L I E) I^AFLY OF THE U N I VER.S ITY or ILLINOIS Return this book on or before the Latest Date stamped below. University of Illinois Library APR 27 19^9 APR n9?5 Mi 0 2 \M JUL ^i m AUG 1 5 i<)97 JUL 1 1 2Q07 L161 — H41 Digitized by the Internet Archive in 2015 https://archive.org/details/elementaryprinciOOhayn ELEMENTART PEIITCIPLES OF ELECTRO-THERAPEUTICS FOR THE USE OF PHYSICIANS AND STUDENTS. WITH 135 ILLUSTKATIONS. PREPARED BY C. M. HAY^^ES, M D. FOURTH EDITION. CHICAGO: W. T. KEENER, 96 -WASHINGTON STREET. 1887. v. Entered according to Act of Congress, in the year 1884, by the McINTOSH GALVANIC AND FAKADIC BATTERY COMPANY, In the Office of the Librarian of Congress, at Washington. CONTENTS. PAGE Introduction 19-33 CHAPTER I. Magnetism. — Law of Magnetic Attraction and Repulsion — Ani- mal Magnetism — Therapeutical Properties of the Magnet 35-47 CHAPTER II. Franklinism. — Insulation — Distribution of Electricity — History of Static Machines — Method by which Electricity is Generated by the Improved Topler Machine — Physiological and Thera- peutical effects of Franklinic Electricity — Method of Electri- fying a Patient, Illustrated 48-85 CHAPTER III. Galvanism. — Voltaic Pile — Simple and Compound Galvanic Cells — Polarization — Local Action — Potential — Electro-Motive Force — Materials of which Elements are Composed, and Relative Value of A^arious Combinations — Arrangement of Cells for Giving a Current of Great Quantity — Arrangement for Potential — Resistance — Ohm's Law — Cells, Grenet, Daniells, Gravity, etc. — Method of Detecting the Presence of a Galvanic Current and its Direction — Galvanic Belt — Galvanic Supporter — Phy- siological Effect of a Galvanic Current — Details of Treatment — Central Galvanization Illustrated 86-145 253978 iv CONTENTS. CHAPTER IV. Electrolysis — Laws of Electrolysis — Needles for Electrolysis — Effect of Electrolysis on Animal Tissue — Batteries for Elec- trolysis — Diseases in which Electrolysis is Employed, and its Exact Value 146-160 CHAPTER V. Galvano-Cautery. — Advantages of Gal vano-Cautery— Cases to which it is Applicable — Instruments for — History of Galvano- Cautery 161-169 CHAPTER VI. Faradism. — Electro-Magnet — Induced Currents — Helix — Rheo- tome — Number of Currents a Faradic Battery should furnish — Physicians' Faradic Batteries — Method of Employing Fara- dic Currents — Primary and Secondary Currents Compared — Local Faradization — General Faradization — Method of Em- ploying, Illustrated 170-192 CHAPTER VII. The McIntosh Combined Galvanic and Faradic Batteries. — Method of Using Them — Suggestions in Regard to the Selec- tion of a Battery — To Discover the Cause when a Battery Fails to Work — Axioms for the Employment of Dynamic Elec- tricity — Electrodes and the Care of Them 193-219 CHAPTER VIII. Electro-Thermal Baths — Kinds and Temperature at which They Should be Given — Apparatus and Bath Tub — Vapor and Hot Air Baths — Cabinet Bath — Electric Chair 220-234 CONTENTS. V CHAPTER IX. PAGE Electro-Physiology. — Comparison df Franklinism, Galvanism and Faradism — Indications for Selection of Current — Motor Points of Muscles Illustrated — Influence of Electricity on the Func- tions of the Nervous System — The Great Sympathetic and Method of Electrizing the Various Organs through it, Illustrated — The Landmarks for Locating the Organs of the Body 235-257 CHAPTER X. Electro-Diagnosis. — To Distinguish between Real and Apparent Death — To Detect Malingerers — To Distinguish between Dif- ferent Forms of Paralysis — To Detect the Presence and Loca- tion of a Bullet or other Metal in a Wound — Electrical Reac- tions in Health 258-274 • CHAPTER XI. Electro-Therapeutics. — Diseases of the Brain, Eyes, Ears, Nose, Throat, Heart, Lungs, Digestive, Urinary and Sexual Organs — Miscellaneous Diseases — Dangers of Electricity 275-417 LIST OF AUTHORS CONSULTED. 1. Allison Dictionary of Electricity. 2. Althaus A Treatise on Medical Electricity. 3. Angell Electricity and Magnetism. 4. Arthius Static Electricity. 5. Bartholow Medical Electricity. 6. Beard and Rockwell Medical and Surgical Electricity. 7. Benedikt Electro-Therapie. 8. Bennett Electro-Diagnosis in Nervous Diseases. 9. Butler Electro-Therapeutics. 10. Channing Medical Electricity. 11. De La Rive A Treatise on Electricity. 12. De Watteville A Practical Introduction to Medical Elec- tricity. 13. Duchenne De TElectrization localise Med. 14. Erb Electro-Therapeutics. 15. Ferguson Electricity. 16. Gordon Electricity and Magnetism. 17. Hamilton Clinical Electro-Therapeutics. 18. Harris Treatise on Galvanism. 19. Hayes Therapeutic Use of Faradic and Galvanic Currents in the Electro-Thermal Bath. 20. HospiTALiER & Maier Modcm Applications of Electricity. 21. Jenkin Electricity and Magnetism. 22. Lardner. Electricity, Magnetism and Meteorology. 23. Lincoln Electro-Therapeutics. 24. Maxwell Electricity and Magnetism. 25. Meyer Electricity in its Relations to Practical Medicine. 26. Miller Electricity and Magnetism. (5) 6 LIST OF AUTHOES CONSULTED. 27. Morgan Electro-Physiology and Therapeutics. 28. Neftel Galvano-Therapeutics. 29. No AD Manual of Electricity. 30. Onimus et Legros Traite D'Electricite Med. 31. Poore A Text-Book on Electricity in Medicine and Surgery. 32. Reynolds Lectures on the Clinical Uses of Electricity. 33. Rockwell Lectures on Electricity. 34. Rosenthal Muscles and Nerves. 35. Ross Diseases of the Nervous System. 36. Schweig The Electric Bath and its Medical Uses. 37. Snell The Electro-Magnet. 38. Sturgeon Electricity and Magnetism. 39. TiBBiTTs A Hand-Book of Medical and Surgical Electricity. 40. Thomson Electro-Statics and Magnetism. 41. Thompson Lessons in Electricity and Magnetism. 42. Tyndall Lectures on Electricity. 43. Walker Magnetism. 44. ZiEMssEN Die Electricitat in der Med. WORKS OF REFERENCE. Cyclop^di^ American, Rees, Tomlinson's Knight, etc. Encyclopedia of Chemistry. Encyclopedia, Edinburgh Brittanica, London, etc. Franklin's Works. Philosophical Transactions. LIST OF ILLUSTRATIONS. PAGE 1. Magnetic Attraction and Repulsion 38 2. Magnetic Lines of Force and Neutral Point 39 3. Mutual Action of Like and Unlike Poles 39 4. Arrangement of Molecules in a Non-Magnetic Bar 41 5. Arrangement of Molecules in a Magnetic Bar 41 6. Franklinic Attraction and Repulsion 49 7. Electroscope 50 8. Leyden Jar 57 9. Electric Machine 61 10. Method of Applying Franklinism 76 11. Electrodes Used in Franklinism 79 12. Method of Applying the Franklinic Induced Current 83 13. Voltaic Pile 87 14. Simple Galvanic Circle 88 15. Compound Galvanic Circle 89 16. Polarization 91 17. Potential 94 18. Electro-Motive Force 96 19. Multiple Arc 98 20. Potential Arrangement 99 21. McIntosh Grenet Cell 107 22. Gravity Cells Ill 23. Tray Cell 114 24. Voltameter 117 25. Galvanometer 118 26. Diagram of Galvanometer 119 27. Binding Posts 121 28. Conducting Cord Tips 124 29. Connector 125 1 2 LIST OF ILLUSTRATIONS. PAGE 30. Galvanic Section 125 31 . Twenty-four-Cell Galvanic Batteey 127 32. Automatic Eheotome 129 33. Pole Changer 130 34. McIntosh Galvanic Belt 131 35. Section of Belt Cells 131 36. McIntosh Galvanic Supporter 135 37. Central Galvanization, No. 1 , 143 38. Central Galvanization, No. 2 144 39. Current Branches between Near Electrodes 148 40. Current Branches between Distant Electrodes 148 41. Needles for Electrolysis 151 42. Needle Conductor . 154 43. Electrolytic Needle-Case 156 44. Twelve-Cell Galvanic Battery 157 45. Eighteen-Cell Galvanic Battery 158 46. Electro-Magnet 170 47. Eheotome 175 48. Helix , 176 49. Physicians' Faradic Battery, No. 1 179 50. Physicians' Faradic Battery, No. 3 181 51. Hydro-Rheostat 183 52. General Faradization, No. 1 190 53. General Faradization, No. 2 191 54. Twelve-Cell Combined Battery 194 55. Eighteen-Cell Combined Battery 195 56. Twenty-four-Cell Combined Battery 196 57. Twenty-four-Cell Battery Box 197 58. Faradic Part of Combined Battery 198 59. Faradic Part Ready for Use 199 60. Galvanic Part Ready for Use 201 61. To Replace Elements 203 62. McIntosh Office Battery 204 63. Diagram of Office Battery 205 64. Small Switch-Board 209 65. Standard Bath Apparatus, No. 1 224 66. Bath-Tub 227 67. Bath Apparatus, No. 2 226 68. Bath Apparatus, No. 3 228 LIST OF ILLUSTRATIONS. 3 PAGE 69. Cabinet Bath 231 70. Electric Chair 233 71. Diagram of Switch-Board on Chair 234 72. Motor Points _ 242 73. Sympathetic Nerve 253 74. " Landmarks " for Locating the Various Organs 256 75. Universal Sponge Electrode 261 76. Folding Foot-Plate 262 77. Duchenne's Points ■. 263 78. Metallic Discs 264 79. Electrode Cover 265 80. Comb Electrode 266 81. Metallic Points 267 82. Spinal Electrode 268 83. Necklet Electrode 269 84. Electric Bullet Probe 273 85. Electric Exploring Needle 274 86. Adjustable Sponge-Holder 278 87. Ball Electrode 279 88. Hand Electrode 280 89. Carbon Electrode 281 90. Double-Eye Electrode 286 91. Eye-Cup Electrode 287 92. Eye-Cup in Use 288 93. Small Eye-Electrode 289 94. Electro-Magnet 294 95. Electro-Magnet in Use 295 96. Rheostat Ear-Electrode 298 97. Rheostat Ear-Electrode in Use 299 98. Double Ear Electrode 300 99. Aural and Nasal Electrode 300 100. Insulated Nasal Electrode 303 101. Tongue Plate Electrode 305 102. Dental Electrode 306 103. Dental Electrode in Use 307 104. Dental Connector .' 308 105. Sponge-Tipped Laryngeal Electrode 309 106. Internal Laryngeal Electrode 310 107. Wire Brush Electrode 311 4 LIST OF ILLUSTRATIONS. PAGE 108. External Laryngeal Electrode 312 109. Tonsil Electrode „ . . . 314 110. Insulated Rectal Electrode 338 111. Ball Rectal Electrode 339 112. New Style Rectal Electrode 341 113. Inflexible Urethral Electrode 356 114. Flexible Urethral Electrode 357 115. Olives 358 116. Double Elastic Vesical Electrode 359 117. New Style Electrode for Stricture 360 118. Catheter Electrode 361 119. Sound Electrode 362 120. Method of Electrizing the Uterus 367 121. Vaginal Electrode 368 122. Vaginal Electrode Insulated in Lateral Halves 369 123. Vaginal Electrode Insulated in Vertical Halves 370 124. External Cervical Electrode 371 125. ' External and Internal Cervical Electrode 372 126. Double Cervical Electrode 373 127. Tinsel Brush Electrode 375 128. Duchenne's Points in Use 377 129. Hair-Brush Electrode 381 130. Method of Removing Hair 382 131. Roller Electrode 392 132. Electrode Case 393 133. Disc Insulated in Points 394 134. Electrolysis of Cancer 410 135. Electrolysis of N^vus 413 YOCABULARY. ACCTJMULATOR. An apparatus to accumulate or store electricity. This name is applied both to the Leyden jar and the storage battery. Action, LocaL Chemical action that takes place in battery cells, consuming zinc with- out producing a working current. Active Electricity. Electricity in a state to exert attractive and repulsive powers or produce heat, light, shocks or decomposition. Free electricity. Agronic Liine. Line of no variation. An irregular curved line drawn so as to connect all the points on the earth's surface where the needle points due north and south. Alternate Ctirrents. Those currents in which the direction is changed every half revo- lution. They are produced by revolving an armature before a magnet, or a magnet before an armature, in magneto-electric machines. Am'algramation. Covering the surface of zinc with mercury to prevent waste. Ampere. The unit of current strength formerly called a Weber. It is the current car- ried in one second by an electro-motive force of one volt through a circuit whose resistance is one ohm. Anelectrotonos. The condition of lessened irritability which exists in that portion of a nerve nearest the positive pole after a current of electricity has been carried through it for some time. Animal Electricity. Free electricity existing in the body. It may exhibit magnetic, static or dynamic properties, according to the circumstances attending its presence. Anions. Those atoms which collect about the anode or positive pole when a chemical compound is decomposed by electricity. Anode. The " way " by which electricity enters. This name is used alike for the positive pole of the battery and the electrode connected with it. Antozone. Oxygen in a positively polar condition. Appliances, Electrical. This term is generally understood to refer to various belts, scles, jackets, etc., inclosing magnets, small cells or coils, to be worn on the person for various complaints. Armature or Keeper. Soft iron bar attached to the poles of magnets to preserve their magnetism. Artificial Magnet. A bar of metal, originally without magnetic properties, to which magnetism has been imparted by another magnet. Ascending Currents. The current applied by placing the positive electrode upon the periphery of a nerve, and the negative to the nerve center. Axial Line. See Magnetic Axis. BASE. The part of a battery upon which is fastened the coil and binding posts, switches, etc. Battery. This name is applied to (1) The apparatus complete, for production of elec- tricity. (2) To the cells. Binding Posts. Clamps for connecting conducting wires with the electrical apparatus. Bound Electricity. Electricity which does not manifest its presence by any of the usual phenomena. This term is also applied to electricity "accumulated" or "con- densed " in the Leyden jar. Break. An opening in the circuit preventing the passage of electricity. CALLATJD