gastric and phrenic nerves, supply nervous filaments to the capsules.

In consideration of this fact, Dr. Habershon and others are of the
“opinion that the more fully the disease is known the more completely
will it be traced to the sympathetic nerve.” The unusual action of even
a mild current on that nerve, in producing nausea, tends to strengthen
this conclusion.

This annoying symptom ‘rapidly became less marked as the patient
gained strength under the influence of electrization, and a most power-
ful current could soon be applied without causing inconvenience.

The patient was subsequently treated by galvanization of the sympa-
thetic, with some further, though not marked, improvement.

Very little scientific attention has been given to the electro-thera
peutics of diseases of the kidneys, although the organs are sufficiently
accessible to electrization. Most of the recognized chronic diseases of
the kidneys are of so grave a character that they have offered but little
encouragement for electrical experimentation.

It is impossible to pass an electric current through the body in the
region of the kidneys without directly affecting these organs, as is clear
from what is known of the conductibility of the tissues, and also from
clinical observation. In many instances patients have called our atten-
tion to the fact that after general faradization the secretion of urine was
much increased.

Complete suppression of urine for six days, following an attack of gravel—Three
applications of general faradization is followed by a copious flow, amounting
in eighteen hours to over twelve quarts,

Case CCXVII.—Mr. S., aged about 50, and weighing some 280 lbs,, had for several
years suffered more or less from gravel. In these paroxysmal attacks the urine would
often become completely suppressed, but by a warm bath and warm drink the func-,
tional activity of the kidney invariably returned in a short time. On one occasion, how-
ever, after an attack of unusual severity, these ordinary remedies completely failed to
re-establish the excretion of urine. Dr. H. H. Gregory was immediately called, and, in
conjunction with Dr, W. H. Draper, vainly endeavored by every means at command
to relieve the suffering patient. At the end of the sixth day but about thirty drops of
a thick and bloody fluid had been passed, and Dr, Gregory requested us to use elec-
tricity. The patient was at this time completely prostrated and very drowsy, but no
odor of urea conld be detected in the breath. We decided to submit the patient to
general faradization, and on Saturday evening, the sixth day of the suppression, made
a preliminary attempt. There was so much adipose tissue to overcome, and the skin
of the patient was so exceedingly sensitive, that it was very difficult to carry out the

.
SUPPRESSION OF URINE—DIABETES, 67g

proposed treatment effectually, On Sunday morning a second application, with an in-
creased strength of current, was given, and again on Sunday evening at 100’clock the
treatment was essayed a third time. Two hours subsequently the patient felt a tle-
sire to urinate and succeeded in passing an ounce. In a few minutes the desire to
urinate returned, when almost without cessation he passed an ordinary sized chamber
full, and up to six o’clock the same day twelve quarts were voided, From this time
forth the kidneys continued active, and the patient recovered,

An instructive feature in this unique and interesting case lies in the
fact that, notwithstanding a complete suppression for 168 hours, the
symptoms of uremic poison were by no means so decided as might be
expected. This amelioration can without doubt be fairly attributed to the
skilful management of the attending physician, especially in the matter
of hot-air baths, by which the excretory function of the skin was kept i in
a constant state of activity.

In relation to the credit due to electricity for the successful issue of
this desperate case, whether the symptoms were self-limited, or whether
the treatmeut by the hot-air baths and internal medication would alone
and in good time have brought about the desired result, it is impossible
positively to decide. On the principle of post hoc et, etc., it would cer-
tainly seem as if faradization should be regarded as the important thera-
peutic factor employed, especially as its power to increasé the urinary
secretion, both in the healthy and diseased condition of the kidney, is
clearly taught by experience.

Diabetes.—The supposed relation of this symptom to the disease of
the brain suggests the propriety of treating it by ga/vanization of the
sympathetic and of the brain and spinal cord.

Dr. Wm. Dickinson,* who has made post-mortem examinations of
the brain and spinal cord of five diabetic patients, found the following
peculiar morbid changes, which were nearly similar in all :—

1. Dilatation of the arteries. This was the earliest symptom.

2. Degeneration of the nervous matter. :

3. Cavities produced large enough to be seen without the micro-
scope, and which contained products of nervous decay.

4. These contents become absorbed.

These changes were found near the arteries and throughout the
spinal cord and encephalon, but especially in the medulla oblongata
and pons varolii.+

* Medical Times and Gazette, March 19, 1870.

+ The relation which has been established by Calvi between diabetes and pruritus of

the vulva, which is a nervous affection, would seem also to speak for the nervous
character of the former disease. (See Damon’s Neuroses of the Skin, 1868, p. 25.)
680 MISCELLANEOUS MEDICAL DISEASES.

These investigations were confirmed by a most distinguished author
ity in nervous pathology, Dr. Lockhart Clarke.

Besides these pathological observations, there are two general con-
siderations which might be adduced in favor of the theory that diabetes
is essentially a nervous disease.

In the first place, it appears, in some instances at least, to be brought
on by excessive mental excitement or worry. That it may be produced
by concussion of the brain is, we believe, conceded. That there is a
relation between diabetes and the base of the brain has for some time
been more than suspected.

Secondly, the results of some of the therapeutical measures would .
seem at least to indicate that this disease may be favorably influenced
through remedies that affect the nervous system. Prof. Austin Flint *
has recently published reports of two or three cases of diabetes that
were decidedly benefited by bromide of potassium.

Experience is the best and only test of the strength of these facts and
considerations. The experiment of cerftral galvanization—including
the brain, spinal cord, and sympathetic—is surely worthy of a faithful
trial, especially in the early stages of this affection. This treatment
would be none the less indicated if, as some suppose, the pathological
changes found in the brain and’ spinal cord of diabetic patients are
merely the reszét of the disease. :

Experimentally faradization of the liver might also be tried.

Semmola + has found both temporary and permanent results from
faradization and galvanization of the pneumogastric. In some cases
both the quantity of urine and of sugar were diminished. It may be re-
marked that it would be difficult to galvanize the pneumogastric without
also affecting the sympathetic.

It is yet too early to offer positive opinions in regard to the electro-
therapeutics of this disease, but the following cases are suggestive of
what may possibly be accomplished in the future.

Diabetes Mellitus of traumatic origin in an aged patient—Rapid relief of all the
symptoms, and apparent arrest of the disease under central galvanization—
Subsequent attack of hemiplegia.

Case CCXVIII,—J. D., a farmer, aged 76, was referred tous January 30, 1873, by
Dr. J. H. Raymond, The patient had always been active, laborious, and well, until
two years previous, when he fell ten feet in a barn, struck and hit on his side. That
same night came pain in the nipple, and a very profuse flow of urine. At one time
he passed as high as two quarts and three pints daily. Jt was ascertained that the

* American Practitioner, Jan., 1870,
+ Quoted by Althaus, op. cit., p. 582.
+

CASES OF DIABETES—GRAVES’ DISEASE. 681

arine contained sugar, and by medical advice he had adopted Camplin’s diet, and
under Dr, Raymond had taken carbonate of soda with advantage.

The symptoms at the time the patient came to us were as follows :—There was
headache, bad taste in the mouth; the urine had a specific gravity of 1024, and he
was obliged to rise in thenight to pass water; about two quarts were passed daily ;
there was considerable muscular debility, so that a short walk was fatiguing.

On the theory that the disease was in the spinal cord, or at least in some part of
the. central nervous system, we began to use central galvanization, with immediate
results. After the first application he began to be stronger, and after a week it was
no longer needful for him to rise at night to pass water. The specific gravity of the
urine soon went down to rorg, at which point sugar could still be detected. The
diet of the patient, and his general manner of life, were the same as before. Sugar
was never entirely expelled from the urine, but in strength the patient so much
improved that he could walk several miles daily. The headaches were felt no more,
and the bad taste was much mitigated. He returned to his home and to his occupation,
and was able to work more or less for six months, when he was taken with hemi-
plegia,

Dr. Bunker informs us that he has similarly treated a case of diabetes, and has from
time to time examined the urine and estimated the quantity of urea, He has con-
firmed the experience above recorded; and besides, has shown what we did not
attempt, that the quantity of urea diminished very markedly under the treatment.

In the following much severer case the apparent results of treatment
were less decided :—

Diabetes mellitus, two and a half years’ standing, apparently caused bya fall,
complicated with various nervous symploms—Temporary benefit from central
galvanization,

Case CCXIX.—Mrs, L., a married lady, under middleage, was sent to us March 4,
1873, Two and a half years before she had a severe fall, which produced a concus-
sion of the spine, and laid her up for a week, In a few months came on excessive
thirst, constipation, and sugar in the urine. She had been through various forms of
treatment, and confined herself to bran-bread, and was then drinking Bethesda water,
which seemed to do her good. Her condition was as follows: Specific gravity of
urine, 1049 ; six gallons passed daily part of the time, and when she paid no regard
to her diet, Considerable facial neuralgia, great thirst, a feeling of aching and stiff-
ness in legs, with pains resembling growing pains; insomnia, partly owing to the fact
that she was obliged to get up several times during the night to pass water; and ten-
derness of dorsal and lumbar vertebrae. Treatment by central galvanization faithfully
used brought down the specific gravity of the urine to 1040, but never lower than that,
enabled her to pass the entire night without rising to make water, and relieved many
of her general nervous symptoms, and this was all it accomplished,

Exophthalmic Goitre, or Graves’ Disease.—The characteristic features
of the disease are enlargement of the thyroid gland, exophthalmus,
and palpitation. It is due to disease of the sympathetic. It has been
6°2 MISCELLANEOUS MEDICAL DISEASES.

treated by galvanization of the sympathetic. Wietfeld and others re-
port successes with this method of treatment.

Dropsical Effusions.—Dropsical effusions are susceptible of treat-
ment by the electric currents, even when they depend on incurable dis-
eases of the heart, liver, or kidneys. Galvanization and faradization
may both be tried with strong currents.

In cedema of the lower limbs we have found both galvanization and
faradization temporarily and sometimes permanently efficacious.

General dropsy the result of valvular heart disease—Powerful faradic currents,
localized, greatly increase the secretory action of the kidneys, and dissipate the
dropsical effusion.

Case CCXX.—December 13, 1870, we were called to see, with Dr. Samuel T.
Hubbard, a lady aged about thirty-five years, who was suffering from general dropsy.
The abdomen was enormously distended, and the lower limbs were double their nor-
mal size. The patient was a frail, delicate woman, and for years had suffered from
valvular disease of the heart resulting from articular rheumatism.

The kidneys were almost entirely inactive, so that she voided not more than a tea-
spoonful of urine at a time, and the aggregate quantity secreted during twenty-four
hours was but a trifle. All that we could hope to accomplish was to whip up the
secretory process, and for this purpose a faradic current of great intensity was directed
through both kidneys and the lower limbs, The current was to the patient hardly ap-
preciable, notwithstanding the great strength of current used, and yet the flow of
urine was so increased that during the next twenty-four hours a greater amount was
voided than she was accustomed to pass when in her ordinary health. The applica-
tions were repeated fifteen times (the increased amount of urine secreted being kept
up) until the water had disappeared from the abdomen and legs. This was only
one of several previous attacks, and her strength was so much reduced by continued
suffering that she gradually sank and died. Electrization evidently prolonged life, and
by relieving the pressure on the lungs, much alleviated the distress.

Brigh?s Disease.—Theoretically, local galvanization through the
region of the kidneys and central galvanization ought to be of service
in the early stages of Bright’s disease. The nutrition of the kidneys
might thus be improved directly and indirectly.

We have not yet experimented as much in this direction as we could
wish. : :

Dr. H. J. Pratt, of Denver, Colorado, reports a case of Bright’s
disease where the galvanic current applied over the dropsical abdomen
and general faradization resulted in relief of the dropsy, and in a dimi-
nution of the amount of albumen and of the hyaline casts.

Rhinitis (Catarrh).—Subacute and chronic inflammations of mucous
membranes are susceptible of electrical treatment—may, indeed, be
permanently as well as temporarily relieved by it, though but rarely
does it work an entire cure unless aided by other measures.
CHRONIC RHINITIS—ANOSMIA. 683

Aside from any chemical effect of the current, its mechanical action
alone would be sufficient to theoretically account for the relief it gives
to inflamed mucous membranes. Stellwag, speaking of irritants in
general in the treatment of external inflammations of the eye, uses the
following language : “The irritation which they set up in the sensory
nerves being carried over to the vaso-motor nerves, may cause a con-
traction of the calibre of the vessels when they are in a condition of
relaxation. This is done by the excitation and invigoration of the
atonic muscular fibres. The resolution of the inflammation is favored
by the lessening or removal of the congestion, which is one of the
causes of the unfavorable course.” *

The theory is fully plausible that electricity operates to a less degree
in the same way, for its primary effect is to increase the amount of
blood in the mucous membrane to which it is applied, and experience
shows that this hypersemic condition thus created soon passes away. +

The same explanation. will apply to the action of electricity on all the
mucous.membranes—the eye, the ear, the pharynx, larynx, and urethra.
Certainly the ultimate result of electrization is to. give tone to the mu-
cous membranes as to other tissues of the body. (For methods of
treatment of rhinitis, see Azosmia.)

Catarrh of eight years’ standing—-Complete and permanent recovery under local
galvanization,

Case CCXXI,—Mr. N., aged 28, was referred to us by Dr. D, B. St. John Roosa.
For eight years the patient had been afflicted with nasal catarrh, of a most persistent
and annoying type. We expressed doubt as to the efficacy of the electrical treat-
ment in her case, and stated that if it was undertaken it would be necessary to be
most persevering in order to test its efficacy.

The patient was willing and anxious to try this or any other method that offered
the slightest chance of relief, and for nearly four months she submitted to the pro-
posed treatment. From four to, six ordinary sized zinc-carbon cells were used, and
the treatment was both external and internal. About sixty applications were given,
and the result was a complete recovery.

Over four years have now elapsed since this case was first published,
but the patient has never felt a symptom of a return of the diffi-
culty.

Anosmia, or Loss of Sense of Smeli.A very frequent result of long-
continued rhinitis is partial or complete anosmia. The acute form that

* Diseases of the Eye, Translated by Drs, Hackley and Roosa, p, 26.

+ Golubew has shown that the capillaries of the nictitating membrane of the frog
contract transversely under the influence of powerful electrical shocks, (Billroth’s
Surgical Pathology. Trans'ated by Dr. C. E. Hackley, p. 53.)
684 MISCELLANEOUS MEDICAL DISEASES.

appears in the early stages of severe cold usually passes away without
treatment on the subsidence of the inflammation. In some cases
anosmia is supposed to, and probably does, result from careless and too
prolonged use of over-irritating injections. There are various grades
of the disease, from simple and scarcely perceptible obtuseness of the
smell to absolute inability to detect any odor whatever.
Kerosene, coffee, illuminating gas, make no more impres-
sion than substances of a negative character.

Anosmia may also result from central as well as peripheral
lesion. i

The ¢veatment of anosmia may be both external and internal.
The external treatment is the same as that recommended
for rhinitis, except that the current should be much stronger ;
the internal treatment consists in the direct application of a
metallic electrode to the mucous membrane of the nasal
passages. We have used for this purpose an insulated elec-
trode, with a metallic bulbous extremity that can be run
some distance up the inferior meatus. An insulated Eus-
tachian catheter, containing a wire with a bulbous extremity,
y serves very well the purpose, or 2 common silver catheter,
a re uninsulated, may be used ; or, indeed, any flexible metallic

trode, electrode of proper size.

   

Anosmia existing six years—Improvement under treatment by local faradization,

Case CCXXII.—Mr. H. I., a medical] student, aged 30, was referred to us by Dr.
Roosa, May, 1869. Some six years previously the patient had fallen from a horse and
sustained severe bruises about the head and face. From that time he had been unable
to distinguish any odor with the exception of that of fresh-ground coffee and kerosene
oil, :

A powerful application of the faradic current was made on either side of the bridge
of the nose, near the eyes, enabling him in the course of a few hours to smell faintly
certain strong perfymes.

On the following morning, however, he was surprised to find himself able to smell
tobacco smoke, camphor, etc.

His sense of smell remained thus acute until three or four in the afternoon, when
it suddenly disappeared.

A second application was followed by the beneficial result of the first, and with
only a partial relapse, while the third and fourth séances rendered him sensible to
most of the ordinary odors.

Anosmia associated with loss of the sense of taste—Recovery under localized galvani-
zation,

Casz CCXXIII.—Mrs, H., sent to us by Dr. A. N. Brockway, aged 45, was suf-

ering from a severe and chronic nasal catarrh, and associated with this disease was a
complete loss of the senses of taste and smell,
TOOTHACHE. 685

It was alike to the patient whether she ate the most delicate morsel or the dryest
crust, or whether she inhaled the perfume of the rose or the most disagreeable of
odors. This condition has existed for several years, but under the influence of the
galvanic current, applied both to the mucous membrane of the nasal passages and ex-
ternally, the senses of taste and smell gradually returned to their normal acuteness,

Toothache (Odontalgia).—The pathological conditions that give rise
to toothache are so various, and the anatomical difficulties in the way
to direct localization of the current in the affected nerve are so great,

‘that uniform results from electrical treatment cannot be expected.

The familiar cause of toothache is exposure tocold. Although the
nerves connected with decayed teeth are more liable to be affected
after such exposure, yet the nerves of any or of all the teeth, even
when they are perfectly sound, may also become hyperzsthetic and
cause exceeding distress, either from exposure to cold, or from anzemia
or nervous exhaustion.*

The applications may be external or internal, either with the faradic
or galvanic currents. The galvanic is preferable, since by it we can
better put the irritable nerve in a condition of anelectrotonos (see p.
281). Externally a moistened sponge electrode connected with the posi-
tive pole may be applied for a few minutes over the seat of the pain,
while the other is held in the hand of the patient.

The application may be made internally by means of a small insulated
electrode, with a metallic extremity. (The nasal or laryngeal electrode
will serve the purpose.)

In both the external and internal applications it is well to begin with
a mild current, and gradually increase it up to the point where thé
patient can conveniently bear it.

Ozone and Ozonized Oxygen.—When sparks of electricity pass be-
tween two metallic plates, a, peculiar odorous principle is developed,
which has been termed ozone (from 62m, to smell). This odor is observed
during experiments with apparatus for statical electricity, while the elec-
tricity is passing from a point, when a discharge from a strong battery is
sent through a number of sheets of paper, and also after an object has
been struck by lightning. As long ago as 1785, Von Marum observed |
that electrified oxygen gave forth an odor much like that which is ob-
served after a lightning stroke. This odor was usually described as “ sul-
phurous.” Mr. Schdnbein, who, in 1840, first called formal attention to
ozone, first discovered that it appears at the positive pole in the elec-
trolyzation of water.

*Frommhold givés an interesting chapter on Odontalgia Rheumatica. See his
Electrotherapie mit besonderer Riicksicht auf Nerven-Krankheiten, 1865, p. 404. °
586 MISCELLANEOUS MEDICAL DISEASES.

The observer also found that this peculiar odoriferous principle can be
preserved in glass vessels for a very long time. The odor may be pre-
vented from appearing by raising the temperature of the liquid toa
boiling point, and it may be at once neutralized by the addition of
quite small quantities of pulverized charcoal, tin, zinc, iron, lead, an-
timony, bismuth, or arsenic, by a little mercury, or by introducing into
the substance red-hot platinum or gold. It is produced by the slow
oxidation of phosphorus. It is disengaged from solutions of a number
of the salts, and from diluted nitric, phosphoric, and sulphuric acids.

Mr. Gann concluded, from his experiments, that this odor may be
evolved from all metals, provided they are so treated as not to become
oxidized or to combine with other metals.*

Tests. —The test for ozone proposed by Schénbein was a paper
moistened with a solution of iodide of potassium and starch. The
ozone sets free the iodine and gives the starch a deep-blue color.

General Properties—Ozone is active, intensified oxygen. Like
oxygen, it has a powerful oxidizing action. It is about half as heavy
as oxygen, and, at a temperature of 290° (Cent.), is changed back into
ordinary oxygen. It is only soluble in oil of turpentine.

Ozone exists in the atmosphere in greater or less quantity, which is
believed to vary with the atmospheric conditions, and to exert a definite
and powerful influence on the health, although precise and satisfactory
demonstration of the nature and extent of the laws of this influence is
yet wanting.

According to the experiments of Prof. Schénbein, Messrs. Martiguer,
Marignac, De la Rive, Becquerel, Frémy, and others, it would appear
that ozone is only a peculiar form of oxygen produced by electricity—a
change analogous to that which the solar rays bring forth in chlorine—
and that its presence in certain quantities is essential to health. Ac-
cording to Dr. Boeckel, Prof. Schénbein, and Dr. Billiard, the presence
of cholera or malaria is attended by the absence of ozone.} It is possi-
éle that ozone has more or less share in the variations of the physical
conditions that have been ascribed to changes in the conditions of atmos-
pheric electricity. Ozone is found to be especially abundant in the
atmosphere after a thunder-storm. It is also supposed to be produced
by decay and the growth of plants. It destroys the impurities of the
air miasms by producing oxidation. It has been estimated that “a

* Lectures on Electricity by Henry M. Noad, London, 1844, p. 232.

+ On the Influence of Variations of Electric Tension as the remote Cause of
Epidemic and other Diseases. By Wm. Craig, 1864, p. 424. See also Cornelius
Fox on Ozone and Antozone, for a résumé of what is known of this subject.
EFFECTS OF OZONE. 687

volume of air containing ggg, of ozone will purify 540 volumes of pu-
trid air.” In the arts ozone has been utilized for bleaching and disin-
fecting.

Physiological and Therapeutical Effects of Ozone.—The physiological
effects of ozone have been studied both on man and on animals. It is
believed that the bracing and inspiring effect of a clear, crisp, and
sparkling morning, is due in part to the great amount of ozone in the
atmosphere.* When it is held in combination with oxygen or common
air, it acts much like oxygen, but more powerfully. It affects the pulse,
the respiration, and the circulation, in various ways, according to the
quantity taken, and the temperament of the individual. In this respect,
it behaves like electricity. It has been thought that ozone is formed
in the body from the contact of oxygen gas with the blood, and there
are those who believe that it is absorbed with the ozone in the air, and
is carried into the blood, where it takes part in the process of oxidation.

There is a possibility, if not indeed a probability, that electricity, in
its passage through the body, generates ozone in very minute quantities,
through the electrolytic and other changes that it produces, and the
theory, that the beneficial effects of electrization are in part due to the
ozone thus generated, has some plausibility. But on all these subjects
very little is known. Experiments made in the laboratory with ozone,
artificially prepared, are highly suggestive. Catarrhal symptoms and
attacks, much resembling epidemic influenza, are produced by long
breathing air laden with ozone. It is stated that it would be difficult to
distinguish between the symptoms of influenza and the symptoms of
an over-dose of ozone. Experiments on animals have shown that irrita-
tion of the mucous lining of the throat and nostrils, with febrile symp-
toms and congestion of the lungs, may be quickly excited by breathing
air containing a large percentage of ozone. If animals are, for a long
time, subjected to ozone, they perish. In their susceptibility to it,
however, they vary widely. A rabbit, breathing air mingled with yyy
of its weight in ozone, has died in two hours. Mice, breathing air about
seam Of ozone, have died immediately. Rats are more susceptible
than guinea-pigs, and guinea-pigs are more susceptible: than rabbits.
Pigeons are quite tolerant of ozone, and frogs are proof against it, pro-
vided they have abundance of water.’ Birds are specially tolerant of
this agent, as might naturally be inferred, since, in the higher strata of
the air, where they fly, ozone is more abundant than near the earth.

A convenient apparatus for the inhalation of ozonized oxygen is that

* Dr. Baldwin (Am. Jour. Med. Sciences, Oct., 1874) gives observations that op:
pose this theory.
688 MISCELLANEOUS MEDICAL DISEASES.

of Siemen’s, which consists of a glass tube lined with tin-foil leaves that
are connected with the current from a powerful helix, anc. slightly,
separated from each other, so that in passing from one to the other the
current is interrupted with sparks. Through this tube the oxygen passes
from an iron receiver, and ozone is developed by the action of the
current at its interruptions. By this apparatus fifteen per cent. of the
oxygen may be converted into ozone. A glass apartment may be con-
structed on the same principle, in which the patient may sit for a long
time and slowly breathe in a natural manner the diffused ozonized
oxygen.

Dr. C. Lender,* of Berlin, has successfully experimented with the in-
halation of ozonized oxygen in the treatment of wounds, and has found
that in malaria and various conditions associated with impure blood
and depraved nutrition, its corrective and tonic effects are very decided.
In this country the therapeutic effects of ozone have been studied by Dr.
Sass, end v ith encouraging results.

Antozone.—This, like ozone, is an active condition of oxygen, and is
produced in the same way and at the same time. The fact that such a
condition as Anfozone might exist was suspected by Schénbein in 1858,
and its properties have since been studied by Meissner, in 1863 and
1869.

Hay Fever—(Summer Catarrh—Rose Cold—Autumnal Catarrh.—
Dr. Beard has recently made extensive researches in this strange dis-
ease, and has shown that the nervous system has more ta do with it
than has been supposed. He has treated two cases of the disease dur-
ing the attack by external galvanization. In one case considerable and
in the other case very decided relief was obtained. Dr. W. F. Hutch-
inson, of Providence, has succeeded not only in relieving, but in break-
ing up an attack by central galvanization.

As a prophylactic a prolonged course of general faradization or cen-
tral galvanization is recommended.

Acute Diseases —Fevers—Convalescence.—General faradization and
central galvanization might be used in acute diseases much more than
they have been. When quinine, iron, etc., are used, these methods of
electrization should be used both for their sedative and their tonic
effects. That the pulse and temperature, when abnormally high, can be

* Das unreine Blut und seine Reinigung durch negatiy-electrischen Sauerstoff
(Ozon). Also, Sauerstoff und Ozonsauerstoff, nebst ihrer Anwendung bei Verwun-
deten nach einem im Berliner Inhalatorium gehaltenen Votrage. Compare also Dr.
A. H. Smith’s excellent paper on Oxygen Gas as a Remedy in Disease. New York,
1870,
FEVER AND CONVALESCENCE. 689

reduced by general faradization and central galvanization we have
abundantly established by many observations, and the greater tonic
effects of these methods of using electricity are now conceded every-
where.

The introduction of these methods to the treatment of acute and sub-
acute diseases offers a great field for enterprising general practitioners.

Dr. Glax treated thirty cases of typhoid fever by galvanization of
the cervical sympathetic, and succeeded in reducing the temperature
and diminishing the fever. ;

In convalescence from any acute disease, general faradization and cen-
tral galvanization are a great assistance, and have been considerably
used for that purpose by ourselves and other observers.

Obesity.—Obesity has been treated by powerful faradization, with a
view to produce absorption of the adipose tissue, and, it is claimed, with
some success. The applications are directed through the abdomen.

Cirrhosis of the Liver.—The pains that accompany this disease may
be relieved by various electrical applications, and it isevery way pro-
bable that the disease might be arrested, in some cases at least, pro-
vided the treatment was begun early and faithfully carried out.

44
ELECTRO-SURGERY.
CHAPTER I.

Electro-surgery is that branch of electro-therapeutics which includes
the electrical treatment of the diseases commonly known as surgical.

Besides the four medical applications of electricity,—localized fara-
dization, localized galvanization, general faradization, and central gal-
vanization—all of which may be used for surgical diseases, it includes
galvano-cautery and electrolysis, both of which may be regarded as pe-
culiar to this department.

History of Llectro-Surgery.—The history of surgical electricity,
though to a considerable degree interwoven with the history of electro-
therapeutics in general, is yet sufficiently distinct to entitle it to special
consideration.

Electro-surgery was born in one of the darkest eras of electro-thera.
peutics, the decade just preceding the great discovery of induction by
Faraday, in 1831. The distrust and neglect with which at this period
especially electro-therapeutics was regarded by men of science was due
partly to the reaction that inevitably followed the extravagant hopes
that had been raised on the discovery and popularization of the voltaic
pile at the beginning of the century ; partly to the inconstancy and un-
reliability of the pile itself, partly to the almost absolute ignorance of
the profession concerning the indications for, the effects of, or the
methods of using electricity ; and partly also to the fact that it was con-
founded with mesmerism, which, after creating absurd and wide-spread
excitement, had fallen into deserved and permanent neglect.

It was in the middle of this era, in the year 1825,* when the cause
of electro-therapeutics seemed hopelessly lost, that Sarlandiere ¢ called
renewed attention to this despised agent by proposing the employment
of electro-puncture, in order to bring the current more directly to bear
on the deeper tissues. The first experiments were made with statical
‘electricity. 5

The subject was afterwards studied by Magendie, who used electro-

* Two years previously (1823) Prévost and Dumas had attempted, with some suc-
cess, the dissolution of calculi of the bladder in animals; and many years before
some surgical diseases had been treated electrically, but the subject was not systemati-

cally studied until 182 5.
+ Mémoires sur Pélectro-puncture, Paris, 1825.
694 HISTORY OF ELECTRO-SURGERY.

puncture. with the galvanic current (galvano-puncture) in the treatment
of various diseases. At first electro-puncture was used medically more
than surgically. The treatment of aneurisms by this method was of a
later date.

The idea of causing coagulation of the blood by galvano-puncture was
originally suggested by Scudamore, and in 1831 Guérard, Pravaz, and
Leroy d’Etiolles proposed the treatment of aneurism by this method,
which was first practised by B. Phillips, about the year 1832,* and after-
wards studied by Liston.

In 1839 Schuster successfully employed electro-puncture for the treat:
ment of hydrocele and other serous effusions, and in 1843 he ever
his successes to the French Academy.

In 1839, and the following year also, Crussel, whose name is so
prominent a figure in the history of electro-surgery, began his investiga-
tions on electrolysis.t| His experiments excited little interest in the
profession.

In 1843, also, Steinheil and Heider suggested the theory that the
nerves of teeth might be killed by placing a platinum wire, heated by
the passage of a galvanic current, in the cavity, and in 1845 Heider
first successfully employed this method. He used for this purpose
one very large element of Grove. The operation took but a few
seconds.

In 1846, Crussel, whose name, as we have seen, is also to be remem-
bered as the founder of electrolytic treatment, successfully removed by
the heated platinum wire a “large fungus haematodes, situated in the
frontal and ocular region.”

In the same year Petréquin, of Lyons, obtained successful results in
the treatment of aneurisms by galvano-puncture. The year 1846 may
therefore be regarded as one of special significance in the history of
electro-surgery. About this time also, the same treatment was used by
Burci, of Italy.

In 1847 Bertani and Milani first treated varicose veins by galvano-
puncture. In the same year Crussel published his method of treating
ulcers by availing himself of the electrolytic powers of the galvanic cur-

* Erichsen’s Surgery, p. 513.

+ Frommhold, Electrotherapie mit besonderer Riicksicht auf Nerven-Krankheiten,
Pest, 1865, p. 104.

The first experiments with electrolysis were made much earlier than this; since,
according to Brenner, Mongiardini and Lando had used a needle-shaped electrode,
connected with the negative pole (probably of a voltaic pile, which was then just com-
ing into notice), for the treatment of gangrene. De/? applicazione del Galvanismo
alla medicina, Genova, 1803.
EARLY HISTORY. 695 .

rent. .This author observed that when two metallic plates are con-
nected with the poles of a galvanic apparatus, and applied to the body,
very different effects were produced at the two poles—the positive act-
ing like an acid, and making harder the tissue; the negative like an
alkali, and causing an increase of fluid. On the strength of this ob-
servation, Crussel treated ulcers and cancers by a flow connected with
the positive pole of the apparatus, while the negative was in the hand
of the patient. The result of this treatment was to cause a scab to
form, which fell off, leaving the sore smaller and more healthful in ap-
pearance. Repeated treatment of this kind wrought cures.

In the same and the following year, Crussel formally called the at-
tention of the profession to “‘the electrolytic method of cure.’ * For
the treatment of strictures another method was subsequently inves-
tigated by Willebrand, Wells, Ciniselli, and has recently been revised
by Scouteten, Mallez, Tripier, and others. In 1850 Marshall sug-
gested and successfully employed the galvano-cautery in the treatment
of fistulee.

