Electrotherapy

“ We are prone to think that electrotherapy is modern, but when electrical machines were quite crude, current strength small and potential low, old-time electro-therapeutists were recording their wonderful results and were getting just as marvelous effects as are reported now by enthusiasts. ”

“ The electrode must be soaked in hot water, the superabundance of which is expressed before it is placed. The water is to be as hot as it is comfortably borne by the patient; cold water must be avoided, as it lessens the conducting power of the electrode, offers greater resistance than hot water because it does not saturate the epidermis so rapidly, and because it is not only uncomfortable, but might even endanger a patient suffering from a chronic inflammatory trouble, for which we so often make these applications. ”

“ Hardaway, so that among a limited number of specialists this one property of galvanism was thoroughly appreciated; but to the profession at large the electric current still remained the same mysterious agent, regarded with indifference, with distrust, or with awe, until Apostoli, in 1883, gave us the key to the successful application of electricity for the destruction of fibroid tumors by urging, 1. Localization, the limitation of effect to one active pole, which must be placed within the tissues; and, 2. The use of currents stronger than any hitherto applied in medical practice. ”

“ Success was impossible with the indiscriminate application of electricity in the various branches of medicine; in gynecology we deal with resistances of 200 and 300 ohms, as low as 40, but never above 600 or 800, whilst we use currents up to 250 milliamperes, most commonly between 20 and 80 milliamperes; the neurologist, on the contrary, rarely goes as high as 20 milliamperes, and usually uses from 2 to 5 milliamperes, and the resistance of the tissues between his electrodes is from 5000 to 10,000 ohms and over. ”

“ The use of electricity is rapidly gaining in favor among gynecologists, and this is due to the galvanometer, mainly, hardly less to the introduction of the polar method—i.e., the direct application to the tissues, and to the use of strong, effective currents—making it possible to apply the current without those long sittings of twenty and thirty minutes, which made it an impossibility for the busy practitioner heretofore. ”

“ These electrodes must be so arranged that firm connection, best by a screw, can be made with the rheophore; and one of the intrauterine electrodes must be of non-corrodable metal, best of platinum, for use in connection with the positive pole; as oxygen and acids are set free at this pole, an electrode of corrodable metal is soon affected and is not only rendered useless, but is imbedded in the tissues and hard to withdraw.
It will be found convenient to have a stylet and sound in one and the same instrument, of platinum, one end straight and pointed, the other curved and blunt, which. ”

“ The density of the current, however important in other methods or in other localities, varies but little in gynecological treatment by the polar method, as it is practically the same in all but the intrapolar applications, as, for instance, to the ovaries. The active pole being always small, either stylet or ball, the effect sought in its immediate vicinity differs but little whether the current is dispersed upon a large or small plate. Still. I have named the location and size of the dispersing electrode among the elements necessary for dosage and record ”

“ But we can go down to the very latest literature without an improvement in that vagueness which has killed electricity as a medicinal agent. What is the practice of those who in their writings urge precision in application and measurement? What is the practice of those who preach exactness, and tell us that the want of progress is due to want of precision? ”

“ Ten amperes, through a resistance of sixty ohms, which is as low a resistance as we may expect in a fibroid, means a force of six horse power, this in electro-chemical force or heat would destroy the abdomen in a few momenls. Any unlucky fireman who for a moment touches non-insulaled parts of a wire carrying a ten ampere current is struck dead, and yet one enthusiastic electro-therapeutist claims to have applied a currenl of ten amperes to a living woman! ”

“ The electric current, both galvanic and faradic, is a most subtile agent, which may be made to serve many purposes, and which possesses numerous, greatly varying, and even antagonistic properties, which can be developed at will by the accessory apparatus and the method of application. ”

“ Do you not see that, by placing my negative pole on the already overcharged and inflamed eyes, I attract to them yet more of the electro-vital fluid, and so increase their positive condition and aggravate the inflammation? and that, by presenting my positive electrode to the eyes already more or less paralyzed, I repel what little electro-vitality there was there, and so make the nerves all the more negative and dead? And yet, I repeat it, this is precisely the plan of almost all the men who [68] use electricity in therapeutic practice with any regard to its polarization. ”

“ As before intimated, the mass of physicians at present, who treat more or less electrically, do so with no knowledge, or next to none, of the great versatility of action of which the electric current is capable. They know nothing of the electrical polarization of the living organism in health, nor how it is variously affected in disease. The particular electrical state of the diseased organs is a matter foreign to their minds. They appear to suppose the point to be immediately aimed at as a means of cure is to get the electricity from the machine into the affected part or parts ”

“ By C. B. Radcliffe, M.D. Macmillan.
[2] See Mr. Netten Radcliffe upon the differential reaction of voltaic and induced currents of electricity. Note to page 331, vol. i., of Bazire’s translation of Trousseau’s “Clinical Medicine.” Hardwicke.
[3] This observation, made in 1873, requires some qualification now (1886) . At several of the great medical schools, though not at all, electrical treatment has been transferred from the hospital porter to some member of the hospital staff; and at more than one a systematic course of lectures upon electro-therapeutics has been delivered. ”

“ This is, under the treatment of most physicians, often accomplished by the use of medicines, and by mechanical or surgical agency. We accomplish it by the proper application of the poles of our electrical apparatus. In cases where there is virus to be destroyed, or abnormal growths to be removed, we also secure the chemical action appropriate to these ends by the proper selection of our current. It often happens that mechanical or surgical action is demanded. In many such cases, we do not profess to secure normal polarization and consequent cure by means of electricity alone. ”