BATTERY. Another name for the Gravity Battery. Capacity. The capacity of a condenser (accumulator) is measured by the quantity of electricity of unit potential which it can contain. Carbon. A substance which collects in the neck of retorts in gas manufacture. (7) 8 VOCABULARY. Catalectrotonus. The condition of increased irritability in that portion of a nerve nearest the negative pole resulting from carrying a current of electricity through it for some time. Cathode. The " way " by which electricity leaves. This name is given both to the negative pole of the battery and the electrode attached to it. Cations. Those products of chemical decomposition which appear at the negative pole are called cations. Cautery. See Galvano- Cautery. Cell. The jar, cup, or other container, which holds the elements and agent which pro- . duces a difference of potential between them. Centimetre. The unit of length. For its value see units. C . G. S. The centimetre-gramme-second system of measurements. See Units. Central Galvanization. The method of applying a galvanic current to the nerve cen- tres. Fully described in text. Centrifugal Current. The descending current. Centripetal Current. The ascending current. Charg-e of Electricity. The quantity of electricity in a body. Circle, Galvanic. This includes fluid, elements, and connections between the elements outside the fluid. Circuit. The path traversed by the current. It includes the elements, battery fluid, conducting cords, electrodes, and any intervening substance or body. Circuit Breaker. An apparatus for interrupting the circuit, also called a rheotome or current breaker. Clamps. Devices for completing the connection between electrodes and conducting cords. Closed Circuit. When the elements are united outside the fluid, either by direct contact or through a good conductor. Closing- Contractions. Muscular contractions produced at the instant the circuit is closed. Coil Induction. Rolls of wire in which a current is induced by the alternate opening and closing of a circuit. The coil is also called the helix. Collecting Plate. The electro-negative element of the pair from which the positive current comes. Called the collecting plate because the hydrogen and other products of decomposition collect about it. Commutator. A pole changer or device for changing the direction of the current. Compound Magnet. Several single magnets united, with similar poles adjacent. Condenser. An apparatus for accumulating or storing a large amount of electricity on a small surface. A Leyden jar is an example. See Micro-Farad. Conductors. All materials which readily permit electricity to pass over them. This term is also applied to the electrodes, and cords by which they are joined to battery. Conjunctive "Wire or Arch. The metal wire joining the two elements of a galvanic pair, outside the fluid. Connections. The wires, metallic cords, binding posts, and all metals used to complete the circuit are included under this term. Constant Battery. A galvanic battery with two fluid or gravity cells. Constant Current. A galvanic current from a Constant Battery. Contact Breaker. See Circuit Breaker. Continued Current. The uninterrupted galvanic current. Continuous Electrization. The protracted applications made by belts, chains, etc., worn on the body. Convection. The discharge of electricity attended by alternate attraction and repulsion of particles of air, and the materials floating in it. Core. A bundle of soft iron wires used as a magnet in the center of the coil. Coulomb. Tlie unit of quantity formerly called the Weber. Current Breaker. A device for alternately opening and closing the circuit. A rheotome. Current, Electric. The transfer of electrical energy along a conductor. It is commonly spoken of as flowing from the positive to the negative points in the circuit. Current Reverser. A pole changer. \ VOCABULARY. 9 Current Selector. This name is applied to two separate devices for altering the strength of current, (o) Galvanic Current Selector brings any number of cells into circuit. (6) Faradic Current Selector brings the primary or secondary current into circuit. Cylinder Machine. A form of static machine. D ANIELLS CELL. Invented by Prof. Daniells, of London. It consists of a porous cup containing dilute sulphuric acid immersed in a jar containing a solution of sulphate of copper. The elements are copper and zinc. Declination. The dip of the needle. The angle it makes with a horizontal plane. Deflection. The turning aside of the marked end of needle from O or N of the scale over which it is suspended when the scale is so arranged that O or N points due north. Demagnetize. To take away magnetic properties. Density. The amount of electricitj^ accumulated on a unit of surface is called " density." The term is also applied to a large quantity passing over a small conductor. Sometimes erroneously used as equivalent to tension or intensity. Derivation "Wire. If two points in a closed circuit be connected by an additional con- ductor, this conductor is called a derivation wire. Derived Current. That portion of the current drawn off, or " derived," by a derivation wire. Its potential is much less than the original or primitive current. Descending: Ctirrent. The negative electrode upon the periphery, and the positive on the nerve center, gives a descending current. Diamagnetic Bodies. Those which are repelled by a magnet. Dielectric. Insulators across which electric action takes place are called dielectrics. The glass of the Ley den jar across which electricity is propagated from the inner to the outer coating is a dielectric. Difference of Potential. When electricity moves or tends to move from one point to another, there is said to be a difference of potential between them. Diffusion of Current. The power of a galvanic current to extend its influence in all directions, that power never being limited to the two electrodes. Dip. See Inclination. Dipping- Needle. A magnetic needle. The compass needle. Direct Current. This term is used in two senses. (1) The descending current. (2) The galvanic current. Discharg-e. A sudden equalization of potentials. Dischargrer. An instrument through which the difference of potential between two surfaces is equalized. This name is also given to the instrument which directs the charge from a condenser through an object. Disruptive Discharg-e. A restoration of the equilibrium of potentials accompanied by light and sound. Downward Current. The term applied to the electric current from the center to the perix>hery. See Descending Current. Dynamic Electricity. Electricity in motion, i. e. propagated as a current. Dynamo-Electric Machine. Also called magneto-electric, are machines in which a powerful electric current is produced by revolving coils of wire between the poles of a horseshoe magnet. Dyne. The unit of force — i. e. the force which, if it acted for one second on a mass of one gramme, would, if the mass was previously at rest, give it a velocity of one centi- metre per second ; or, if it was previously in motion in the direction of the force, would in that time alter its velocity by that amount. EBONITE. Black rubber rendered hard by vulcanizing ; also known as vulcanite. Electric. Any substance, such as glass, amber, etc., in which electricity can be excited. Electrical Machine. See Machine. Electric Aixra. A current of electrified air, also called " Electric Wind." Electric Bath. This term is applied to two methods of electrization. 1. Allowing an elec trie charge to be slowly drawn off or dissipated from an insulated patient by the sur- rounding air. 2. Electrizing a patient while In a water, vapor or hot-air bath. Electric Brush. A wire brush used as an electrode. It is connected with one pole of the battery. Electric Disks. See Electrizers. 10 VOCABULARY. Electric Endosmosis. When a porous diaphragm is placed in a liquid traversed by a continuous current, the liquid will pass through tbe diaphragm in the direction of the positive current. This process is electric endosmosis. Electric Fish. Certain fishes that give electrical shocks when touched. The best known are the Torpedo or Electric Ray of the Mediterranean, the Gymnotus or electric eel found in certain ponds in Surinam, and the Malapterurus or electric shad of the Nile. Electric Elmd. This name was formerly given to electricity, in accordance with the theory that it is a subtle and imponderable fluid which permeates all bodies. Electric Force. The power of electricity to move matter. Electric Hand. The hand of the operator used as an electrode. Electrician. One versed in the science of electricity in its relation to the arts. A term that is often incorrectly used instead of electro-thera})eutist. Electricity. A mode of motion of the atoms of matter. Electric Machine. This term is usually applied to the apparatus for producing static electricity. See Machine. Electric Moxa. A burn made by the galvanic current on the skin, as a counter-irritant. Electric Potential. See Potential. Electric Residue. See Residual Charge. Electric Tension. Free electricity struggles to escape from the surface upon which it is accumulated, and this effort is termed electric tension ; it may be considered a kind of pressure or strain acting from the center of a body outward. Electrify. To communicate electricity to a body not previously exhibiting its presence. To charge with electricity. Electrine. Belonging to amber. Electrization. The act of applying electricity. Electrizers. Discs of different metals, as copper and zinc or silver and zinc, which are sometimes applied to the surface of the body and connected with copper Avire ; the per- spiration excites a feeble galvanic current that may be kept up for an indefinite time. Electro-Biology. Electrical currents developed in living animal tissues, by friction, chemical decomposition, etc. This term is also applied to the phenomena supposed to be developed by mesmerism. Electro-Bioscopy. Testing the muscles by electricity to see if life is extinct. Electro-Cautery. See Galvano-Cautery. Electro-Chemical Bath. The introduction and withdrawal of metals from the living body by means of a galvanic current applied through a bath. Electro-Chemistry. See Electrolysis. Electrodes. The name originally given to the points at which electricity enters and leaves a substance. The name is now generally given to the instruments fastened to the conducting cords that are used in applying electricity to the human body. Electro-Diagnosis. The discrimination of disease by means of electricity. Electro- Pathology. Electro-Dynamics. The phenomena of electricity in motion. Electro-lithotrity. The disintegration of calculi in the bladder by electricity. Electrologist. One who makes a specialty of electro-therapeutics. Electrolysis. Separation of a chemical substance into its elements, by electricity. Electrolyte. The body acted upon by electrolysis. Electrolytic. Relating to chemical decomposition produced by electricity. Electro-magnet. A mass of soft iron surrounded by a coil of wire, which is rendered temporarily magnetic by passing a current of electricity through the coil. Electro-magnetism. 1. Magnetism developed by electricity. 2. A current from a mag- neto-electric machine. Electrometer. Instrument for measuring the strength of the attractions and repulsions between electrified bodies. Also see Electroscope. Electro-Motive Force. The force which tends to move electricity from one point to another. Electron. Amber. Electro-Negative Bath. Electrifying a patient from negative jar of a static machine. Electro-Otiatria. Electricity applied to treatment of diseases of the ear. It also includes the electro-physiology of the ear. YOCABULAKY. 11 Electro-Patholog-y. See Electro-diagnosis. Electroph.orus. This consists of (a) a lower disc or generating plate of resin or hard', rubber; (b) an upper disc or collecting-plate of metal two inches less in diameter than the lower plate. Its use is to generate small quantities of static electricity. Electro-Physiolog-y. The effect produced on the healthy tissues of the living body by electricity. Electro-Positive Bath. Electrifying a patient from the positive jar of the static machine. Electro-Puncture. The application of any form of electricity by means of needles thrust into the tissues. Electroscope. Apparatus for detecting the presence of static electricity, and determining. whether it is positive or negative. Also see Electrometer. Electro-Statics. That science which treats of static or franklinic electricity. Electrostixis. Electro-puncture. Electro -Surg-ery. The use of any form of electricity in surgical diseases. Electrolysis and galvano-cautery are the principal forms in which it is employed. Electro-Therapeutics— Electro-Therapy. Treatment of disease Ijy electricity. Electro-Therapeutist. One who is versed in the use of electricity in disease ; incorrectly called an electrician. Electro-Tonic. The name Faraday gave to the changing state of the conducting wires while the current is forming or ceasing. Electrotonos. The peculiar condition of a motor-nerve when a continuous galvanic current is passed along it. Electrum. Amber. This name is also given to an alloy of gold and silver. Elements. The metals, or carbon and metals, immersed in battery fluid to generate a current of electricity. ^ Endosmose. See Electric Endosmosis. Equator. See Magnetic Equator. Erg-. The unit of work ; i. e., it is equal to the work required to move a body through one centimetre against a force of one dyne. Essential Resistance. The resistance Avithin a battery cell (internal resistance.) External Resistance. Resistance in the circuit outside the cell (non-essential resist- ance). Extra Ciirrent. This name refers to («) the appreciable current in the primary coil which is due entirely to induction, and is partly galvanic and partly magnetic. (6) It is also given to currents taken from different layers of the secondary coil, (c) The transient currents in a coil, produced by the induction of each portion of the current on the neighboring wires, on which it acts as if they were portions of another circuit. Extra Polar. Electricity is believed to be propagated within the tissues in every direc- tion from the electrodes. Its effect upon those not between tne two poles is called extra-polar. FARAD. A million micro-farads. 