In 1852 Baumgarten and Wertheimer, with the co-operation of Mal-
gaigne, successfully operated on an aggravated case of varicose veins in
the arm. :

In 1852, also, Ciniselli,} who still cultivates with distinguished suc-
cess the department of electrolysis, first established by experiment that
the alkalies appear at the negative, and the acids at.the positive pole.
His method of demonstration was to lay a piece of flesh across the
edges of two vessels filled with distilled water, and alternately con-
necting each of the vessels with a pole. The acids were found .in
the vessel containing the positive pole, and the alkalies in the ves-
sel containing the negative. The piece of flesh was shrunken and
burned.

In 1853 Ellis first used the heated platinum wire for cauterization
of the cervix in inflammations and ulcerations. In this same year
Hall sucessfully treated a case of ununited fracture by galvano-punc-
ture.

A great and important impulse was given to galvano-cautery by
Middeldorpff, who, in 1854, published his celebrated work on the subject. |

* Die Electrolytische Heilmethode, Neue Med. -Chir. Zeitung, 1847, No. 7.
Med Zeitung Russlands,.1847 and 1848, Quoted by Meyer, op. cit., p. 474.

+ Dell’ azione chimica, dell’ electricita, Cremona, 1852.

+ Brenner, Untersuchungen und Beobachtungen auf dem Gebiete der Elektrother-
‘apie, Bd: ii., p. 265.

| The Galvano-Caustic, Breslau, 1854.
696 HISTORY OF ELECTRO-SURGERY,

In 1855 Demarquay removed a swelling of the submaxillary gland
by galvano-puncture. In the same year, Vergnés and Poey published
their experiments on the removal of poisonous metals from the body by
the electro-chemical bath.

In 1856 Boulu caused resolution of tumors in a number of cases by
magneto-electricity, applied by means of metallic disks. Two cases of
swelling of the parotid gland were in this way entirely cured. In the
same year Meding extracted mercury from a patient who had long
suffered from mercurial poisoning, by means of the electro-chemical
bath.

In 1858 and 1859 Zsigmondi published the result of his successful
experience with galvano-cautery after the system of Middeldorpff. In
1859, also, Delstanche, Lehmann, Burdel, and Thevissen reported suc-
cesses in the treatment of hydrocele by farado-puncture.

In 1861 Braun and Von Gruenewald introduced the galvano-cautery
into gynzecology, where it has since been employed for the removal of
polypi, excision of the cervix, and so forth.

Both in the extent and the variety of his operations in this depart-
ment Middeldorpff far surpassed all his predecessors. He devised a
powerful, though somewhat bulky apparatus, as well as various burners’
and loops for operating on different parts and organs of the body.

In 1867 Althaus * revived the attention of surgeons to the surgical
powers of electricity, by reports of successful experiments in the treat-
ment of navi and tumors of various kinds by electrolyzation.

During the past five years extensive researches have been made in
nearly all the prominent departments of Electro-Surgery by the authors
of the present treatise.+ The results of the researches are recorded in
this section. Experiments made in those departments of Electro-Phy-
siology bearing on Electro-Surgery have already been recorded in the
section on Electro-Physiology. During the same period the various
departments of Electro-Surgery have been studied by Althaus, Von
Bruns, Byrne, Groh, Neftel, Duncan, Newman, Voltolini, Caldwell,
Prince, ourselves + and others.

Surgical compared with Medical Electricity.—In comparing this his-
tory of surgical with that of medical electricity, we observe a number
of interesting points both of similarity and of contrast. Surgical is
much younger thah medical electricity, dating, as we have seen, from
1825. In neither department has the progress been uniform or consistent.

* Tumors and other Surgical Diseases. 1867.

+ Clinical Researches in Electro-Surgery. By A. D. Rockwell, A.M., M.D., and
George M. Beard, A.M., M.D, William Wood & Co. 1873.
SURGICAL AND MEDICAL ELECTRICITY COMPARED. 697

Eras of extravagant expectation have been followed by eras of indif-
ference, although with surgical electricity the contrast has been much
less marked than with medical, The interest that was aroused by
the introduction of electro-puncture in 1825, of electrolysis and gal-
vano-cautery in 1846-47, was followed by a reaction of neglect that
allowed the whole subject to sink into nearly absolute forgetfulness.
The progress of surgical even more than of medical electricity has been
impeded by want of convenient and reliable apparatus, and by this dif-
ficulty is explained the fact that so few workers have entered this most
promising field. While the number of experimenters in medical elec-
tricity, both in the profession and out of it, and in various countries, is
very large, including very many of the ablest writers of modern medica]
literature, the practice of distinctly surgical electricity has been con-
fined to a few, and the authors by whom it has been really advanced
could be counted on one’s fingers.

Surgical, unlike medical electricity, has been studied and pursued
mainly by men of science, and the progress that has been made in it
has been much more frequently the direct result of scientific observa-
tion and experiment. Those physicians who have made eras in medi-
cal electricity have done so by improving, developing, systematizing,
and introducing to the profession methods of treatment which either by
charlatans or others had been substantially known and practised before
them. Sarlandiere, Stenheil, Heider, and Crussel, on the contrary,
first suggested and employed as well as introduced to the profession
electro-puncture, galvano-cautery, and electrolysis.

Another important distinction is this, that nearly all the surgical dis-
eases for which electricity is employed have been treated with more or
less success by other methods, while in many of the medical diseases in
which electrization has been most successful it has been the chief, and
in some the only dependence.

Finally, it should not be forgotten that the surgical successes
achieved by electricity have been of great service to electro-therapeu-
tics in general. A surgical operation appeals to the eye and to
mechanical skill, while medicine appeals more to the higher and rarer
qualities of reason and imagination. Many who fail to comprehend a
complex medical fact or principle may be fascinated and carried to en-
thusiasm by whatever strikes the senses. Hence we find that the sug-
gestion of electro-puncture in 1825 revived an interest in electricity
that its purely medical applications failed to sustain, and from that
time to the present the fortunate operations of galvano-cautery and
electrolysis have aroused the attention of many who had no faith in
698 HISTORY OF ELECTRO-SURGERY.

and no comprehension of the remarkable powers of electricity over
nutrition.

Temperament of the Patient less important in Surgical than in Medi-
cal Electricity.—In medical electricity, as we have seen, the results of
treatment largely depend on the temperament. Some can bear almost
any amount of electrical treatment, others can bear but a little, and
others still can bear none at all (see p. 291). We have seen in the
chapter on Hysteria and allied Affections that symptoms for which
electricity is peculiarly adapted, and over which its greatest victoriés are
obtained, sometimes refuse to yield and are indeed aggravated when any
form of electricity is used by any mode of application, for the reason
‘that the ¢emperament of the patient contra-indicates electricity. Tem-
peraments that will not bear electricity at all or but little are quite
frequently found, especially among the better classes. In surgical dis-
eases that are treated by distinctively surgical applications of electrici-
ty the temperament need not usually be taken into account. Electro-
surgical operations are of a thermal or chemical character, and are not
dependent for their success on the idiosyncrasy of the patient. We
have seen, furthermore, that the electro-susceptibility of patients may
appear either in the form of farado-susceptibility or galvano-suscepti-
bility—-some who can bear and be benefited by the faradic current,
cannot bear the galvanic, and vice versa. In electro-surgical operations
the possibility of these special idiosyncrasies need not be considered.
It is true that patients behave very differently after electro-surgical
operations, that some suffer from irritative fever and others do not,
and these differences of effect may very likely be due to differences
of electro-susceptibility, but such differences are not usually of suffi-
ciently serious importance to require consideration.
CHAPTER II.
ELECTROLYSIS—ITS NATURE AND GENERAT, METHODS.

Tue definition and derivation of electrolysis, as well as its general
laws and phenomena, have already been given (see Electro-Physics,
Chapter IV.). Its physiological relations have also been presented in
considerable detail (see Electro-Physiology, p. 91). It remains for
us here to speak only of electrolysis in its surgical relations, and to
describe the rules and methods of the various operations in which it has
been found of service. Electrolysis in surgery is, however, so closely
dependent on electrolysis in physics and physiology, that no one can
intelligently utilize and explain it in operative procedures who does
not also understand its physical and physiological relations.

The term electrolysis is a general one, and signifies decomposition
by electricity. As such it applies to the electrical decomposition of in-
organic as well as organic substances, and of animal tissues, whether in
health or in disease, living or dead. Practically, however, the term is
now pretty well restricted, in electro-therapeutical language, to the
electrical decomposition of morbid’ growths, or to parts affected by
chronic inflammation, by means of some form of needle electrodes, and
although more or less electrolytic action takes place in all applications
of the galvanic current externally or internally, yet the term, when ap-
plied to any electrical operation, is understood to imply that electro-
lytic action was the leading effect sought for, and that it was obtained
by needles, or at least by some form of metallic electrode more or less
pointed at the extremity. :

On the other hand, when electrodes with very large surface are used,
with a view to chemical effect, and the transfer of fluids with absorption,
the process is called catalysis. Catalysis depends in part, at least, on
electrolysis, and the distinction between the terms, which has been ob-
served by electro-therapeutists is practical rather than scientific.

Theory of Electrolysis of Morbid Living Tissue.—For electrolysis,
living as compared with dead tissue has the twofold advantage that its
solutions are warmer and therefore better conductors, and that it is
capable of the processes of absorption.
700 ELECTROLYSIS—ITS NATURE AND GENERAL METHODS.

When needles connected with the poles of a galvanic battery are
inserted into a tumor, a threefold action is produced.

1. Decomposition of its fluid Constituents —Hy drogen and alkalies,
soda, potassa, etc., go to the negative, and oxygen and acids to the
positive. The special character of these electrolytic phenomena will
depend on the character of the tumor, and the rapidity of the action
will be proportioned to the relative amount of its fluidconstituents. As
the body is mostly composed of water holding salts of potash, soda, etc.,
in solution, it is a good electrolyte, and in most of the conditions of dis-
ease undergoes rapid decomposition. Scirrhus and fibroids, when hard
and firm, require considerable strength of current, and are electrolyzed
with comparative slowness. Erectile tumors, which are almost entirely
of fluid composition, can be electrolyzed very rapidly. Although elec-
trolytic action takes place at both poles when inserted in tumors, as
when inserted in inorganic substances, yet this action on the whole ap-
pears to be the more vigorous and more effective for causing absorption
and disintegration at the negative pole, and in practice this pole is
usually found to be the more efficacious, although successful results are
obtained by the positive pole or by both combined. Epithelioma,
being largely composed of water, also decompose rapidly.

Reasoning from what we know of the electrolysis of inorganic sub-
stances, it is proper to assume that in the electrolysis.of a malignant
tumor, for example, the many chemical substances of which it is com-
posed undergo manifold combinations and recombinations, the precise
nature of which cannot well be fully divined, and the practical effect
of which in causing discussion of the tumor can only be determined by
extended clinical experience.

2. Absorption.—Absorption may be hastened both by the chemical
changes that take place, and also by the mechanically irritating effect
of the needles and the transference of the anions and cations. This
absorption takes place both during and after the treatment. In some
cases it is not at all observed during the operation, but goes on slowly
for weeks following. Stimulation of absorption is especially marked
when electricity acts on hydrocelé and cystic tumors.

3. Disintegration and Atrophy.—As a result of the decomposition
and absorption, and associated with them, the tissues become dried,
separated, shrivelled, and the tumor decreases in bulk and may entirely
disappear. All these processes, or rather the effects of these processes,
may be distinctly observed during the electrolysis of any small wen,
mole, nzvus, or wart, both during and after the operation. Shortly
after the needle is inserted, the growth will be seen to change in color ;
BATTERIES FOR ELECTROLYSIS. 7ol

the skin soon begins to shrivel and contract, like an apple when it is
baking. The next day the growth will be still smaller, and perhaps
nearly or entirely obliterated.

Apparatus for Electrolysis.—Electrolytic action is chietly obtained
by the galvanic current, although there is little question that the ‘faradic
current (both the electro-magnetic and magneto-electric) has more or
less electrolytic power, and the magneto-electric current has been used
in electro-plating.

The magneto-electric rotary machine, as constructed by Saxton or
Stéhrer, is capable of producing electrolysis.* It has, however, for
this purpose, in therapeutics at least, no advantage, and decided disad:
vantages as compared with the galvanic current.

It has been shown that for the purposes of galvano-cautery quantity
with moderate tension was required, and that this was obtained by a
few large elements ; for the purposes of electrolysis tension with mod-
erate or fair quantity is required, such as is obtained by a considerable
number of elements of medium size (see chapter on Ohm's Law in
Electro-Physics, p. 77).

Any of the galvanic batteries described in the chapter on apparatus,
can be used. for electrolysis. The zinc-carbon batteries are the best
for the purposes of electrolysis, but with the cabinet battery and with
most of the combinations and modifications of Daniell’s cells, the elec-
trolytic action is comparatively feeble, and only answers for trifling oper-
ations. Deficiency in electrolytic power in a battery may to a certain
extent be compensated by protracted applications.

Methods of Testing the Electrolytic Batteries.—Batteries may be ap-
proximately tested with a view to ascertaining their comparative advan-
tages for electrolytic operation, by the amount of deflection they cause
to the needle of the galvanometer of known construction (p. 46) ; by.
the rapidity and amount of decomposition which they cause in simple
compounds, such as acidulated water, iodide of potassium, or common
salt, and by their capacity for heating platinum wire (p. 82).

An approximate test for the qualities that are needed in electrolytic
operations is found in the decomposition of iodide of potassium, The
rapidity with which this yields to the current of a battery, and the
amount of iodine evolved in a given, time, very fairly indicates the
capacity of that battery for electrolytic purposes.

* See Frommhold’s Electrotherapie mit besonderer Riicksicht auf Nerven-Krank-
heiten. Pest, 1865, p. 104.

+ In experimenting with galvanic batteries care must be taken to avoid frequent or
long-continued connection of the »eta//ic portions of the electrodes, since, on account
702 ELECTROLYSIS—ITS NATURE AND GENERAL METHODS.

Needles.~-For producing electrolysis in, tissues beneath the skin
fine needles of gold or gilded. steel are used. The advantage. of the
gold is that it resists oxidation better than any other metal. Gold
or gilded needles can, however, be used only with the negative pole,
since with the positive they would be acted on. The conductors
may be composed of two, four, six, eight, or more needles. The
needles may be insulated with hard rubber, or collodion, or shellac,
for about one-third of their length, so that when introduced into a
tumor the skin may not be acted on and inflammation excited. In-
sulation, however, is only necessary in those cases where, .as in sub-
cutaneous nevi, it is desirable that the skin should not be affected
by the current.

The shape of the point is of considerable importance. Round
needles are introduced with difficulty. The bayonet-pointed needles
are preferable. The common glover’s needle, as sold in the fancy
stores, we have found to be easier of introduction than any other
form.

Althaus has employed a conductor, a modification of which is repre-
sented in the following cut :

 

Fic. 147.
Conductor for Electrolysis.

This consists of a conducting wire, composed ofa number of small
wires twisted, with a number of branches, each one of which is so
arranged that it can be attached to a needle after it has been introduced
into the part to be treated.

The advantages of this arrangement are that one needle or more
can be used, and that the number can at pleasure be increased or
diminished during the operation, and that the needles can be intro-

of the feeble resistance thus offered—metals being far better conductors than the hu-
man body—powerful action takes place in the cells (as is shown by the active evolue
tion of gases, attended with a boiling or hissing sound), which, if allowed to continue,
eats holes in and rapidly consumes the zinc.
NEEDLES FOR ELECTROLYSIS. 703

duced in any'direction. In the conductor which we have constructed,
and which is represented in the cut (Fig. 147), the needles are united

to the conducting wires by being inserted in miniature cups or cavities
at the end of the wires.

 

Fic. 148. Fic. r49.
Bayonet-pointed Needles for Electrolysis, Rockwell’s Long Needle
insulated and non-insulated (Kidder). for Electrolysis of Uterus

through the Vagina or the
Walls of the Abdomen.
704 ELECTROLYSIS—ITS NATURE AND GENERAL METHODS.

flexible Copper Wire for Connecting the Needles in Electrolytic
Operations.—These needles are attached to connecting wires by fine
flexible copper wire. Wire of this kind, it may be remarked, is a most
convenient.and almost necessary adjunct to an electrolytic case, and to
the operating-room of the electro-therapeutist. It is useful for many

    
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8
«a f
Ik
a
Ei
ell ®
5
:
S
®
g
2
x
—
Se
—_—_—_—— = Wie. iets :
Fic. 150. Beard’s Long Cutting Needles for
Needles for Electrolysis, with Rock- Electrolysis of the Base.
well’s Needle- Holders, (Tiemann and Galvano-Faradic Mfg. Co.)

purposes of connection, and when thumb-screws are out of order or
broken off it very well supplies their place.

Dr. Murray, of this city, has employed needles insulated at both
ends, leaving an uninsulated portion in the middle. He uses these
needles in the treatment of hydrocele and cystic tumors. They are
ELECTROLYSIS OF THE BASE, 705

introduced so that the insulated portion is on the skin, and the unin-
sulated portion within the tumor.

Method of Introducing the Needles.—The skin in some parts of
the body is quite tough, and needles go in with much greater diffi-
culty than one might suppose. The method of introducing a hypo-
dermic syringe is the best method of introducing needles for electro-
lysis. The skin may be pinched up and kept tense with the left
hand, while the right pushes in the needles the required depth. If
it is impossible or merely difficult to push the needles in as far as is
needed, it is better to let on the current, and allow a little electro-
lytic action to take place around the needle. This will loosen it at
the negative pole (though at the positive it will have the opposite
effect, and bind it close and firm). The negative needle thus loosened
can easily be pushed further in.

The pain attendant on the introduction of the needles is, of course,
best combated by full anzesthesia or by ether spray; but there are
many cases where anesthetics are hardly required, where ether spray
cannot be conveniently used, and where it is desirable to diminish in
some way the pain. A mixture of ether and carbolic acid in equal parts,
first suggested to us by Dr. Sterling, has a positively benumbing effect
on the part to which it is applied. The mixture can be localized
to a very small spot, and the benumbing effect begins to be felt in less
than five minutes, and lasts for fifteen or twenty minutes, varying with
the amount used. It turns the skin a little white. The disadvan-
tage in its use is that it sometimes makes a slight sore afterward.

The benumbing influence of the faradic current may be utilized for
this purpose (see Electro-Anzesthesia).

Electrolyzing the Base.—During the past three years we have been
treating malignant tumors of various kinds by a method of electrolysis
which Dr. Beard has termed zorking up the base, or electrolysis of the
base.

The ordinary method of electrolysis does not suffice for malignant
tumors. It will relieve the pain, but relief of pain can be obtained by
simple external galvanization without any needles. It will cause a
certain reduction in size, but this reduction is almost always limited,
rarely exceeding ten or twenty-five per cent. In some cases, not the
slightest perceptible reduction is caused, even by the most persevering
use of electrolysis. . When powerful currents are used, there. must, of
course, result more or less destruction of tissue near the point where
the needles are inserted, and by successive operations the entire growth
may be broken down, or may slough away after the operations are dis-

45
706 ELECTROLYSIS—ITS NATURE AND GENERAL METHODS,

continued, and it is possible to extend the operations far into the base
and surrounding tissues. Some of our first cases were treated in this
way; but it is to the last degree awkward, tedious, and involves a great
waste of time and force.

Method of Operating by Electrolysis of the Base.—The patient must
first be fully etherized. The method of operating on a smad/ tumor is
to first insert the needle connected with the positive pole underneath
the tumor and near the border. <A similar needle connected with the
negative pole is inserted also underneath the tumor, and, if possible, at
some distance below the base of the growth, so that the point emerges
on the opposite side. ‘The current is now gradually let on, and ithe
strength increased until the electrolysis becomes active, as will be in-
dicated by the yellowish foam that appears at the negative pole, gradu-
ally loosening the needle. As the action increases, the negative,
pole may be slowly worked from side to side, with a slight cutting mo.
tion, so as to undermine the tumor. The positive meanwhile remains
in situ ; it becomes firmly adherent through oxidation, and need not
be removed until the close of the operation.

4

 

Fia. 152.

Electrolysis of the base in a case of scirrhus of the breast Large and long nega-
tive needle manipulated by the operator in the healthy tissue, some distance from the
border of the tumor. Connection made by ordinary positive needle inserted near the
base of the tumor.

After the tumor falls off, through the underminmg of its base, the
base itself can be worked up in all directions with the needles, or
with the harrow electrode that we have devised for this purpose.
After the removal of the growth, it is well to change the position of the
poles in working up the base, so that all parts of the surface may
get the benefit of the action peculiar to both poles,
INSTRUMENTS USED IN ELECTROLYSIS OF THE BASE. 707

If the tumor is a large one, as an extensive epithelioma, or scirrhus,
it is better to have it first removed by the knife. The base can then
be worked up in the manner just described.

The cavity after the operation has a charred appearance and alarms
the patient and his friends unless they are forewarned..

 

Fra, 153.
Electrolysis of the base of a scirrhus of the breast after removal of the tumor by the
knife. Harrow electrode connected with the negative pole and long cutting needle
with the positive pole, ‘ :

The time required in an operation of this kind ranges between ten
minutes to a half or three-quarters of an hour. Some swelling and
cedema in the surrounding tissues follow the operation, but little or no
pain, although the charred appearance of the cavity that has been thor-
oughly electrolyzed is sometimes quite formidable.

Instruments Required.—For this method of working up the base Dr.
Beard has devised needles, or electrodes, that are quite different from
those employed in the ordinary method of electrolysis. The needles
are long, spear-shaped, double-edged, and tolerably sharp, so that a slight
cutting action may be combined with the purely electrolytic action.
These needles are not insulated, except in that portion that is grasped
by the hand in operating. In nearly all of these operations we have
used the zinc-carbon batteries of sixteen or thirty-two cells, and usually
those of the Galvano-Faradic Manufacturing Company; and when a
good deal of work is to be done in a short time, as in important electro-
lytic operations, no batteries are better than these. The various mod-
ifications of Daniell cells, which are'so excellent in central galvaniza-
tion, are not well adapted for powerful electrolysis.

Theory of the Method.—The most recent pathological investigations
secm to point pretty clearly to the view that cancer, whatever the dia-
708 ELECTROLYSIS—ITS NATURE AND GENERAL METHODS.

thesis may be, is a local disease, and affects the adjacent parts and the
general system by actual transfer of the cancer-cells.*

If we accept these views we must also accept the view that cavcer,
whatever constitutional treatment we adopt, should be treated locally,
and by some method of local treatment that acts not only on the body of
the tumor, but also and especially on the surrounding tissue, and that the
earlier such treatment is used the better the prognosis.

When we remove the tumor and close up the wound, we leave the
areola mostly untouched, and shut up the cancer cells in a soil best of all
adapted to nourish them. Hence we need not wonder that the disease
recurs either immediately in or near the place of removal, or'that the
cells wander to some distant part where another tumor appears after
months or years.

The. morbid or semi-morbid tissues that surround malignant tumors
have been treated in various ways by caustics, in substance, by caustic
needles, and by the actual and galvano-cautery. So far as we can learn
from the experience of surgeons who have faithfully tried any one or all
of these methods, the results are more satisfactory than the results of
ordinary treatment by the knife or ligature.

The theoretical arguments that electrolysis of the base would pro-
duce more radical results than the use of caustics are based necessarily
on our ideas of the nature of the electric force and of the process of
electrolysis. When electrodes connected with the two poles of a gal-
vanic battery are inserted into the animal tissue, the vibrations of the
electric force not only pass between the electrodes, but extend to a
considerable distance in all directions from them, and much further
than the direct effect of caustics would reach.

Advantages of the Method.—1. Less liability to recurrence of malig-
nant tumors.

We have kept close watch of a majority of the cases that have been
treated in this way during the past three years. In the list of cases are
found several epithelioma of the lips and face, and one case of malignant
cystic of the neck. But one of the cases of epithelioma of the lips and
face has yet recurred ; although the time that has elapsed since the
treatment varies all the way between three years and four months.
The case of malignant cystic has not yet recurred. Itis yet too early

* See ‘* A Lecture on the Structure of Cancerous Tumors, and the Mode in which
Adjacent Parts are invaded,” by Dr. Woodward, Assistant Surgeon, U.S.A. The
‘Toner Lectures of the Smithsonian Institute, Washington, November, 1873. See
also the recent and admirable discussion on the subject by Drs. De Morgan, Hutchi-
son, Paget, and others, in the Lamce¢ for March and April, 1874.
ADVANTAGES OF ELECTROLYSIS OF BASE. 709

to arrange any statistics on this subject, for, as every surgeon knows,
some cases of epithelioma are permanently cured by the knife, and their
prognosis under ordinary surgical treatment is better than that of scir-
rhus of the breast, or indeed scirrhus anywhere.

Some hopeless cases—notably a case of scirrhus of the rectum, and
epithelioma of the vagina—we have treated by this method in order to
palliate the symptoms and prolong life, and with the most interesting and
remarkable results, Indeed, we have been as much encouraged by the
palliative effects obtained in these hopeless forms of malignant disease
as by the apparently radical cures of milder cases.

It follows, from the theoretical considerations above given, and ex-
perience confirms this view, that the results of this method of working
up the base will depend entirely on the thoroughness with which the op-
eration is performed. If the base be but half electrolyzed, if patches
of morbid tissue be allowed to remain, then there will be a recurrence,
in all probability, just as after other modes of operating.

2. Less hemorrhage than other methods of operating. The reason
for this has already been explained—electrolysis coagulates the blood,
constricts the tissues, and slightly cauterizes them. Ordinary paren-
chymatous hemorrhage is thus controlled in the most satisfactory man-
ner, so that if a strong current is used, neither sponges nor styptics are
required.

3. Less liability to shock. We form this judgment from protracted
operations made on patients in various stages of debility, and in the
extremes of life, infancy and old age. We have not yet seen any
effect at all suggestive of shock, after very long sittings under strong
currents, even where sensitive localities were operated on. The
electric current would indeed appear to be one of the very best anfi-
dotes to shock, and for a long time it has been known and used as a
means of resuscitation.

4. It is followed by a more satisfactory healing than other operations.
This fact has been observed markedly in several severe and hopeless
cases, and has attracted the attention of all the surgeons who have
seen the cases,

5. There is reason for the belief that the future will show that septi-
cemia and pyzemia are less likely to follow electrolysis than other surgi-
cal operations. It is more than probable that electrolyzation, like
cauterization, constringes the absorbents so that they cannot absorb
pus.

6. To all these facts must be added the consideration that many
patients dread the knife—without reason it may be, and without com.
710 ELECTROLYSIS—ITS NATURE AND GENERAL METHODS.

mon-sense ; but patients are not expected to exercise reason or com.
mon-sense—and such persons are willing to submit to electricity, how-
ever employed.

The advantages of working up the base by electrolysis, as compared
with working up the base by caustic, the actual cautery, or the galvano-
cautery, are worthy of study.

Disadvantages of the Method.—1. It requires apparatus more or
less bulky, and they require more or less experience in their manage-
ment.

2. Electrolytic operations frequently require more time than opera-
tions with the knife or ligature, and in some cases the operation must
be repeated.

If electrolysis produced shock, this element of time might, perhaps,
be a serious one; but, inasmuch as it appears to act as an antidote to
shock, and as the stimulus of the current allows us to prolong aneesthe-
sia with safety, and, as in many of the cases where electrolysis is used,
treatment by knife or ligature is contraindicated, this objection need
not deter us from resorting. to it.

3. The irritative fever that follows powerful and prolonged electro-
lytic operations is sometimes severe. The parts around the tumor
operated on become more or less swollen, but are not usually painful,
and this swelling also soon subsides.

Itis proper to state that the ordinary method of electrolysis, if
thoroughly used and repeated a sufficient number of times, may run into
this method of working up the base, and in epithelioma, at least, may
accomplish good results. The body of the tumor may be gradually
broken and destroyed ; and then, in successive operations, the needles
may be made to work up the base and surrounding tissue. Groh,* of
Vienna, has used this method with success in quite a number of cases
of epithelioma, as well as of sarcomatous growths. We have used the
same method in epithelioma, and with success. The method has,
however, the. sufficiently serious objection that it first wastes the time
and strength of the patient on unnecessary treatment of the tumor, and
is only successful in proportion as it falls back on the method of work-
ing up the base and surrounding tissue.

* Die Electrolysis in der Chirurgie, Vienna, 1871. Groh has also treated sarco-

matous growths by very prolonged electrolysis, with mild currents, This method
seems to have greater inconveniences, without any compensating advantages,
CHAPTER IIL.
GALVANO-CAUTERY,

Galvano-Cautery.—Galvano-cautery is cauterization by a resisting
wire heated by the galvanic current. It is very often confounded with
electrolysis, but as we have seen electrolysis is the decomposition of a
compound substance by means of electricity. A slight cauterizing ac-
tion may indeed accompany electrolytic operations, but it is incidental
merely, and is not a part of the electrolysis, nor the end desired.

It is a law of electricity that when it passes through a resisting wire
it raises its temperature in proportion to. the resistance of the wire and
the quantity of the electricity (see Electo-Physics, p. 91). Zhe wire
thus heated is capable of producing cauterizing effects. Platinum offers
a greater resistance to the passage of the electric current than any
other metal except mercury and lead, and is therefore used in galvano-
cautery. It will be seen at once that the electricity is not applied to
the body, as in the various forms of electrization, but only the wire
heated by the passage of the current.

Advantage of Galvano-Cautery over the Actual Cautery. —The one
great advantage of the galvano-cautery over the actual cautery is, of
course, the fact that the heat in the wire connected with the battery
can be controlled at will. It can be let off and on, increased or dimin-
ished at pleasure and instantaneously. With the actual cautery such
control is manifestly impossible.

Heat is heat, however obtained; and the heat of a platinum wire
through which. a current is passing has probably no advantage as such
over the heat of a poker that has been thrust into the coals, The
advantage lies simply in the fact that’in the one case the heat is under
the complete control of the operator during a long operation if neces-
sary; in the other case it is not under such control.

' Apparatus for Galvano-Cautery.—Galvano-cautery operations re-
quire batteries composed of a few large cells. Rarely are more than
eight cells used, and the best batteries can be turned into one or two

 
712 GALVANO-CAUTERY.

cells, The batteries employed in electrolysis or in ordinary galvaniza-
tion are not available for galvano-cautery—vice versa, galvano-cautery
batteries are of but little use in electrolytic operations or in ordinary
galvanization. The explanation is to be found in the chapter on
Ohm’s Law (see Electro-Physics, pp. 77-95)-

‘There has been great practical difficulty in obtaining galvano-cautery
batteries that would be at once sufficiently powerful and conveniently
portable. ‘The original battery of Middeldorpff was extremely heavy
and in every way inconvenient, though, like all combinations of Grove’s
cells, it was very powerful.

During the past decade, and notably during the past fem years, the
progress in the direction of portability and convenience of galvano-

we

a

AU

ss

 

Fic. 154.
Byrne’s Multiple Element Battery (Shepard & Dudley).

zautery batteries has been rapid and decided. In this department no
one has labored harder or more successfully than Dr. John Byrne, of
Brooklyn, N. Y. After long and tedious experimenting, he has com.
APPARATUS FOR GALVANO-CAUTERY, 713

ne

Zinc-Carbon Galvano-Cautery Battery (Drescher & Co.).

eee lM af i

i
1 Be !

 

 

Fic. 156.
Zinc-Carbon Galvano-Cautery Battery (Kidder),
714 GALVANO-CAUTERY.

pleted a galvano-cautery battery that is as portable and easy to manage
as any galvanic battery for electrolysis or ordinary galvanization.

Batteries. that are non-portable, or at least not easily so, are also
made by all the companies that manufacture electrical instruments.
Some of them that we shall describe are most excellent. Those who
make a large use of galvano-cautery will probably require two kinds of
batteries—portable and stationary—just as they require portable and
stationary faradic and galvanic apparatus.