“ If the patient be immersed up to his neck in an electric bath, much stronger currents can be passed without causing either pain or injury, as in this case the whole area of the skin in contact with the water acts as an electrode. In passing the current it must be remembered that the negative electrode or kathode is the more painful of the two, and its action more stimulating than the positive electrode or anode, which is sedative. If a muscle be stimulated over its motor point, it will contract with a sharp twitch and then become quiescent. ”

“ Galva.—That electricity has proved of great use in the treatment of disease is unquestionable, though it is quite as certain that it has opened a way to quacks and other swindlers of fleecing invalids and others, and in this way it has proved a great enemy to medicine. As regards its uses in medicine, it has given us the electro-cautery, electrolysis, the portable electric light—a most valuable addition to our consulting-rooms—and it has given us the electric currents so much used in the treatment of nervous diseases. No person should start practising on herself with the electric current. ”

“ If, in electro-therapy, an electric current is applied to the cartilages of the long bones in children whose limbs have apparently been arrested in development, the result is a rapid increase in length, amounting to a luxuriant osteogenesis.
Since we know that the electric current can stimulate the nerve filaments and the fibres of the striped muscles when they have been rendered inactive from the effects of paresis or even of paralysis, we realise that electricity can exert an influence over the entire physiological life of an organism. ”

“ But when a patient is under treatment, the conducting-cords, the electrodes, and so much of the patient's person as is traversed by the current while passing from the positive electrode through to the negative electrode, are also included in the whole circuit. And whatever elements may serve to conduct the current in any part of its circuit—be they metal, fluid, nerve, muscle, or bone—the same are all, for the time, component parts of one complete magnet, which, in all its parts, is subject to the law of polarization, precisely as if it were one magnetized bar of steel. ”

“ The stimulant effects of electricity are occasionally beneficial in the treatment of paralysis of the nerves of special sense, especially of the optic and auditory nerves, while its use has been advocated in a multitude of diseases to which I shall not further refer, than by saying that a clear comprehension of the principles of electro-therapeutics will prevent the occurrence of difficulty in any special application of them ”

“ The patient is insulated on a suitable platform and treated by means of charges and discharges from an electrical machine. The effect is to increase the regularity and frequency of the pulse, raise the blood pressure and increase the action of the skin. The nervous system is quieted, sleep being promoted, the patient often becoming drowsy during the application. If while the patient is being treated a point electrode is brought towards him he feels the sensation of a wind blowing from that point ”

“ The power of the pseudo-scientific aspect of electricity to influence patients, far from being lost in our time, has rather been increased. Our newspapers make their readers eminently suggestible because they constantly furnish suggestions, and nothing so strengthens a function of any kind as exercise of it. All sorts of electrical contrivances and apparatuses are advertised to cure various pains and aches. Many of them actually seem to relieve long-standing discomfort, though it is not through any electrical power that they do so, but entirely through their influence on the patient's mind. ”

“ But even where we are in doubt or positively ignorant as to the origin of the symptoms, we are justified in giving preference empirically to electricity, not only because, the disease being essentially of a nervous character, we find in electricity the most powerful of neurotics, but also because recent statistics, those that embrace a period when electricity has been permitted to participate, if not duly, at least more largely than heretofore, in the treatment of disease, go to show that by means of this remedy better average results have been obtained than with any other. ”

“ But the medical faculty have too widely employed electricity in the treatment of disease, and that with too frequent success, to admit of its being denied a place among important therapeutic agents by any respectable practitioner. ”

“ It lacks sufficient electro-vitality—is improperly negative, and needs to be treated with the negative pole.
It will often happen that diseased action is found in parts where the patient was entirely unaware of its existence until the practitioner's fingers or other electrode revealed it. Again, it will sometimes be found that there is no disease whatever in parts where the patient supposed disease to be active. ”

“ On the contrary, everything is made so clear that any practitioner, whether he previously knew anything of electricity or not, may from this book at once begin the practical use of it, and if there are any lingering doubts in the minds of some ultra-conservative persons as to the practical value of electrical treatment, this book should dispel them.... the busiest practitioner can, without difficulty, learn how to effect a large amount of good which he was previously quite unable even to attempt.”—The Practitioner. ”

“ Electricity is coming into use in mental diseases. Faradism, and especially cutaneous irritation with the wire brush, would seem to be most suitable for cases accompanied by depression or torpor, the stimulating effects being of service in inspiriting the patient, while the soothing influence of a direct application of the constant Voltaic current to the brain may be employed in cases of over-excitement requiring a sedative. ”

“ If the patient be a man we let his trunk be disrobed, giving free access to the back, chest and abdomen. If the patient be a woman, let her be covered with a treating-robe, [89] of which garments the practitioner should keep a supply. They are made much like a lady's plain nightgown; but large and loose, so as to serve ladies of any size, and give ample room to work the electrodes under them. Her skirts should be dropped below the seat, so far that their bands shall lie across her lap.
Let us now suppose the machine to be working. We will take the B D current. ”

“ By persisting with this treatment thrice weekly over a period of two months, so great an amount of relief was obtained that little distortion of the face remained, and the patient was able to pursue her business with comfort.|Emotional Aphonia.| Electrization by sparks over the larynx has been found so effective in the relief of cases of hysterical or emotional aphonia, even those of long standing, that it is well to use it in the treatment of these cases before having recourse to induced electricity. ”