1. The capacity of a condenser which holds one cou- lomb at a potential of one volt. 2. A coulomb in a farad condenser is capable of causing a difference of potential between the poles of a circuit that it will require an electro-motive force of one voli to overcome. Faradic Current. The current generated in a coil of wire by induction. Also called induced, interrupted or extra current. Faradic Induction. A current of electricity passing through a wire excites a wave of electricity in a second wire placed near and parallel with it at the instant of opening and closing the circuit. This is faradic induction. Faradism. The application of induction currents to the treatment of disease. Faradization. Application of the faradic current. Ferro -Magnetic. Iron and similar bodies that are attracted by iron. Also called para- magnetic bodies. Field, Magrnetic. See Magnetic Field. Franklinism. Static electricity employed as a remedial agent. Named from Benjamin Franklin. Frictional Electricity. Electricity set free by friction. Static or Franklinic elec- tricity. 12 VOCABULAKY. Pree Electricity. Unbound electricity. That state in which it exhibits attraction and repulsion. Pustig-ation, Electric. The application of electricity through a metallic brush. GALVANIC APPAErATTJS. Apparatus ior generating and furnishing the galvanic current. Galvanic Battery. See Batteries. Galvanic Belt. An appliance for the continuous application of galvanism. It consists of a series of small cells containing elements which are fastened to a belt to be worn around the body. Galvanic Chain. A series of links usually composed alternately of zinc and copper, to be worn around the body. The current is generated by dipping them in vinegar or water, or simply by the moisture supplied by the perspiration. Galvanic Circle. This usually refers to a pair of elements immersed in battery fluid and connected outside the fluid. A single circle is one galvanic cell in action. A compovind circle is two or more connected together. Galvanic Current. The current direct from the battery cells. It is frequently called a voltaic current. When carried through a coil of wire it becomes a faradic current. Galvanic Disks. Disks of two dissimilar metals arranged alternately on a band, jacket, sole, etc., between which a communication is established when moistened and placed on the skin, and a feeble galvanic current is set up. Galvanic Elements. Two dissimilar metals, or two pieces of the same metal, which are of unequal hardness, that are used in generating a current of electricity. Galvanic Pair. See Galvanic Elements. Galvanic Pessary. An instrument for retaining the uterus in position and at the same time conducting to it a galvanic current. It may be composed of alternate pieces of two dissin^lar metals which generate the current when moistened with the secre- tions of the surface to which the instrument is applied, or it may be connected with a belt or pocket battery which generates the current. Galvanic Poultice. Minute pieces of zinc and copper wrapped in cotton wool, each pair separated by flannel, all inclosed in a bag, one side of which is made of rubber cloth, the other of cotton. The cotton surface is applied next the skin, and the ac- cumulated perspiration excites galvanic action. Galvanism. The science which treats of that form of electricity which is generated by chemical action. • Galvanization. The medical application of the galvanic current. Galvanization Liocalized. An application of the galvanic current limited to a particu- lar muscle, nerve or organ. Galvanize. To affect by the galvanic current. Galvano-Cautery. Also written Galvano-Causty. Burning or cauterization of the tis- sues by an electric current sent through a wire or plate of great resistance (usually platinum). Galvano-Cauterization. To burn with a galvanic current. Galvano-Contractility. Usually refers to muscular contraction produced by the gal- vanic current. Calvano-Faradization. Name given by Beard and Rockwell to the simiiltaneous appli- cation of the galvanic and faradic current. Galvanometer. An instrument for measuring the total quantity of electricity which passes through it in one second. Galvano-Plasty. (a) The art of separating chemical elements from their compounds by electricity, (b) The art of depositing metals by electricity, as in electrotyping. Galvano-Puncture. See Electro- Puncture. Galvanoscope. An instrument for detecting the direction and presence of a galvanic current. Galvano-Surg-ery. The application of the galvanic current to surgery. It includes (a) Electrolysis, {b) Galvano-Cautery. Galvano-Therapeutics. The application of the galvanic current to the treatment of disease. O'eneral Electrization. The application of electricity to all parts of the surface of the body during a treatment. VOCABULARY. 13 General Faradization. General Electrization with the faradic current. General Galvanization. General Electrization with the galvanic current. Gramme. Theoretically, this is the mass of one cubic centimetre of distilled water at 4° C. Gravity Batteries. Galvanic cells in which the elements are placed horizontally, and the two fluids are kept separate by difference in density. HELIX. See Coil. Horseshoe Mag-nets. Magnets in the form of the letter U. Horticulture, Electrical. The process of exposing fruit, flowers, etc., to electric light during the night and the sun during the day. Dr. Siemens having tested this during late years, announced that the growth is twice as rapid as under other conditions. Hydro-Electrization. A term coined by Beard and Rockwell to indicate that electricity is applied by means of water as an electrode. Hydrostat. A device for preventing the spilling of fluid out of battery cells. Designed to render a battery portable without the necessity of removing the fluid from the cells. IONS. Elements into which a substance is divided by electrolysis. Inclination or Dip. The angle which a freely suspended magnetic needle, when parallel with the magnetic meridian, makes with the horizon. Induced Charg-e. When a charged body is brought near another, but not in contact with it, the latter becomes electrified or posesses an induced charge. Induced Currents. See Faradic Current. Inducing" Current. See Primary Current. Induction. The process of exciting electricity In any object by bringing it near to but not in contact with a circuit through which a current of electricity is passing, or an electrified body. Induction Coil. This refers to the coarse wire coil through which the primary current passes. It is also used to include the entire coil and its core which are necessary to the production of a faradic current. Initial Charg-e. A charge excited on glass or rubber and conveyed to the plates of a static machine by contact. Insulators. Substances such as glass, rubber, shellac, etc., which hinder the passage of electricity over or through them. Insulation. Supporting or surrounding a body by an insulator. Insulating- Stool or Platform. A stool or platform which has glass or rubber legs. Any stool, platform, or chair, may be insulated by glass tumblers or saltcellars. Intensity. The energj' or effectiveness with which electricity acts, as estimated by the results produced. Intensity, Magnetic. The amount of force with which a magnetic needle is brought back to its natural position when moved out of it. The same term is applied to the po^ver with which a magnet retains its hold upon attracted objects. Interrupted Current. A current from a circuit that is alternately opened and closed. Inverse Current. Ascending or centripetal current. JARS, ^ee Leyden Jar. KEEPER. See Armature. LABILE CURRENT. Moving or gliding one or both electrodes over the surface treated. Latent Electricity. Passive, bound, or natural electricity. That form of electricity which does not manifest any of the properties peculiar to it. Leyden Jar. The ordinary form consists of (a) a glass jar or bottle. (6) An outside and inside coating of metal reaching within two to four inches of the top. (c) An insulating cap fitting into the neck of the jar which supports a brass rod terminating above in » knob, and below in a strip of foil or chain, that lies upon the inner metallic coating on the bottom of the jar. Local Action. Decomposition of zinc in the battery fluid when the elements are not connected. Local Electrization. The application of electricity to a single organ, muscle, or nerve, with a stationary electrode. Lodestone. An ore found in iron-mines which possesses the property of attracting iron or steel, and when freely suspended, the direction of the magnetic meridian. Line of Force at any Point. The direction in which a charged body placed at that point tends to move. 14 VOCABULAEY. Lines of Magnetic Force. The curved lines through which the force emanating from a magnet acts. They may be illustrated by holding the poles of a magnet against a sheet of stiff paper upon which iron filings are sprinkled. Lines of Flow. The direction of a current passing through a conductor. have been demonstrated to be in curves similar to the lines of magnetic force. MACHINE, ELECTRIC. According to common usage this term refers to the appa- ratus for generating static or franklinic electricity, and also the magneto-electric or dynamo-electric apparatus. Strictly speaking, this term applies to all batteries or devices for generating electricity. Magrnet. l. The lodestone. 2. A bar of steel or iron to which the peculiar properties of the lodestone have been imparted. Magnetic Axis. The line joining the poles of a magnet. Magnetic Equator. The line of no dip. An imaginary curved line connecting those points on the earth's surface where the dipping needle remains parallel with the horizon. Magnetic Field. 1. Any region Avhere magnetic force acts. 2. Within the influence of a magnet. Magnetic Induction. The influence of magnets through space either to produce other magnets, or to induce electric currents in metallic circuits. Magnetic Meridian. A great circle parallel with the direction of the magnetic needle, and passing through its poles. Magnetic Poles. Points in the northern and southern hemispheres at which the mag- netic needle stands exactly vertical. Magnetic Potential. The potential of a magnetic pole is of precisely the same nature as that due to an electrified body at that place. See Potential. Magnetic Substances. Iron, nickel, cobalt and all other substances to which the properties of the lodestone may be imparted. Magnetism. That force which causes the lodestone and other magnetic bodies to exhibit the phenomena of attraction, repulsion, polarity, etc. Magnetize. To communicate magnetic properties to substances that do not naturally exhibit them. Magneto-Electricity. Electricity generated or set free by the action of a magnet. Magneto-Electric Machine. See Dynamo- Electric Machine. Ifficro-Farad. Practical unit of capacity. A condenser of one micro-farad capacity would contain about 300 circular sheets of tinfoil separated by mica plates, and would be contained in a box ?>% inches deep and inches in diameter. Molecule. The minute particles of which matter is supposed to be composed. Motor-Points. The points on the surface of the body where the various branches of the motor nerves supplying the muscles may be affected by electricity. Multiplier. A coil of wire through which a galvanic current is passed to increase or multiply its effect upon a magnetic needle placed above it. Mutual Action of Two Currents. Two currents moving in the same direction repel each other ; moving in opposite directions they attract each other. NATUIIAL ELECTRICITY. When electricity exists in such a form that its equi- librium must be disturbed before its presence is manifest, it is called natural electricity. Negative Electricity. Also marked. Originally referred to that form of electricity developed by rubbing sealing-wax. Electricity from any plate, condenser or element which affects the electroscope in the same way as sealing-wax is called negative. Negative Element. That portion of the carbon, copper or platinum element immersed in the fluid is electro-negative. The zinc, from which negative electricity is obtained, is, however, usually spoken of as the negative element. Neutral Point. A point midway between the poles of a magnet to which iron filings will not adhere, and which exerts no signs of magnetic force. Non-Conductor. Any substance that does not freely transmit electricity, such as glass, paraflinc, rubber, etc. An Insulator. Non-Electric. Those substances which permit electricity excited on them by friction to escape as fast as formed, in consequence of which it was formerly supposed that they were incai)able of being electrified, hence the name. Non-Essential. External resistance. The resistance in the circuit outside the cell. VOCABULAKY. 