Byrne's Multiple Element Galvano-Cautery Battery. _—Byrne’ s com.
bination of zinc-carbon elements is the most compact and portable bat-
tery tor galvano-cautery purposes yet constructed, and for its size has
greater heating power than any other. This battery, in its latest modi-
fication, consists of zinc-carbon cells, in a case inches long,
inches high, and inches wide. The plates of each cell are split up
into a number of smaller plates, all of which are contained in one jar
of fluid, and are connected at the top. By this arrangement more sur-
face both of the zinc and of the carbon is exposed to the fluid than
when the plates are not so subdivided. Besides this arrangement gives

Poe

 

Fic, 157.
Zinc-Carbon Galvano-Cautery Battery (Galvano-Faradic Mfg. Co.),
CASE OF GALVANO-CAUTERY BATTERIES. 715

many corners and angles on which the exciting fluid acts with greater
vigor than on smooth surfaces.

The plates are very near to each other, from 7, to 7 of an inch, so
that the internal resistance of the battery is comparatively small.

The arrangement is sueh that one or two cells can be used as may
be required. The heating power of, this small, light battery, is quite
remarkable, and is indeed sufficient when well nurtured for a very large
number of electro-surgical operations,

Dr. Byrne* says that he has found by experiment that greater heat
may be obtained from 120 inches of surface in the multiple element
form (three inches by five) than from 378 inches of surface with ele-

a!

SW
SE AMAA

A

:
| | i ! |

 

: Fic. 158.
,Galvano-Cautery Battery with handle and wire-loop (Mayer & Meltzer, London).

ments four times the size. While the battery made of large elements
would bring five inches of platinum wire to a red heat, the multiple
element battery would raise the same wire to a burning white heat.

“ Electro-Cautery in Uterine Surgery, p. 67.
GALVANO-CAUTERY.

          
  
 

FIG. 159. Fic. 160, Fic, 161.

BURNERS AND CUTTING-LOOPS FOR GALVANO-CAUTERY (BRUNS),

Fic. 162,—Handle for Burner, with knob and spring for interrupting
or connecting the current.

Fic. 163.—Handle and Cutting-loop.

Fic. 164.—Handle for Cutting-loop where only one hand is at liberty; the other
hand may be employed in holding some other instrument, as the laryn-
geal or aural mirror,

Fic. 165.—Burners of various shapes,

Fic. 166,—Burner for larynx.

Fic. 167.—Cutting-loop for larynx.

   

SHEPARD & DUDLEY.NY.
Fic. 169. Fig. 170. Fic, 171. Fic. 172. Fic. 173. FG. 174. *

 
USES OF THE GALVANO-CAUTERY. 717

 

  

 

 

 

 

 

 

 

 

  

 

 

 

 

 

 

 

ul UU ll uy ul

Fic. 183.

GR

Fics. 375. 176. 377. 178. 179. 180, 181. 182.

Care of Galvano-Cautery Baiteries.—In order to attzin the maximum
of power from galvano-cautery batteries, and to keep them in good

“working order, much more care is necessary than in the case of ordinary

batteries for galvanization.

The reasons for this are twofold :

1. The chemical action is very vigorous because the solutions are
“strong and the circuit is metallic throughout. In ordinary external
'. galvanization or in electrolysis the resistance of the body interposed
in the circuit is so great that only a small quantity of electricity can
be evolved (see chapter on Ohm’s Law); hence the zinc is not so
rapidly consumed.

2. The galvano-cautery batteries—especially the portable varieties—
have comparatively little reserve power. If the solution becomes old
or the plates become corroded badly, the heat generated may be too
feeble for important operations.

It is therefore necessary to frequently renew the solution entirely,
and not in part, as is so often done with ordinary galvanic batteries.
With the portable zinc-carbon batteries it is a great advantage to thor-
oughly soak the carbons in tepid water after each operation.

/A practical point of much importance is that when the zinc plates
718 GALVANO-CAUTERY.

  

Fic, 184. Fic. 185. Fic. 186. Fic. 187. Fic. 188. Fic. 189.
‘Various forms of handles, wire-loops, cauterizers, and so forth, for galvano-cautery
operations (Shepard & Dudley, Galvano-Faradic Mfg. Co., and Kidder).

 

i TT

   

TUS ILE MS:
Fic. 190.

Fic. 19%
Galvano-cautery operating case (Galvano-Faradic Mfg. Co.).

become much worn, and the distance between the carbon plates is
correspondingly increased, the internal resistance of the batteries is
greater and the power is diminished.

Accompanying Instruments.—In the operation of galvano-cautery a
large number of burners, loops, and handles isused. These are of every

variety and can be adapted by the operator to the needs of any spe-
cial case.
RULES FOR USE OF, GALVANO-CAUTERY. 719

: Uses of the Galvano-Cautery.—The special purposes for which
galvano-cautery has been recommended and employed are the follow-
ing :—

1, Removal of tumors of various kinds, in parts that are not readily
accessible to the ordinary methods of extirpation—pediculated tumors
of the larynx, polypi of the larynx, naso-pharyngeal space, external
auditory canal, vagina, rectum, and uterus. Malignant tumors in any
accessible position may be removed by galvano-cautery in order to
avoid hemorrhage.

2, Amputation of diseased organs or parts of organs, like the neck
of the uterus, the tongue, etc., as a palliative.

3. Cauterization of ulcers.

4. Cauterization of chronic inflammations of mucous membrane, in
the urethra, nasal duct, conjunctiva, etc.

5. Cauterization of cancerous tumors to stop the hemorrhage.

6. Cauterization of the base and tissue surrounding malignant tumors
that have been previously removed by the knife or ligature.

7. Cauterization of erectile tumors so as to cause coagulation, ab-
sorption, and in some cases sloughing.

8. Treatment of fistulae, by cauterizing the fistula alone, or by cau-
terizing surrounding parts, or by cauterizing both the opening and the
parts surrounding, or by opening the fistula.

g. Treatment of neuralgia by cauterizing and killing the nerve.

10. Treatment of prolapsus uteri by cauterizing with the burners the
vaginal walls, and thus causing inflammation, suppuration, and cicatricial
contraction.

Advantages of the Galvano-Cautery.—The advantages of the galvano-
cattery over the actual and potential cautery and the ordinary opera-
tions by cutting instruments, are these :—

1. It can be used on parts that are not easily accessible to ordinary
instruments.

2. It saves all or nearly all hemorrhage.

3. It combines the after-cauterizing effect with the other results of
the operation, as is sometimes desirable.

4. It is more sure in its action, and can be more accurately localized,
especially in cavities, than the ordinary methods of cauterization.

5. It is but little painful after the operation, and is rarely or never
dangerous.

6, It is followed, like electrolysis, by a more satisfactory healing than
by the knife or ligature, and as after electrolysis there is less liability to
pyemia.
720 GALVANO-CAUTERY.

The one disadvantage of the galvano-cautery is the difficulty of
managing the necessary apparatus.’

This difficulty is now diminishing ; the advances that have recently
been made in this department will bring the galvano-cautery within the
reach of all who are willing to devote. the amount of attention which
a new department must at first demand.

There is reason to believe that in the future, with accessible and
compact appliances, the use of the galvano-cautery will be greatly ex-
tended. Vo one can expect to succeed with the galvano cautery who is
not to some degree a master of electro-physics. s

Rules for the Use of the Galvano-Cautery.—1. For ali large and im-
portant operations fresh fluid should be used in sufficient quantity, and
the battery should be in all respects clean and in good order.

In the use of the galvanic current for ordinary galvanization, fluid
needs entire renewal but rarely, and if an evaporation or waste reduce
the strength, simply pouring in new fluid into the old, or pouring in
water alone will answer to bring up the battery power to the necessary:
standard.

2. Before beginning the operation, the apparatus should be in thor-
ough preparation. One battery should be tested, and the handles and
wires or knives should be carefully overhauled, so that there may be
no chances of bad connection or bad working of the screws, wheels, or
other appliances.

3- In all operations of importance it is almost indispensable to have
an assistant, whose exclusive duty it shall be to immerse and take out
the elements as may be required during the various steps of the opera-
tion, or to use the bellows or air-bulb to increase the strength of the
cutrent. The operator will have all he can do to control the instru-
ments in his hands.

4. The strength of the current employed in the operation should be
carefully adapted to the size and length of the wire-loop or knife that
is used in the operation. If too great a quantity of electricity is used
for the size and length of the wire loop, the wire may break before or
during the operation—very likely very near the close of the operation,
to the annoyance of the operator. If too little quantity of electricity
is used, the loop or knife will not be sufficiently heated, and will not
burn through the tissues, or if the tissues are divided, hemorrhage
may occur.

As the loop grows smaller near the end of an operation, the quantity
of electricity should be diminished by raising the elements somewhat
in the solution, so that less surface may be exposed (Byrne).
RULES FOR USE OF GALVANO-CAUTERY. 721

Accurate judgment in this regard can only come from careful and
repeated preliminary experimentation, and from entire familiarity with
the battery employed.

5. In the case of malignant growths of all kinds, the heated wire,
loop or knife should go sufficiently far beneath or around the growth
as to include healthy tissue. In amputation of the cervix, for example,
the wire should be placed above the ulcerated or indurated part so as
to remove the entire cervix, and very much more if the disease extends
far into the body. of the uterus.

In some cases this would be impracticable, and then it is necessary
to abandon all hopes of radical or permanent relief, and content our-
selves with palliation merely.

6. In cases where the wire-loop is used, the traction on it -by the
wheel or other contrivance should be very gradual, and by intervals, so
that the surfaces.of the parts exposed may be thoroughly cauterized.
The temptation is to make the operation brilliant and brief, by rapidly
contracting the loop. ‘Those operators who yield to this temptation
may be annoyed by immediate or secondary hemorrhage.

7. When the shape and position of a part to be excised are such
that a loop cannot be adjusted, a groove should first be burned around
the part by the galvano-cautery knife (Byrne).

8. The wire-loop or knife shaquld be accurately adjusted, and be per-
fectly in position before the connection is made and the current let
on. :

g. The loop should not be contracted until it has passed into the
submucous tissues, and then passing through superficial or cellular tis-
sue, the wire should not be brought to a white heat (Byrne).

to. In protracted operations, where delay is necessary between the
different stages, the elements should be raised out of the solution when
the current is not needed, so as to rest the battery and economize its
force.

_ Adaptation of Galvano-Cautery to various Departments.—In- the
adaptation of galvano-cautery to any of the special departments, one
needs to be guided by the general principles already laid down. The
efficient contrivances and modifications of apparatus, and of modes of
Operating, will depend on the skill and experience of the surgeon.*

Dr. Byrne presents the following résumé of his operations with the

galvano-cautery, up to December 1, 1872:

e

* On the special department of the adaptation of the galvano-cautery to gynzcology,
as well as for valuable suggestions in regard to galvano-cautery in general, we may
refer to Dr. Byrne’s work on the Electro-Cautery in Uterine Surgery.
722 GALVANO-CAUTERY.

“19 cases of epithelioma, including cauliflower cancer.
mz encephaloid, or medullary cancer. ,
13 «CS catarrhal, inflammatory, and ulcerative affections of the
cervical canal of uterus.

5 « amputation of cervix (non-malignant).

4 # fibrous and fibro-cellular polypi.

4 #8 sessile fibroid tumors.

2 & deep ulceration of os and cervix.

1 intra-uterine vegetation (non-malignant).

a #8 vascular tumors of urethra.

4 * granular urethritis.

3 & hemorrhoids.

1 ¢ perineo-vaginal fistula.

r  — lipoma of scalp.

rts lipoma of cheek.

ros lipoma of ear.
72

Of the thirty cases of malignant disease, .

17 were of the uterus alone.

ye ote “uterus and vagina.

g-s “« perinzeum and vagina.

1 was of the left labium.

rs “clitoris. :
ry “¢  Dreast.

Among the nineteen cases of epithelioma,

7 were indurated or ulcerated only, and
. 12 were of the vegetating or cauliflower character. Of the latter,

7 * cervix uteri alone.

3 ©  perinazeum and vagina.

1 was restricted to the left labium.

1.of the clitoris.”

Dr. Thomas Bryant, of London, has recently published the results
of a large variety of experiments with this form of “bloodless sur-
gery.”

The cases of amputation of the cervix uteri with the galvano-cautery
that have been attempted by the surgeons of the Woman’s Hospital,
with the assistance of Dr. Rockwell, have proved entirely satisfactory.
In these cases, if the platinum wire be of sufficient size, and the cutting
be done slowly, not a drop of blood need be lost.

The galvano-cautery has been used by ophthalmologists for the cau-
RULES FOR USE OF GALVANO-CAUTERY. 723

terization of granular lids, and inflammations and abscesses of the lachry-
mal ducts. By aurisis it has been used for the removal of polypi and
other tumors from the external auditory canal. By laryngologists it has
been used for the removal of nasal and naso-pharyngeal polypi, for the
cauterization of granular inflammations, for the cauterization and removal
of various laryngeal growths, and for tracheotomy. One of the most.
successful workers in this branch is Voltolini.*

In the rectum the galvano-cautery has been recently utilized for oper-
ation on fistulae and for the removal of piles. By general surgeons it
has been used for amputation, and for the treatment of epithelioma and
other malignant growths.

* Die Anwendung der galvano-kaustik in Innern des Kehlkopfes und Schlundkopfes.
Wien, 1872. On the Application of the Galvano-Cautery to Laryngology. See also
Cohen’s Diseases of the Throat, 1873.
CHAPTER IV.
BENIGN AND MALIGNANT TUMORS.

Tue success of the electrolytic procedure in benign and malignant

. tumors depends on the method used. One may fail by one process and

succeed by another, just as in any other surgical operation. The ten-

dency has been to be satisfied with the mere employment of galvano-

puncture, without regard’ to the method, and to accept the results,

whether favorable or unfavorable, as serving to settle the question of the
value or uselessness of electricity i surgery.

In electrolysis everything depends on the method ; and with the same
method skill, care, and thoroughness may succeed, when awkwardness,
carelessness, and inattention fail utterly. ‘The failure of electrolysis in
any form of tumor—benign or malignant—is not to be counted a re-
proach until we know the actual method used and the character of the
operator. ;

The errors that have been and are continually made in electrolytic
operations begin and+end, as we have seen, in ignorance or forgetful-
ness of the laws and facts of electro-physics and electro-physiology, and
especially of the former. No one can be a scientific and successful
electro-surgeon without also being more or less of an electro-physicist.

N#VI—ERECTILE TUMORS—ANGIOMATA—MOTHER’S MARKS,

Neevi (erectile or vascular tumors) are both cutaneous and subcu-
taneous. The terms cutaneous and subcutaneous, however, simply in-
dicate a difference in seat, but not in kind. The two forms are often
associated, and the wide-spread dilatation of cutaneous vessels, attended
with little swelling, that are commonly called “mother spots,” are evi-
dently similar in character to the subcutaneous variety to which Bell
gave the name of aneurism by anastomosis. Erectile tumors may be
either venous or arterial.

This variety of tumors may be treated by the ordinary method of
electrolysis, with a good probability of success, provided the conditions
of success are skilfully observed,
ERECTILE TUMORS. 725

It is first of all necessary to understand that to cure all forms of
erectile tumors electrolytically without leaving any scar or trace is
simply impossible. In many cases, and notably in those of larger size,
and which are partly cutaneous and partly subcutaneous, sooner or
later destruction of tissue is requisite to bring about a cure; and de-
struction of tissue after electrolysis, like destruction of tissue after the
use of other agents, is followed by cicatrization.

When the nevus is small and superficial, then a mild electrolytic
operation may be followed by a shrinking of the tumor, and a rapid and
permanent absorption of the débris without any scar; but such cases
can hardly be said to constitute the majority. The scars following the
electrolytic treatment of nzevi may, however, rapidly disappear ; at least
the little patient may in time entirely outgrow them.

It is necessary to be understood, in the second place, that the elec-
trolytic operations for nevi, as for other kinds of morbid growths, are
usually sufficiently painful to require some form of local or general
anesthesia. It is almost absolutely safe to give ether to young chil-
dren ; and the operation, even though it be but very short and but little
-painful, can be conducted far more successfully when the. child is anzs-
thetized than when it is not. With adults, and sometimes with children,
local aneesthesia by ether‘spray is sufficient ; but it is generally inferior
to general anesthesia. The struggles of the child to get free, its terror
at the sight of the instruments, can all be saved by a carefully adminis-
tered anzsthetic. The details of the operation differ with the site and
character of the tumor. Success has followed the use of both poles in
the tumor, or only one, while the connection is made by a sponge-elec-
trode on some indifferent point. If the tumor be small, and but one
pole is used, it is better that it should be the positive, since the clot
formed at the positive pole, though small, is hard and firm. If the
tumor be large, needles connected with both poles may be used.
Whether one or more needles are to be used depends on the size of
the tumor, but generally one needle connected with each pole is suffi-
cient, If many needles are used, it is difficult.to manage them; and
some may fall out, and thus disturb the operation. It is better, asa
rule, to take out the needle at different stages, and insert it in various
parts, until the entire growth is acted upon. We have sometimes found
it of advantage to reverse the current during the operation, so that all
portions of the tumor may be acted on by both poles. Insulation of
the needles is only required in the case of entirely subcutaneous tuniors
—where, as in the case of aneurism, it is desired to produce a coagulum
(which may be slowly absorbed) without injury to the skin,
720 BENIGN AND MALIGNANT TUMORS.

The length of the operation may range between five and twenty-five
minutes, according to the strength of current used, the size of the needles,
and the size of the tumor.

The great point in all electrolytic operations for nevi is to do just
enough without doing too much. If the operation be not reasonably
thorough, absoption will not take place, or the tumor may recur. If
the operation be too extensive or prolonged, the destruction of tissue
may be greater than is needed, and the: subsequent cicatrization may
amount to at least a temporary deformity. For very large and semi-
cutaneous or semi-subcutaneous neevi, that exhibit a tendency to spread
in all directions, it is necessary to place the needles at or near the base
of the tumor, and in the surrounding tissue, among the enlarging and.
tortuous vessels, in a manner somewhat resembling the method of elec-
trolyzing the base of malignant.tumors. If such tumors are treated
timidly, no good result will come, and the“operation may be several
times repeated without satisfaction.

The advantages of the electrolytic procedure in nzvi are these :

1. In small and superficial tumors, the cure may be effected with
little or no scar. On the face and other exposed parts of the body,
this advantage is very great.

2. In large nevi, and those which are partially or entirely subcu-
taneous, the liability of recurrence would be less, and probably the ex-
tent of the cicatrization would be less than after the ordinary method of
treating these growths.

e
Subcutaneous erectile tumor of the right cheek ; complete recovery follows electrolytic
treatment,

Case CCXXIV.—In April, 1871, Dr. D. F. Reynolds consulted usin regard to the
case of a little child aged eight months, who was afflicted by a subcutaneous erectile
tumor in the right cheek, It appeared shortly after birth, and had gradually enlarged
until the date mentioned, when it measured one and a half inches in width and from
one-half to three-quarters of an inch in depth. Upon firm pressure the enlargement
would almost entirely disappear. The patient having been placed under the influence
of chloroform, we operated at Bellevue Hospital, in thé presence of Dr. Frank Ham-
ilton and his class, by introducing into the four quarters of the tumor four small
gilded steel needles insulated to within one-quarter of an inch of the points, Two of
the needles are connected with the positive and two with the negative pole.

During the passage of a current of very moderate tension the enlargement gradually
grew harder and more prominent as the blood coagulated, and at the expiration of
eighteminutes, when the needles were withdrawn, the part was quitefirm. The child
suffered no inconvenience during or after the operation, and when seen the next
morning was as well and playful as usual. The process of absorption soon became
manifest, and in two months three-quarters of the clot had disappeared.
ERECTILE TUMORS. 727

From this time there was a most marked decrease in the rapidity of absorption,
since but two months more were required before the clot had entirely disappeared.

A large arterial tumor in a weak, ill-nourished child ; the result of electrolytic
treatment unsatisfactory,

Cask CCXXV,—Annie , achild aged one year, was directed to us by Dr. H. P.
Farnham, ‘On her back, over the upper dorsal vertebrze, we found a large fluctuating
arterial tumor, nearly two inches in diameter at its base.

The child was markedly anzemic, and her general condition was much below par.

It was thought best, however, to operate, and in the presence of Drs. Farnham,
Pinkney, Grant, and others, the needles were used in the same manner as in the pre-
vious case. Coagulation was readily produced, but owing to some unpleasant symp-
toms in the respiration of the child the needles were withdrawn (as the progress of
the case subsequently attested) a little prematurely,

Absorption set in very slowly indeed, and after a few weeks its effects were barely
perceptible. After a couple of months it was evident that the circulation in one por-
tion was beginning to be re-established, but the mother refused to allow anything
more to be done for the little patient, It should be stated that on the night follow-
ing the operation, the child was allowed to lie upon its back with the hard enlarge-
ment of coagulated blood entirely unprotected. Subsequently a soft circular ring
was prepared and placed around the tumor, but the irritation already caused by the
pressure was followed by slight ulceration and discharge.

This, however, healed in the course of two weeks, but it undoubtedly contributed
towards the general unsatisfactory result. The slowness with which the absorbing
process was carried on is to be attributed undoubtedly to impaired nutrition, and the
re-establishment of the circulation mainly to the unfortunate necessity of cutting short
the operation.

 

Arterial erectile tumor from birth in achild fifteen months old ; complete, recovery
under electrolyzation.

Casz CCXXVI.—Ina little child fifteen months old, upon whose face, near the angle.
of the lower jaw, a small erectile tumor had existed from birth, electrolysis was com-
pletely successful, The patient was placed under the influence of chloroform, and
two platinum needles, insulated to within one-third of an inch of the points, and
connected with the positive pole, were introduced into the two lower quarters of the
tumor ; while two steel needles, connected with the negative pole and insulated in a
similar manner, were thrust into the two upper quarters. The current from twelve
medium-sized cells of a zinc-carbon battery was allowed to pass for ten minutes, at the
end of which time the coagulation was complcte. Absorption of the clot rapidly
became manifest, and in four months it had entirely disappeared, leaving no scar.

In subsequent operations we have not hesitated to use steel or gilded
needles for the positive pole, since the oxidation which these needles
undergo in all probability tends to accelerate coagulation.

Subcutaneous erectile tumor treated by electrolysis ; too strong currents used ; sub-
sequent sloughing.

Casz CCXXVII.—At the request of Dr, Geo. K. Smith, we operated, Nov. 22,

1871, on a case of subcutaneous erectile tumor, just over the inner angle of the eye,

 
728 BENIGN AND MALIGNANT TUMORS.

in a child sixteen months of age. The tumor, which was about the size of a hazel-
nut, could easily be compressed. The child was thoroughly etherized with the assist-
ance of Dr. F. H. Colton, and three insulated needles were inserted into the tumor—
two connected with the positive, and one with the negative pole.

The current was from sixteen weak cells; the séazce' twenty minutes. The color
of the tumor changed during the operation and became hard through the coagulation,
Subsequently the tumor sloughed at certain points, and the result was not satisfactory,
since a deformity was left that may be permanent,

The mistake we made was in using too strong a current and unduly
prolonging the operation. In our desire to avoid repeating the opera-
tion, we went to the other extreme.

- The delicate skin of the child was so affected by the action of the
current that sloughing ensued in spite of the insulation of the needles.
This mistake is one that can be easily avoided.

_ Dr. Rockwell, by a somewhat rare coincidence, treated, within a com-
paratively short time, four widespread nzevi involving the nose. The
first case, sent by Dr. Lafayette Ranney, submitted to two operations.
The first successfully obliterated the dilated vessels of one-half the
nose ; but circulation becoming re-established in the other half, a sec-
ond operation, performed after an interval of several months, resulted
in complete recovery. The second case, sent by Dr. Stephen Smith,
was apparently successful ; but as it passed from under his observation,
he is uninformed of the ultimate result. The remaining cases recovered
promptly after a single operation, and with hardly an appreciable scar.

Drs. L. F. Sass and R. P. Lincoln, of this city, have communicated
to us the details of an interesting case of successful treatment of a
venous erectile tumor of the neck :—

The patient, Gen. K., aged 33, of nervous temperament, represented that in April,
1869, after a special effort in public speaking, he felt a pain in his neck, on the left
side, Six weeks later a small tumor appeared in the locality of the pain, which in a
few months increased much in size, It was subsequently reduced by sulphur-baths,
cathartics, tincture of iodine, etc., but returned, and in F ebruary, 1870, was again
reduced by the same treatment, which left him, however, exceedingly weak. July 4,
during the excitement of a public reception, the tumor again appeared, with severe
pain, loss of voice, and feeling of suffocation, so that death appeared imminent ; and
again it was dispelled by the same treatment. On account of the frequency of these,
and the exhaustion that followed the treatment, the patient was compelled. to resign
the public position which he held, and return home,

When he came under the observation of Drs. Sass and Lincoln, a tumor of the size
of a large goose’s egg was found on the left side of the neck, in the antero-inferior
portion of the region defined by the sterno-cleido-mastoid and trapezius muscles and
the clavicle. The trachea was parted half an inch to the right of the median line.

The tumor was rounded, smooth, and readily compressible ; but after compression it
returned to its natural shape.
GOITRES. 729

An attack of indigestion, active exercise, or mental excitement of any kind, would
cause the tumor to increase sometimes to twice its usual size,

Sept. 30, 1870, in the presence of Drs, Hammond and Hackley, the patient was
anzsthetized and submitted to electrolytic treatment. Four gilded steel needles, in-
sulated to one-half or three-fourths of an inch from their points, were introduced into
the four quarters of the tumor ; the two upper being one and one-fourth inch apart,
and one inch above the lower, which were one inch apart. The two inner needles
were connected with the subdivided anode, and the two outer with the subdivided ca-
thode. At first ten, then fifteen elements of a battery similar to Stéhrer’s were em-
ployed. The strength of the current was increased gradually.

_ At the expiration of fifteen minutes the two lower needles were disengaged from the
current, thus concentrating the whole force upon the two upper; at the expiration of
fifteen minutes more the needles were removed.

During the operation all the prominence of the tumor disappeared, and a delicate
examination detected a hard mass in its place; not a drop of blood escaped on the
removal of the needles. The skin over the tumor presented a bright blush, and the
trachea had returned to its proper position. The patient kept quiet for three days,
using a cold-water compress. At the endof that time the soreness, which had been
considerable, had nearly all passed away. é

At the latest date, October 24th, the patient was well, and ‘‘ the induration in the
neck was steadily diminishing in size.”

Goitres.—Goitres are to be treated by ordinary electrolysis with sharp,
bayonet-shaped needles, which may be either insulated or non-insu-
lated. Needles that are smoothly insulated can be inserted through the
skin of the neck without very much more difficulty than non-insulated
needles ; but if the insulation be roughly put in, the difficulty in inser-
tion may be very great. An advantage of non-insulated needles is that
by the action which takes place in the skin around it, the needle be-
comes loosened at the negative pole, and so can be pushed in still fur-
ther without difficulty. For goitres of all kinds the negative pole is
much preferable to the positive pole, just as in cystic and fibroid tu-
mors. ‘There is no danger in inserting a needle even into a smail
goitre to a considerable depth, say one or two inches. By great
carelessness, it would, we suppose, be possible to wound the carotid
artery. We do not usually employ an anesthetic in the operations on
the neck; we find that the ether spray, or local application of a mix-
ture of carbolic acid and ether, equal parts, prevents, to a considerable
extent, the fear of the introduction, which the patient much dreads,
and which is really more severe than the pain of the electrolysis after
the needles are in position.

In a few cases we have observed that the needles, when inserted in 4
goitre, cause, by reflex action, pain in the forehead; in other cases
nausea and a tendency to faintness are observed. The majority of
730 BENIGN AND MALIGNANT TUMORS.

patients do not bear an operation of more than from five to fifteen min-
utes, which may be repeated two or three times a week.

This purely electrolytic treatment may be varied by external galva-
nization and faradization with strong currents.

There is no question that external galvanization and faradization witn
strong currents, both steady and interrupted, will cause a considerable
reduction of, and sometimes completely dissipate goitres ; and even when
these methods do not cause any perceptible diminution, they at least
relieve the sense of pressure, the heaviness, and the sense of suffocation,
or of choking that goitres often cause. External electrization alone is
not as satisfactory as electrolysis with needles.

The prognosis of goitre, under electrical processes, varies with the
nature of the tumor. Those which are small and soft may disappear
entirely and permanently. Those that are large, provided they are not
too hard, may also entirely disappear. The cystic varieties also give a
good prognosis. Those that are both very large and very hard may
diminish a certain percentage, but they do not entirely disappear. The
best method of estimating the results of treatment is to take measure-
ment of the neck. Almost all goitres will go down more or less, and
usually at the outset of the treatment. Afterwards they recede more
and more slowly ; and, even in those cases where the cure is complete,
the last quarter will require more treatment than the first three-quar-
ters. This is true of all hard growths that are treated by electricity.

Goitre of three years’ standing—Rapid reduction and approximate cure under gal-
vano-puncture—LExternal faradization with very strong currents.

CasE CCXXVIII.—March 30, 1874. We were called to treat a case of goltre,
where the measurement around the neck was sixteen and a half inches, The patient
was a young man twenty-one years of age, and the growth had existed three years. The
tumor was moderately but not excessively hard. We commenced treatment with
electrolysis, the needle being passed into the centre of the tumor, In one week half
an inch was gained ; in five weeks one and a half inches, which, in effect, amounted
to acure. We used only mild currents, combined with external faradization, with
very strong currents, violently interrupted, as suggested by Meyer. The result, there-
fore, was due to the combined effect of different kinds of electrization.

The great majority of cases of this kind will become reduced ten, fifteen, or twenty
per cent., and will become stationary. Even in this case the reduction of the last
quarter irich consumed as much time as all the rest of the cure,

In the above case—which may be regarded as a type of the more
successful, results of electrical treatment in goitre—the galvano-punc-
ture certainly accomplished more than the external faradization with
strong interrupted currents. The latter method did something, and is
CYSTIC TUMORS. 731

worthy of trial in the treatment of goitre in connection with galvano-
puncture.

Simple or adenoid goitre in a child aged fourteen—Relief of choking sensations—
Steady decrease in size under external galvanization and electrolysis,

CaszE CCXX1X.—L, W., a girl aged fourteen years, first observed four years since a

slight enlargement of the thyroid gland. It rapidly increased in size until December 5, 1871.
When she presented herself for examination it was one and a half inches in depth, and
two inches in width, reaching to the anterior border of either sterno-cleido-mastoideus
muscle. The mass was quite movable and did not in any way cause. inconvenience,
excepting when she attempted to sing. Iodine, both internally and externally, had
been used without appreciable benefit. For the first two months localized external
galvanization repeated twice a week, was alone tried, resulting in no diminution in
the size of the swelling, but in a very decided alleviation of the distressing sensation of
strangling, which invariably occurred whenever she attempted to sing.
. Subsequently the needles were introduced, and to this date the tumor has steadily
decreased in size, until, June 1, it was one-quarter its original size, and the indications
were that it would entirely disappear. The needle (a small glover’s needle) was in-
troduced some twenty times, but as the pain produced was very slight no chloroform
was used.

Dissipation of a goitre of fifteen months’ standing under external localized gal-
vanization.,

Cas—E CCXXX.—Miss H., a young lady aged 24, was directed to us by Dr. J.
Marion Sims, Nov. 26, 1872.

Fifteen months before she observed in the neck a slight enlargement, which grew
with considerable rapidity. On examination, we found a goitre, that spread widely
all over the anterior portion of the neck, extending, indeed, beyond the outer margin
of either sterno-cleido-mastoid muscle. The measurement around the most promi-
nent portion was 14% inches.

We first attempted simple external localized galvanization, with the effect of
reducing the measurement in 13 séances to 13 inches. The deformity was now barely
perceptible, and decreased with characteristic slowness, but finally completely disap-
peared after some 15 additional applications, At the close of the treatment, the
neck measured just 12§ inches,

Cystic Tumors.—Benign cystic tumors may be successfully treated by
the ordinary method of electrolysis. We have treated a number of
cases, small and large, and with excellent results. The object of the
electrolytic procedure in benign cystics is, of course, very different
from the object of the same procedure in nevi. The therapeutical
aetion of the current on cystics is somewhat complex.

1st. The fluid is decomposed. The gaseous products of this decom-
position sometimes escape through holes made by the needles.

2d. The walls of the cyst are stimulated, so that the fluid is absorbed,
and thus the tumor is caused to shrink. ‘This is, in fact, the rationale
of electrolysis in hydrocele.
732 BENIGN AND MALIGNANT TUMORS.

3d. Decomposition of the walls of the cysts. This takes place, of
course, only when uninsulated needles are used. When the needles
are insulated near to the end, the walls of the cyst are not acted on.

4th. Evacuation of the fluid contents of the cyst without decompo-
sition. his result may follow puncture of any kind, even when no
electricity is used. It is more likely to follow electrolysis with the
negative needle, for the reason that the needle, when not insulated,
acts on the walls of the cyst, and enlarges the opening made by the
needle.

In operating on cystic tumors by electrolysis, the best procedure is
to insert a needle connected with both poles. The positive needle may
be kept fixed, while the negative is worked in various directions, so as
to act upon all the inner surface of the cyst, and also to enlarge some-
what the hole made by the needle in the walls of the tumor, so as to
allow free exit of the fluid or gases. ;

Large, long, cutting needles are usually preferable when the tumor is
large ; but for small tumors almost any kind of needle will answer.

 

Fic, rg2.

Benign Cystic or Erectile Tumor, treated by ordinary electrolysis’ by insulated
needles,

Cystic tumor of forehead of forty years’ standing ; immediate and permanent cure
by electrolysis. ,

CasE CCXXXI.—Mrs, H., aged 60, we first saw in consultation with Dr, A. W.
Catlin, of Brooklyn, Nov. 9, 1871.

For forty years she had been afflicted with a tumor on the forehead, which, in ap-
pearance and size, and in its feel and compressibility at the time we saw it, exactly
resembled a ripe Isabella grape, This appearance had not, however, been constant ;
its size varied, and at one time, after stooping, it had considetably enlarged, and a vein
connected with it and leading towards the upper part of the nose became swollen and
prominent.

Whether the enlargement was erectile or cystic was a matter of doubt. Dr. A. B,
CYSTIC TUMORS. 733

Crosby, who saw the case with us, regarded it as cystic. The patient haa refused
to submit to any operation for the radical cure of the tumor—partly on account of.
fear of hemorrhage, and consequently had worn the unpleasant deformity the
greater portion of her life. Nov. 11, 1871, with the assistance of Drs. Catlin,
Crosby, Cooper, and Wyckoff, local anzesthesia was used, and two small insulated
needles were inserted into the tumor near the base, one pole connected with the posi-
tive and the other with the negative pole of ten cells of a portable Galvano-Faradic Co.
zinc-carbon battery (Fig. 61). Immediately the color of the tumor began to lighten,
through the change of its fluid contents into oxygen and hydrogen gases, and in five
minutes the whole surface was almost colorless, and the tumor was much distended.
The needles were now withdrawn ; there was no hemorrhage, but the gases began to
escape at the places where the needles were inserted. Dr. Crosby now used a little
pressure, and the tumor flattened with more escape of gas, Under repeated pressure
still more gas escaped; and in ten minutes from the beginning of the operation the
tumor was perfectly flattened. Gradually the residuum of the tumor disappeared,
and in a few weeks scarcely a trace of the lung-standing deformity existed.

Cystic tumor of the breast, possibly malignant, treated by external galvanization
and electrolysis—Great reduction in size, and apparent cure.

CasE CCXXXII.—Mrs. P., a lady of middle life, consulted us, December 3d, 1873.
The patient had a tumor in the left breast, of the size of a small orange. About two
months had passed since it was first observed.

Both her family physician, Dr, Wikoff, and another surgeon of eminence hegeaded
the tumor as scirrhous, and advised its removal.

The patient, we may remark, traced the origin of the growth very directly to a
severe bruise of the breast from striking against a bed-post. When we first saw the
case, the tumor could be easily felt and grasped between the fingers, and seemed
quite hard. The nipple was but slightly affected, and there was no involvement of
the glands in the axilla.

There had been little or no pain, the tumor had not extended to the skin, and
there was no discoloration ; except by examination the presence of the growth would
hardly have been suspected. The growth was quite movable.

The patient was of a very nervous temperament, and had suffered much from neu-
ralgia. In spite of the lack of very severe symptoms, we concurred in the opinion
of her previous advisers, that the tumor was scirrhous, The patient so dreaded the
thought of the knife that she wanted to give electrical treatment a good trial.

We began with local external galvanization with moderate currents. After one
week’s treatment the tumor seemed looser, softer in portions, and a trifle smaller.
Subsequent treatment added nothing to this apparent improvement. We therefore
resolved to use galvano-puncture.

December 31st, we inserted two needles into the part of the tumor that was most
superficial; one needle was connected with the positive and the other with the nega-
tive pole,

Ether spray was used before the needles were introduced. The needles had not
been in position more than five minutes when a fluid as colorless as water began to
flow out of the places where they were inserted, and on pressure the quantity that
came away was much increased, and more or less flowed out during the whole opera-
tion, which lasted fifteen minutes,
734 BENIGN AND MALIGNANT TUMORS.

‘When the needles were withdrawn, and pressure was used, still more fluid exuded,
and the tumor had become reduced two-thirds in size. The tumor was evidently
cystic.

January 2d and January 8th, we again operated with Dr. Beard’s'‘long cutting-needle,
without assistance and without anzesthesia, so as to reduce the tumor to a minimum,
and if possible cause absorption or atrophy. ,

At the second operation a less quantity of fluid exuded, and still less at the third
operation, The patient left for home. We occasionally hear from her, and, up to
the date of writing, the tumor has not resumed its original size, and does not in any
way trouble her.

In the above case one of three results are possible :

ist. The tumor may remain comparatively small, causing no annoy-
ance to the patient. This result we have seen in other cystic tumors
(though not: in the breast), from the same method of treatment that
was adopted in the present case.

2d. The tumor may again fill up with fluid, and may require a repe-
tition of the same treatment.

3d. It may take on the scirrhous form. It is, of course, possible that
the walls of the growth may already be of a scirrhous character. Even
if it should prove to be a scirrhous growth, it would not follow that re-
moval would be at once indicated.

If in the above case there should ever be a rapid and ugly recurrence
of the tumor, with threatening indications of any kind, the method of
electrolyzing the base would be indicated, the knife or the galvano-
cautery being used to remove the body of the growth.

Cystic tumor of the submaxillary region, probably malignant ; three operations—
Electrolysis of the base—Rapid healing with slight disfigurement—Permanently
successful result,

CasE CCXXXIII.—Miss ——, a young lady in her teens, was sent to us March 25th,
1872, by Dr. Wm, W. Reese. The patient was ofa fragile constitution, and had be-
come debilitated by confinement in the stifling air of a manufactory where she was
employed, For one year she had been troubled with a tumor on the submaxillary
region of the left side, that was at first supposed to be simply an enlarged gland. It
did not, however, yield to the usual treatment that various physicians and surgeons
had given her, and at the time we saw it, it was about the size of an English walnut,
and was apparently encysted. Lancinating pains of a tolerably severe character
were sometimes felt in and near the growth.

Careful examination made it pretty clear that the enlargement was cystic ; that a soft
substance was inside of it, although the walls were quite hard. March 27th, with
the assistance of Drs, Reese and Hyde, we electrolyzed a portion of the growth, and
found that it was really cystic and contained a dark, cheesy substance. The patient
was fully etherized during the operation, which lasted forty minutes, Large and long
needles were employed, and sixteen zinc-carbon cells,
CASE OF MALIGNANT .CYSTIC TUMOR. 735

The operation was followed for two days by irritative fever, but by no other un-
pleasant result, There was considerable sloughing, but the bulk of the growth re-
mained as a large unsightly mass. April 14th, we again operated by working up the
base of the tumor, undermining it and separating it from the surrounding healthy
tissue. Dr. A. B. Crosby assisted at the operation, and enucleated a portion of the
mass before the needles were inserted. The irritative fever was slighter than after,
the previous operation. An ulcer 14 inches in length and a half an inch in depth re-
mained—the surface presenting, as usual after electrolytic operations, a charred ap-
pearance which at first ‘alarmed the patient. The subsequent healing was, in the
judgment of all the surgeons, surprisingly rapid and satisfactory. Dr, Crosby, in proper
time, brought the edges together, and thus expedited the reparative process, so that
at the end of a month only a trifling scar remained. At one of these operations the
parenchymatous hemorrhage was excellently controlled by the action of the current,
and no other styptic was required. The patient had now positively improved in her
general health, and was free from any sign of the disease. It was hoped by all par-
ties that she would hear no more from the tumor. It had been suspected at the close
of the operation that a small portion of the growth remained, but it was not deemed
advisable to protract the operation.

Very soon pains of quite a severe character began to be felt just beneath the skin
in the region of the sublingual gland; then followed swelling, and in a few weeks a
tumor as large as a horse-chestnut, of the same appearance and feel as the previous -
growth. We decided to operate again, this time with absolute thoroughness ; the
same surgeons being present. Dr, Crosby made an incision and enucleated the growth,
the operation being completed by electrolyzation with large needles as before.

The work was thorougniy done; the base was thoroughly electrolyzed (Fig. 193).
During the operation, a branch of the facial artery was severed by the needle ; this was
tied by Dr. Crosby. The wound was treated as before and with the same result—rapid
and satisfactory healing, that has been permanent. The scar disfigures but slightly,
while the patient has improved in her general health, and at the date of writing, three
years after the last operation, weighs much more than at the time of the operation,

 

Fic. 193.

Electrolysis of the base of the malignant cystic tumor of the neck, after removal
of the tumor by enucleation. Long negative needle manipulated by the operator;
connection made by a similar positive needle also in the base,
736 BENIGN AND MALIGNANT TUMORS.

The above was one of the earlier cases in which the method of elec
trolysis of the base was employed.

Unfortunately the tumor was not examined by the microscope. The
evidences of malignancy of the tumor were its recurrence, after enu-
cleation and ordinary electrolysis, the facts that it seriously affected the
‘general health of the patient, and that her health greatly improved when
the tumor was finally removed.

Hydatids of the Liver.—Durham and Forster* have treated eight
hydatid tumors of the liver with success by electrolysis at Guy’s Hospi-
tal and the Royal Infirmary for Children, Waterloo Road.

**In one patient, who was under the care of Dr. Hilton Fagge, and who was
operated upon by Mr. Durham in June, 1868, the dulness in the hepatic region
measured seven inches vertically, the ribs on that side were bulged, and the intercostal
spaces prominent, Two needles were introduced into the most prominent part of the
swelling, one piercing the space between the eighth and the ninth costal cartilages,
and the other about two inches behind it, between the ninth and ‘tenth ribs. The
needles passed in to a depth of two or three inches. One of them was evidently free
in the fluid, for it could be moved about and rubbed against the other. “The posterior
needle doubtless passed through the diaphragm, as it was jerked about by the respiratory
movements. Both needles were connected with the negative pole of ten cells of the
battery, freshly charged. The positive pole, connected with a moistened conductor,
was placed between and near the needles. The current was allowed to pass for twenty-
five minutes, and during this time there was a crackling feeling under the finger as
of emphysema, owing to the development of hydrogen from the liquid of the cyst.
After the operation there was some pain for four or five hours. 1n the evening the
temperature was 100.9°, and the patient did not sleep well that night. Next day the
temperature was 99.6°, and on the morning after it had risen to 101.2°. At this time
the hypochondriacal tumor had greatly disappeared, and the man expressed himself as
feeling quite well. On examining the right side of the chest, however, Dr. Fagge
was a little startled at finding absolute dulness behind, up to the fourth or fifth dorsal
vertebra; and over this extent of thorax there was less vocal vibration, marked tubu-
lar respiration, and zgophonic character of the voice, which afforded conclusive evi-
dence of a large effusion of fluid. There was very slight pain about the points where
the punctures had been made, but no pleuritic pain. The man lay on his back, and
was quite comfortable. The liquid had evidently been squeezed through the puncture
in the diaphragm into the pleural cavity, The man went on perfectly well, and the
chest symptoms disappeared entirely. Twenty days after, all traces of the abdominal
tumor had disappeared,”

Fibroids.—Fibroids are usually hard, and therefore slow to decompose
under electricity. This is true of all fibroids, wherever situated,—in the
neck or any portion of the periphery, or in the uterus. Inasmuch as they
are not usually malignant, the method of electrolyzing the base, here-
after to be described, is not needed. They are to be treated by ordinary

* Althaus, op. cit., p, 645. See also Med, Times and Gaz., Nov. rgth, 1870.
FIBROIDS. 737

electrolysis, needles connected ‘with both poles being inserted in the
tumor. The needles may be insulated or non-insulated, according to
the situation of the tumor.

The behavior of fibroids after electrolysis is not generally satisfactory ;
the amount of decomposition, on account of the density and compara-
tive dryness of the tissue, is but slight; and the subsequent shrinkage
‘and atrophy is not so marked as in goitres or cystic growths.

If a current of sufficient strength be used, the patient being anzesthe-
tized, suppuration may be excited, and, as a result of the destruction and
loss of tissue, the tumor may become somewhat smaller.

Recurrent fibroid tumor of a year's standing—Repeated Electrolyzations without
_ etherization and attended with trifling pain—Arrest of Growth—Gradual de-
crease in the size of the tumor.

Case CCXXXiV.—Mrs, P., a lady of middle age, was directed to us by Dr. F,
Winston in February, 1871.

On examination, we found under the right ear a large tumor, soft and movable,
and equal in size to the closed fist. The enlargement was of the recurring fibroid
character, entirely painless, but most unsightly in appearance. The patient first ob-
served the growth some ten years since, when its size was barely appreciable. It
gradually enlarged until it attained the size of an ordinary hen’s egg, and was removed
by the late Dr. Cheeseman.

A few months subsequently it made its appearance a second time, and steadily en-
larged, until at the expiration of three years its size was somewhat greater than when
the first operation was performed.

‘It was again removed by Dr. Willard Parker, but in course of time returned. The
patient was now unwilling to have the operation by the knife repeated, and for seven
years the tumor slowly increased to the size above stated,

To ‘avoid any possibility of exciting an action in the tumor that might render it
‘truly malignant in character, we at first made use only of external galvanization.

. After a dozen applications no change could be perceived in its outward conforma-
tion; but that the treatment had not been without some effect was manifested from
the fact that the head could now be turned in any direction without causing the dis-
agreeable and sometimes painful sensations that had formerly followed pressure of the
deep portion of the growth on the underlying tissues.

We now decided to try the ordinary method of electrolysis, and accordingly intro-
duced, an inch into the tumor, a needle insulated to within half an inch of its point.
The application, alternating with external galvanization, was repeated some twelve
times during the course of two months, and resulted in a very decided alteration in the
shape, as well as a marked diminution in the size of thegrowth. After each operation
a large quantity of free hydrogen gas escaped through the opening made by the needle,
followed by a slight flow.of blood,

At this time two needles were used--the second one of platinum, and connected
with the positive pole. It should be stated that previously only twelve zinc-carbon
cells had been used, and the current allowed to pass but ten minutes. We now in-
creased the cells to twenty, and permitted the needles to remain some fifteen minutes ;

47
738 BENIGN AND.MALIGNANT TUMORS.

but when they were withdrawn, neither gas nor blood escaped, and yet it was abso-
lutely certain that the current had been passing every moment, and with power
greater than in previcus operations,

In a few hours the tumor and tissues surrounding it became greatly swollen, accom-
panied by very considerable pain.’

The pain and swelling were relieved by a poppy poultice, but a slight discharge con-
tinued through the months of July and August, during which time treatment was in-
termitted. In September, when the patient returned to the city, the discharge, which
had ceased two weeks previously, had evidently resulted in a still further reduction of
the tumor.

The treatment was resumed, and continued at intervals during the ensuing winter
and spring. The effect was a slow but constant decrease, until it was reduced to
about one-third its original size.

At one time during an interval in the treatment the patient observed, in a portion
of the tumor to which the needles had not been applied, a projection which rapidly
enlarged until it was one-third of an inch in diameter, and extended downward into the
healthy tissue for more than an inch. A single needle was introduced into this un-
welcome addition, and a mild current allowed to pass for ten minutes. The process
of absorption was excited, and in two'weeks this protuberance completely disappeared.

It is interesting to note in this description, that while the growth was slowly but’
steadily enlarging before the use of needles, it did not, after the treatment by electro-
lysis was begun, show the slightest disposition to increase in those parts actually in-
fluenced by the current—although at one time several months elapsed between the
operations, Subsequently what remained of the tumor was again removed by Dr.
-Parker.

While the above case cannot be cited as a brilliant result of electro-
lytic treatment, it is of exceeding interest, and has afforded many useful
hints that have been of value in other cases. The pain of introducing
the needles was trivial ; and the electrolytic action, even when it was
very intense, produced little or no sensation ; consequently it was at no
time necessary to use chloroform, and the treatment was as readily
borne as if the applications were merely external.

Fibroids of the uterus are of sufficient importance to be specially
considered. They may be treated electrolytically, either through the
vagina or through the abdominal walls, according to the position.

The danger of creating peritonitis by thrusting needles through the
abdominal walls is but slight ; and if the needles are well insulated by
rubber, there is really no danger. The insulated part should, of course, «
go beyond the peritoneum.

Dr. Kimball, of Lowell, reports excellent results from treating
fibroids in this way. Our own observations in this direction have not
been of the most encouraging nature. We have never seen a large and
hard uterine fibroid tumor disappear under electrolysis. Relief of pain,
of neuralgia and anzesthesia, and of many of the attending symptoms, we
ADENITIS—OVARIAN TUMORS. 739

have many times obtained, but never a complete or approximate dis-
persion of the tumor.

Lipomata (Fatty Tumors).—Ordinary surgical treatment with the
knife is so successful for fatty tumors, that electrolysis would hardly be
indicated, even if it could accomplish as much and as easily as the
knife. Fatty tumors are, of course, benign ; and when operated on do
not recur. Fat decomposes slowly and with difficulty, and from our
first experiments on a number of fatty growths, we were led to’ be-
lieve that secondary absorptive effects would not, as a rule, follow elec-
trolysis. Dr. Rockwell's later experience, however, in this direction,
has been more satisfactory. By using an increased number of needles,
more powerful currents, and by prolonging the operations, several of
these tumors have been completely dissipated. In every case the
operations were rendered entirely painless by the use of the ether spray.

Adenitis —Enlarged glands of the neck or groin may be treated by
external faradization with strong currents, interrupted so as to break
up the glands, as recommended by Meyer, or by external galvaniza-
tion, or by electrolysis.

The prognosis is very capricious. In some cases the enlargements
diminish quite rapidly, and entirely disappear ; in other cases they are
as obstinate as scirrhus of the breast. In one case referred to us by
Dr. C. L. Mitchell, an enlarged parotid gland was treated at first by
external faradization and galvanization with the effect of hastening
suppuration. After the tumor was opened the inner portions were
treated through the opening by mild electrolysis, and the tumor speedily
disappeared.

Ovarian Tumors.—Ovarian tumors in their early stages have been
treated by electrolysis and by external galvanization, and it is claimed
with the effect of dispersing them. The difficulty of diagnosing ovarian
tumors diminishes not a little the value of this claim. Electrolysis is,
however, worthy of a better trial than it has yet had in the treatment
of ovarian tumors. Galvano-puncture with insulated needles might
accomplish here what it has already accomplished in cystic growths in
other localities. This treatment might reduce the size of ovarian
cysts, and arrest their growth, even when it could do no more. This
method demands a careful trial in cases where the ordinary operation is
dreaded or impossible.

Dr. Hayes reports a case of multilocular sero-cystic ovarian tumor
successfully treated by galvano-puncture.*

* Chicago Medical Journal, Sept., 1874.
740 BENIGN AND MALIGNANT TUMORS.

Polypi.—Naso-pharyngeal polypi have been treated by a series of
electrolytic operations with success. Von Bruns records a notable case
of thiskind. As a rule, however, it would be difficult to entirely cure a
naso-pharyngeal polypus by electrolysis, and the treatment. would be
very annoying. Polypi in accessible localities are best treated by the
galvano-cautery wire-loop. :

Epithelioma, Scirrhus, and other Malignant Growths.—Malignant
growths may be defined clinically as those growths which are liable to
recur after removal.

Under this head may be classed epithelioma, recurring cysts and
fibroids, encephaloids, scirrhus, and so forth. If tumors of this kind
are to be treated at all by electricity in the hope of permanent relief,
it should be by the method of electrolysis of the base as already describ
ed, provided, of course, the tumors are sufficiently accessible.

Pain may, however, be relieved, and in some cases a reduction in
size may be gained by the ordinary method of electrolysis, or by simple
external galvanization or faradization ; and by these methods also the
tumor may be arrested in its progress perhaps for a long time.

Of the different forms of malignant growths, the best prognosis for a
permanent cure, or for a long deliverance, is in recurring cysts and
fibroids ; next would come epithelioma, of which we have successfully
treated a number of cases, and last of all scirrhus.

Cancers of the neck of the uterus have been removed by galvano-
cautery, but not, so far as we know, by electrolysis of the base.

 

il
Fic. 194.
Removal of epithelioma of face by electrolysis of base. Both negative and positive
needles inserted in the healthy tissue dercarh the tumor.

LEpitheliona of the face, originating in an old scar, six months’ standing, removed
by a combination of electrolysis of the base and the galvano-cautery,

Case CCXXXV.—Captain D. was brought to us, April 27, 1873, by Dr. Fes-

senden, The patient had a tumor that appeared to be an epithelioma, about the size

of a small walnut, over the zygoma. It had developed from an old scar that had
EPITHELIOMA, 741

existed from childhood, When he was first brought to us the tumor had been in
existence six months, It had been treated by caustics, but rapidly recurred. We
decided to treat the tumor by electrolysis of the base, combining with it the galvano-
cautery, if necessary or convenient, in order to shorten the operation.

“ April 30th, We operated, assisted by Dr. Fessenden, who gave the anesthetic for
ten minutes, with eighteen zinc-carbon cells, We used the long cutting needle, pass-
ing one connected with the positive pole zzder the tumor near the edge, and another
long cutting needle connected with the negative pole, also under the tumor, and
parallel to the positive needle. The electrolytic action was moderately strong, and
the growth was rapidly loosened. The positive needle became fixed in the tissue
where it was imbedded, through the oxidization, as is always the case with the posi~
tive needle, while around the negative ‘needle a yellowish foam appeared, caused by
the mingling of the hydrogen evolved with the blood. The needle was very loose in
the tissue, and we worked it slowly to the right hand and left until the tumor was un-
dermined by the electrolytic action, and nothing remained but a portion of the skin,
We completed the operation by a short wire connected with Byrne’s galvano-cautery
battery. After the tumor was removed, we worked up the base, partly with the
needles and partly by the heated galvano-cautery wire.

Both needles, positive and negative, were plunged into the base and edge of the
tumor, into healthy tissue, until all was bloodless, charred, and dry, Scarcely any
blood flowed during the operation.

The patient was soon able to leave the operating-room. Cold-water dressing only
was used, Some sloughing followed, and satisfactory granulation. In six weeks the
sore had completely healed, with a moderate cicatrix, and at the date of writing,
Sept. 1st, 1874, seventeen months from the time of operation, there are no signs of
recurrence. The growth was examined microscopically by Dr, Ormiston, and by
him pronounced malignant. :

Large and painful epithelioma of the upper lip of several months’ standing—-Re-
moval by ordinary electrolysis and the method of working up the base—Satis-
factory healing.

CasE CCXXXVI.—Miss ——-, aged 20, was brought to us by Dr. Corey, Oct. 23,

1871, to be treated for an epithelioma of the upper lip that had distressed her for
several months, At this time the growth extended from the median line to the left

' corner of the lip, being about one inch in diameter and one-half an inch in length,

The pain of the growth was at times very great, especially when exposed to the cold ;
the disfigurement was annoying, and there was an evident tendency to quite rapid
increase. At the base, on the inner surface of the lip and especially at the corner,
hard nodules were easily detected by the finger. With the assistance of Dr, Corey,
and in the presence of a number of physicians, we electrolyzed the upper portion of
the growth with five small needles, three connected with the negative and two with
the positive pole. Full anaesthesia was used, and the operation lasted twenty
minutes. The needles were inserted directly into the body of the tumor and not
around the base. The method of working up the base, we had not at that time
begun to employ. The soft parts of the tumor in the vicinity of the negative pole
decomposed with rapidity, A yellowish foam was developed, which, forcing its way
underneath the scab that covered the tumor, gradually lifted it up and completely ©
detached it from the body of the growth.
742 BENIGN AND MALIGNANT TUMORS.

The parts presented the usual charred appearance after the operation, but there
was little or no pain, either in: the tumor or in the vicinity. There was, however,
considerable irritative fever, and the face was somewhat swollen, In the course of a
week, the portion of the diseased part that had been electrolyzed began to contract,
and near the median line healthy tissue appeared. The lower part, that was little
affected by the needles, remained as before. Nov. 9, we again operated by the
method of electrolysis of the base with four negative and one positive needle with the
same number of cells (sixteen zinc-carbon) and for about the same time. Dr. Corey
administered the anzesthetic, and Drs, Armor, Caldwell, and others were present. This
operation was more thoroughly performed than the previous one, but the needles
were not inserted into the nodules or the inner surface, but only into the superficial
parts of the growth. No bad, result followed, and by Nov. 27th the tumor had
contracted to one-third of its original size and was healing rapidly. The healing
process continued until scarcely any trace of the disease remained. The healing was
almost perfect ; there was an entirely natural skin in the region where the tumor had
formerly existed, and the only cicatrix was at the corner of the mouth, Twitches of
pain have been felt in the vicinity of the scar, especially on exposure to cold, giving
rise to the suspicion that possibly that portion of the growth was not thoroughly
treated.

It is now three years since the patient was treated, and the recovery
may be regarded as most satisfactory. In reference to this case it may
be remarked :—

1. If the diseased mass had been thoroughly separated from the
surrounding healthy tissues by inserting large needles, one operation
would. have been sufficient, and the cure would probably have been
absolute. This was the first case of the kind that we had treated, and
we had not then employed the method of working up the base, and had
not devised the long, sharp, double-edged needle which we now employ
in the electrolyzation of large growths.

2. There was scarcely any hemorrhage or other unpleasant symp-
toms during or after the operation, excepting the irritative fever of which
we have spoken.

Epithelial cancer in a lady aged thirty, involving the rectum, vagina, and exter-
nal parts—Eleven operations by ordinary electrolysis and electrolysis of the base re-
move the growths, alleviate pain, and modify very greatly the rapidity with which
the disease subsequently reappears—Subsequent treatment by galvano-cautery by Dr.
Byrne, with relief—Death of the patient,

Case CCXXXVII.—The wife of a physician, aged about 30, had for eight years
of her married life suffered from what was supposed to be scirrhus of the rectum,
which had been removed by ligatures at different times and by different surgeons.

About three years before we saw her, an epithelial cancer appeared at the entrance
of the vagina ; this gradually increased in size and protruded, until October, 1871, it
appeared to be about one-half as large as a cauliflower, and much resembled one in
REMARKABLE CASE OF EPITHELIOMA. 743

appearance. The discharge was very profuse and very offensive ; the.pain terrible and
almost constant. The growth was evidently increasing, and only with difficulty could
the patient walk about the house,

A more distressing case of disease of any kind we had never seen. After each re-
moval of the mass by the ligature, it would spring up almost before the sight and be-
come larger than before. There was about it a rankness, a fierceness, a malignity,
quite unusual, Like rampant weeds in rich soil, the more it was cut off, the faster it
grew, Escharotics of all kinds, as well as cundurango, had been tried, the latter
remedy seeming to do injury.

 

Fic. 195.

   

   

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Fic. 196.

Appearance of granulating base after removal of a portion of the epithelioma of vagina
and vulva by electrolysis.

The galvano-cautery had been suggested by Dr. E. R. Peaslee, whom the patient
consulted, and Dr. Byrne had intended to give it a trial, but deferred the operation
in order to experiment with cundurango. We began treatment with external galva-
nization in order to relieve the pain. The first treatment accomplished nothing ; the
third treatment, we connected an insulated rectal electrode with one pole, while the
744 BENIGN AND MALIGNANT TUMORS,

positive, by means of a wet cloth, was gently passed over the very sensitive surface of
the tumor. The patient was relieved of pain for a whole night. Satisfied with the
result, we now resolved to use the needles,

With the assistance of Dr. Rotton and the husband of the patient, we operated
eleven times, with intervals of two or three weeks between the séaxces. Full etheri-
zation had been obtained in each operation,

We used two, three, or four needles, according to circumstances, and both poles
were inserted into the base of the growth.

The first operation, Oct. 20, which lasted twenty-five minutes, removed anethird
of the growth ; and by the end of the third operation, all the growth external to the
orifice of the vagina was removed.

Far up in the vagina the diseased portion could readily be detected, spreading out
in all directions like a watermelon vine,

Nov. 15th, there was some evidences of a reappearance of the external growth in
those parts that were not thoroughly electrized. Nov. 22d, operated again by elec-
trolysis for half an hour.

Dec, 5th, operated again by electrolysis i in connection with Dr. Byrne, who by the
aid of his speculum applied the galvano-cautery to the portions of the growth in the
vagina, Jan. 17th, again operated by the same method for thirty minutes, The ex-
ternal ulcer caused by the removal of the tumor had hitherto been about four inches
long, three inches wide, and one inch in depth, extending from the middle of the
labia beyond the anus on the right side.

This ulcer now began to heal at the edges and to contract. Jan. 6th, began the
use of nitrate of silver, applied to the ulcer. Jan. 8th, the discharge which had come
from the vagina was much diminished and the ulcer had contracted to half the origi-
nal size. Jan, 21st, operated by electrolysis in the vagina chiefly. ©

March 24th, repeated the operation with long needles, in the vagina, on some rag-
ged portions of the growth, We were now able to ascertain by digital examination
that there was a pretty direct connection between the growth in the rectum and the
one in the vagina ; they seemed, indeed, to be extensions from a common centre.

The septum at the base of the tumor in the vagina was so thin that we much feared
a recto-vaginal fistula, and great care was necessary in operating, to preserve this deli-
cate and partially disorganized tissne that separated the two canals. April 21, again
operated by electrolysis, :

Subsequently the actual cautery was once used, inthe hope that perhaps it might
cause a more thorough drying up of the profusely discharging surface in the vagina ;
but the results of its use were unsatisfactory. The febrile condition that followed was
alarming, and the local pain was terrific for several days after the operation, During
the summer, local applications of various kinds have been experimented with ;
among others, a mixture of iodine, iodide of potassium, and glycerine, which was
employed at the suggestion of Dr. Byrne, and with good effect,

During the year the patient had taken cod-liver oil, and except by intervals has had
a good appetite. Twice a severe and protracted attack of sciatica has been brought
on, apparently by exposure to cold.

At one time the patient was confined to her bed, and was somewhat hysterical.
During the summer the external part of the growth gradually reappeared, but there
was no difficulty in urination or defecation ; and hence we conclude that the portion
in the rectum has not greatly enlarged, and at the last examination the condition of
REMARKABLE CASE OF EPITHELIOMA. 745

the vagina was not seriously altered. We have all along feared that the disease would
extend to the uterus, but examinations made at different times gave no evidence of
involvement of that organ,

The operations were performed with a zinc-carbon battery of eighteen cells,
freshly charged,

The constringing power of the current was observed at both poles, but most de-
cidedly at the positive. After each operation the surface presented a dark and some-
what charred appearance, as though it had been slightly burned. No large artery was
severed during the operations, hence it was not necessary to use either the ligature
or persulphate of iron. During the winter of 1873 Dr. Byrne twice operated on the
external portion of the growth with the galvano-cautery. The result was a most
satisfactory healing of the external ulcer. This healing was much more permanent
than the healings that followed electrolysis.

We have given the above case in considerable detail, because of its
great interest to surgeons, and especially because it illustrates most
vividly at once the value and the limitations of electrolysis in malignant
tumors. It illustrates:

1. The power of electrolysis to control hemorrhage. The growth
was so vascular that it bled quite profusely on the slightest touch, and
yet, under the various and protracted electrolytic treatments to which it
was subjected, the amount of blood lost was but a trifle.