15 OHM. The unit of resistance. It is very nearly equal to the resistance of a cylindrical wire of pure copper 250 feet in length, having a diameter of 1-20 of an inch. Ohm's Law. The law devised by Ohm for determining the current generated and the amount of work it can do under given conditions, when the force of the battery and the resistance of the circuit are known. His formulae (E standing for electro-motive force ; R, resistance ; C, current) are : E E C=- R=- E-C+R R R Olim Meter. An instrument for measuring ohms. Opening- Contractions. Muscular contractions produced by opening or breaking the circuit. Oxidation. This term here relates to rust collected upon the metal parts of a battery. Rust is a poor conductor, and impedes the passage of electricity. It must be scraped off". Ozone. Oxygen rendered electro-negative by passing through it a positive charge of static electricity. PARAFFINE. carbo-hydrogen obtained from petroleum and 'other sources. It is a white, waxy solic. not acted upon by acids or alkalies. It is an excellent insulating sub- stance, unequalled for its resistance to moisture. It is used to insulate wires, and a thin layer of it on the upper end of the battery elements and their metal connections, prevents an accumulation of salts on them. Whenever applied for insulating purposes it should be melted and the objects to which it is applied should be hot. Para-Magnetic Bodies. Iron and similar substances which are attracted by the magnet. Passive Electricity. Electricity in a state of equilibrium. See Natural Electricity. Peripheral Electrization. Electricity applied to the periphery, or external surface of the body. Permanent Magnet. Those which retain magnetic properties when removed from the source from whence they acquired it. Phreno-Magnetism. Excitement of the organs of the brain by mesmeric passes of magnetic influence. Pile. Originally the name given to a pile composed of disks of zinc and copper separated by a moist, porous material, constructed by Prof. Volta, hence called the Voltaic pile. It is now frequently applied to the combination of elements in battery cells. Plantinode. Name given by Daniells to the collecting plate, platinum, carbon, copper, etc. Platinum. A metal first discovered in the mines of Choco, Peru. It is nearly of the color of silver but less bright, and is the heaviest of metals. It is much used for the collecting plate in battery cells, because it is not acted upon by the fluid. Polar. Relating to the poles. Polar Force. That force with which similar ends of magnets attract, and dissimilar repel each other. Polarity of Electricity. That property of electricity which causes it to exhibit attraction and repulsion. Polarity of Magnets. That property which causes them when freely suspended to assume a northerly and southerly direction; also to attract dissimilar, and repel similar, poles of other magnets. Polarity of Nerves. That condition of a nerve in which the part nearest the negative pole is in a state of increased, and that nearest the positive is in a state of diminished, irritability. Polarizable. The property of exhibiting polarity under certain conditions. Polarization. The act of arranging the substances which form an electric circuit in polar order, that is the positive atoms collected together in one part of the circuit, and the negative in another, so arranged that they react on each other. Polarization of Elements. When the hydrogen set free in a cell is permitted to collect about the carbon, platinum or copper plate in the fluid, there is a counter-current set up between the gaseous envelope and the zinc within the fluid, which tends to counter- act or destroy the current passing through the external circuit, and the elements are said to be polarized. Polarizing. Giving polarity to. Polarizing Current. A current which produces the electrotonic condition. 16 VOCABULARY. Polar Method. This is accomplished by placing the pole whose distinctive effect is wanted, over the part to be treated, and the other pole over some indifferent part. Pole Changer. A rheotrope or current reverser. A device for changing the direction of the current without removing the electrodes. A useful instrument for employing a galvanic current to produce contractions. Poles, Electric. Points where electricity passes in and out. Poles, Mag-netic. Points where magnetism is concentrated. Poles, Consecutive or Consequent. When a magnet is irregularly magnetized, it frequently contains three or more poles, and the term consequent is applied to the extra poles. Portative Force. The power of a magnet to sustain weights fastened to its armature. Positive Electricity. That which is set free by rubbing glass with silk. Positive Pole. The binding post, conducting cord and electrode connected with the carbon, copper or platinum (electro-negative) element of the battery are respectively called the positive pole. Potential. This term holds the same relation to electricity that the term level does to gravity. Just as water at a higher level tends to flow to a lower one, so electricity at a higher potential tends to move to a point of lower potential. It is often used synony- mously with tension ; but since the latter term is used to express very diverse con- ditions, electricians now make use of the term potential in referring to " electric level," whether static, dynamic or magnetic. Potential (Dynamic). Difference of " electric level " between two elements, when both are immersed in the same fluid, Avhich acts chemically upon one of them. The same term applies to difference in electric level produced by revolving coils of wire between the poles of horseshoe magnets. Potential (Magnetic). The potential or " electric level " due to a given magnetic pole is of precisely the same nature as that of an electrified body at that place. Potential (Static). This is the difference in " electric level " between an electrified body and the earth, the latter being the standard and regarded as zero. Potential at a Point. An abbreviation for difference of potential between the point and the earth. Primary Coil. The layers of coarse wire which form the inner coil of the helix. Primary Current. The inducing current from the primary coil. Sometimes the gal- vanic current direct from the cells is incorrectly called primary, to distinguish it from that obtained indirectly by induction. Primitive Current. When two points in a closed circuit are connected by an additional conductor, a portion of the current is drawn off. The current, as it existed before a part is drawn off, is the primitive current. Protracted Applications. The continued application of electricity by means of belts disks, etc., for a long time. €ITJALITY OF A CURRENT. This refers to its strength as determined by its electro- motive force and resistance, and also to the rapidity of its interruptions, and whether it is smooth or harsh. Quantity. The amount of electricity generated in a given time. For purposes of calcu- lation, electricity is regarded as if it were a material, incompressible fluid ; e. g., if two bodies contain equal quantities of one kind of electricity, and it all be transferred to one, the latter will contain twice the quantity it did before ; on the contrary, if the electricity in one body is divided with another not previously electrified, the former will have only one-half the quantity it had before. RADICALS. The io7is or elementary atoms into which a chemical compound is divided by electrolysis. Reaction Electrical. The phenomena developed in any part of the body under the in- ^ fluence of electricity. Regulator (Current). See Shield. Residual charge. A feeble charge of electricity which can be obtained from a Leyden jar a few minutes after it has been thoroughly discharged. Literally " the charge left over." Residual Magnetism. Moderately hard iron when magnetized retains some magnetic polarity, this is residual magnetism. VOCABULARY. 17 Resinous Electricity. Negative electricity. That which is excited by rubbing wax or resin with flannel. Resistance. Opposition to the transfer of electricity, or to its development as a current. Reverse Current. See Ascending Current. Reverser (Current). Pole changer. Rheochord. A metallic wire introduced into a circuit to measure the resistance or vary the strength of the current. Rheometer. (Gr. rheos, a current, and metron, a measure.) An instrument for measuringa galvanic current. Galvanometer. Rheomotor. (L. motor, a mover, from moveo, I move.) An apparatus by which an elec- trical current is originated. Rheophore. (Gr. phoreo, I bear along.) An electrode. Rheoscope. (Gr. shope, I view.) An apparatus for ascertaining the existence of a gal- vanic current. A galvanoscope. Rheostat. (Gr. statos, that stands.) An instrument for bringing a definite amount of resistance into the circuit. It receives its name from its power to keep the galva- nometer needle standing at the same point during an experiment. Two forms are com- monly used for medical batteries, the hydro-rheostat and resistance coil. The resistance coil differs from the rheochord in that the wire composing the former is in a coil, in the latter it is straight. Rheotome. (Gr. temno, I cut.) A current breaker. Rheotrope. (Gr. trepo, I turn.) A pole changer, or current reverser. Rotary Machine. Magnetic- Electric Machines in which electricity is generated by turn- ing a crank. Ruhmkoff Coil. A very powerful induction coil invented by Ruhmkoff", a celebrated electrician of Paris. SECONDARY ACTION. See Secondary Electrolysis. Secondary Battery. A storage battery. An apparatus for accumulating electric energy. Secondary CoiL A coil of fine wire wound in many layers around the primary coil from which it is separated by insulation. Secondary Current. The induced or "to and fro" current from the secondary coil of the helix. The faradic current. Secondary Electrolysis. Decomposition supposed to be accomplished by the chemical action of the elements set free by electricity. It is secondary action that causes the hydrogen to be used up by the chromic acid set free in the battery fluid, and the con- sequent formation of chrome alum. Sensibility, Electro-Muscular. The peculiar sensation produced when a muscle con- tracts under the stimulus of an electric current. Shield. The tube or sheath which answers the purpose of a current regulator. When it is moved entirely within the coil, the strength of the current is diminished ; when withdrawn, it is increased. Shock. 1. A sudden discharge of electricity from a Leyden jar or the conductor of a static machine. 2. The unpleasant or painful impression made on the nerves by opening or closing the circuit or suddenly increasing the strength of the current. Short Circxiit. Name given to the circuit when it is completed before reaching the con- ductors or electrodes. Polarization depends upon the establishment of a short circuit within the cell. Stabile Current. A current applied with both electrodes in a fixed position. Labile and stabile were terms selected by Remak to describe the method of applying a current. Statical Electricity. Electricity at rest. It is set free by friction, pressure, cleavage, etc. Static Machines. Apparatus for generating frictional or Franklinic electricity. Storag-e Batteries. See Secondary Batteries. They have been used for supplying a current for galvano-cautery purposes, and also for illuminating internal cavities of the body. Switch. Metallic bars revolving on a pivot, used to connect sections of cells, as current reversers, and current selectors. They form a part of the battery accessories that are attached to the base. 18 VOCABULARY. TANGENT GALVANOMETER. An instrument for the accurate measurement of the strength of the galvanic current. Tension. Potential. This term is applied by various authors to (1) the tendency of electricity to overcome resistance ; (2) the strain put upon the circuit by the electro- motive force ; (3) the difference of potential of any two points joined by a conductor. Tetanization. The production of a tetanic or contracted state in a nerve by passing an electric current through it. Thermo-Electricity. Electricity that is generated v^^hen two metals are soldered together so as to form a closed circuit, and one of the junctions is heated more than the other. To and fro Ciirrent. Faradic Current. Torpedo. The electric ray, a species of fish found in the Mediterranean. Tray Cell. One form of gravity cell which is named from its shape. Trembler. The vibrator or rheotome. Two-Fluid Cell. A cell in which a different fluid is used with each element. UNIFORM CURRENT. A current that is kept at the same