2. The fact that the electrolytic treatment does not cause shock, to
the extent that-similar destruction of tissue by other methods would be
likely todo. Twice, when chloroform was employed as an anesthetic,
the pulse acted badly and compelled us to suspend the operation sooner
than we desired; but under etherization the needles were used for half
an hour and longer without causing any shock. The stimulus of the
current, with the occasional interruptions that are required, seemed, by
reflex influence on the central nervous system, to act as an’antidote to
shock, as it has appeared to do in other cases,

3. Better healing, and later reappearance of the growth than after the
operation by ligature and caustics. When removed by ligature this
growth sprang up with great rapidity—in the course of a few days;
even before the eyes, as it were, it seemed to enlarge, and to develop
an offensive discharge ; and the base never began to heal, even on the
edges. After thorough electrolysis of the base, this growth not only
did not show signs of recurrence for several weeks, but an external
ulcer of large size entirely healed. With the internal ulcer on the
feebly organized mucous tissues of the vagina we were not so successful.

4. The severe itritative fever that sometimes follows electrolysis.
After all the operations, the patient was confined to her bed for several
days, and was more or less distressed by inflammation and swelling, not
746 BENIGN AND MALIGNANT TUMORS.

only on the edges of the ulcer, but at some distance down the nates and
through the labia. The swelling of the labia was so great that difficulty
and pain were experienced in passing water. It should be noted, how-
ever, that after the operations with the galvano-cautery and the actual
cautery, the irritative fever and surrounding inflammation were much
more decided and distressing, and for that reason we returned to elec-
trolysis.

5. The utter inability of even the most thorough and repeated elec-
trolyzations of the base, to permanently eradicate the growth in those
parts where it was connected with the mucous membrane. Although the
base was thoroughly worked up by inserting the needles into the healthy
tissue surrounding it so as to completely cut off all communication be-
tween the natural and morbid parts, yet the disease extended from the
vagina, until quite distant parts were attacked and became saturated
with cancerous degeneration. The external portion of the growth con-
nected with the perineum and nates was apparently eradicated as
thoroughly and as successfully as the cases of epithelioma of the lip,
previously reported, and the subsequent reappearance of the growth
was due to the extension of the disease from the vagina, which part
could not be thoroughly impressed by electrolysis.

6. The comparative value of electrolysis and galvano-cautery. The
healing after electrolysis was incomparably more satisfactory than after
the ligation; but in the course of months the growth returned, appa-
rently by extension from the vagina. The irritative fever that followed.
the electrolytic operations was not observed to any marked degree after
the use of the galvano-cautery, and more time elapsed before recurrence.

Take the case all in all, its long standing and wide extent, its ex-
cessively rapid growth and still more rapid reappearance after operation
by ligature, the frequent repetition of long electrolyzations, and the
temporary benefit resulting therefrom, and the opportunity it afforded
for comparing the advantages of electrolysis and galvano-cautery, it
may probably be regarded as without a precedent in electro-surgery.

Two general varieties of cancer of breast.—In their relations to
electro-therapeutics there would appear to be two general varieties of
tumors of the breast; one variety in which all or nearly all the
mamma is involved, and which is very hard, firm, and unyielding, the
skin being tense, glossy, and indicating inflammation and induration.
The variety is more obstinate and unyielding ; the pain may be re-
lieved, but the tumors do not grow smaller under the action of the
current; they can be diminished in size or removed only by actual
destruction of the tissue.
SCIRRHUS. 747

In the other variety the tumor involves but a limited portion of the
breast ; the skin is not tense, but is soft and yielding, and of the natural
color; the growth is felt as a nodule beneath the skin, and the pain is
not usually so severe as in the other variety, and the growth is much
slower. This variety is the one that is most disposed to yield to elec-
trical treatment. Not only is the pain relieved, but the tumors grow
softer and smaller. In other cases their advance js arrested by the
treatment, so that they remain stationary for months or years.

Whether what we call, for convenience’ sake, and for clinical reasons,
only two varieties, are really but different stages of one variety ; whether
the latter may sometimes come under the head of abscess, or of the
atrophying cancer described by Billroth—these questions we resign to
the pathologists of the future.

 

Fic. 197.
Scitrhus of the breast treated by ordinary electrolysis, Three needles connected
with negative pole in body of tumor ; connection made by a sponge, the positive pole
at the indifferent point on the lupus.

Scirrhus of the left breast in a woman aged forty-five—Complete and instant relief
rom excruciating pain, and in the course of four days disappearance of one-half
the growth from one electrolytic operation—Retrocession of the disease to the
bowels, resulting in death,

Cast CCX XXVIII. —Mrs. , aged about 45, an inmate of Bellevue Hospital,
was affected with cancer of the left breast.

The main portion of the scirrhus was the size of an ordinary orange, and extend-
ing into the axilla were a number of cancerous nodules of. considerable size.

The surrounding and intervening tissue was as hard and unyielding as the tumor
itself, The process of suppuration was beginning to manifest itself, and for several
weeks the patient had suffered night and day the most excruciating pain through the
diseased parts, The first operation was performed in one of the wards of the hos-
pital, in the presence of Prof, Frank H. Hamilton (who had requested us to operate
by the electrolytic method) and his private class. The patient having been etherized,

 
748 BENIGN AND MALIGNANT TUMORS.

we introduced deeply into the upper portion of the breast three gilded needles, and
with a fourth transfixed the largest of the axillary nodules. The positive pole (a
large moist sponge) was applied to the under portion of the gland. No very decided
change was manifest in the appearance of the mass during the operation other than
some puffing up of the skin, due to the disengaged hydrogen ; but very soon after it
began to decrease in size, and in one week not only had all the hardness of the sur-
rounding tissue and all the axillary enlargements entirely disappeared, but the
mammary tumor had decreased in size at least one-half. The most grateful relief the
patient experienced, however, was the complete and seemingly permanent dissipation
of pain, In ten days we again operated, and by the same method,in the amphi-
theatre and before Dr. Hamilton and the regular class of the college. On the fol-
lowing day the patient felt so comfortable that she left the hospital, and in a week’s
time presented herself for examination, when it was found that there had been a still
further decrease in the size of the tumor, She still remained entirely free from pain,
and was delighted with the results of the treatment. Most unfortunately, we now lost
sight of the patient ; but afew months subsequently she returned to the hospital, suffer-
ing from malignant disease of the intestine, of which she died.

The following is a condensed report of a case treated by us in co-
operation with Dr. A. B. Crosby. We give it substantially as detailed
by him: *

A case of scivrhus of the rectum—Rellef of symptoms—Satisfactory healing—
Death,

Cast CCXXXIX.—Mrs, L., aged 60, a lady of a nervous, but, on the whole, of a
healthy temperament, came under our care Nov. 7th, 1871. . For three years she had
been suffering from a tumor of the rectum that was evidently of a malignant charac-
ter—such at least had been the opinion of the large number of physicians and surgeons
who had:seen the patient. Bougies were frequently inserted and various remedies had
been tested—among others cundurango, which the patient thought afforded some relief.
On examination, it was found that the growth extended about three inches up the rec-
tum, forming a hard ring and a stricture so narrow in the upper portion as hardly to
admit the end of the index-finger. The patient was tormented with flatulence, and
the distress in the region of the tumor and of the nerves that supplied it was very
great, The pain in defecation was severe, and the passages were small and very fre-
quent. She was able, however, to go about the house more or less, and occasionally
rode out.

We began treatment by localized galvanization externally by various forms of rectal
electrodes. By these applications, there was a decided and grateful relief of the pain
and of the flatulence, This relief continued so long as this method of treatment was
used,

January 7th, 1872, Dr, Crosby ruptured the sphincter with the assistance of Drs,
Reese and Ostrander, who administered ether. We operated with a zinc-carbon bat-
tery on these protuberances by the ordinary method of electrolysis. The usual small
needles were used. The operation was followed by some irritative fever, but the
patient, on the whole, bore it excellently, and the whole growth was relaxed s> that

* Archives of Electrology and Neurology, May, 1874.
SCIRRHUS OF RECTUM. 746

the passages were easier. Three weeks after the operation the patient was very
much better, and went round the house.

The operation, which lasted forty minutes, including intermissions consisted in
inserting one needle connected with the ‘positive pole into the body of the growth,
while the negative needles were run through the base and made to work around the
inside of the rectum at the base of the tumor, as far as it was deemed prudent to go.
The growth was mostly removed in this manner, and with very little hemorrhage.
The entire thirty-two cells were employed, and the patient was kept under ether for
two hours. Irritative fever. followed the operation for five days, The pulse went up
to 120. There was some flatulence and pain in the abdomen, but no positive tender-
ness, There was considerable urethral irritation and dysuria, and the urine was

. drawn by a catheter. — s

In a few days, the patient was able to discharge large and well-formed faeces, For
about a month, there was some discharge from the rectum, but no symptoms of
pyzmia, or of peritonitis or of cellulitis that might be feared from so formidable an
operation.

From May to June there was but little pain in the rectum comparatively, and the
patient was able to walk about and to go out,

May 1 sth, the patient rode out with comfort, and she strongly hoped that the
relief would be permanent ; but there were signs of a recurrence of the growth, in-
creasing stricture and induration, and the feeces gradually became smaller.

During all this time, Dr. Crosby was in the habit of introducing sponge-tents of
good size about every week or ten days. , 7

Dr. Crosby being called away July 1st, Dr. George K. Smith was called in, and
suggested the use of ox-gall injection to soften the fseces, This suggestion was acted
upon with good results. °

The patient, who was subsequently seen by Dr. Colton, gradually grew weaker
during the excessive heat of the summer, and died October 27th, 1872, apparently
from exhaustion,

Dr. .Crosby thus epitomizes the important features of this case in its
electro-surgical aspects :

“That this growth was malignant was evident from the history of the
case and all the symptoms, and was established by the microscopic ex-
amination of Dr. Spier. I am disposed to believe that if the tumor had
been in a position where it could have been more readily reached, and
where the whole growth and she adjacent parts could have been
thoroughly electrolyzed, the results would have been very much better.
As it was, it seemed unjustifiable to interfere too seriously with the gut,
lest we might destroy it and produce recto-vaginal fistula.

“The stricture extended upward, about three inches above the anus,
and ranged from three-fourths of an inch to an inch in breadth,

“Tt was only at one point anteriorly that it extended higher than three
inches. At this point, a little indurated tissue could not be removed
without endangering the recto-uterine pouch of the peritoneum.
750 BENIGN AND MALIGNANT TUMORS.

“Whatever, then, might have been hoped in case the removal had been
absolutely complete, it was certain that the disease must continue to
develop in this particular case. Anatomically, three inches of the rec-
tum—that is, that portion within the perineum—may be safely removed
by the knife even. In the.above case, the spear-pointed electrodes
brought away a large annular mass of scirrhus when the operation was
performed.

“This was followed, a few days later, by thé separation of a large
annular slough, and the rectal wall was left soft and free from disease,
except. the small, indurated spot that extended above the floor of the
pelvis and could not be safely removed. It is a fair question whether
if the operation had been done earlier, radical improvement might not
have followed.

‘A point of practical convenience was seen in the method adopted
to reach the stricture.

“I first. completely ruptured the sphincter ani, so as to induce com-
plete relaxation. A piece of two-inch lead pipe, about two inches in
length, with a handle soldered on one side, made an excellent speculum,
which was pushed up to and brought the stricture fully into view.

“ Through this, it was possible to carry the spear-shaped electrodes
through the stricture with ease and certainty, and move them freely
around the circumference of the bowel.

‘This case showed, what I have witnessed in other cases treated by
electrolysis, no primary shock.

“The irritative fever which followed was very marked for some
days, but there was no primary disturbance, either of temperature or
pulse. :

“The removal immediately by the electrodes and secondarily by
sloughing of so much tissue necessitated free granulation.

“The repair which followed was unusually rapid. In fact, in this
and in other cases treated in the same way, I have been impressed with
the fact that proliferation is very rapid after electrolysis.

‘‘In this case, the granulating surface healed rapidly and completely.
We anticipated, independently of any recurrence of the disease, decided
contraction of the cicatricial tissue.

“ Electrolysis did not save the patient’s life, but it was more efficient
than any plan of treatment I have seen adopted in these most distress-
ing cases.”
SCIRRHUS OF BREAST. 751

Extirpation of a mammary cancer by the knife, followed by complete destruction of
the underlying tissue by electrolysis—Reappearance of the growth.

Case CCXL.—Mrs. H., a married lady, aged about forty, came under our observa-
tion, through the kindness of Prof. J. L. Cabell, of the University of Virginia. The
patient was suffering from cancer (scirrhus) of the left breast of about the size of an
ordinary orange, and in addition one of the axillary glands was enlarged to the pro-
portions of an ordinary hickory-nut,

She had cbserved while in India, eighteen years before, a small lump in the breast,
but during all the years of her residence in that climate it remained stationary and
never annoyed her. About eighteen months before we saw her, she left India for Eng-

‘Jand, and soon after arriving in that colder and damper atmosphere the lump began
to enlarge. During the process of its growth she has suffered from occasional neural-
gic pains, but of no great severity. .
On June 12, 19, and 28, 1873, we operated by the ordinary method of electrolysis,
‘on each occasion introducing three needles. These efforts merely resulted in a softer
condition of the tumor, with possibly some slight diminution in size, and we deter-
mined to extirpate the growth, and to destroy the surrowiding tissue by the under-
mining electrolytic process. The patient went to her home, and in October she
returned and submitted to the radical operation, Instead, however, of taking away
the tumor by the process proposed, we secured the-services of Dr. A. B. Crosby, who,
on the eighth day, after the patient had been thoroughly etherized by Dr, N. B,
Emerson, quickly removed both the breast and the enlarged gland of the axilla.

We had at hand an appliance consisting of some twenty points, projecting from a
metal plate an inch and a half long, by an inch in width. :

This contrivance, which we call a harrow electrode, was placed on a portion of the
surface of the wound, and the operation was continued, :

The needles penetrated somewhat into the exposed tissues, and the electrolytic pro-
cess, which was at once begun, gave evidence of its usual activity. Hydrogen was
developed in abundance, and the tissues changed in color and consistency, and rapid
and complete destruction followed to a considerable depth. By this method the whole
of the freely exposed surface was worked over and destroyed, and those portions that
were more or less hidden were treated by two or three ordinary electrolytic needles,
It was necessary to observe some caution in the regulation of the strength of the
current and the position of the poles, for when the current was increased above a cer-
tain point, or, through the position of the poles, affected too directly the pneumo-
gastric nerve, the heart’s action became most markedly lowered both in frequency and
force. On modifying the influence of the current, however, the circulation became
as strong as usual—for a moment, indeed, there was an increased vigor in the reaction,
The suppuration, which was quite profuse for a time, was followed by a healthy gra-
nulating surface, and in ten days the patient was sufficiently recovered to return to
Virginia, where the healing process progressed favorably throughout.

Some six months subsequently the growth began to redppear, and will undoubtedly
destroy the patient.

The above history is of interest, simply as an illustration of the
special method of treatment employed. The case was of many years’
standing—for two years the growth had been constantly enlarging, in-
752 BENIGN AND MALIGNANT TUMORS.

volving the axillary glands—hence it cannot by any means be regarded
as atest case. Of the two methods of treating scirrhus, viz., the re-
moval of the growth by the electrolytic process alone, without the use
of the knife, or—as in the case just related—extirpation by the knife,
with the subsequent employment of electrolysis for the purpose of
destroying the reproductive power of the disease—the latter seéms, at
least to one of the authors of this work, decidedly preferable. —

By this method, although two distinct operations are performed, less
time is consumed in the operation; and it is possible more effectually,
and to a greater depth, to destroy the underlying tissue.

Relief of the pain of cancer by galvanization—So \ong as we are
able to do so little towards the radical cure of the worst forms of cancer,
it can never be amiss to dwell upon any means that will even fora,
time relieve the awful agony that so frequently attends it.

It is not sufficiently understood what a magic influence an intelligently
directed application of the constant current exercises, as a rule, over
the throbbing pains of scirrhus, especially of the female breast. The
woman at Bellevue, we referred to in Case CCXXXVIII., p. 747, had
suffered most severely for many weeks. After the first introduction of
the needles every vestige of pain left her, and during the two weeks
that she was under observation, before leaving the hospital, she was
entirely comfortable. A number of similar cases might be recorded,
but we will offer only the following, which is perhaps of more interest
than the majority:

An immense ulcerating scirrhus of the breast attended by the most excruciating and
constant agony—No relief follows the use of the: galvano-cautery or electrolysis,
but by external galvanization the pain is kept almost entirely in abeyance for
months.

CasE CCXLI.—In February, 1873, Mrs. ——, a patient of Dr. Everett Herrick,
came to us, seeking relief from an immense ulcerating cancer of the breast. The
tumor had been removed more than a year previously by Dr. W. H. Van Buren,
but the wound did not entirely heal, and, « few months subsequently, the ulcerative
process began, and steadily progressed. For many months the pain from which she
suffered had been of unusual severity,

By the advice of her physicians, above-named, she was submitted to localized gal-
vanization of the sound portions surrounding the ulcerating part, and by frequent
applications the intense pains were for nearly four months held in almost complete
abeyance. At times, however, her sufferings were most intense, and words fail to ex-
press the instantaneous and absolute relief that invariably followed the treatment.
We would occasionally find her in the morning suffering most acutely. An applica-
tion would dissipate the pains, and for twenty-four hours frequently, and sometimes
for forty-eight, she would move about and rest in perfect comfort, In the latter part
SCIRRHUS OF BREAST. 753

of May it was observed that the current did not afford the same relief as formerly.
The character of her sufferings had, however, changed. In the place of the sharp,
shooting pains simulating neuralgia, the distress consisted in a constant burning and
itching, which annoyed her more or less until her death some few months subse-
quently, It must be remarked that her later sufferings were not to be compared with
those which the current so effectually allayed,

Was the change in the character of her pains the result of the galvanization, or is
it probable that, if left to nature, the characteristic neuralgic pains would in the same
way have been replaced by the less distressing symptoms of itching and burning ?

It is impossible to say, but it seems reasonable to attribute the changed action to
the influence of treatment, It is proper to say that, during the course of treatment,
we operated in the presence of Drs. Van Buren and Herrick, by both the galvano-
cautery and electrolysis, with the vain hope of modifying in some degree the profuse
and offensive discharge and checking the rapidity of the ulcerative process. This
case was alone sufficient to teach the necessity of care in the application of electricity,
and to confirm the statement that it is not so much electricity that relieves and cures
as the method of using it. An application too prolonged, or with a current of too
great tension, would not only fail to relieve, but on the contrary decidedly aggravate
the distress, The cathode, applied to the seat of pain, did not relieve as did the
anode,

The pain was for some time overcome by simple localized galvanization, but dur-
ing the last weeks of treatment the applications were effectual only when the elec-
trodes were separated as far as possible.
CHAPTER V.
ANEURISMS AND VARICOSE VEINS.

In the treatment of aneurism the great end sought is coagulation. A
knowledge of the differential action of the poles in producing coagula-
tion is essential to an intelligent use of electricity in treating aneurism.
Coagulation takes place at both poles of the galvanic current; that
at the positive pole being small, black, and hard ; and that at the nega-
tive being larger, softer, and of a yellowish color.

Aneurisms may be treated, with greater or less success, according to
their size and position, the condition of their walls, and general health
of the patient, by either of the poles, or by both combined.

The best method forthe majority of cases, certainly for aneurisms of
any considerable size, is to use both poles, and a large number of needles
that are insulated, so that the current will not act on the walls of the
aneurism. In the treatment of aneurism, especially, careful insulation is
needed. The advantage of using both poles is twofold.

First.—A double clot is formed, one at the positive and the other at
the negative pole. Although the negative clot is soft and yielding, still,
in combination with the positive clot, itis of decided service in closing
the aneurism ; and, so far as we can ascertain, there is no evidence that
embolism is ever caused thereby.

Secondly. The resistance is greatly reduced'by placing needles con-
nected with both poles in the sac, so that the electrolytic action is
very much inore effective than when one pole is placed on the surface
of the body. The blood is the portion of the body that best conducts
electricity ; and when both poles are inside of the sac, and near to each
other, as of course they must be, a mild current will cause vigorous
electrolysis. On the other hand, if one pole be applied by a wet
sponge to some indifferent point on the surface, a strong current is
needed to produce a clot, and a long operation ; and, unless the sponge
on the surface is occasionally moved, it would cause great pain ; and if
the patient is under an anesthetic, a blister may be caused. As the
negative pole is more painful than the positive, when the positive alone

Ps
STATISTICS OF ANEURISM. 755

is in the aneurism, the negative on the surface may be very uncomfort-
able, even with a feeble current. We are aware that tolerably good re-
stilts have been secured in many cases of aneurism, and especially by
the English surgeons, by the positive pole alone ; but we suspect that
better results might have been obtained if both poles had been inserted
into the sac. At all events the use of both poles should be thoroughly
tested.

In the electrolytic treatment of aneurisms, as in so many other elec-
trical applications, it is an advantage to have a rheostate, so as gradually
to let the current on or off without shock.

Statistics of Aneurism treated by Electricity—The published statis-
tics of aneurism treated by electricity are of little or no value, and for
two reasons: 1. They represent experiments made, in a large percent-
age of the cases,"by those who are but little familiar with Electro-
Physics, or Electro-Physiology. Quite frequently the poles have been
confounded, so that it is impossible to tell whether the positive or
negative is used, and from many of the accounts, it is impossible to
tell even approximately the strength of current employed.

2. The statistics are derived, in part, at least, from cases that are re-
ported too early. The temporary relief that results from the coagulum
formed in the aneurism by the chemical action of the current has been
interpreted as indicating a perfect recovery.

Some of the cases hastily reported as cured probably died soon after,
if not before, the account of their recovery was fully in print.

For these reasons we omit all the statistics that have appeared on
this subject ; preferring the general average opinion, so far as it can be
obtained, of those surgeons and electro-therapeutists who are best qual-
ified to speak on this subject.

Our general conclusion, derived from many experiments on animals,
from actual experience, and from a comparison of the various observa-
tions that have been made on the subject, is that for those varieties of
aneurism—such as the thoracic, abdominal, and so forth—that cannot
well be treated by the old methods, and in some cases for those that are
accessible to other treatment, galvano-puncture, rightly performed, may
be of great service in relieving the accompanying symptoms, in prolong-
ing life, and may now and then achieve a radical cure.

The following case is condensed from the published account of Dr.
Keyes,* in co-operation with whom the operations were made :

* New York Medical Journal, December, 1871.

a
'56 ANEURISMS AND VARICOSE VEINS.

'neurism of abdominal avrta treated by galvano-puncture—Relief of symptoms—
Death and post-mortem.

CasE CCXLII.—A widow, 42 years of age, had been afflicted for many months with

‘swelling in her stomach,” that all the surgeons regard as aneurism of the superior
iesenteric, or of the aorta. The patient was in Charity Hospital. There was pain in the
pigastric region, which was aggravated by movement. The tumor, which was about
ie size of the fist, was situated to the left of the median line, and extended a little
elow the umbilicus, A thrill could be detected at the upper part of the tumor, but
ot at the lower.

The patient was gradually failing.

The only case of treatment of abdominal aneurism by galvano-puncture recorded at
iat time was that ofan Italian nobleman, a patient of Dr. Felice Dell’ Acquia.* In
iis case the patient died directly after the operation from rupture of the aneurismal
ic, caused by violent muscular contractions while under the influence of chloroform.
‘hree needles, connected with a voltaic pile, were used for forty minutes, Only a
nall coagulum was formed. S

March 3oth, 1871. A hollow steel needle was cautiously introduced, and connected
ith the positive pole, while the negative pole was applied externally by means of a
songe. Only from eight to twelve zinc-carbon cells were used. Drs. Wood, Sayre,
nd Mason made digital compression to the aorta below the umbilicus, The needle
dhered and came out with some difficulty, but no blood followed. The bruit seemed
‘ainter than before the operation, No unpleasant result followed except some pain
aat was produced by the compression, and exhaustion that was produced by the
therization.

April 6th, Operated as before, but with two positive needles, insulated to within

short distance of the points. One of the needles was hollow, and was introduced:
ntil the blood flowed through it. From twelve to sixteen freshly charged zinc-carbon
ells were used for twenty-five minutes. The solid needle was more acted on than the
ollow needle, being nearly destroyed at the non-insulated extremity. No compression
rasused. Defore the operation two murmurs were heard ; after the operation, but
ne, Patient suffered less than after the other operation. Some irritative fever ap-
eared. Evidence of solidification of the tumor.

May 4th, Six positive needles were introduced ; three connected with a zinc-carbon
attery of seventeen cells with larger plates. The current was passed for forty-one
iinutes. There was no compression of the aorta.

June 22d. Patient greatly improved; gets up and dresses herself. Tumor quite
ard,

Used two batteries as in previous operation. Eleven needles were used, and the
urrent was passed sixty-five minutes, There was less irritation after this than after
he other operations, The tumor became harder, but not smaller, and a murmur
ould be heard only with great difficulty.

In spite’ of the improvement in the condition of the tumor the patient grew weaker
md weaker, and died of exhaustion, July 18, 1871.

Post-mortem examination by Dr. Drake revealed the surprising fact that the patient
ad three aneurisms : one of the arteria innominata about twice the size of an English
valnut ; one of the aorta opposite the sixth and seventh dorsal vertebree, about eleven

* Gazzetta Medica Italiana, Lombardia, No. 28, 1870, p. 217.
CASE OF ANEURISM—VARICOSE VEINS. 757

inches in circumference ; and the one operated on, which was found to arise from the
anterior wall of the aorta at the origin of the superior mesenteric. This aneurism was
about twelve and a half inches in circumference. In all three of the aneurisms organized
light-colored clots were found The one operated on was less solid than the others.
There was, indeed, uo evidence that the galvano-puncture had produced any perma-
nent clot. It is possible, however, that it caused a temporary clot that was wasted
away by the current of blood, There is no question that the tumor became more
solid after the operation, and that this solidification was attended with diminution of
the nausea and pain,

Luigi Ciniselli* has written a monograph on aneurisms of the tho-
racic aorta treated by galvano-puncture. He speaks of twenty-three
cases. Of these six recovered, sixteen died, and in one case the result
is not known. Of the six reported as cured, one relapsed in three
months, another in seventeen months, another in four months, but was
again operated on, and after eight months there had been no relapse.
Of the remaining three cases one had not relapsed up to ‘nine and a half
months, another had not relapsed at eight and a half months, and the
last remained well at four and a half months.

Eyre has reported a case of aneurism of the left external iliac artery
by farado-puncture. Symptoms of inflammation appeared, but after
seventeen days the tumor was firmer, and evinced less pulsation. The
faradic current, however, has nothing to commend it for the treatment
of aneurism.

Ciniselli successfully treated an aneurism of the ascending aorta in a patient forty-
six years of age, by a galvano-puncture. Three needles, connected with a voltaic
pile of thirty pairs, were inserted in the third intercostal space where the tumor was
prominent and the pulsation strong. The operation lasted forty minutes. After the
operation the skin over the tumor wasred. For three weeks the patient kept his bed
and took digitalis. Forty-three days after the operation he left the hospital.

Fifty-eight days after the operation only a slight prominence remained, and no pul-
sations could be seen. Seventy-eight days after the operation the patient resumed
his occupation, which was that of a coachman,

Varicose Veins.—Varicose veins were'treated by galvano-puncture
after the manner of aneurisms many years ago.

Bertani and Milani experimented in the treatment of varicose veins
by galvano-puncture as far back as 1847. These observers applied a
bandage or tourniquet to the limb to diminish the blood supply before
operating.

* Sugli aneurismi dell’ aorta toracica finora trattati cola elettro-puntura, Miliano,
1870, Quoted in Dr. Keyes’s paper on Practical Electro-Therapeutics, N. Y. Medical
Journal, December, 1371.
58 ANEURISMS AND VARICOSE VEINS.

Baumgarten and Wertheimer successfully treated a severe case of vari-

ose veins of the upper extremity up to acromion, whence the evil
xemed to spread over the trunk. The patient wasa young girl. The
mb had doubled in size.

‘¢ Baumgarten and Wertheimer introduced in three sittings, at an interval of two
‘three days each time, about ten needles into the most extended veins, placing a
mductor connected with the negative pole in the hand of the patient, at the same
me connecting all the needles with the positive pole. The operation caused but
tle pain. After a few minutes the needles were removed, when, in place of the
lated veins, full resistant cords were felt, a sure sign of complete coagulation.
fter a month, the greater portion of the veins were obliterated, and the volume of
e limb considerably reduced; only then those veins, heretofore of normal size, be-
in to dilate a little, which circumstance can exercise no influence'on our opinion of
is modus operandi.” *

For the treatment of varicose veins the positive pole would possibly
2 better than the negative or than both together, and for the reasons
dove given. The space within the enlarged vein is comparatively
nall, and the small clot made by the positive pole ought to be sufficient
: obstruct the flow of blood. The positive clot would have the ad-
intage of firmness, and embolism would be less likely to follow than after
ie use of the negative pole.

* Meyer, op. cit., p. 471.
CHAPTER VI.
STRICTURES.

Strictures of the Urethra.—FElectrolysis for strictures was first used
by Crussel. The same treatment was subsequently employed by Wille-
brand and Wertheimer.

The method of Willebrand was to introduce to the stricture a metallic
sound, insulated up to the tip, and to connect this with the negative
pole, while the positive was held in the hand of the patient. The ap-
plication was continued for ten or twenty minutes, and the cure was
accomplished in eight or ten days.

The subject was afterwards studied, though not with special success,
by Jaksch and Leroy d’Etiolles. ,

The first important and successful results in the electrolytic treat-
ment of strictures of the urethra were obtained by Mallez and Tripier,
in 1867. *

Their method of treatment was to introduce an insulated sound with.
a metallic extremity to the seat of the stricture, connecting it with the
negative pole, while the positive was applied to the inner side of the
thigh by a moistened sponge electrode.

At the commencement of the operation the patient feels a pricking
sensation. This sensation becomes less and less miarked. The me-
tallic extremity is then passed along until all parts of the stricture are
affected. After the operation a catheter can be introduced without
difficulty.

The operation lasts about five minutes ; from one to five applications
are necessary. In the majority of the thirty-one cases treated by Mallez
and Tripier, as they claim, one application was sufficient.

The diameter of the urethra seems to increase slightly for a few days
succeeding the operation, and in some cases an eschar was thrown off ©
in a few days after the operation.

* De la Guérison durable des Rétrécissements de I’ Uréthre, par la Galvano-Caustique
Chimique, Paris, 1867. The term ‘‘ chemical galvano-cautery,” used by these authors,
is synonymous with e/ectrolysis.
760 STRICTURES.

Experiments made in Charity Hospital by Drs. Keyes and Beard,* and
the experience of Dr. Rockwell in private practice, do not entirely
confirm the results given by Mallez and Tripier, although substantially
the same method was used. The operation was found to be painful
oftentimes, and the results not always satisfactory, as the following record,
which is a fair sample, will show.

CasE CCXLIII.—F., aged forty, general health excellent. First gonorrhoea at
twenty-second, second at thirty-eighth year of age. Stream became gradually
reduced until Jan. 11, 1871, at which time he had complete retention for fifteen
hours, relieved by hot baths. The patient entered the hospital, and was treated
by dilatation.

February 6th,—Examination detects the following strictures (orifice admits 14
easily): At orifice, stricture (linear) arresting No. 14 soft bulbous sound. At two
and a half inches, stricture (linear) arresting No. 12. At five inches, stricture, one-third
inch long, arresting No. g. Current from ten cells was passed through second stric-
ture for five minutes, A good deal of pain complained of. Current from ten cells
was passed through lower stricture for ten minutes.

No. 12 bulbous sound passed easily into the bladder after the operation,

March 4th.—No slough has been passed. No. g steel sound is grasped by
stricture.

March 15th.—(Using my own instrument with steel bulb 154 -)

Stricture at the orifice ; fifteen cells; five minutes ; bulb passed. Structure at two
and a half inches; sixteen cells; ten minutes; bulb passed. Stricture at five inches;
sixteen cells; thirteen minutes; bulb passed. A little blood was lost at this opera-
tion, and « good deal of pain was felt afterwards. No slough was passed. . The-
orifice swelled and became hard and inflamed. Patient refused to follow up the
treatment or to be examined further, :

Dr. Robert Newman reports far more satisfactory results in the
treatment of strictures of the urethra.

The leading and distinctive features of his method are these : 1. The use
of very mild galvanic currents, just perceptible to the patient, and from
three to five minutes in duration. Like other observers he uses the
negative pole. The instrument should be held loosely against the ob-
struction, and no pressure should be used, and no force whatever. 2.
Long intervals, from two to four weeks, between the applications.

Dr. Newman insists on a careful preliminary diagnosis of the nature
and exact seat of the stricture. He operates with bougies provided
with metal bulbs of various sizes. Unless the stricture is too firm
or fibrous he uses a bougie which is three or four times larger than the
stricture. After he has ascertained by measurement the exact locality

* From article of Dr. Keyes in the N.Y, Medical Journal, December, 1871,
+ Archives of Electrology and Neurology, May, 1874, p. 18.
.

CASES OF STRICTURE OF URETHRA. 761

of the stricture, he pushes a small india-rubber ring over the bougie, at
such a distance from the end that when’ the ring reaches the meatus
he will know that the bulb is in contact with the stricture, and then
he is assured that the electricity acts only on the stricture.

Dr. Newman regards a patient as cured when a No. 12 English
sound can be passed without trouble. He claims to have treated in
this way over thirty patients, and that his results have been uniformly
good, and for the reason in part that he has selected his cases. He
does not claim that all strictures can be treated successfully in this
way, but states that some of his cases were bad and complicated.*

Two strictures—Chancroid—Failure of dilatation—Success with electrolysis,

R, A., hotel-keeper, came under treatment in March, 1872, Had been treated
in the country for stricture by dilatation, with no success, Found a chancroid
in the urethra, which was treated first. The two strictures were found situated at
one and a quarter and four and a half inches from meatus respectively.

March 22, Electrolysis was used with a bougie No. 10, with a metal bulb as ne-
gative ; positive electrode in the palm of the hand. Ten cells of the galvanic battery
were used for nine minutes, and the bougie passed slowly through the strictures into
the bladder.

April 14. The operation was repeated with'a bougie No. 12, The patient has
been heard from recently, and has not had a relapse,

One stricture, spermatorrhea, impotence, melancholia,

March, 1872.—R. S., a merchant of Philadelphia, came to my office in an
advanced stage of hypochondriasis, complaining of general malaise, spermatorrhcea,
impotence, small stream of water, pain in the urethra, etc. A steel sound
No. 12 entered the urethra easily, but was arrested at seven inches, Sounds of

* Dr, Newman gives the following bibliography of the subject :

Mallez et Tripier, ‘Traitement des Rétrécissements Urétraux par la Galvano-
Caustique Chimique Négative, Compte Rendu de I’Acad. des Sciences. Bulletin
Thérapeutique, Mai 30. Med. 58.

Mallez et Tripier, “¢ De la Guérison durable des Rétrécissements de PUréthre par
la Galvano-Caustique Chimique.”

Althaus, in Goeschen’s ‘‘ Deutsche Klinik,” No. 34-36, ‘‘Heilung der Harnréh-
ren-Stricturen durch die Electrolyse.” :

Keyes, “‘ Electrolytic Treatment of Stricture of the Urethra.” New York Medical
Journal, December, 1871.

Bautisto Campos: ‘De la Galvano-Caustique Chimique comme moyen du
Traitement des Rétrécissement de l’Uréthre.” Paris, 1871. ;

Dutrieux, “De la Galvano-Caustique Chimique dans le Traitement des Rétrécisse-
ments Organic de l’Uréthre.” Press. Med. Belge, No. 25, 1872.

Mallez et Tripier, London Lancet, October, 1871. ;

“Multiple Strictures of the Urethra treated by Electrolysis,” by T. F, Frank,

M.D., Medical Record, February 2d, 1874, page 62.
762 STRICTURES.

smaller size were all arrested likewise at the same place. There is no doubt that a
itricture exists, and at last a sound No, 7 passed it with difficulty, The trouble must
sxist either at the junction of the membranous and prostatic portion, or in the lat-
er only, Galvanism was used with ten cells. Bougie No. 10, with the usual metal-
ic end as negative into the urethra, met the same obstruction at seven inches. The
sositive pole was a nickel bulb, and grasped firmly with the closed hand. After five
ninutes of electrolytic current, the bougie passed the stricture slowly and slipped into
the bladder. The withdrawal of the bougie was followed by a thick, gleety- dis-
charge. It seems that this matter had accumulated behind the stricture, irritated the
orostatic portion and the ducts, and thereby was accessory to creating a spermator-
‘hoea, On passing water, shreds came along of a thick white mass, which were the
sroduct of electrolysis. The operation has not caused any pain, and the patient
travelled home without unpleasant feeling.

April 16, On examination with a sound No. to, found the stricture at the exact
slace; the sound passed the stricture after persistent and patient efforts.

Then the galvanism was used as before, with a bougie No. 12 as negative, and with
the same result.

May 9. In Philadelphia, a sound No, 12 could be easily passed into the bladder,
which proves that the stricture is cured. The patient has been kept under observa-
tion for two years, and has been seen only two weeks since. He is perfectly well ;
as married since, and is the father of a healthy child.

Casz CCXLIV.—J. A., aged forty. Two attacks of gonorrhoea in’ 1856 and 1869.
Drifice admits 18. Double linear stricture in first half-inch, admitting 13 bulbous
sound, From one and a quarter to six inches from the meatus the whole urethra is
stiff and rigid, ,

It grasps No. 13 steel sound throughout. At six inches a short stricture exists,
:hrough which No, 11 passes into the bladder.

Feb. 21, 1871. Steel bulb 154; six to sixteen cells, gradually increasing. First
stricture passed in one and a quarter minutes,

In half a minute more, lowest stricture was reached. In half a minute lowest stric-
ture was passed. Some blood followed.

March 4. Steel sound No, 15 passed into bladder. No. 16 was grasped and
would not go. Patient left the hospital.

Case CCXLV.—S, F. P., aged sixty. Gonorrhcea at eighteen, another at twenty.
[n 1836 he entered a hospital to be treated for stricture, and was gradually dilated to
12. In 1860 forcible dilatation was practised under chloroform, He neglected to
pass instruments for himself, and had to be treated again in 1864, this time by gra-
dual dilatation. Since then, he passes No, 3 soft bougie ‘‘every time he makes
water,” but he does not pass it into the bladder. On examination, I find stricture
zommencing at two inches from meatus, and continuing indefinitely as far as could be
ascertained, Only a No, 3 bougie could be passed into the bladder. Urethra feels
(outside) like a fibrous cord.

March 16. Steel bulb 6; sixteen cells; twenty minutes; no progress; battery
seemed very weak.

Spasmodic Stricture.—This condition may be relieved by the faradic
STRICTURE OF THE C&SOPHAGUS. 763

current, which by its mechanical action probably has the effect to relax
the parts.

Dr, Chadsey* reports a case of retention of urine, of two days’ standing, in 1844,
caused by hard work and exposure to cold, that he treated successfully by faradization.
The stricture was about two-thirds of the distance from the penis to the bladder. No
kind of catheter could pass, The positive pole of a faradic apparatus was applied
against the stricture for twenty minutes by means of a knitting-needle in a gum elas-
tic catheter. The retention was completely relieved.

Dr. Chadsey states that he has met with partial success in other similar cases,

In this case the result was probably due, in the main, to the mechan-
ical effects of the current, and not to any electrolytic action.

Stricture of the Gsophagus.——This terrible condition might very ap-
propriately be treated by electrolysis. Althaus suggests that the ceso-
phageal electrode should be applied to the seat of the stricture and con-
nected with a negative pole, while the positive is applied to the neck or
back. From fifteen to thirty cells would probably be required. Dr.
Frank informs us that he treated successfully a case of spasmodic stric-
ture of the cesophagus, by the galvanic current, applied by means of
an oesophageal electrode.

* New York Medical Journal, February, 1869, pp. 574, 575+
CHAPTER VII.

ULCERS, FISTULA, AND SINUSES.

Ulcers-—Bed-sores.—The earliest attempts to treat ulcers by elec-
tricity were made by Crussel, in 1847.

The same treatment has been used in syphilitic ulcers by Kyber, of
Cronstadt, Rosenberger, of St. Petersburg, and in the majority of their
reported cases with success.

Ulcers may be treated with both currents by means of metallic disks
or plates covered with soft sponge. Galvanization serves to cure in
such cases partly by its electrolytic effects. One electrode may be ap-
plied to the ulcer, and the other to the nearest large nerve-branch or
plexus, or to the sympathetic or spinal cord. The applications should
not be excessively painful. In some cases decided results may follow
a single application of electricity to an ulcerated surface. In a case of
an ulcer in the leg of a girl eight years of age, one faradization with a
current of moderate strength so improved the nutrition of the parts that
healing at once commenced, and in a short time entire recovery took
place without any further treatment. Ulcers may also be cauterized by
the galvano-cautery.

In the treatment of ulcers, and indeed of many conditions, it is a con-
venience to have one electrode kept in a fixed position without the aid
of the physician or of an assistant. For this purpose the adjustable
electrodes, provided with a rubber belt which can be passed around the
limbs or body, are convenient.

Ulcers may also be treated by prolonged applications with the so-
called “body batteries.” A disk of zinc connected by a wire with a
disk of silver. Either the zinc or the silver disk may be applied over
the ulcer, and the circuit completed by one disk on an indifferent point,
or in case there are two ulcers, one may be covered with the silver disk,
and the other with the copper disk. ‘These disks may be keptin posi-
tion and worn all the time, or only at night.

Garrett’s electric disk may also be used for the same purpose.

The results of these prolonged applications are most excellent, es-
CASES OF ULCERS AND FISTULA. 765

pecially in bed-sores. We have known them to fail, however, in very
bad cases, and notably when great debility existed.

Indolent ulcer of the arm; recovery under local galvanization.

Casrk CCXLVI.—Mary H., aged forty, while moving, May 1, 1871, fell and in-
jured the arm immediately above the external condyle. The pain was excessive and
continued to distress her for several weeks, when a small ulcer made its appearance and
enlarged until it was two inches in diameter.

The patient applied for treatment, July 18. The ulcer was covered with a dark-
colored scab three-fourths of an inch, partly lifted from its resting-place by exuberant
and unhealthy granulations,

The scab was removed, and a wet cloth in connection with the positive pole was
applied to the diseased part, while the negative was placed on an indifferent but ap-
proximate part. The galvanic current was used. She suffered no more pain after the
second séance, and as the applications were repeated the ulcer rapidly healed, until
August 30, when the part was covered by sound, healthy skin.

Syphilitic ulcer ; recovery follows three operations by electrolysis,

Case CCXLVII.—Catherine McK., aged forty, suffered three years since from a
number of syphilitic tubercles and ulcers about her hips, thighs, and vulva. They per-
sisted along time and gave her much annoyance, but finally healed, with the exception
of one on the inside of the thigh. It was elevated nearly one-half an inch above the
surrounding surface, was excessively painful, and discharged an offensive secretion, A
needle counected with the*positive pole was passed through the base of the elevation,
and a current of moderate tension allowed to pass for a few moments. This applica-
tion dissipated all pain, and after the third séazce, given several weeks after the first,
soon healed, and the patient was discharged from the Dispensary. :

Anal Fistula of long standing treated by galvanization with both poles—Relief
of pain.

CASE CCXLVIIL—A case of fistulze, at and near the anus in a shoemaker, was
brought to us by Dr. Russell, of Brooklyn, The patient had a fistula with four open-
ings—one in the rump and the others at the border of the anus. The origin of the

_ difficulty was local injury. The patient had once been operated on with the knife
without permanent relief Examination had made it pretty clear that necrosed bone
was the cause of the fistula, and kept up the constant discharge.

We first electrolyzed away with the long cutting needles the painful protuberances
at the orifice, near the anus, ‘The removal of these caused great relief, and enabled
the patient to sit down and to resume his occupation. We then placed long, polished
steel conductors into the opening in the rump, connecting them with the negative
or positive pole, using the positive when the hemorrhage was greatest. The con-
ductors were introduced up to the bone. Strong currents were borne, and great re-
lief obtained of the pain and uneasiness, but no permanent cure,

Galvano-Ozonization.—This is a term employed by Dr. A. Murray,
of New York, to designate the combined action of ozone and the gal-
vanic current in the treatment of ulcers. He claims that his experi-
766 ULCERS, FISTUL#, AND SINUSES.

ments show that ozone is generated at the positive pole when the gal.
vanic current is applied to an ulcer, and that the ozone thus generated
has a curative effect on the ulcer, and aids the other action of the current.

For this reason he regards the positive pole superior to the nega-
tive in the galvanic treatment of ulcers, fistulae, and so forth.
‘CHAPTER VIII.

‘MISCELLANEOUS SURGICAL DISEASES,

Stumps after amputation that are slow to heal have been successfully
treated by electricity, like ordinary ulcers, by Dr. Geo. K. Smith and
by Dr. Snively, of Brooklyn.

_ Hematocele.—Hematocele of the pelvis or pudenda, or of other por-
tions of the body, may be treated electrolytically, like erectile tumors,
and by ordinary faradization.

Gangrene.--Gangrene may be treated electrically in various ways,
but especially by electrolysis and galvano-cautery.

Carbuncles and Furuncles.—Dr. Rockwell demonstrated long ago
that faradization was capable of hastening suppuration, and we have
frequently utilized this fact in the treatment, not only of carbuncles
and furuncles, but of various other forms of abscesses. Dr. Sass in-
forms us that a number of years since he used this treatment in two
instances with good effect.

Burns.—Burns in a subacute stage might not unlikely be helped
toward recovery by faradization or galvanization. .

Frost-bite (Chilblains ).—In the first edition of this work we stated
that we were not aware that any attempts have been made to treat chil-
blains by electricity, but that it certainly would not be irrational to try
the power of galvanization in this disease. Successful results have been
recently reported by various observers. Chilblains are to be treated like
ulcers. :

Synovitis.—In effusions of an acute and very sensitive character,
electricity is usually not indicated, but in the subacute and chronic
forms it is of great efficacy. The treatment should be directed by the
cause and stage of the disease, and by the results of trial in each case.

The treatment of those cases that depend on rheumatism, or hysteria,
should be constitutional as well as local. In some cases general
faradization, with special attention to the affected joint, is sufficient ; in
others the general treatment is sensibly aided by galvanization or fara-
dization of the joint.
768 MISCELLANEOUS SURGICAL DISEASES.

Whether the galvanic or faradic current is to be preferred for local
applications can only be determined by the results of trial. Our cus-
tom is to begin with the faradic current, and to use it so long as benefit
results, and then to change to the galvanic. It should be borne in
mind that the greater chemical effects of the galvanic current are in
these cases frequently more than counterbalanced by the powerful
mechanical action of the faradic. Stable increasing currents are to be
preferred.

This is one of the conditions in which localized galvano-faradization
(see p. 302) may be tried. The electrical treatment of effusions of
the joints is‘much aided by using the hands as an electrode, with gen-
tle but firm manipulation. There is no question that under the influ-
ence of “rubbing” have been wrought many important cures in these
affections. :

Electrolysis has been successfully employed in effusions. It may be
resorted to in all obstinate cases.

Synovitis of the knee, complicated with hemiplegia— Recovery under faradization,

Case CCXLIX.—Mr. Geo. ‘L., aged 35, stated that about the 1st of July, 1866, he
was sunstruck ; and between the 2oth of the same month and the 15th of August, he
suffered from three strokes of hemiplegia, resulting finally in total blindness, His
sight gradually returned, but by degrees his shoulders became lame and stiff, so that
he could with difficulty use them. This state of things continued until about the mid-
dle of September, when both knees and ankles commenced to enlarge. In November,
when the patient applied to us for treatment, we found him suffering from severe sub-
acute synovitis. Both knees were enormously swollen, the fluid having accumulated
to such an extent that the patella projected forward more than aninch, Four applica-
tions of the faradic current were given, one every day, but with no marked effect, ex-
cept that the lameness of the shoulders and ankles was much relieved.

He then left the city and was absent one week. On his return the improvement
was found to be very great, The accumulation of fluid in the knees had almost entirely
disappeared, and the swelling was reduced in proportion. At first, the strongest cur-
rent from Kidder’s apparatus made no impression, when applied down the spine. The
legs were but little sensitive to the electric stream, and the feet and toes, which are
generally very readily affected, were remarkably torpid. The applications were con-
tinued on Dec. 3d, 4th, sth, 7th, and oth, effectually removing this want of sensation,
and completely dissipating the remaining swelling and tenderness of the knees.

fy drocele.—Electro-puncture was first tried for hydrocele by Schuster
in 1839.

The method is to introduce the needle into the tumor at opposite
sides, and so deep that the points nearly approach each other. The
needles are then attached to from three to six elements of a galvanic
battery. The application should be made for five or ten minutes. One,
SPRAINS AND STRAINS. 769

two, or three applications usually suffice to coniplete a cure. The
same treatment has been successfully employed by many others.

Successful results from the faradic current have been reported by
Burdel, Deletanche, Lehmann, and Thevissen. The galvanic is un-
doubtedly the current to be employed in such cases.

Hydrocele, in short, should be treated electrically like cystic tu-
mors. ‘The great end to be accomplished is not the withdrawing of
the fluid, which can be done with the ordinary trocar, but the stimulation
of the membrane of the sac, so that absorption shall take place and the
fluid not again collect. Many of the failures that have occurred in the
treatment of hydrocele have been due to a misapprehension of this fact.
Dr. Frank has combined the use of galvano-cautery with electrolysis in
the treatment of hydrocele. In some cases there will be a return of
the disease even after electrolysis.

Sprains (strains).—Sprains of joints of all kinds may be treated by
electricity ; faradization and galvanization of the affected part with a
mild, stable, or gently labile current are indicated. We have in this
way treated all stages of sprains—acute, subacute, and chronic—and
almost uniformly, thus far, with beneficial or curative results. We
have not been able to decide which current is preferable.

Sprains in the acute stage, or just passing into the subacute stage,
should be treated by very mild currents and by short applications.

In such cases no electrode is so agreeable as the hand of the opera-
tor gently passed over the painful part.

We have treated a number of cases of sprains of the wrist in patients
who are engaged in manual employments. In such conditions the lo-
calized application of the faradic current alone rapidly brings on the
recovery.

Strains of muscles with rupture of fibres, so far as our limited ob-
servation goes, do not yield to electrical treatment. In the few cases
where we have perseveringly used faradization and galvanization we
have not been able to see that the slow improvement was in any degree
hastened.

Lameness and swelling caused by a sprain—Relieved by local faradization.

CaszE CCL.—The power of the faradic current to allay irritation and relieve
lameness, in cases of sprains or injuries, was well illustrated in the case of a Mrs. B.,
directed to us by Dr. Kissam. Her foot was heavily pressed upon by the rocker of a
chair, and caused such ecchymosis, pain, swelling, and lameness, that for two months
she was unable to walk more than from her house to her carriage. The faradic cur-
rent, applied over and around the foot a number of times, relieved most decidedly the

49
'

770 MISCELLANEOUS SURGICAL DISEASES,

swelling and lameness, and enabled the patient, in a few wéeks, to exercise in walking
without serious difficulty.

Spondylitis (Potts Disease).—Spondylitis is a term that is applied
to inflammation of the vertebre. Among its symptoms are at first
changes in shape of the spinal column, obstinate gastralgia, or neuralgic
pains in the breast and various parts of the body, and subsequently pro-
jection of the diseased vertebrze, deformity of tlie spine, peculiar attitude
and paralysis,* sensitiveness of certain vertebre, and spontaneous
pains in the spine.

The form in which it appears is in the cervical and upper dorsal verte-
bra, with the symptoms of neuralgia in the arm, or neck, or lower
limbs. Some cases of torticollis, and even of chorea, may depend on
disease of the vertebra. Other symptoms are paralysis, atrophy, or
contraction of certain muscles. In many cases of inflammation of the
vertebra the nature of the disease is not suspected, because the changes
in the form of the spinal column and the immobility of the vertebra only
appear after the morbid process had made considerable advance.

In making the diagnosis it should be considered that the appearances
of the spine, which are usually regarded as evidences of spondylitis,
may arise from paralysis, or atrophy of the muscles, with contractions
of the antagonists.

The treatment consists in galvanization of the affected vertebre,
the positive pole being placed over the seat of the disease, and the
negative at some point above or below. The results are sometimes
beneficial.

Spinal Curvature.—Lateral curvature of the spine, depending on re-
laxation of the muscles and ligaments, and associated with general de-
bility, is a condition for which general and localized faradization and
galvanization of the sympathetic are well indicated, and in which they
have wrought most important results. General faradization alone is
pretty sure to be of service, both in raising the tone of the system and
in permanently relieving the curvature. The electrical treatment may
be used in connection with mechanical appliances. '

Pseudo-arthrosis (Ununited Fracture).—Burman obtained a good re-
sult from electrical treatment of a transverse portion of the tibia and
‘fibula. After the lapse of a month the bones had not united. A
bandage was applied and a current (whether faradic or galvanic is not

* See paper on Differential Diagnosis of Diseases of the Spine, by Chas, F, Taylor,
M.D.
+ Benedikt, op, cit., 312.
HERNIA—MORBUS COXARIUS. 771

stated) was applied for half an hour by two needles. Suppuration fol-
lowed, callus was formed, and entire recovery took place.

Hall also obtained a successful result in a fracture of the thigh
by the same treatment. The operation was repeated daily for two
weeks.

Hahn also reports a successful result from electro-puncture in a case
of fracture of the thigh.’ He used at first magneto-electricity, and sub-
sequently the galvanic current. No improvement followed the use of
magneto-electricity, while the galvanic current brought on inflammation
in six days. The inflammation thus excited produced a union of the
fracture in ten days.

We treated a case of ununited fracture of femur at the Long Island
College Hospital. Insulated needles were used, and very strong cur-
rents. Inflammation was excited, and some improvement was mani-
fest, but the bones were: so far apart that it was found necessary for the
surgeons to operate in the usual manner.

Hernia.—Delaux reports a case of incarcerated femoral hernia in a
woman who refused to submit to an operation. Tumor disappeared
after a few applications. The first application was directed to the her-
nia, and in the other applications one pole was applied to the hernia
and the other in the rectum. Before electrical treatment was tried the
patient was growing worse. Faradization might give tone to the weak-
ened muscles in reducible hernia, and for this purpose we have em-
ployed it in a single instance; of the results we have not been in-
formed.

Morbus Coxarius (Disease of the Hipzjoint)—This condition may
be treated electrically, in connection with ordinary mechanical treat-
ment, with a twofold object of hastening the recovery of the lesion
and improving the general condition. The methods of treatment that
would seem to offer most hope are stable faradization or galvanization
of the diseased joints, five, ten, or fifteen minutes daily, alternating
with general faradization. This treatment might be used in connection
with the ordinary method by extension.

Club-Foot (Talipes).—In club-foot it is not unfrequently a great
advantage to combine faradization or galvanization of the partially
paralyzed muscles with the use of mechanical appliances (see chapter
on Infantile Paralysis).

Warts.—Warts, if they were regarded as of sufficient importance,
might be removed by electrolysis of the base, or by the galvano-cau-
tery.

Dissolution of Calculi in the Bladder.—The employment of the gal-
772 MISCELLANEOUS SURGICAL DISEASES.

vanic current to dissolve calculi was proposed by Bourier in 1801, by
Morgiardini and Lando in 1803, and by Gruithuisen in 1813, but was
first successfully carried out by Prévost and Dumas in 1823.

The theory of Prévost and Dumas was, the calculus could be made
to crumble by the mechanical effect of the gases generated by the cur-
rent. In-their first experiment they placed a fusible human calculus
in water, submitted it to the action of a voltaic pile of 120 elements
for twelve hours. Platinum wires were placed against the calculus, on
opposite sides. Fine powder soon appeared. At the end of the oper-
ation the calculus was found to have lost 12 grains in weight, the origi-
nal weight having been 92 grains, It'was again submitted to the cur-
rent for 16 hours, at the end of which time it was reduced to very small
fragments that could have easily passed the urethra.

Their second experiment was made on a fusible calculus in the blad-
der of a living bitch, into which warm water had been injected. The
application, which lasted an hour, was repeated 12 times during six
days. The calculus had become so friable that the operation was not
repeated. Examination of the bitch after death showed evidence that
the bladder had been injured by the operation.

In 1835, Bonnet proved that by applying platinum electrodes to the
opposite sides of a calculus in a solution of nitrate of potash, electro-
chemical decomposition ensued, by which nitric acid appeared at one
electrode and potash at the other. The effect of these two substances
was to dissolve the calculus. Stones composed of phosphate will be
dissolved on the acid, and those composed of uric acid or urate of
ammonia on the alkaline side. Under this action, the stone, unless
very hard, becomes friable and falls to pieces. ‘These experiments
were confirmed by Bence Jones, who also found that calculi of oxa-
late of lime could be slowly dissolved in the same way. Neither.of these
experimenters attempted the dissolution of calculi in the human blad-
der. Some experiments made by Dr. Rockwell in this line, and also
by Dr. Beard, at the suggestion of Dr. Gouley, did not give very satis-
factory results. The amount of decomposition of phosphatic stone was
very trifling, even when strong currents were used for several hours.

Electric Explorer or Probe —This apparatus (Fig. 198) indicates at
once the presence of metallic bodies in gunshot wounds.

Fig. 1 represents its natural size. Fig. 2 shows one of the exploring
sovrn.s., There are generally two sounds, one stiff, the other flex.
ible.

The trembler or needle is so arranged as to resist all shocks and fulfil
the following conditions :—
o

ELECTRIC EXPLORER. 773

1. It is very portable, and in all possible positions can be carried in
the vest pocket, or in the ordinary surgical case.

2. It cannot be deranged.

3. Three senses take part in making the
exploration—the hearing, the touch, and the
sight.

4. It indicates with certainty the presence
of a ball by the movement of the trembler,
an effect which is only produced when the
circuit is closed by a metallic body. Experi-
ence has shown that the contact of organic
tissues, even with a battery of 15 elements
(and probably with even a greater number),
will not put the trembler in vibration.

5. The explorer indicates at the same time
the depth at which the ball is situated, and
in some cases also the flexible sound pre-
serves the form of the canal through which
it passes.

The battery is in acase made of hard rub-
ber. This holds the elements, zinc and car-
bon, which fill only half. The other half is
occupied by the exciting liquid, a solution of
sulphate of mercury. When the case is re-
versed, or in a horizontal position, the liquid
flows on to the element and a current arises ;
when the case is in a vertical position the

metals are not touched by the liquid, and Fic 198.
there is no current.* Trouve’s Electric Explorer,

 

* The first apparatus for the electric exploration of wounds was devised by M.
Favre, of Marseilles, of which the following description was given by Nélaton, in re-
marks to his class at the Wépital des Clinigues : ‘*‘ Two conducting wires are placed in
a sheath, or the two electrodes may be covered by an isolating substance. These wires
are in communication with a battery of only one couple, and a galvanometer is fastened
on one of the wires. If you introduce the end of these into a wound, the contact of
the soft parts, the bones, or pus, is not sufficient to establish a current, but if the
ends come in contact with a metallic body, the needle of the galvanometer will rise,
this being a proof that the circuit is complete. Only one couple, however, should be
used, so as to avoid the decomposition of the fluids in the wound, which would imme-
diately give rise to a current."—(Am, Four. Med. Sciences, vol, xlv., 1863, p. 218.)
During the recent Franco-Prussian war an ‘‘ Electric Bullet-seeker,” that strikes a
little bell when metallic connection is made, has been successfully used,
774 MISCELLANEOUS SURGICAL DISEASES.

Extraction of Foreign Bodies by the Electro-Magnet.—Dr. Delore *
has suggested the electro-magnet as a means of extracting foreign bodies
ffom the eye, urethra, auditory canal, etc. He states that the magnet
has been used for the purpose of extracting pieces of iron and steel
from the eye since the days of Fabrice de Hilden. Delore’s attention
was called to the subject by an attempt which he made to extract a
piece of a pin from the external auditory canal. A slender magnet
was prepared by M. Fasse, which could be bent at will, but it was
found to be not sufficiently powerful. Then M. Fasse suggested the
idea of using the electro-magnet for this purpose. With this view he
constructed a small electro-magnet, composed of a stem of iron, with.
a bulbous extremity, and covered with several windings of insulated
copper wire.

- The force that is obtained is in proportion to the strength of the
current used to magnetize the iron, the number of spirals, and the
diameter of the magnet.

In order to ascertain how much power was necessary to extract
needles from the body, a number of experiments were made.

“*A needle embedded in the horny substance of the hand to the
_ depth of three millimetres requires for its extraction a traction of 89
grammes.” '

“« Embedded sixteen milli. deep in the heel of a cadaver requires 400
grs.”

«Embedded four centimetres deep in the calf of the leg it requires
400 grs.’’

“Tf it has perforated the cornea it must have a traction of 39
grs.”

The advantage claimed for this method of extracting foreign metallic
bodies is that ‘*it produces no sensation on the surface of the tissues,”
and also is less liable to injure them than forceps or probes.

LElectro-Chemical Baths—Removal of Poisonous Metals from the
Body.—In 1855 Vergnés and Poey, of Havana, reported to the French
Academy a method of removing poisonous metals from the body by
means of the galvanic current. Vergnés, while practising electroplating
in 1852, had brought an obstinate ulceration on his hands. He placed
his hands in an electric bath, connected with the positive pole. In 15
minutes a metallic plate connected with the negative pole in the bath
was covered with gold or silver from the ulcer. A few such treatments
cured the ulcers. .

An electro-chemical bath is taken as follows: An isolated metallic

* Translated from Lyon Dfédicale, in N. Y. Medical Gazette, Aug. 20, 1870,
FARADIC ANASTHESIA. 775

tub is placed on an isolated bench. The tub is filled with water, acid-
ulated with nitric acid of mercury, gold or silver, and sulphuric acid if
lead is in the patient. The patient is placed in the bath, and the tub
is connected with the negative pole, while the patient takes the positive
pole, part of the time in the right and part of the time in the left hand.
The current now enters the arms, and passes through the body to the
tub. The metal that is extracted from the body is found on the sides
of the tub, in the water in the tub, and in the atmosphere of the room
from evaporation.

These experiments were confirmed by Caplin and Meding.. Meding

. extracted mercury from a patient in this way. Vergnés employs elec-
tro-chemical baths also for introducing medical substances into the body.
The patient sits in the bath containing the solution, and in the position
described, and absorbs the substance while the current is passing.
Among the remedies that Vergnés employs for the purpose are phos-
phate of iron and nitric acid. There is little question that the passage
of the current through the body, immersed in certain medicated solu-
tions, aids in the absorption of some portion of the compound. This
whole subject, however, is yet in dispute, and will remain in dispute
until it is carefully investigated by competent men, and all possible
sources of error are guarded against.

faradic Anesthesia.—The benumbing effects of the. faradic current
on the nerves may be utilized for the production of local anzesthesia.
(See Electro-Physiology.) It is only indicated for slight or at least
short operations, such as the opening of abscesses, felons, bubnes, the
extraction of foreign bodies and of teeth.

For opening abscesses a strong faradic current should be directed
through the parts as the incision is made. The relief thus afforded is
slight, but is positive, and is not unworthy of a trial.

Faradic anzesthesia has been chiefly used in the extraction of teeth,
where it is certainly of some service. The patient places his foot ina _
metallic slipper, or on a plate, or holds an electrode in the hand, while
the circuit is completed as soon as the forceps of the dentist, which is
connected with the battery, seizes the tooth. It is well to connect the
forceps with the negative pole, because it is the stronger.

The contractions produced by the passage of the current are certainly
disagreeable, for a current of considerable strength is required, but the
pain of the extraction is less severely felt than it would be when made
unaccompanied by the current. ,

This method of producing local anzesthesia was at one time somewhat
popular among dentists, but partly on account of the fact that itis at
776 MISCELLANEOUS SURGICAL DISEASES.

best an imperfect method of preventing the pain of the operation, partly
on account of the mechanical difficulties in the way of its employment,
and partly, also, on account of the popularization of nitrous oxide, it
has fallen into disuse.

Faradic anzsthesia may be utilized for the relief of the irritation
caused by the application of caustics to the larynx, eye, or uterus.