strength during the appli- cation. (B & R.) Unipolar Application. See Polar Method. Uninterrupted Current. The galvanic current. Units, Absolute. They are based upon units of mass (gramme), length (meter), and time (second). Unit of Current. An ampere. It is the current through a circuit with electro-motive force of one volt, resistance one ohm. Unit of Electro-Motive Force. One volt represented by the current from one Daniells cell. Unit of Resistance. The ohm. Unpolarizable Electrodes. Those made of pure amalgamated zinc or zinc tljat has been immersed in a syrupy solution of sulphate of zinc. Used in delicate physiological experiments. Unpolarized. Not possessing polarity. Upward Current. Term applied to the current when it passes from the branches toward the trunk or root of a nerve. The negative pole is placed on the trunk, the posi- tive on the branches. VITREOUS ELECTRICITY. Electricity excited by friction of glass. Volt. The unit of electro-motive force. Voltameter. An apparatus for measuring the strength of a galvanic current by decom- posing water.. Voltaic Alternatives. Galvanism acts as a stimulus to nerves and muscles most ener- getically when the circuit is frequently opened and closed. When a pole changer is introduced into the circuit so as to not only break the circuit, but change the direction of the current at every break, the method has been named voltaic alternatives. This reversal is a much more powerful stimulant than simple interruption of current. Voltaic Pile. The compound galvanic circle invented by Volta in 1800. Described in text. "Weber. The name formerly given to the standard unit of electrical current, sometimes incorrectly written " Veber." See Amptre. I]SrTRODUCTIOSr. There is no branch of science which received earlier attention or has been the subject of more persistent research than Elec- tricity in its various forms. To those whose attention has not been called to the subject specially, it is a matter of surprise that so much has been accomplished in the various departments of this science without its having sooner obtained a recognized place in the armentarium of the medical profession. It may not be out of place to give a brief resume of its history, and the various practical applications made of it in the past, before undertaking to show the position it at present occupies and its promises for the future. It was fully six centuries before the Christian era that Thales, one of the seven sages of Greece, discovered that amber, when rubbed with a dry cloth, developed a peculiar force capable of attracting light bodies such as chaff, bits of paper, pith, etc., and in consequence he believed it to be possessed of a soul which was nourished by the attracted objects. The luminous appearance attending friction of certain sub- stances was noticed by Roman historians. They also record the appearance of flame, on various occasions, at the points of soldiers' javelins, and on the top of ships' masts. One ancient philosopher relates of himself that, when changing his clothing, sudden sparks were emitted from his person, and at the same time his servant received slight shocks on touching him. 19 20 INTRODUCTION. The electric fish, of the Mediterranean, were known to have the power of sending shocks through the water some distance away, of sufficient power to benumb their prey and to disagree- ably affect the fishermen, whose spears conveyed the shock from the water to their hands. The loadstone, also named magnet, from Magnesia, a coun- try in Thessaly, where it was first noticed, is referred to in the Talmud imder a Hebrew name, meaning ''the stone that attracts." Lucretius, in a poem written sixty years before the Christian era, mentions the power of a loadstone to suspend a series of rings hanging in a chain, one to another. These references show that the power of attraction possessed by the magnet, and its capability of communicating this property to pieces of iron, were known at the very dawn of our history. It is equally certain that the peculiar property which causes a magnet, when freely suspended, to point toward the poles of the earth, was not only known, but made of practical use. More than one thousand years before our era, at the obscurely known Epoch of Codrus, and the return of the Heraclidse to the Peloponnesus, these people employed magnetic cars on which was the figure of a man whose movable outstretched arm, always pointing to the souths guided them on their way across the vast and grassy plains of Tartary. During the third century of our era, at least seven hundred years before the introduction of the compass in European seas, Chinese vessels navigated the Indian ocean with needles pointing to the south. The magnetic needle was brought from China to Italy in 1260, and one traveler asserts that he saw a pilot in the East Indies direct his course by a compass, like those now in use, in the year 1500. With the exception of the application of the loadstone to tlie use of the mariner, the various phenomena of electricity and magnetism awakened only vacant wonder, and, while INTRODUCTION. 21 many centuries rolled away, remained but barren facts on the surface of human knowledge. Gilbert, physician to Queen Elizabeth, in the year 1600 wrote a book in which he gave a classified account of all the electrical phenomena known to his time, and added the results of his personal investigations. He first gave the name poles to the ends of the magnet, because they point toward the poles of the earth. He also gave the name electricit}^ (from elektron^ amber) to the force developed from amber by friction. The needle does not, however, point directly to the north and south poles of the earth, except in certain localities (for the magnetic and geographical poles do not coincide), neither does it preserve an undeviating direction. . Since its use ren- dered possible voyages of discovery by land and by sea, and it early became a commercial necessity to the merchant who traded with distant people, whether across the trackless water or the equally trackless desert, the fluctuations to which it is subject seriously impaired its value. The observation of this variation or declination is usually credited to Columbus, who is stated to have discovered it in September, 1492, during his first memorable voyage of discov- ery; yet one Peter Adziger, in a Latin letter to a friend, written in 1269, describes the process by which he has reckoned the amount of the variation of the needle, showing that this sub- ject had commanded attention long before the period generally named. The commercial necessity for some method of accurately com- puting the variations of the needle, whereby its deviations could be corrected, has led to the construction of costly appa- ratus for recording its changes. Observations upon its behavior have been carried on over the entire globe during every season and under all conditions of stormy or clear weather, and the phenomena of magnetism (which gives to the needle its value) 22 LNTBODUCTION. have been classified under their appropriate laws, and these laws arranged to form a systematic whole until the science of magnetism is as well established as any of the physical sciences. The earth is now regarded as a magnetic mass, acting on a magnetic needle, as one needle acts upon another. To the variations of this magnetic influence of the earth is due in part the variations of the .needle. The result of various ob- servations may be summed up as follows : 1. There is a daily variation which consists of a slight easterly movement of the north end of the needle that reaches its maximum about 7 a.m. It then recedes till its westerly maximum is reached, about 1 p.m. It again returns easterly more slowly, reaching its maximum about 10 p.m. The range of variation is greater during the day than during the night, which is believed to be due to the magnetic influence of the sun. 2. There is a variation of the eartWs magnetism accompany- ing the change of seasons. This is indicated by a movement of the magnetic pole from east to west. During the months between the vernal equinox and summer solstice the needle retro- grades to the east, and during the following nine months its general motion is to the west. The magnetic influence of the earth is strongest during December, January and February, when it is nearest the sun, and least during May, June and July, when it is farthest from the sun. 3. Irregular or fitful agitations of the needle were first ob- served in 1750, by Worgenthin, and later, in 1806, by Hum- boldt, who gave the accompanying phenomena the name of "magnetic storms.'* 4. There is still another variation of the magnetic pole of the earth for which no theory has fully accounted. The pole of the magnetic needle now points more than "one thousand miles away from the geographical pole of the earth. The needle pointed due north in 1660 (in London, where the observation INTRODUCTION. 23 was made). It then moved westward until 1818, when it was directed to a point 2-1° 27' from the pole, then it began to move back again, and will point due north again in 1976, making a complete cycle in three hundred and twenty years. Self-recording apparatus, now used in magnetic observato- ries, give daily and hourly reports of all magnetic variations, and when sufficient time has elapsed to secure enough observa- tions from different parts of the world, much light will un- doubtedly be thrown on the cause of the earth's magnetism and its changes. The earth, atmosphere and clouds form a Leyden jar on an extensive scale, the earth and clouds representing the coatings of the jar, and the air fulfilling the part of the glass through which the electricity passes by induction or discharge. It is found that in fine weather the atmosphere is almost invariably charged positively ; before rain it often assumes a negative state. The rain that first falls is usually negative, although the atmosphere before and after the fall may be posi- tive. Fogs, snow and hail, if unattended by rain, are nearly always positively charged. Clouds are always positive. Elec- tricity, like magnetism, has a period of maximum and minimum intensity during the day, that may be traced to the influence of the sun, and another during the night, dependent on the moon. There is also a yearly variation, dependent upon the relative position of the earth and sun, atmospheric electricity having thirteen times as great intensity when the earth is in that part of its orbit nearest the sun, as when it has receded to that part of its orbit most remote from the sun. There are also irregular or fitful disturbances of the electrical conditions of the atmosphere accompanying the agitation of the needle during magnetic storms. These perturbations manifest themselves often simultaneously over land and sea, over hun- dreds and thousands of miles, or propagating themselves gradu- 24 INTRODUCTION. ally, in a short space of time, in every direction, over the surface of the earth." At these times occur brilliant displays of the au- rora borealis, which are believed to be neither the cause nor effect, but simply an accompanying phenomenon, of the electrical dis- turbances, and due to the same cause. To the German astronomer Schwabe is due the honor of recording daily observations during more than thirty years, by means of which he established the periodicity of these phe- nomena. He finds they increase in number and frequency during a little more than five years, then decrease for the same period, occupying, to complete a cycle, about eleven years. He also dis- covered that they coincide with the appearance of dark spots on the sun ; although, from any evidence yet adduced, no one can say that the storms are caused by the sun-spots, or that the sun- spots are caused by the magnetic storms. Whether the sun is the source of electricity, or whether the magnetism of both earth and sun is derived from some common central reservoir of this force, still remains an unsolved problem. The influence of terrestrial magnetism and atmospheric elec- tricity over health and disease is a subject of practical interest to every physician. That electricity is at all times present in the human body, and that under certain circumstances it becomes manifest through sparks emitted from the person, as well as by other means, has long been known to all who have given any attention to the natural sciences. Cecil relates an instance of a gentleman whose sensitiveness to atmospheric electrical condi- tions was so great that he was advised to insulate himself by wearing silk underclothing. So successful was this measure that he declared, "it made life another thing." Dr. Hosford, of New Hampshire, reported in 1837 the following, which is interesting as describing a condition due to disturbed electrical conditions of the human body. On January 25 of that year, during a brilliant display of aurora INTRODUCTION. 