Dr. A. Tripier,* of Paris, has recently advanced the theory that faradic
anzesthesia is explained by the interference of the different impressions
that are made on the nerve, The impression made by the faradic cur-
rent first reaches the cerebral centre, and neutralizes, or, at least,
diminishes, the impression made at the same time by any other irritat-
ing influence. This theory seems to us sensible and just. Dr. Tripier
further recommends a return to the practice of faradic anzesthesia for
slight operations.

Hydro-Electrization.—Dr. Beard has devised a method of apply-
ing electricity by means of a continuous stream or jet of water flowing
from a metallic tube—or one that has a metallic orifice—connected
with one pole, while the body of the patient is in any convenient way
connected with the other. A jet or stream of water, so long as it is
not broken into spray, will conduct the current from one-eighth of an
inch to one or two inches from the orifice, according to the size of the
stream, to any part where it may be applied. Contractions of muscles,
and all the effects of ordinary localized electrization, may be thus pro-
duced.

This method of electrization is adopted for those localities where, on
account of the natural sensitiveness, or from the nature of the disease,
ordinary e’ectrodes, by their mechanical irritation, cause unbearable
pain, or where, for anatomical reasons, they cannot be applied.

For supplying a continuous stream of water we use an ordinary stiff
rubber bag, which is filled with water in the usual way, by first com-
pressing the sides and exhausting the air. Connected with this bag we
use silver tubes of various shapes and sizes, provided with small thumb-
screws for making the connection with the battery, and either insulated
or non-insulated, according to the special purpose at hand.

The various douches that are used for the cavities cf the body may
be utilized for the same purpose, provided the leather tubes are lined
with spirals of wire, to keep up the connection of the current, or the
tubes are composed of metal and insulated.

On this principle, and in order to meet the same therapeutical in-
dications for which ordinary electrization is employed, applications may

* Archives of Electrolugy and Neurology. May, 1874, p. 109.
HYDRO-ELECTRIZATION— ELECTRO-MEDICATION. 777

be made to the external auditory canal, and, in cases of rupture or
ulceration of the membrana tympani, to the middle ear, by a straight,
insulated tube, or by the ear douche; to the conjunctiva by a single
tube or by the ear-douche ; to the nasal passages by the nasal douche
or metallic posterior nasal syringe ; to the pharynx and naso-pharyngeal
space by a properly curved tube ; to thé stomach by the stomach-douche,
such as has recently been used by Ploss, of Leipsic, or by the stomach-
pump; to the d/adder by the bladder-douche ; to the vagina and os by
the vaginal douche; and to the cavity of the uterus by the uterine
douche; to the cavities of opened abscesses ; to stumps that aré slow to
heal, and finally to all zrritable ulcers, wherever situated.

Either the galvanic or the faradic current may be used, and the water
may be pure or variously medicated. Warm water conducts better than
cold, and is therefore preferable, except for those cases where the tonic
effects of cold are indicated. The conducting power of the water is
also increased by the addition of common salt, and various medicinal
substances which are ordinarily used for the treatment of the conditions
for which hydro-electrization is indicated, and may, therefore, be proper-
ly combined with it. Potter's hydro-therapeutic contrivances are very
convenient for the purposes of hydro-electrization.

Electro-Medication—Long ago it was contended by Fabré-Palaprat,
Orioli, and Vergnés that medical substances could be introduced into
the body by means of the galvanic current, but by Remak, Rosenthal,
Tripier, and others their statements have been discredited. From our
experiments it would seem that atropine might be introduced into the
system by means of the faradic current in sufficient quantities to slight-
ly affect the pupil.

Recently Beer, of Vienna, and Von Bruns * have succeeded in intro-
ducing iodine into the dead and living subject, by means of the elec-
trolysis of iodide of potassium. For this purpose they have used a glass
tnbe, containing a solution of iodide of potassium (1 to 1, or 1 to 2),
‘tightly corked at one end, and at the other covered with cloth ora
piece of bladder, and connected through the cork with the negative
pole of the galvanic current by*a piece of platinum. The positive
electrode may be of a similar construction, or an ordinary sponge elec-
trode.

If by this arrangement an application be made through the face—an
electrode being placed on each cheek—for a few minutes, traces of
iodine can be detected in the saliva. A good test for iodine is disul-

* Die Galvano-Chirurgie oder die Galvanokaustik und Elektrolysis bei chirurgischen
Krankheiten. Tiibingen, 1870, p. 133 ¢f seg.
778 MISCELLANEOUS SURGIGAL DISEASES.

phide of carbon, which will detect one part in 1,000,000 parts of water
by the purple-red color which it produces. Another test is glycerine,
which, mingled with iodine and electrolyzed, gives a dark-blue or black
line. The electrolytic introduction of iodine has been used in gland-
ular swellings (as goitre), effusions in the joints, periostitis, and with
asserted success, after simple galvanization has failed. We have ex-
perimented in this direction considerably without arriving at any con-
clusive results.

The difficulty in.all therapeutical experiments is that we are using
simultaneously two remedies, iodine and electricity, both of which are
separately efficacious in producing absorption.

fodalgia.—There are certain obscure painful affections of the feet
that appear to be sometimes of a nervous character—a kind of hyper-
zesthesia—and sometimes appear to depend on actual injury of the
bones or tendons, The former class—of which we have seen several
cases—are really medical cases, and are to be treated by central and
local galvanization. The latter are surgical cases and are to be treated
by local applications.
GLOSSARY.

Explanation of the terms used in ELECTRO-THERAPEUTICS (Medical and Surgi-
cal), ézcluding also many of the terms of ELECTRO-Puysics axd ELECTRO-PHyYsI-
OLOGY,

WitTH the progress of the study of Electricity in its relations to Physics, Physi-
ology, Practical Medicine, and Surgery, there has arisen a new and extensive termi-
nology.

The terms used, especially in Electro-Therapeutics and Electro-Physiology, have
been introduced by different observers, in various countries, and in different lan-
guages, and are all necessarily based on an incomplete knowledge of the mysterious
force whose phenomena and manifold relations they aim top describe. It was inevita-
ble that a nomenclature devised under such circumstances should be more or less
inaccurate and confused. This inaccuracy and confusion have been still further
increased by the carelessness of writers, who have misunderstood and misapplied
these terms, and greatly perverted them from their original meaning. It would be
difficult to find any two authors who entirely agree in their use of terms, even of
those which are most frequent and most important ; and readers who are not thor-
oughly familiar with all branches of the subject in the various languages, and with
the incorrect as well as the correct phraseology, are constantly bewildered.

It is believed, therefore, that a list of the words and phrases employed by writers
on Electricity, which should present their original and derived meanings in their
various combinations, with their correct and incorrect synonyms, would be of service
not only to those who consult this volume, but to all who occupy themselves with
the department of Electro-Therapeutics.

The need for such a list is rendered the more imperative from the fact that many
of the terms it includes cannot be found in the most recent dictionaries.

The terms which we have ourselves introduced, or to which we have given a new
combination or attached a peculiar signification, are designated by a star (*). The
figures refer to the pages in the present work where the terms to which they refer are

explained.
‘780 GLOSSARY.

AMALGAMATION. To compound mercury (quicksilver) with another metal. In Electro-Physics. the
term is usually applied to the covering of the zinc plates with mercury, by first pouring over them
an acid solution and then dipping them in mercury, or pouring it over them.

ANEIECTROTONOS, The phase of diminished irritability which appears at the positive pole when a
nerve is in the electrotonic condition (p. 113). '

ANIMAL ELEcTRICITY (p. tor),

Anions. In electrolysis the electro-positive substances that go to the cathode (Faraday) (p. 53).

ANODE (ava, upward, and 650s, way). Where the current enters, called also Jositive or copper pole
(Faraday). :

ANTOzONH (p. 688).

Apparatus. A contrivance or combination for a certain purpose; often used synonymously with
machine or battery. Strictly, however, apparatus is applied only to the more simple contrivances,
and machine to the more complex.

Armatoures. Bars or 4¢eefer's, which, when placed in contact with the pole of a magnet, preserve its
magnetism.

ASCENDING. From periphery toward the centre, applied especially to the nervous system.

Battery Current (see Galvanic Current).

Latrerry, Evecrric (or galvanic), A serdes of Ieyden jars, or (more frequently) cells, connected
together. The term is applied, however, to a sémgde cell, and incorrectly also to a machine or
apparatus.

Bounp Etectriciry. Electricity in the Leyden jar.

. CATALYsIS (kata, and Avots, from Avw, to disengage). The absorption, and the accompaniying trans-
ference of liquids caused by the chemical action of the galvanic current (Remak). It is a part and
result of electrolysis.

Caratytic. Pertaining to catalysis.

CatTeLectroronos. The phase of i#tcreased irritability which appears at the negative pole when a
nerve is in the electrotonic condition (p. 113).

CaTHopr (kara, downward, and 686s, way). Where the current passes out; called also negative
or zine pole (p. 53).

Cations. In electrolysis, the electro-negative substances that go to the anode (Faraday) (p. 53).

CEut (see Element).

CenTRAL GALVANIZATION * (p. 412).

CuemicaL GaLvano-Cautery (see Electrolysis),

CHRONOSCOPE AND CHRONOGRAPH (xpévos, time, and cxometv, to observe), Instruments for measur
ing and recording the velocity of the nervous force, electricity, etc.

Circte GALvANic (p. 28).

CLosinG Contractions. Contractions produced at the closing of the circuit.

Coercitive Force (p. 5). :

Com Inpuction. Rolls of wire in which the current is induced by the alternate opening and closing
of the circuit, as Rhumkorff’s coil (see Induction).

Commurator. An arrangement for reversing the current.

Conpenser. An apparatus for condensing a large quantity of electricity on a small surface.

Conpuctinc Wires. The wires that conduct the electricity from the machine to the electrodes.

Conpuctivity (or conductibility), That property by which a body conducts electricity.

Conpucror. That which conducts electricity. Sometimes used for electrode.

Constant Current. The galvanic current from elements with two liquids. ‘The constant batteries
that are best known are those of Daniell, Grove, and Bunsen and their modifications (p. 26).
Applied also to the galvanic current in general, and used synonymously with continuous. It is
sometimes prefixed to galvanic current (constant galvanic) in the sense of unduterrupted (see
Galvanic Current).

Continuous. Constantly flowing in one direction, sometimes used in the same sense as constant or
gelvanic, Strictly, it should be applied to the uninterrupted galvanic current, since the faradic
current is always interrupted (see Galvanic Current). ;

Continuous EvectrizATion.* This term might appropriately be applied to the protracted applica-
tions made by galvanic disks, belts, chains, poultices, etc., worn on the body.

ConTRACTILITY, ELECTRO-Muscurar. That property of muscles that causes them to contract, when
acted upon by the electric current. It is to be distinguished from irritability, which it includes.
Electro-muscular irritability may exist in muscles that have wholly lost their electro-muscular con+
tractility (see Irritability).
GLOSSARY. 781

Copper Pots (see Positive Pole). :

‘CuRRENT CHANGER (see Current Reverser).

Current, Exectric. The continuous discharge of electricity that results from chemical action, such,
for example, as takes place in any ordinary galvanic cell.

Current INcREASER.* A contrivance for increasing the strength of the current without breaking the
circuit, A form of rheostat.

CURRENT OF THE PILE (see Galvanic Current).

CurrEnT Reverser. An arrangement for reversing tne current (p. 360).

Current SeLector. A contrivance for bringing any desired number of elements into the circuit.

CyvinpeR Macuine. A form of machine for generating statical electricity.

DEctinoMETER. An instrument for measuring magnetic declination. The mariners compass is a
declinometer.

Density. Compactness. The density of a current, other conditions being the same, is in proportion
to the smallness of the electrodes.

Descenpinc, From the centre toward the periphery.

Driamacnetism. That property of bodies by which they manifest the same magnetic phenomena as
iron (p. 8).

Dierectsic. A medium through which induction is propagated.

Dir.ecic ConTRACTIOnS (p. 315). .

DivoLarR ARRANGEMENT (p, 113).

Dievinc Neevie. A needle for measuring the magnetic dip.

Direcr Current (see Descending current), also used fur ga/vanzc current (see Galvanic Current). }

Direct ELeEcTRIZATION (p. 369). 2

Dry (or cutaneous) Faravization. Faradization with dry electrodes (p. 368).

DynamicaL ELEcTRICITY (p. 25).

Execrric (electrical), Pertaining to, derived from. or containing electricity.

E.ecrrics. Those substances which, when held in the hand and rubbed, become electric.

Exectric BATH (p. 431).

ELectric (or metallic) Brus. A wire brush used as electrode.

Execrric (or galvanic) Disks (p. 544).

E.ecrric HAnp. The hand used as an electrode in electrization.

Evectric Moxa (p. 368).

Exectric Porn'rs * (see Motor Points).

Execrrician, One who studies electricity in its piysécad relations, as in telegraphy ; oftentimes used
erroneously for electro-therapeutist. ,

ELECTRICITY (jAextpoy, amber) (p. 2).

Evecrriry. This term is usually applied to the use of statical electricity, and is therefore synonymous
with franklinization. It is used sometimes synonymously with electrize,

ELEcTRIZATION. The act of electrizing. The term includes faradization, galvanization, and franklini-
zation, or the application of statical electricity.

For the sake of uniformity, and in order to preserve the distinction between the different methods
of application, e/ectrization has in this work usually been preferred to the periphrastic expression
—the use of electricity.

ELEcTRIzE. To affect by electricity.

Execrro-Anastuesia.* The production of local anesthesia by the application of electricity. The
faradic current is used for this purpose (on faradic anzsthesia).

Evectro-CHemicat. Pertaining to electro-chemistry,

Execrro-CHEMIcaL BATH (see p. 774).

Execrro-Cuemistry. Electricity in its relations to chemistry, of which electrolysis is a branch.

ELECTRODE (jAextpoy and 68és, way). The way by which the positive and negative electricities
emerge. The positive pole is connected with the negative metal of the element, and the negative
pole is connected with the positive metal.

E.ecrro-Diacnosis. The use of electricity as a means of diagnosticating disease (p. 259), called
also electro-pathology.

” E_ecrro-Dynamics. The phenomena of electricity in motion. Especially applied to the material

attractions and repulsions of currents on currents, and currents on magnets,

Exectrotocy.* Electricity in its relations to Physics, Physiology, Pathology, and Therapeutics,
medical and surgical.
782 GLOSSARY.

¥xectrovocist.* One who is versed in electricity in its relations to Physics, Physiology, Pathology,
and Therapeutics. That is, Electro-Physics, Electro-Physiology, Electro-Pathology (Electro-Di
agnosis), and Electro-Therapeutics (Electro-Medicine and Electro-Surgery).

ELEcTROLYsIS (HAextpov and Avw—through Avous, disengaging). The act or process of decomposing
a compound substance by electricity.

ELECTROLYTE. A substance which is susceptible of electrolysis.

ELecTROLYTIC, Pertaining to electrolysis. 4

ELectRoLyze. To decompose a cbmpound substance by the action of electricity.

ELecTROLyzATION. The act of electrolyzing.

E.ectro-Macnet, A bar of soft iron which, under the influence of the galvanic current, becomes
magnetic.

Evecrro-MaGNetisM. ‘The phenomena of magnetism produced bv an electric current.

ELecrro-Mepicine. Electricity in its relations to medicine,

ELectro-MEDIcAL. Pertaining to electro-medicine.

Evecrro-MepicaTion.* The introduction of medicines into the body by means of electricity
(p. 777).

E.ecrromerer. An instrument for measuring the charge of a battery.

ELECTRO-MOTIVE FORCE (p. 78).

Execrro-motor. The metals that generate an electric current.

Execrro-Otiatrics. The electro-physiology or electro-therapeutics of the ear.

Evecrro-PaTHOLoGy (see Electro-Diagnosis).

Enecrropuorus. A contrivance for collecting electricity by induction.

ELecrropHorus MACHINE (p. 19) %

Evectro-Puysics.* Electricity in its physical relations.

Execrro-PHysioGnomy * (p. 165).

Evectro-Puysto.ocy (p. 99).

ELecTrRo-PHystoLoGicaL ANATomy.*

ELECTRO-PHyYSIOLOGIST. One who studies electricity in its physiological relations.

Evectro-Puncrure. The application of electricity (galvanic, faradic, or franklinic) by needles
introduced beneath the surface. ‘i

E.ectroscopg. An instrument for detecting the presence of statical electricity.

Evrctro-SensiBiLiTy.* Sensibility of the body to electricity.

Evecrro-Surcery. The use of electricity, of any form, or by any method of application in surgi-
cal diseases. It includes galvano-surgery.

E.ectro-SuscertisBiLity.* Susceptible to electricity, including farado-susceptibility and galvano-
susceptibility.

ELECTRO-THERAPEUTICAL ANATOMY * (p. 319).

ELecTro-THERAPEUTICS, The use of electricity of all forms to the treatment of disease. The term
includes both medical and surgical electricity (electro-surgery) ; also gelvano-therapeutics and
galvano-surgery.

ELECTRO-THERAPEUTIST. One who studies electricity in its Therafeutical relations. Electro-thera-
peutists are frequently and erroneously called Electricians (see Electrician).

ELecrrotonic. Pertaining to or derived from electrotonos.

ELEcTroTonos. The modification which a nerve-current undergoes when acted upon by the galvanic
current (p.111).

ELEcrro-VITAL. Pertaining to animal electricity, which is dependent on wz¢aZ processes.

ELEMENT (couple, or pair, or cell), GALvANic or VotTaic. Two heterogeneous metals immersed in
acid solution. Thus we have Smee’s, Grove’s, Bunsen’s, and Daniell’s Elements, called also a
battery, although strictly a da¢¢ery means a series of elements.

Exrra Current. The current which is induced by any coil of wire on the adjacent coils of the same
wire (p. 69).

Exrra-potar. Not included in the intra-polar region between the poles (p. 113).

Farapic (FARADAY) CURRENT, The induced current (p. 59). The term is applied both to the electro-
magnetic and magne.v-electric currents, since they were both discovered by Faraday. Called
also secondary, interrupted, induced, inductive, to and fro, indirect, electro-magnetic, and
magnete-electric. In this work the term faradic has been uniformly adhered to.

Farapism. The phenomena of the faradic current. Sometimes used for faradization.

farapize. To affect by application of the faradic current.

Farabizavion. Affecting by application of the faradic current. (According to our highest authority
GLOSSARY. 783

in the orthography of this department of terminology—Mr. William Wheeler—/faradazzation, as
derived from Faraday, would be more consistent with analogy than faradization. The latter mode
of spelling the word has the twofold advantage that it has been Idng used and is the more simple,
and accordingly we have retained it in this work and in all our recent writings.)

FaRADO-CONTRACTILITY. Contractility under the faradic current.

FARADO-ELECTROLYZATION.* The simultaneous use of faradization and electrolyzation,

FARADO-PUNCTURE. Electro-puncture with the faradic current, not much used.

FARADO-SUSCEPTIBILITY.* Susceptibility to the Faradic current.

Frankuinic. Pertaining to statical electricity.

FRANKLINISM (FRANKLIN). The phenomena of statical electricity.

FRANKLINIZATION. The application of statical electricity.

FRICTIONAL ELEcTRICITY. Electricity generated by friction. It is one form of statical electricity,
which is the wider term, including electricity generated by pressure or cleavage; but the terms
are used synonymously.

Ga.Lvanic Apparatus, Apparatus for generating and furnishing the galvanic current.

GaLvanic BELT (p. 544).

Ga.vanic CHAIN (p. 544).

Gatvanic Circr.e. Two metals in a liquid—the galvanic element, pair or cell 2 action is called also
acircuit or chain. A circle may be single—one cell or pair; or compound—several joined to-
gether.

Ga.vanic CurRENT. A current generated by chemical action and coming directly from the cell, pile,
or battery in which it is generated ; distinguished from the faradic current, that is, induced on a
coil of wires ; called also continuous, constant, direct, primary, current of the pile, battery cur-
vent, and voltaic current.

Gatvanic (or Electric) Disks (p. 544).

Gatvanic Pair (see E’ement).

Gatvanic PEssariEs (intra-uterine) (p. 6or).

Gatvanic PouLtTices (p. 544).

Gatvanism. The science which treats of electricity that arises from chemical action ; called also wod-
tatc or dynamicad electricity or voltaism. Physicists are of late inclined to prefer the terms derived
from Volta; Physiologists and Physicians generally employ the terms derived from Galvani.

Ga.vanizaTION. Affecting by application of the galvanic current,

Gauvanize. To affect by application of the ga/vanic current, erroneously applied to all forms of
electrization.

Ga.vanist. One who uses galyanism (little used).

Ga.vano-causTic (see Galvano-cautery).

GALVANO-CAUTERISM. The application of the galvano-cautery (see Galvano-cauterization).

GALVANO-CAUTERIZATION. The act of burning or searing by a non-conducting-wire, heated by the
galvanic current. : ’

GaLvaAno-cauTeRY, Cauterization by a resisting wire (usually platinum), heated by the galvanic cur-
rent; called also galvano-caustic, or guxdvano-causty (p. 712).

GALVANO-CONTRACTILITY. Contractility under the galvanic current.

GALVANO-FARADIZATION.* The szv¢ultancous application of the galvanic and faradic currents.

GALVANOMETER (or multiplier). An instrument for determining the presence and direction and measur-
ing the strength of acurrent. It is frequently used by electro-therapeutists in order to ascertain
the dose of the galvanic current that they are giving. It is. however, only an approximately cor-
rect guide (p. 46 and p. 352).

Gatvano-puncrurE. Electro-puncture with the galvanic current.

Gatvanoscorr. An instrument for indicating the presence of dynamical electricity without determin-
ing its amount.

GALvANo-suRGERY. The application of the ga/vanic current to surgery, a part of electro-surgery.,

GALVANO-SUSCEPTIBILITY.* Susceptibility to the galvanic current.

GaLvANo-THERAPEUTICS. The application of the ga/vanic current to therapeutics, a part of electro-
‘therapeutics,

GeNnERAL ELECTRIZATION * (p. 383).

GeneraL FARADIZATION.* General clectrization ‘with the faradic current (p. 383).

GENERAL GALVANIZATION.* General electrization with the galvanic current (p. 383).

Hexix. The coil of wires of the electro-magnetic apparatus (p. 61).

Hypru-ELecrrizaTion.* The application of electricity by means of water as an electrode (p. 776}.
784 GLOSSARY.

INCREASING CurRRENT.* An application in which the strength of the current is gradually increased
without breaking the current, called also svvedling current.

InpIREcT ELECTRIZATION (p. 369).

Invucep (or Induction, or Inductive) CurRENT. As usually understood, the current which is induced
in a coil of wires from another coil through which the current passes. Currents may, however, be
induced in any metallic conductor from any other metallic conductor that is traversed by the elec-
tric current, or from powerful magnets, or from the magnetic action of the earth.

Tnpucinc Current. The current that gives rise to an induced current.

InpucTIion (p. 5 and p. 59).

InpucTiveE (see Induced Current). .

Intensity. Strength of currents erroneously used for tension.

InsuLaTon (or Isolator), A bad conductor of electricity.

InsuLatep. Placed on non-conducting supports, or covered with some non-conducting substance.

INTERRUPTED CuRRENT. Broken, intermitted. The faradic current is necessarily interrupted by the
apparatus that generates it. The galvanic current may be either centinuous or interrupted.

InTRA-vOLAR, Between the poles (p. 112).

Ions. ‘The constituents into which the electrolyte is decomposed (p. 53).

Irrirasitity. That property of organized substances that causes them to respond to stimuli.

IRRITABILITY, ELecTRo-MuscuLar. The property of muscular fibre that causes it to be excited to
movement by the electric current. Electro-muscular irritability may exist without electro-muscular
contractility ; that is, the muscles may quiver or be spasmodically excited by even a mild current,
even when they fail to contract under a very powerful current.

IRRITABILITY, PRIMARY, SECONDARY, AND ‘TERTIARY. Degrees of irritability that are observed during
a séance of galvanization (p. 148).

Lasice Current (or application). An application in which one or both of the electrodes is moved or
glided over the surface.

Leynen Jar. A glass bottle partially coated with tinfoil, for condensing statical electricity.

Locat EvectrizaTion. Application of electricity to some part or organ, as distinguished from geu-
eral electrization, in which the application is made all over the body. Joced/ is practically synony-
mous with /ocaéized electrization, although, strictly speaking, localized implies that the direct
action of the current is confined to the part to which the application is made, while local does not
suggest any such meaning. According to this distinction, electrization may be local without
being necessarily localized. For the sake of uniformity, the term localized has been generally ad-
hered to throughout this work, to distinguish all local applications of electricity (see Localized
Electrization). .

Locaizep ELECTRIZATION (p. 367) (see Local Electrization).

Macuting (Electric or Electrical). Any mechanical contrivance that generates any form of electricity ;
also called electric apparatus, but strictly is more complex than apparatus. Thus, fo. example,
we have Holtz’s machine for statical electricity ; Kidder’s machine for the galvanic and faradic
currents, etc,

Macnetism. The power which certain bodies possess of attracting iron.

Macnetization. The act of magnetizing.

Macneto-Etectriciry. ‘The current induced by a magnet, as in the magneto-electric or rotary appara-
tus. Itis one form of the faradic current, of which the electro-magnetic is the other (p. 68).

MAGNETOMETER. An instrument for measuring magnetic declination.

Macnets, Substances that have the property of attracting iron. . .

Mo tecutes, The minute particles of which bodies are composed (pp. 25-35).

Motor Points. Points on the body where the nerves and muscles most readily respond to electriza~
tion ; more specific than electric points, which is a general term, and includes all forms of reaction tc
the electric current.

Muttipuier, An instrument for multiplying or increasing a force—as heat or electricity. The term is
applied both to the gadvanonzeter and thermo-multiplier (p. 74).

NeGative MopiricaTIion (p. 114).

NEGATIVE PoLe. Where the current passes out ; called also zinc-pole or cathode, Thecurrent is felt
stronger at the negative than at the positive pole.

NEGATIVE VARIATION (p. 114).

Nerve-Muscir Current (p. 377).

Oveninc Contractions. Contractions produced at the opening of the circuit.

Ozone (p. 685).
GLOSSARY. 785

PARAMAGNETISM, That property of bodies by which they manifest magnetic phenomena opposite and
corresponding to iron (p. 8).

PERIPHERAL ELECTRIZATION, Electrization of the periphery.

PERIPOLAR ARRANGEMENT (p. 112).

PILE-LIKE ARRANGEMENT (p. 52).

Pratinum (or Platina) (from Spanish platina, silver). A metal used in electrical researches.

PLexus-NERvE CURRENT (p. 183).

Pocar. Relating to the poles. g

Povarrry or Eecrricity. That property of electricity by which peculiar phenomena of the positive and
negative are exhibited at certain points (p. 33). Polarity of anerveis that condition of a nerve by
which one part is exhibiting a positively and the other a negatively electric state.

PotarizaB_e. Susceptible of polarization,

PorarizaTion. The act of giving polarity to a body in batteries (p. 36).

Porar Meruov. The method of application by which the distinctive and differential action of each pole is
obtained, by placing one pole over the part to be aftected and the other in some indifferent point;
called also zxzpolar.

PovarizE. Tocommunicate polarity to.

Potarizinc. Giving polarity to.

Porarizinc CurRENT. The current that produces the electrotonic condition.

Pores. Points where magnetism is concentrated, or where the electric current passes inor out. The

) terms fositive and negative are relative, not absolute, since their position varies with the relative
position of the electrodes,

Posiriwe MopiFICATION (p. 114)

Positive Poe. Where the current enters, called also copper dole or anode (p. 53).

Primary Current or Inpucinc Current. The current that passes through the inner coil of wire in a
helix, and that induces a current on the coil that surrounds it (p.62). Used erroneously as synony-
mous with galvanic or constant current,

PROTRACTED APPLICATIONS.* Applications that are made for a very long time. Applications of gale
vanic belts, disks, and poultices are protracted,

Quatity oF A CuRRENT, as distinguished from quantity and intensity, refers to its smoothness or harsh-
ness, or to the rapidity or slowness of interruption.

Quantity (p. 84).

Execrric REacTIoN. The phenomena developed by any part of the body under the influence of
electricity.

Reaction (Gatvanic). (See Electric Reaction.)

Reopuore. An Electrode.

Resistance. The opposite of conductivity. That property of bodies that makes them resist or oppose
the passage of the current (p. 82).

Reverse CurrEnT ‘(see Ascending Current).

Rueocorp. An instrument for controlling the fluctuations of the current.

RueomoTor (see Electromotor).

RuHEOTOME (péw réuvery, to cut). A current breaker (p. 64).

RuEostTATE (p. 48).

Rotary Macuine. Magneto-electric machines, in which the induced electricity is generated by turn-
ing a crank.

SEcoNDARY CuRRENT. The faradic current, called also the zxterrupred, induced, inductive electro-
magnetic, faradic, etc.

Sensrpitity, ELecTro-Muscutar. The peculiar subjective sensation which is experienced by the con-
traction ofa muscle under the electric current.

Suock. A sudden single discharge of electricity, such as is given from a Leyden jar, or apparatus for
statical electricity. t

Spark, Evectrric. The spark that attends the discharge of electritity on the passage of the current
from one conductor to another.

Spinat-CorpD CurRRENT

SpinaL-Corp Musc.e CurRRENT :

Srinac-Corp Nerve Current | P. 327-328.

Spinat-Corp PLExus CURRENT

SpinaL-Corp RooT CurRRENT

STasie CuRRENT (or application). An application in which both electrodes are kept in a tixed
position.

50
786 GLOSSARY.

Sraticar Exrecrriciry. Electricity in rest, generated by friction, pressure, or cleavage (p. 25).

STRENGTH OF THE CURRENT (p. 84).

Sweiinc Current (see Increasing Current).

Tension (p. 80).

TrTanizaTion, The production of a tetanic state in a nerve by passing a galvanic current through i it. .

‘Tuermo-Execrricity. The electricity that is d by heating two h 1g at
their point of junction (p. 72).

To-anv-FRo CurrenT (see Faradic Current),

Unirorm Current.* A current thatis keptat the same strength during the application.

Unirocar Metuop oF APPLICATION. One pole on the part that is to be affected, and the other on some
indifferent point ; called also polar method.

 

 

UNINTERRUPTED. Unbroken, i (see Conti ). Applied only to the galvanic current,
since the faradic is always interrupted by the machine that generates it.
Unit (p. 77).

UNroLarizaBLe. Not susceptible of being polarized,

VortTa-E.ectric InpucTion (see Induction).

Vo.tTaic ALTERNATIVES. Changes in the direction of the galvanic current.

Vorraic Pitg or BaTTery (Volta). A series of elements so arranged that the zinc of one element is con-

' nected with the copper of the other (p. 36).

Vorraic CurrENT (Volta) (see Galvanic Current),

VOLTAISM (see Galvanism). Although the honor of giving the name to electricity generated by chemical
action is really deserved both by Volta and Galvani, and has, to acertain extent, been accorded to
both, yet the term galvanism with its.derivatives has practi dan dancy which it will
probably retain. |

VoLTAMETER. An apparatus for testing the strength of the current by measuring the quantity of gas
given off in a given time during the decomposition of water (p. 46)e

Working up the Base.* Electrolysis of the Base of tumors,

Zinc Poe (see Negative Pole) ; called also cathode,

 
INDEX.

 

Abbreviations in Electro-therapeutics, 296,
Acute diseases, 688.

Adenitis, 739. .

Addison’s disease, 674.

Adjustable electrode, 357.

After-effects of electrical treatment, 294.
Acne, 567.

Rosacea, 568.

Ague, 674. ee a
Aldini’s researches in Animal Electricity, 103.
Alopecia, 573. |
Alcoholism, chronic, 469.
Amalgamation of zinc, 3.
Amaurosis, 644.
Amblyopia, 644.
mise: 587.
rognosis in, 592.

Cases of, 592.

Ampére’s theory of Magnetism, 59.
Anzesthesia, 492.

Tactile Sensibility in, 492.

« Farado sensibility in, 492.
Electro-diagnosis, 493.
Prognosis, 494.

Treatment, 493.

Cases of, 494.

Anesthesia, cutaneous, 567.
Anesthesia, electro, 122.
Anesthesia, hysterical, 495.

tomy, electro-physiological, 163.

Anatomy, electro-therapeutical, 319.
Anelectrotonos, 113.

‘Anelectrotonos, theory of, 15.

Angiomata, 724.

Aneurism, 754.

Aneurism, statistics of, treated by electricity, 755.

, Cases of, 756.

Angina pectoris, 668,
Ani, prolapsus, 628.
imal Electricity, 101.

History of its discovery, roz.

Aldini’s researches, 103.

Humboldt’s researches, 102,

Du Bois-Reymond’s researches, 103.

Nobili’s researches, 103.

Matteucci’s researches, 103.

, Apparatus for studying, 106.
Animal magnetism, 209.
Anosmia, 683.

Cases of, 684. i
Apparatus for electro-therapeutics, 327.
Antozone, 688,

Aphonia, 629.

Prognosis, 633.

Treatment of, 631.

Cases of, 634. . .
Applications of electricity, care in details, 276,

Time of day for, 278.

Time of, 269.

Frequency of, 282.

Prolonged, 281.

Combination of methods, 282.
Armatures, magnetic, 6,

 

Artificial magnets, 3.

Arthritis nodosa, 546.

Artificial respiration, 664.

Ascites, 602.

Aspermatism, 621.

Asphyxia, 664,

Asthenopia, 642.

Asthma, 554.

Astraphobia, 456.

Ataxia, locomotor, 527.

Asophy, progressive muscular, 536.

‘ases of, 537.

Auditory nerve, galvanization of, 143.
Reaction of, 650.

Normal formula of, 143.
Changes of reaction in, 650.
Hyperzesthesia of, 650.
Anesthesia of, 65x.

Baths, electric, 431.

Baths, electro-chemical, 774.

Batteries, galvanic, 38.
Wollaston’s, 44.

Daniell’s, 38.

Grove’s 39.

Bunsen’s, 40.
Thermo-electric, 75.
Farmer's thermo-electric, 76.
Cabinet, 345.

European, 362.
Becker-Muirhead, 364.
Marine, 45.

Callan’s iron-zinc, 44.
Gas, 37.

Polarization in, 36.
Double-cell constant, 38.
Bunsen’s bichromate, 41.
Walker's single-cell, 41.
Smee’s, 42.

Lechanché’s, 43. .
Water, 45.

Bed-sores, 704.

Belts and chains, 490.
Pulvermacher’s, 490.
Galvanic, 490.

Benign tumors, 724.

Bioscopy, electro, 317,

Bladder, diseases of, 624.
Paralysis of, 626.
Dissolution of calculi in, 771.

Blepharospasm, 644.

Branch currents, 35.

Bright's disease, 682.

Boils, 767.

Brass ball, 356. .

Brain, action of electricity on, 124.

Brenner's apparatus, 352.

Burners for galvano-cautery, 716.

Buboes, 627.

Bunsen’s battery, 40.

Burns, 767.

Byrne's galvano-cautery apparatus, 712

Calculi in bladder, dissolution of, 771.

Callan’s iron-zinc battery, 114.
788

Cancer treated by electricity, 740.
Cancer, relief of pain of by galvanization, 752.
Carbuncles, 767.
Cataract, 647.
Catarrh, 682.
Catelectrotonos, 113.
Catelectrotonos, theory of, 115.
Central galvanization, 412.
Electrodes for, 416.
Battery for, 416.
and localized galvanization, 419.
and general faradization, 420.
History of, 230.
In the treatment of skin diseases, 563,
Cephalalgia, 475.
Cerebral congestion, 463.
Cerebro-spinal fever, 672.
Chilblains, 767.
Children, new-born, resuscitation of, 666.
Children, Diseases of, 603.
Chorea, 603.
Whooping-cough, 603.
Cholera infantum, 603. __.
Laryngismus stridulus, 603.
Marasmus and debility, 603.
Incontinence of urine, 603.
ee a ae
nfantile sis, 603.
Cholera-infantum, op.
Chorea, 603.
Electro-diagnosis, 454.
Treatment of, 603.
Prognosis, 604.
Cases of, 604.
Chromated lead as an electro-negative element,

344.
Chromatogenous diseases, 572.
Chronic alcoholism, 468.
Circles, galvanic, 28.
Cirrhosis of the liver, 689.
Club-foot, 771.
Coil, primary, 65.
Coils, induction, 65.

Rubmkorff’s, 66.

Conduction, the converse of resistance, 82.
Condenser of Ruhmkorff’s coil, 67.
Congestion, spinal, 463.

Case of, 464.

Constipation, nervous, 579.

Prognosis, 579.

Cases of, 580,

Internal applications in, 581.
Contact and chemical action, theory of, 49.
Contractions, muscular, 555.

Contractility, elecfro-muscular, 160.
Contractions, diplegic, 315.
Galvano-tonic,
Convalescence, 688.
Cough, nervous, 636.
Coughing produced by electrizing the pneumogas-
tric, 133
Cornea, opacities of, 645.
Coulomb's theory of magnetism, 4.
Cramp, writer’s, 548.
Crystallization, thermo-electric force influenced by,

74.

Current, break, 64.
Extra, 64.
Chemical action, the origin of, 32.
Derived or partial, or branch, 35.
Thermo-electric, general purposes of, 74.
Thermo-electric, electro-motive force of, 74.
Induced, properties of, 68.

Curvature, spinal, 770.

Cutting loops for galvano-cautery, 716.

Cystic tumors, 731.

Daniell’s battery, 38.

Deafness, hysterical, 657.
Following cerebro-spinal fever, 659.

 

INDEX.

Declination, ro.

Definition of electricity, 2.

Derived currents, 35.

Density, 18.

Diamagnetism, 8.

Diabetes, 679.

Diarrheea, chronic, 58.

Digestion, diseases of the organs of, 575.
Electro-diagnosis, 575.
General principles of treatment in, 575.

Diplegic contractions, 315.

Disks, galvanic, 490.
In myalgia, 544.

Dose of electricity, 272. ‘

Double-cell-constant batteries, 38.

Drescher’s galvano-faradic machine, 350.
Galvanic battery, 349.

Dropsy, 682. : ‘

DuBois-Reymond’s researches in animal elec

tricity, 103.

Duchenne and Remak, 225.

Duchenne’s apparatus, 363.

Dynamical electricity, terminology of, 5z.

Dyspepsia,‘577.

Dysmenorrheea, 587.

Dysphagia, from spasms of the pharynx, 555.

Dysphonia, cases of, 635. :

Ear, diseases of, 648. . 7
Internal method of electrization of, 649.
External method of electrization of, 650.
Electro-diagnosis of the diseases of, 650.
Middle, chronic suppuration of, 659.
Middle, subacute inflammation of, 655.

Eczema, 563.

Effects of electrical treatment, how to judge of the,

283.
Of localized electrization, 379.
Of general faradization, 400.
Electrical relation of elements, 21.
Treatment, after-effects of, 294,
Electricity, frictional, 14.
Statical, 14.
Distribution of, 17.
Magneto, 68.
Thermo, 72.
Animal, Reymond’s theory of, 103.
Statical use of, 426.
Animal, roz.
Induced, sg.
A mode of motion, 33.
Franklinic, 14.
Loss of, 15.
Polarity of, 33.
Conversion of, into heat, 34.
Nature and definition of, 2.
In the living man, 104.
Action of on the skin, 117.
On the brain and spinal cord, 124.
On the sympathetic and pneumogas-
tric, 128
On the nerves of special sense, 140.
On motor and sensory nerves, and
voluntary muscles, 153.
On involuntary muscles, 170,
Effects of on nutrition, 180.
Mechanical, physical, chemical, and physio:
logical effects of, 180.
Effects on secretion and excretion, 197.
Absorption, 200.
Reflex effects of, 200.
Relation to life, 207.
Free in the body, 209.
In plants and fruits, 220.
General therapeutical action of, 253.
Dose of, 272.
Spe are of, 287.
ts use by the laity, 295.
Fishes, or. ao
Electric Machines, 18.
INDEX.

Electric Light, 35.
Baths, 431.
Effects of, 433.
General rules for giving, 434.
Moxa, 368. :
Explorer or probe, 772.
Disks, 490.
Electrical endosmosis, 191.
Electrization, localized, 367.
History of, 223.
Rationale of, 257.
Instruments for, 367.
With moistened electrodes, 368.
Details of application of, 371.
Of plexuses, nerves and muscles, 377.
Effects of, 379. J 5
In its relations to other 1orms of treatment,

294.

Direct and indirect, 369.
Electro-anzesthesia, 122.
“lectro-chemical baths, 774.
Electro-bioscopy, 317.
Electro-conductivity of the human body, 180,
Electro-diagnosis, 304. ‘
Electro-sensibility, 305.
Electro-muscular contractility, 160,

Sensibility, 160.
Electro-dynamical induction, 59.
Electro-magnetic helix, 61.

Machines, 6s.
Electro-magnetism, 59.

Electrodes, 355.

Metallic, 359.

’ Unpolarizable, 36r.

Moistened, electrization with, 368.

Brass ball, 356.

Foot plate, 195, 202.

,' Uterine, 589.

Intra-uterine, 589.

Rectal, 581.

Double uterine, 590.

Vaginal, 591.

Double vesical, 590.

Adjustable, 357.

Care of, 362.

Polarization of, 37.

Universal handle for, 353.

Long sponge, 356.

Hard rubber handle, 356.

Duchenne’s, 356.

Stationary, 357.

* Spinal, 359.

Current reverser, 360,
Electro-magnet in extraction of foreign bodies, 774.

Negative, 28,
Electro-medication, 777.
Electro-motive force, 78. .
Electro-muscular sensibility, 308.
Electro-physics, 1.

Electrometer, Thompson’s quadrant, 22,
pre pelnaltey; 304.
éctro-physiology, 99.
Electro-physiognomy, 165.
Electro-physiological anatomy, 165.
Positive, 28.
Electro-surgéry, 693.

History of, 693.
Electro-therapeutics, history of, 214.

Apparatus for, 327. ‘

Rapid progress in America, 243.

In advance of electro-physiology, 248.

Causes of failure in, 410.
Electro-therapeutical anatomy, 2x9.
Electrolysis, definition of, 53.

History of, 53.

‘Terminology of, 53.

Laws of, 54.

Theory of, 57- |

Its nature and: general methods, .699.

 

789

Electrolysis, NeedJes for, 702.

Of living and dead tissue, 192.

Of the base, method of operating by, 706.

Apparatus for, 7or.

Conductor for, 702.
Electrolyzing the base, 705.
Electrophorus, 21.

Electrophorus machine, Holtz’s, 19.
Electroscope, gold leaf, 21.
Electrotonos, definition of, 111.

Molecular theory of, 111.

Of muscle, r15.

In the living man, 116.

Practical bearing of its laws, 116.
Elephantiasis, 372.

Elements, electrical relations of the, 30,

| Endosmosis, electrical, 191.

Erectile tumors, 724.
Epithelioma, 740. .
Epilepsy, 558.

Cases of, 558.

Epileptiform neuralgia, 479.

Cases of, 480,

Exhaustion, nervous, 444.
Exophthalmic goitre, 681.
Extra current, 64.

Eye, diseases of, 639.

Paralysis of ‘Re muscles of, 640.

Electrization of, 639.

Prognosis in paralysis of the muscles of, 640.

Asthenopia, 642.

Amblyopia and amaurosis, 644.

Lid, spasm of, 644.

Eyelid, cases of spasme of, 643.
Eye, opacities of the cornea, 645.

. Ptosis, 646. ;
Mydriasis and myosis, 646.
‘Neuro-retinitis, 646.
Strabismus, 646.

Opacities, vitreous humor, 645.

Photophobia, 645.

Cataract, 647.

Facial neuralgia, 479.
Cases of, 480,
Facial Eeralyais, 519.
‘ases of, 520.
Facial spasm, 555-
Farad, 78.
Faradic current, effects of, 119.
Faradic anesthesia, 775.
Faradie and galvanic currents, comparative value
of, 297.
Baradsaten era of, 223.
° Galvano, 302.

Dry or cutaneous, 368.
Faradization, general, 383.

History of, 227.

Apparatus for, 386.

Effects of, 400.

Rationale of, 406.
Farado-sensibility, 324.

Degrees of, 324.

As compared with galvano-sensibility, 326.
Farmer’s thermo-electric battery, 76.
Fatty tumors, 739. 5
Feigned diseases, 316.

Ferrier, researches of, 124.
Fevers, 688.

Convalescence from, 688.
Fever, intermittent, 674.
Fishes, electric, rox.
Fistula, 764.
Flatulence, 585. .
Fibroids, 736. 2
Force, electro-motive, 78.
Fothergill’s disease, 479.
Foveaux’s battery, 364.
Franklinization, 426. ,
Franklinic electricity, action of, 119.
799

Franklinic Era of, 215.

Fritsch, researches of, 124.

Free electricity in the body, 209.

Franklinization, methods of, 427.
Apparatus for, 429.

Frictional electricity, 14.

Frost-bite, 767.

Furuncles, 767.

Gaiffé, battery of, 363.

Galvani’s researches, 49.

Galvanic batteries, 38.

Galvanic current, effects of, 122.

Galvanic and faradic currents,

of, 297.

Galvanic belts and disks, 490.
Circuits, compound, 34-
Circuits, homogeneity of, 29.

Galvanism, 25.

Early history of, 48.
Era of, 219.

Galvanization, central, 412.

History of, 230.

Of the head, 371,

Of the sympathetic, 372.
Of the pneumogastric, 373.
Of the spine, 374.

Galvano-cautery, history of, 712.

pepecnes for, 711.

ses of, 719.
Advantages of, 719.
Advantages of, over the actual cautery, 711.
Burners and cutting-loops for, 716.
Rules for the use of, 720.
Adaptation to various departments, 721.
Byrne’s, 712.

Galvano-faradic apparatus, Drescher’s, 350.
Meyer and Metzger’s, 366.

Galvano-puncture in sciatica, 487,

Galvanometer, 46, 349. |
Thomson’s reflecting, 47.

Galvano-tonic contractions, 357.

Galvanoscopes, 349.

Gas batteries, 37.

Galvano-faradization, 302,

Galvanometer, astatic, 47.

Gangrene, 767.

General faradization, 383.

History of, 227.

Length of applications, 397.

Application to spine, 392.

Details of its application to different parts

of the body, 388.
Applications to the neck and throat, 389.
. Applications to the head, 389.
General galvano-faradization, 390.
General faradization, applications to the upper ex-
tremities, 392. .
Applications to the lungs and heart, 392.
Applications to the liver, spleen, and towel:

value

P

393-
Applications to the stomach, 394.
Applications to the female genitals, 394.
Applications to the lower extremities, 394.
Effects of, 400.
Rationale of, 406.
Persistence in treatment, 397.

General and localized faradization, differential

indications for the use of, 408.

General therapeutical action of electricity, 253.

Genito-urinary organs, diseases of, 617.
Treatment of, 616, 619.
Electro-diagnosis, 619.

Gleet, 646,

Glosso-laryngeal paralysis, 514.

Glottis, spasm of, 635.

Goitre, 729.

Gonorrhaea, 626.

Gout, 541.
Case of, 546.

 

INDEX.

Gout, rheumatic, 546.
Treatment of, 546.

Graves’ disease, 681.

Grove’s battery, 39. , ‘ct

Gustatory nerve, action of electricity on, 151.

Hall’s faradic machine, 337.
Twenty-cell battery, 351.

Hay-fever, 688.

Hezmatocele, 767.

Hemorrhoids, 628.

Hand as an electrode, 398.

Head, galvanization of, 37%.

Headache, 475,

Prognosis, 475.
Cases, 476.

Heart, galvanization of, 172.

Diseases of, 667.
Palpitation of, 667.
Cases of, 667.

Helix, 60.

Hemiplegia, 511.

Cases, 510.

Hemorrhage, post-partum, 662. -

Herpes zoster, 569. 7
Frontalis seu ophthalmicus, 569.

Hernia, 721.

Hiccough, 556.

Hip-joint, 771.

History of central galvanization, 238.

History of electro-therapeutics, 214.
General faradization, 227.

Hitzig, researches of, 124.

Humboldt’s researches in animal electricity, x02.

Hydatids of liver treated by electrolysis, 736.

“Hydrocele, 768.

Hydro-electrization, 776.

Hydrophobia, 556.

Hydrostat, 338.

Hypochondniasis, 441.

Treatment, 442.
Cases, 442.

Hysteria and allied affections, 435.
Electro-diagnosis, 435.
Treatment, 435.

Prognosis, 435.
of, 436.

paralysis, sor.

anzesthesia, 495.

deafness, 657.

 
 
   

Tleus, 581.
Impotence, 618.
Causation, 619.
Electro-diagnosis, 619.
Treatment of, 6x9.
Cases of, 622.
Incontinence of urine, 609.
Induced currents, different orders of, 62
Properties of, 68.
Induction of a current on itself, 64.
Induction, statical, 16.
Induction coils, 65.
Magnetic, 5.
Electro-dynamical, 59.
History of, 70.
Infantile paralysis, 610.
Examination of muscles, 610,
Early symptoms, 610.
Electro-diagnosis, 612.
Treatment, 613.
Prognosis, 613.
Cases, 614.
Tasca 458.
lases af, 460.
Infantum, cholera, 609.
Interruptions, slow, comparative value of, 330.
Insomnia, 454.
Treatment, 454.
Case of, 454.
Intensity of magnetism, 10.
 

INDEX.

Intensity vs. quantioy, 80.

Intra-uterine electrode, 589.

Intermittent fever, 674.

Irritation, spinal, 449.

Isolation, 672,

Involuntary muscles, action of electricity on, x70.

Irritability, restoration of, 115.
Degrees of, 148.

How long retained after death, 153.
Tris, action of electricity on, 170.
Invagination, 581.

ar, Leyden, 22.
aundice, 580.
eratitis, 645.

Kidder’s faradic apparatus, cut of, 332.
Galvanic apparatus, 342.

For galvano-cautery, 713.

Rules for the use and care of, 333.
Lacteal secretion, deficient, 662.
Larynx, diseases of, 629.

Laryngismus stridulus, 635.

Larynx, external electrization of, 629.
Anesthesia of, 638.
Hyperesthesia of, 637.

Lead palsy, 499.

Lechanche’s battery, 43,

Leucorrheea, 587.

Leyden jar, 22.

History of, 23.

Leucoderma, 572.

Lichen, 567.

Life, relation of electricity to, 207.

Localization, absolute of electricity, impossible, 38.

Light, electric, 34.

Liver, cirrhosis, 689.

Lightning, fear of, 256.

Lipomata, 739. | .

Localized faradization, history of, 223.
Galvanization, history of, 225.
Electrization, 367.

Instruments for, 369

Details of application of, 371.

Effects of, 379.

Localized and general faradization, differential in-

dications for the use of, 409.

Locomoter ataxy, 527.

Electro-diagnosis, 528.

Treatment, 529.

Prognosis, 528.

Cases of, 530.

Lungs, diseases of, 670.

Machine, electric, Holtz’s, 19.
Electro-magnetic, 65.

Magnets, artificial, 3.

Shape of, 6.

Polarity of, 3.

Magnetic armature, 6.

ot Induction, 5.

etism, 2.

Bae Coulomb’s, theory of, 4.

Of rotation, 70.

Of broken magnets, 4.

Terrestrial, 10.

Electro, 59.

Ampére’s theory of, 49.

Animal, 209.

In headache, 344.

Magnetization, 6.
physical effects of, 9.

Magneto-electricity, 68.

Electric machines, 337.
Malignant tumors, 724.

Marasmus, 608.

Maritime battery, 45. | . i

Matteucci’s researches in animal electricity, 103.

Melanoderma, 572.

Meyer and Metzger’s apparatus, 366.

Mammary gland, diseases of, 662.

Melancholia, 441.

 

791

Menorrhagia, 587.
Midwifery, 661,
Migraine, 478.
Milk, deficient secretion of, 662.
Treated by electricity, 663.
Miscellaneous medical diseases, 672.
Sequelz of sunstroke and cerebro-spinal
fevers, 672.
Intermittent fever, 674.
Addison’s disease, 675.
Suppression of urine, 678,
Diabetes, 679.
Exophthalmic goitre, 681.
Dropsical effusions, 682.
Bright's disease, 682,
Catarrh, 683.
Anosmia, 683.
Odontalgia, 685.
Hay fever, 688.
Obesity, 689.
Cirrhosis, 689.
Morbus coxarius, 771.
Motor points of muscles, 319.
Nerves, action of electricity on, 153.
Mother’s marks, 724.
Moxa, electric, 368,
Multiplier, thermo, 74.
Multiple element battery, Byrne’s, 712.
Muscle, eleéctrotonos of, 115.
Muscular atrophy, progressive, 536,
Muscular contractions, 555.
Muscular rheumatism, 544.
Treatment, 544.
Cases of, 545.
Myalgia, 544. 7
Mydriasis and myosis, 646.
Myosis and mydriasis, 646.
Myo-sclerotic paralyses, progressive, 540.
Nature of electricity, 2.
Neevi treated by electrolysis, 724
Neck, applications to, 389.
Needles for electrolysis, 702.
Method of introducing for electrolysis, qos.
Negative modification, 114.
Variation of the muscular current, x14.
Nerves, electrization of, 377.
Nerve muscle current, 377.
Nervous exhaustion, 444.
Cough, 636.
Dyspepsia, 576.
Force, speed of, 207.
Neurasthenia, 444.
vs. anemia, 444.
Treatment, 445.
Prognosis, 445.
Cases, 445.
Neuralgia, 470. |
lassification, 470.
Electro-diagnosis, 470.
Treatment, 470,
Prognosis, 472:
Constitutional, 471.
Intercostal, 473.
Central, 475.
Cephalalgia, 475.
Facial, 479.
Epileptiform, 479.
Spinal irritation, 449.
Peripheral, 482.
Gastralgia, 483.
Sciatica, 486.
Angina pectoris, 668.
Galvanic belts and disks in, 490.
Cases of facial, 367.
Reflex, 489.
Neuro-retinitis, 646.
Neutral line, 3.
Point, 114.
Nipples, sore, 663.
792

Nipple Shield, galvanic, 663.
Nobili’s researches in animal electricity, 103.
Nutrition, effects of electricity on, 180.
Obesity, 689.
Odontalgia, 685.
Cidema, 682.
(Esophagus, stricture of, 763.
Ohman, 77.
Ohm’s law, 77.
Opium poisoning, paralysis from, 500.
Ophthalmoscopic examination of the retina in gal-
vanization of sympathetic, 136.
Optic nerve, action of the galvanic current on, 140.
Orchitis, 627. 2
Case of, 627.
Ovaries, irritation and congestion of, 601.
Ovarian tumors, 739.
Ozone, 685.
Physiological and therapeutical effects of,
68'

’

Ozonization, galvano, 765.

Oxygen, ozonized, 685.

Ozonized oxygen, 685.
General properties of, 686.

Paralysis, 498.
Accessories to electrical treatment of, 508,
Time of beginning treatment in, 508.
Classification, 498,
Rheumatic, 498.
Lead, 499.”
Syphilitic, 499.
From opium pgisoning, 500.
Hysterical, 501.
Central, sos.
Glosso-pharyngeal, 514.
Spinal sclerosic, 527.
Infantile, 610.
Peripheral, 519.
Facial, 519.
From pressure, 523.
Reflex, 525.
Calorific, 525.
Progressive myo-sclerosic, 540.
Agitans, 552.

Pain of cancer, relief of, by galvanization,

752
Palsy, shaking, 552.
Paramagnetism, 8.
Paraplegia, 516.
Differential diagnosis, 516,
« Electro-diagnosis, 516,
Treatment, 516.
Prognosis, 517.
Cases of, 517.
Paresis of muscles of eye, 640,
: Of bladder, 624.
Partial currents, 35.
Pathology, electro, 304.
Pathophobia, 441.
Pessaries intra-uterine, galvanic, 6or.
Petit mal, 558.
Pectoris, angina, 668.
Pflueger’s law of contraction, 116.
Photophobia, 645.
Physical effects of magnetization, g.
Physical and vital torces, theory of correlation,

269.
Physiognomy, electro, 165.
Physiology, electro, 99 :
Pile, voltae, 36.

: ry, 46.
Piles, 628. £
Plexus uerve current, 377.
Pneumogastric, galvanization of, 373.

Action of electricity on, 128,

Poles, how to distinguish, 343.
Podalgia, 78.
Potential of the electric current, 80,
Polarity of the circuit, 99, .

 

INDEX.

Polarity of Magnets, 3.

f Electricity, 33.

Polarization of electrodes, 37.

Post-partum hemorrhage, 662.

Polypi, 740. .

Positive modification, 114.

Pott’s disease, 770.- .

Primary coil, object of the iron core in, 65. _
Primary and secondary coils, differential action of

156.

Probe, electric, 673.

Pityriasis, 568.

Progressive muscular atrophy, 536.
Symptoms and diagnosis, 447.
Eleotro-diagnosis, 536.
Treatment, 536.

Case of, 537.

Muscular hypertrophy, 540.

Myo-sclerosic paralysis, 540.
Prolapsus uteri, 600.

Ani, 628.

Prostate, enlargement of, 627.

Prurigo, 566

Psoriasis, 568.

Pseudo-hypertrophic paralysis, 540.
arthrosis, 770.

| Ptosis, 646.

Quantity of the electric current, 84.
Absolute and actual, 86. | 7
Radcliffe, Dr. C. B., views of animal electricity,

105.
Rectum, scirrhus of, 748,
Restorative effect a electrization on voluntary
muscles, 158. _
Remak and Duchenne, 225.
Reflex effects of electricity, 200.
Remak’s galvanic apparatus, 365.
Resistance, 82.
Effects of temperature on, 83.
Rectum, discases of, 628.
Reflex neuralgia, 489.
Paralysis, 525.
Regurgitation, 584.
Resuscitation of new-born children, 666.
Respiration, artificial, 664.
Retina, ophthalmoscopic examinations of, during
galvanization of sympathetic, 136.
Rheostat of Mayer and Wolff, 353.
Hydro, 353.
Rheotome, 64.
Rheumatic paralysis, 542.
Gout, 546.
‘Treatment, 546.
Rheumatism, 541.
Rheostat, 48, 352.
Rhinitis, 682,
Ringworm, 571.
Rotation, magnetism of, 70.
Rosacea, acne, 568
Ruhmkorff’s coil, 66.
Rubber covers for conducting wires, 361.
Sciatica, cases of, 487.
Sarrhus, 740.
Sclerosis, spinal, 527.
Sea-sickness, 585.
Secondary and primary coils, differential action of,
156.
Scleroderma, 571.
Sensory nerves, action of electricity on, 153.
Seminal emissions, 617.
Sensibility, electro-muscular, 160,"308.
Shaking palsy, 552.
Shape of magnets, 6.
Shottening: of muscles during a contraction.
158.
Siemens-Meidinger battery, 364.
Single coil and separate coil faradic machines,

328.
Sick headache, 478.
 

INDEX.

Sick headache, case of, 478.
Singultus, 556.
Sinuses, 764. oo
Skin, diseases of, 560.
Treatment of, 561.
Eczema, 563.
Prurigo, 566.
Lichen, 567.
Anesthesia, 567.
Acne, 567.
Rosacea, 568.
Psoriasis, 568.
Pityriasis, 568.
Herpes, 569.
Ringworm, 571.
Scleroderma, 571.
hromatogenous diseases, 572,
Leucoderma, 572.
Melanoderma, 572.
Elephantiasis, 572.
Alopecia, 573.
Smee’s battery, 42.
Solenoids, 60.
Spark, electric, 20.
Spasmodic stricture, 762.
Spasms of the eyelid, 644,
Facial, 555.
Spasmus glottidis, 635.
Spasmodic diseases, 548.
Spermatorrhoeza, 617.
Sphincter, paralysis of, 628,
Sphygmograph, experiments with, 137-
Spinal congestion, diagnosis, 463.
Case of, 463.
Cord, direct electrization of, 126,
Current, 377.
Root current, 377.
Cord, plexus current, 378.
Nerve current, 378.
Muscle current, 377.
_ Curvature, 770.
Spinal Irritation, 449.
- Differential diagnosis, 449.
Pathology, 450.
Treatment, 451.
Prognosis, 451.
Cases of, 451.
Sclerosic paralysis, 527.
Spine, galvanization of, 374.
Spondylitis, 770.
Sprains, 769.
Stammering, 557.
Statical electricity, 14.
Induction, 16.
Era of, 215.
Use of, 426.
Stéhrer, apparatus of, 363.
Stéhrer’s zinc-carbon battery, 364.
Stomach, action of electricity on, 170.
Strabismus, 646.
Strain, 769.
Stricture of the urethra, 759.
Cases of, 760.
Of the cesophagus, 763.
Spasmodic, 762.
Stumps after amputation, 767. i
Suggestions in regard to the therapeutical uses of
electricity, 262. , 2 é
Agee: action of electricity on cranial portion
of, 130.
Nerve, action of electricity on, 128.
Galvanization of, 372. : m
Action of electricity on the cephalic thoracic
and abdominal ganglia of, 131.
Sunstroke, 672.
Suppression of tirine, 678.
Surgery, electro, 693.
History of, 693-
Synovitis, 767.

 

793

Synovitis, case of, 767.
Syphilis, 627.
Talipes, 771.
Temperature of electrodes and operating-room,
276.
Tension of the electric current, 80,
Terrestrial magnetism, 10. °
Tetanus, 556.
Thermo-electricity, 72.
Multiplier, 74.
Electric batteries, 75.
Thermo-electric currents, general properties of,

745

Thomson’s quadrant electrometer, 22.

Eines applications to, in general faradization,
389.

Tic-douloureux, 479

Tinnitus aurium, 655.

Galvanization of sympathetic ing 656,
Tobacco, excessive use of, 310.
Tonics, definition of, 254.

Tonic effects of electricity, 254.

In general faradization, 403.
Toothache, 685.

Torticollis, 550.

Diagnosis of, 550.

Electric examination of, 551.

Treatment of, 551.

Prognosis, 551+

Cases of, 551.

Tremors, 466.

Trowbridge, experiments of, 107.

Trocar, Duchenne’s, 610.
Noeggerath’s, 610.

Tuberculous diathesis, 291.

Tubercula quadrigemina, direct electrization of,

61.

Tumors, removal of by galvano-cautery, 721.
Non-malignant, 724.

Erectile, 724.

Malignant, 724.

Cystic, 731.

Fatty, 739.

Ovarian, 739-

Ulcers, 764.

Unit, a, 77.

Unpolarizable electrodes, 361.

Ununited fracture, 770.

Urethra, strictures of, 759.

Cases of, 760.

Hypereesthesia of, 629.

Water battery, 45.

Wollaston’s battery, 44.

Urethritis, chronic, 626.

Urine, incontinence of, 609.
Suppression of, 678.

Uterine electrode. 589.

Uterus, faradization of, 588. |
Diseases of, prognosis in, 587.
Enlargements of, 599.
Prolapsus, 600.

Anteflexion of, 600.

Retroflection of, 600,

Retroversion of, 600,

Anteversion of, 600.

Amputation of neck of, by galvano-cautery,

72a.
Congestion of, 599.
Displacements of, 599.
Atrophy of, 599.
Fibroids of, 738.
Uteri prolapsus, cases of, 600.
Vaginal electrode. 591.
Variations of the needle, 11.
Varicose veins, 754.
Veins, varicose, 754.
Vital and physical forces, theory of their correla
tion, 209.
Vitreous humor, opacities of, 645.
794. INDEX.

Viscera, abdominal, localized electrization of, 576, | Water rheostat, 353.

Volta constructs the voltaic pile, 36. Wesley, Mr., 217.

Volta’s researches, 49. Wires, conducting, rubber cover for, 362,
Voltaic pile, 36, Whooping-cough, 609,

Vomiting, 584, 609. Wollaston’s battery, 44.

Volta meter, 46. ‘Women, diseases of, 587,

Walker’s single cell zinc-carbon battery, 4x. Writer’s cramp, 548,

Warts, 771. Wry neck, 550,
\V 0 Dec e (ov)
enna Sell

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CONSERVATION 1998