25 borealis (magnetic storm), a cheerful, intelligent lady, about thirty years of age, became suddenly and u-nconsciously oharged with electricity, which she first discovered on attempting to pass her hand over her brother's face, when all the family were astonished to see a display of sparks pass from her fingers to his face. This peculiar con- dition continued without diminution until the last of February, when it began to decline, and disappeared permanently in May. During its continuance, being greatly annoyed by disagreeable shocks on touching any conducting substances, — such as kitchen utensils, needles, springs of chairs, — every effort was made to relieve her, but neither the change of clothing from flannel and silk to cotton, nor any other device, gave her relief. She was not conscious, from any internal sensations, of her peculiar power, but sparks continued to pass from her fingers at the rate of three or four per minute when brought near a conduc- tor, and she could charge others when insulated. She had never been confined to her bed by a day's illness, but had sufiered for some months during the previous year with neuralgia, which permanently disappeared with the return of her normal electrical condition in May. Dr. C. Woodman, of Paw Paw, Michigan,"^ reports the following curious case : A patient, aged twenty-seven years, can generate light through the medium of his breath, assisted by manipulations with his hands. He will take anybody's handkerchief and hold it to his mouth, rub it vigorously with his hands while breathing on it, and immedi- ately it bursts into flames and burns until consumed. He will strip, and rinse out his mouth thoroughly, wash his hands, and submit to the most rigid examination to preclude the pos- sibility of any humbug, and then by his breath, blown upon any paper or cloth, envelop it in flame. He will, when out * Medical News. [We do not vouch for this.— C. M. II.] 26 INTRODUCTION. gmmirig and without matches, desirous of a fire, lie down after collecting dry leaves, and by breathing on them, start the fire, and then coolly take oft' his wet stockings and dry them. It is impossible to persuade him to do it more than twice a day, and the eftbrt is attended with the most extreme exhaustion. He will sink into a chair after doing it, and on one occasion, after he had a newspaper on fire as narrated, I placed my hand on his head, and discovered his scalp to be violently twitching, as if under intense excitement. He will do it any time, no matter where he is, under any circum- stances; and Dr. Woodman has repeatedly known of his sit- ting back from the dinner-table, taking a swallow of water, and by blowing on his napkin at once set it on fire. He says that he first discovered his strange power by inhaling and exhaling on a perfumed handkerchief, that suddenly burned while in his hands. The following case has been reported by Dr. C. A. Leale : * A strong man was able to light the gas with ease after a few frictions with his finger. He was recommended to rub his wife, who was suflfering from neurasthenia. She recovered, but he became morose, restless, and complained of a disagree- able feeling when his wife touched him. He finally recovered, but was not able to engage in his former business. There are occasionally reports through the newspapers of the eftect of magnetic storms upon invalids, and nervous people, faintings, spasms, palpitations, etc., having occurred when the subjects were not at the time aware that there were any electrical disturbances. Many invalids are enabled to foretell changes in the weather by the aggravation or amelioration of their disease, and their change of symptoms will be found to correspond to the change in atmospheric electricity from positive to negative, or vice versa, which immediately pre- * Journal oj Nervous and Mental Diseases, Oct. 1876. INTEODUCTION. 27 cedes or follows storms. The daily and nightly rise and fall of the grave symptoms attendant upon many acute diseases correspond very nearly with the variations in terrestrial elec- tricity, and are recognized as occurring with such regularity that the experienced practitioner can often readily predict the condition of the patient for hours in advance. Certain groups of diseases are influenced by the seasons. The greater prevalence of lung diseases during the winter months, and of bowel complaints during the summer, cannot be fully explained by the differences in temperature and diet ; while of the epidemics, small-pox is recognized as a winter disease, and cholera as a summer disease, although no feasible theory for this has hitherto been advanced, so far as known to the writer. The variation in atmospheric pressure undoubtedly exerts considerable influence over the state of the health ; but this very variation of pressure would, of itself, greatly influence the electrical conditions of the human body. From the days when the Greek slave of Anthero Was sub- jected to the shocks of the torpedo, or electric flsh, to cure him of his infirmity, and the Grecian women and children wore amber beads under the belief that its mysterious soul would exert a healing influence over their diseases, mankind has, from time to time, sought in electricity a ' ' panacea for all human ills. " At times its champions have made the most impossible promises for it, which, failing to be fulfilled, have thrown disfavor upon its power, and it would pass into obscurity, forgotten by the public, until an opportunity presented to again call attention to it as possessing almost miraculous properties. During the period it has been undergoing these alternations in popular favor, a few ardent lovers of science have quietly pursued its investigation with such a wealth of reward in knowledge of its properties and its possibilities, that it has been recently remarked by one writer that probably "the age of discovery^ so far as electricity is 28 • INTRODUCTION. concerned, is past, and we have actively entered upon the age of the practical application of principles long ago demon- strated. " The discovery of the Leyden jar, in 1746, was followed by important results to science. The following year the present of a pair to the Literary Society at Philadelphia, awakened Franklin's attention to physical science, to which he does not appear to have previously given any special attention, but he now took up experiments with avidity, and in 1749 made the discovery of the identity of lightning and electricity, which, although long sus- pected, had never, previously to his celebrated experiment of drawing lightning from a cloud with a kite attached to a hempen cord, been actually demonstrated. The same year he wrote as follows to Mr. Collinsen, the donor of the jars : " We are not a little chagrined that we have hitherto been able to produce nothing in the way of use to mankind, and the hot weather coming on, when electrical experiments are not so agreeable, it is proposed to put an end to them for the season in a party of pleasure on the banks of the Schuylkill. Among other experiments which we shall exhibit for our diversion, will be the firing of spirits by means of a spark sent from side to side through the river without any other conductor than the water — an experiment which we have some time since performed to the amazement of many. A turkey is to be killed for dinner by an electrical shock, and roasted by the " electrical jack " (a little moving power he had invented) before a fire kindled by the electrified bottle, when the health of all the famous electricians of England, Holland, France and Germany is to be drank in " electrified bumpers," under the discharge of guns by the electrical battery." In 1730 Dufaye transmitted electricity along a cord of moist packthread for 1300 feet. In 1774 Le Sage, a Frenchman at Geneva, transmitted a message over wires. He used twenty- four, one for each letter of the French alphabet, insulating them in glass tubes buried in the earth. These wires were connected with an electrical machine at one end, and electroscopes at the other, their divergence marking the letters. INTRODUCTION. 29 Three years afterward, near London, a current was passed through wires for a distance of two miles, the wires being insu- lated by and supported upon logs of baked wood. But one dis- covery must wait upon another, and it was not until the discovery of the electro-magnet that transmission of messages over wires could be rendered practical. In 1840 Prof B. Silliman took daguerreotypes by an electric light obtained from a zinc and copper battery in the laboratory of Yale College, and in 1854 an electric light was used in Paris during four months to enable eight hundred men to continue the work of excavation of a hill that had to be removed for some public purpose. Nearly all these earlier investigators made numerous experi- ments in treating disease both with electricity and the magnet. Many points of resemblance between the nervous force and elec- tricity were noted, which, taken together with the evident influence of electrical variations over disease led to the belief that nervous force was but electricity modified to adapt it to the animal system. In 1848, Matteuci, who had devoted much time to this subject, conclusively proved that electricity and nervous force are not identical, but bear the same analogy to each other as exists between heat, light and electricity. In addition to this, it has been claimed that there are electrical currents generated in the muscles and secretory organs, the result of the chemical changes going on within the tissues, and that these currents may be modi- fled by artiflcial currents from witho.ut the body. For many years the influence of electricity in all its forms over the tissues of the body has been diligently investigated, and the application of electricity to treatment of disease is now claiming the attention of the medical world more universally than at any previous period of its history. It is to be regretted that the early observers, who, with meager materials at their command and no preceding records to guide them, made those brilliant discoveries which now 30 INTRODUCTION. form the bases of all the practical electrical inventions that so delight and astonish the public of the present daj^, have left us no fuller account of their experience with disease. Frequent mention is made by them of remarkable cures of nervous disorders, paralysis, epilepsy, neuralgia and rheumatism. Those disorders, well known to be influenced by changes in external cii'cumstances of weather, season and climate, seemed to receive the most benefit. These reports of marvelous cures are not confined to a single observer, nor any one land. Records from almost every country on the globe, and from many experimenters, are found throughout our literature of the past two hundred years, confirming the valuable properties possessed by electricity as a remedial agent, but in regard to the particular condition of the patient with which successes or failures occurred, the strength of current used, and frequently the kind of electricity employed, we are left in the dark. Its use, until very recent j^ears, has been entirely empirical. The large class of neuroses, including hysteria, epilepsy, paralytic, neuralgic and spasmodic affections which so frequently baffie us when other therapeutic agents are employed, and tax professional skill to the utmost, should invite our investigation to this field, which, the experience of the past encourages us to believe, offers greater inducements to the original investigator than any other branch of our art. Since the specialist, who has used galvanism only, reports gratifying success in the same class of cases as those who employ exclusively either franklinism or faradism, we conclude that at present success depends more upon the care with which the details of treatment are carried out than upon the form of electricity employed. There is reason to believe that the time is not far distant when the differential indications for selection of the particular current best suited to various diseased conditions shall be clearly defined, and to Dr. Rockwell is due the honor of first INTRODUCTION. 31 directing the profession in our own country to this path of investigation. We need a series of carefully recorded obser- vations, no less accurate and extensive than those which estab- lished the cycle of magnetic storms, to determine how much diseases are actually influenced by electrical disturbances, and what relation the cycles of magnetic and electric phenomena bear to the appearance of epidemics. We also need full and complete clinical reports from conservative and observant prac- titioners before a satisfactory knowledge can be acquired of the true place electricity should occupy in our armentarium. Many reports of cases as now made are worthless, in not being sufficiently explicit. In reporting cases these points should be distinctly brought out, after describing the diseased condition in the usual manner : 1. The method of applying the current; whether general or local, labile or stabile, continuous or interrupted. 2. The kind of current used. 3. The direction of the current and location of electrodes. •1. The length of sitting. 5. The number of sittings. 6. The interval between sittings. 7. The power of battery current employed. Batteries of different makes, and of the same make under varying con- ditions, as described in chapter on batteries, differ so much in the force of current sent between the electrodes that it is important to settle upon some standard of comparison for medical batteries, as has been done for those employed in the arts, that the actual current strength may be indicated in reports of clinical cases. Evaporation and condensation of vapor are constantly set- ting free vast amounts of electricity, which cannot but exert an influence over the electrical conditions of the human body. The lightning flashes transform oxygen of the atmosphere into 32 INTRODUCTION. ozone, which purifies noxious vapors and destroys poisonous exhalations. There is some ground for believing that the prevalence of certain epidemics may bear some relation to electrical conditions of the earth and air. When cholera pre- vailed in 1849 with great fatality, it was observed that in localities in England where the pestilence raged most severely the magnetic attraction was diminished one half. Dr. Henry Stone has proposed a novel theory, which he terms the Electro-Galvanic Theory of Yellow Fever, in which he attributes the presence of the disease as an epidemic to disturbed electrical conditions. Among other indications point- ing to this origin, he cites what he terms the popular belief, that telegraph operators, other things being equal, are especially liable to violence of attack. Those interested in learning his views, and the arguments by which he supports them, will find the article referred to in the New Orleans Med, and Surg. Journal^ July, 1881. G. A. Sprechor^ also advances the theory that malaria! diseases depend upon the same cause. He cites the state- ment of Audrand that during the great cholera epidemic in Paris, an electrical machine, which he was in the habit of using, gave, during April and May, sparks not more than half as long as those which it usually emitted. During June 4th, 5th and 6th, only a slight crackling could be obtained, and on the 7th of that month no electrical phenomena could be excited. The days of the greatest mortality corresponded with the absence of electrical manifestations, and the rapid abate- ment of the epidemic coincided with a return of electrical phenomena in the atmosphere. Dr. Sprechor suggests that the extension of our telegraph and railroad systems through the country may have some in- fluence in modifying and directing malarial troubles, by the * Pacific Med. and Surg. Jour., Feb. 1883. INTRODUCTION. 33 formation of extensive conductors of electricity, and notes the effect these have upon the manifestation of electrical phenomena bj the fact, which he asserts, that our great hurricanes and tornadoes follow the lines of railroads. He further suggests that an explanation of the fact that animals and negroes are not at all, or very little, affected by malarial disease may be found in the fact that the hairy coat of the one and the dense oily skin of the other are a more or less perfect means of electrically insulating them. It may seem chimerical to suggest at the present time the possibility that at some future time the relation of epidemics to electrical disturbances, and dependence upon them, may become established, and that some method can be devised by which the electrical currents of the human system can be modified so as to render it less susceptible to contagious influence, and thereby prove as efficient a protector against certain of our most fatal epidemics as vaccination is against smallpox or antisepsis against zymotic poisons. This certainly offers a most attrac- tive field for study and experiment. I i i CHAPTER I. MAGNETISM. THE THEORY CONCERNING THE NATURE OF ELECTRICITY. Electricity is now very generally regarded as a form of motion akin to light, heat and sound, which pervades the earth itself, all objects upon its surface, the atmosphere sur- rounding it, and the heavenly bodies. We know that from electricity we can obtain heat and light, while from, heat, and the action of the sun's rays, we can obtain electricity, but al- though we have tolerably correct ideas in regard to the char- acter of motion of heat and light, our ideas as to the precise nature of the change which motion must undergo to appear as electricity, are still very defective. ACTIVE AND PASSIVE ELECTRICITY. So long as its distribution is uniform throughout any object, its presence cannot be detected ; it is then said to exist in a passive or hound state^ or in a state of equilibrium. When the electric equilibrium between any two points of an object, or between two objects, is disturbed, electricity is said to be free or unbound. It is with electricity in a free state that we have to do in its application to electro-therapeutics. OBSCURITY OF ELECTRICAL LANGUAGE. Formerly it was believed to consist of a fluid or fluids, which flowed through bodies as a stream of water flows through its channel, and many of the terms used bj the earlier writers (35) 36 MAGNETISM. on the subject are still retained, and convey an incorrect idea of the real nature of electricity. At the meeting of the electri- cal congress at Paris, in 1881, a revision of electrical language was suggested, which should make it conform to the present theories concerning this force. Some important changes were made, although much remains to be done, and there is still some confusion, even in the works of recent writers, in the use of terms. For the convenience of the reader, a full vocabulary of electrical terms is arranged on page 7, to which reference should be made when the meaning of the text is not clear. FORMS or ELECTRICITY. Tlie manifestations of electricity may be arranged under three heads : 1, magnetic ; 2, static ; 3, dynamic. Its magnetic properties as existing originally in the loadstone will be con- sidered under the head of Magnetism. The phenomena attend- ing static electricity set free by friction belong to Franldinism. Free electricity, moving as a current, is termed Dynamic. Dynamic electricity includes Galvanism and Faradism. MAGNETISM. The fact that the earth is a vast magnet, exerting magnetic influence over all objects upon its surface, was long since proven. It is the magnetic power of the earth which gives to the loadstone its peculiar properties, and Sir Wm. Thomson holds the belief that man possesses a setenth sense, which he terms the "magnetic sense," that enables its possessor to detect, by peculiar sensations, marked variations in terrestrial magnetism. The notion that the magnet exerts a peculiar influence upon health is a very old one. In ancient times, the mineral ore, or natural magnet, either alone or mixed with other materials, was used as medicine externally or internally for the cure or MAGNETISM. 37 relief of certain disorders of mind or body. Before reviewing the experiments tiiat have been made with this agent, it is necessary to define the properties it possesses and the laws which govern its manifestation. The presence of magnetism in any object is shown: 1. By its power of attracting iron filings, needles, etc. 2. By attracting or repelling other magnets. 3. By arranging itself, when freely suspended, so as to point toward the poles of the earth. 4. By its power to impart its own magnetic properties to iron or steel. NATURAL AND ARTIFICIAL MAGNETS. A natural magnet consists of a reddish brown or gray ore found in iron mines throughout the world. Artificial magnets are those in which the peculiar proper- ties of magnetism are induced artificially. Artificial magnets are of two kinds : 1. Temporally ^ made of soft iron, which acquires magnetism readily, but loses it as readily as acquired. 2. Permanent^ made of hardened cast steel, which cannot be so highly magnetized as soft iron. MAGNETIC POLARITY. When a small magnetic bar or needle is freely suspended it will be found that it will arrange itself so that one end will point toward the north pole of the earth ; and if the needle be turned in any other direction, as soon as it is free to move it will return to its onginal position, the same end always pointing in a northerly direction. Manufacturers mark one end of the needle in various ways to distinguish it ; sometimes by a notch, paint, or letters N or S. It is important to know which end of the magnet is pointing 38 MAGNETISM. in a given direction when it is used as a compass-needle, and also when it is used in making or testing other magnets. THE MAGNETIC POLES OF THE EARTH. The earth's magnetic poles do not correspond with the geographical poles. Thej are located at points in the northern and southern hemispheres, where the magnetic needle becomes vertical or perpendicular to the horizon when so hung that it may revolve perpendicularly to the earth's surface. Midway between these points is a place where the needle stands parallel with the horizon, and when passing northward from this, the north end of the needle begins to dip more and more until its pole is reached. Passing southward, the south end of the needle dips in the same way. ATTRACTION AND REPULSION. When a magnet is ^ brought near a magnetic N needle, or a small mag- net that is free to move, Fig. 1. it will be found that the north pole of one magnet repels the north pole of the other, and the south pole of the one repels the south pole of the other. When, however, the north pole of the first magnet is brought near the south pole of the movable magnet, the latter 'will be attracted and will approach nearer. Fig. 1 represents a large magnet with two small movable magnets at each end. The latter were at first parallel, but the attractive power of the large magnet has been exerted at the north end to draw toward itself the soutli ends of the small magnets, the repulsive force of its south end has driven off the south ends of the small parallel magnets near it. MAGNETISM. 39 THE LAW OF MAGNETIC ATTRACTION AND REPULSION. Like poles repels imlihe poles attract each other. The power of attraction is not equal throughout the entire length of the magnet. Dip a magnet in iron filings, and it will be noticed that the greatest cluster will be attracted to the poles or ends, while toward the middle will be found a space where none adhere. LINES OF MAGNETIC FORCE. If iron filings be spread on a stiff sheet of paper with a strong magnet held near to the paper, and underneath it, when the paper is slightly jarred the filings will arrange themselves in curved lines, as shown in Fig. 2. > j° These curved lines are called lines of magnetic force., and the space through which the magnet exercises ^ its force (the space covered by the ••v curved lines) Faraday named the Magnetic Field. Fig. 2. The lines of force diminish in number and length the further they are from the poles, until they entirely disappear, as repre- sented by the white space at the center of a. The line across the center marks the neutral point., or point of no attraction. 5 . ... Fig. 3. In Fig. 3 we have two equal magnets brought near, but not in contact with, each other, h represents what takes place when their north poles are adjacent. The particles, repelled by one, 40 MAGNETISM. after a little distance fall within the lines of repulsion of the other, and are repelled alike bj both, c shows the same magnets with unlike poles adjacent. Particles repelled by N are attracted by S, and vice versa^ illustrating why like poles repel and unlike poles attract each other. TRUE POLARITY OF THE COMPASS NEEDLE. Since like poles repel and unlike attract each other, it fol- lows that if two magnets be freely suspended within the sphere of their attraction (their magnetic field), the marked end of one will arrange itself parallel to the opposite or unmarked end of the other magnet ; therefore, that end of the compass-needle that points toward the north magnetic pole of the earth must be in an opposite or unlike magnetic state; or, in other words, that end of the needle pointing north possesses south magnetism, and that end pointing south possesses north magnetism. Some authors call the magnetism of the north pole of the earth horeal^ and that of the south pole austral; while the magnetism of the end of the needle pointing north is called austral^ and its opposite end boreal. Unfortunately there is no uniformity in the marking of magnets among manufacturers. In England and Germany the end of the needle that, when freely suspended, points toward the north is marked N, while in France this same end of the needle is marked S. In determining the polarity of unmarked magnets, this discrepancy should not be lost sight of. EFFECT OF DIVIDING A MAGNET. If a magnet is divided, since there is in the bar a neutral point where no magnetic properties are exhibited, it might be supposed that one half would exhibit only boreal and the other only austral magnetism, but such is not the fact ; each MAGNETISM. 41 half has two poles exactly like the original magnet, and no division can be made so small but that the resulting portions will exhibit both kinds of magnetism. No magnet was ever seen that had hut one pole. MAGNETIC INDUCTION. When a soft piece of iron is brought near a magnet it immediately assumes the magnetic state. This influence of a magnet operating at a distance is called magnetic induction. It is through induction that iron filings, tacks, etc., are at- tracted, and that magnetic properties are transferred from one bar to another when charging magnets. Arrangement of molecules in a bar Arrangement of molecules in a magnet, that exhibits no magnetic attraction. The irregular line across the bar marks a line of fracture which always occurs at a point which sets free a north and south atom. Magnetizing a bar of iron or steel consists in breaking up the magnetic affinity of the atoms and rearranging them so that the layer at each end is left without a mate. This explanation of the process has been suggested : 1. Each molecule of iron, steel, or other magnetic sub- stance, is a separate and independent magnet, having a north and a south pole exactly the same as that shown by a steel bar magnet. 2. The inherent polarity or magnetism of each molecule is a constant quantity, like gravity, and can neither be increased nor destroyed, but may be rotated by magnetism or electricity so that the entire magnet may have its poles reversed. 3. When a magnet seems to have lost its magnetism there is no actual loss, but the molecules have arranged themselves so as to satisfy their mutual attraction by the shortest path, forming a complete closed circuit of attraction. 42 MAGNETISM. 4. When magnetic properties are evident, the molecules or their polar atoms have all rotated in a given direction, and we still have a symmetrical arrangement, but the circuit of attrac- tion is not complete except through an external armature connecting both poles. 5. Permanent magnets are those in which the atoms are bound together with sucli rigidity (as in tempered steel) that they cannot rotate. Temporary magnets are those in which the atoms (as in soft iron) are held so loosely that they can readily rotate. 6. The neutral line of the magnet, or point of no attraction, found at a little distance from each extremity, does not indicate that there is no magnetism at that point, but that the attrac- tion of the molecules is satisfied by a short circuit of attraction within the magnet itself. MAGNETIC INDUCTION OK ATTEACTION ACROSS BODIES. If a sheet of glass, wood or paper be placed between a magnet and iron filings, they will be seen to be influenced by the magnet, and will arrange themselves in lines as if in actual contact with it. It is found that magnetic force acts across a vacuum, water, and all known substances, except across a network of iron, or other magnetic material. FORM OF MAGNETS. Artificial magnets are generally in the form of a bar or U ; the latter are called horseshoe magnets. Both forms may be simple or compound. A simple magnet consists of a single piece of metal. A compound magnet consists of several simple magnets made of thin plates of steel, placed side by side with their like poles together. If one plate is thinner or smaller than the rest, it weakens the entire combination. MAGNETISM. 43 A magnetic battery consists of several compound magnets of the same shape and size bound together. A magnet of this kind is much more powerful than a solid one of the same weight, because thin plates can be more strongly magnetized than thick ones. KEEPERS OR ARMATURES. When a magnet is not in use, the molecules after awhile will commence to arrange themselves, as in Fig. 4, and it will gradually cease to exhibit magnetic properties. To preserve a horseshoe magnet, its two poles are connected by a piece of soft iron called an armature or keeper. Bar magnets must be arranged in pairs, with unlike poles parallel, and connected by a keeper. TO CHARGE A MAGNET. When a bar of slightly-tempered steel is held vertically and struck several blows with a wooden mallet, it will acquire magnetism, and will attract iron filings, or deflect a magnetic needle, the same as a natural magnet. Magnetism may be communicated from one bar to another in the following manner : lay the unmagnetized bar horizontally north and south ; place one end of the magnet on its center and carefully draw it to the end of the horizontal bar ; raise it, always carrying it back to its starting point in a curve through the air ; repeat several times, then pursue the same course with the other half of the bar, first reversing the magnet. The latter loses none of its own magnetism by the operation, and the polarity of the new magnet is opposite to that of the inducing magnet. TO PRESERVE THE POWER OF A MAGNET. 1. When laying it aside, place it as nearly as possible in the position which it would assume if freely suspended, so as to be acted upon by the earth's magnetism. When the poles 44 MAGNETISM. are kept for a long time in any other position than this, unless made of the hardest steel, the magnet will eventually^ lose the whole of its magnetic power. 2. Two magnets rapidly weaken each other, if placed even for a short time with similar poles opposite to, or facing, each other. 3. All rough and violent treatment, such as falls, blows from a hammer, scratching the surface with sandpaper, or great heat, weaken the power of a magnet. 4. Neither horseshoe nor bar magnets should be laid aside without an armature. They are improved by keeping dry iron filings around the poles. LIFTING POWER OF MAGNETS. Natuml magnets do not increase in power in proportion to their increase in size. Sir Isaac Newton is said to have worn a loadstone, set in a ring, which weighed only three grains, yet could lift seven hundred and forty-six grains, or nearly two hundred and fifty times its own weight. One brought from Moscow to London, that weighed one hundred and twenty-five pounds, could support only about two hundred pounds. A horseshoe magnet is three or four times as pow- erful as a bar magnet. A horseshoe magnet weighing one pound ought to lift a weight of twenty pounds. It has been observed that when a magnet attracts iron a reaction takes place, the iron in turn attracting the magnet. The lifting power of a magnet can be greatly increased by add- ing day after day small pieces of iron, until its limit is reached. If more pieces are added after this point is reached, they will tear ofi" the armature and reduce the power of the magnet to its original value. ANIMAL MAGNETISM. Although the peculiar powers manifested by the torpedo and gymnotus were known to the ancients, it was not known until MAGNETISM. 45 1772 that these powers were due to electricity. The most eminent anatomists and physiologists have devoted much time to the investigation of animal magnetism since the discovery that shocks from these fish can magnetize needles and produce sparks. A German philosopher, named Father Helil, appears to have been the first to write on the subject of animal magnet- ism. His views were published in 1774, and subsequently they were adopted by Frederick Mesmer, of Suabia, who soon deviated from the tenets of his instructor, and in 1779 published what he termed a new system of treating disease, to which the name Mesmerism has been given. He claimed that the magnet was not directly necessary to produce the effects as- cribed to it by Hehl, but that one human being acts magneti- cally on another, on concentrating the attention and making with the hands certain passes over the body of the person to be magnetized. His extravagant pretensions attracted so much attention, that the King of France appointed a committee, composed of members of the Royal Academy of Science, with Benjamin Franklin at its head, to investigate the subject. After numerous experiments, they decided that mesmerism had nothing to do with magnetism, and it soon lost its popularity. THERAPEUTICAL PROPERTIES OF THE MAGNET. The ancients ascribed various medical properties to the loadstone. Galen ascribed a purgative property to it, and recommended it in dropsies. Paracelsus, in the year 1503, recommended it in the treatment of epilepsy, and for the suc- ceeding two hundred years it was extensively employed in dis- ease. In 1760 amulets were employed, consisting of pieces of magnetized metal so united as to form collars, garters, brace- lets, or plates adapted to various parts of the body. It was some- times pulverized and mixed with plasters, which acquired the 46 MAGNETISM. reputation of extracting iron and other metallic substances from the body. The chemists of those early times were not behind their brethren of the present day in extravagant pre- tensions, for they claimed to extract an oil of wonderful efficacy from the loadstone, which possessed all its properties in a con- centrated form. Recent observations in Paris hospitals, to determine the effect of the magnet upon patients, showed that it usually lessens the pulse, although sometimes it produces no effect upon it. Breathing is not modified, but patients sometimes complain of throbbing, pricking sensations at the positive pole. Metallo-therapy* is a term used to designate the employ- ment of metals, externally and internally, in the healing of certain diseases in which it is claimed they have been found serviceable. It includes also the magnet in its list of appliances. This subject has been thoroughly discussed in the French journals during the last five or six years, and Charcot and Yigoureaux having made numerous experiments, both pronounce their con- fidence in it as a valuable acquisition to medical science. The popular notion that sleeping with the head to the northward, so that the body will be j^arallel with the terrestrial magnetic cur- rents, is useful in certain nervous complaints, has long been regarded as a harmless superstition; but the subject, in this da}^ of enthusiastic investigation of all questions pertaining to electrical science, is again attracting attention, and we quote from The Electrician\ the latest in regard to the subject : M. G. De Tiocquigny writes as follows to the editor of Le8 Mondes: " M. C. Vignier wrote in the Revue Philosophique for 1882, No. 7, July, p. 31 : ' Is there, then, an agency capable of exercising a con- tinuous action on the apparata of the nerves (canaux), varying with the position of the head ? To my mind this agency exists, and is none ♦Archives of Medicines, October 1883 (Dr. Peckham), t November 1883. MAGNETISM. 47 other than terrestrial magnetism. That an all-pervading force should be without any action on our organism when we see it influenced by the least variation of light and heat, is surprising enough already. But it is beyond dispute that galvanic currents not only exercise a powerful effect on our nervous system, but that electro-magnets themselves produce well marked eJBfects in certain nervous affections. The experiments undertaken at Salpetriere, by M. Charcot, leave no room for doubt on this ix)int; and there must be some foundation for the practice adopted by the Swedish peasants, who cause themselves to be buried for several hours so as to lie North and South in order to cure neuralgia.' " To this the author adds the note : ' I have this fact from M. Nord- strom, Swedish Consul at Alger. It is, moreover, sufficiently proved by physiological experiments that a very close relation exists between the nervous system and electricity, of which magnetism is but one form.' In another note the author quotes the following experiment, carried out by M. Ziegler, of which M. Vogt was a witness : ' M. Ziegler takes a lens of soft iron, he exposes it in a place where it will receive the lines of terrestrial magnetism and redirect them on to the organ to be studied. By thus projecting the magnetic lines concentrated in this manner on the heart of a rabbit, the rhythm of the heart is changed ; if the lines are concentrated on the intestines, violent peristaltic movements {p/ris- taltiques) are caused {Journal Officiel, May 18, 1881). The preceding facts will, perhaps, appear to you, Monsieur I'Abbe, to add some degree of probability to the theory put forward by The Electrician of London.' " Dr. Hammond has reported some experiments in the use of the magnet that will be refei-red to elsewhere. In the present state of our knowledge of this subject the use of the magnet in the treatment of disease must be wholly empirical, and is only resorted to in isolated cases by way of experiment, when other forms of electricity have failed to produce a bene- ficial effect. CHAPTEE 11. FRANKLINISM. Frictional or static electricity when applied to medical pur- poses is known as Franklinism^ in honor of Benjamin Frank- lin, whose investigations marked an era in electrical science, and who was the first in this country to apply it to the treat- ment of disease. The presence of frictional electricity is mani- fested by the following effects : 1. Luminous^ as when lightning flashes through the sky. 2. Mechanical^ as when lightning strikes an object, rending and destroying it. 3. Calorific^ when the object struck is at the same time set on fire. 4. Chemical^ as shown by its power to convert oxygen into ozone. The change in the atmosphere after a thunderstorm is due to the development of ozone on a large scale by the lightning. Milk is soured during a thunderstorm by the chemical action of lightning. 5. Magnetic. When masses of metal receive a lightning stroke and afterward exhibit magnetic properties. 6. Physiological^ as when a person has survived a stroke to remain paralyzed from the tremendous shock to the nerves ; or as in those rare instances where sight or hearing has been suddenly restored by the same means. ATTRACTION AND REPULSION. Previous to the investigations of Gilbert, in 1600, jet was the only substance known to possess the same peculiar power (48) FRANKLINISM. 49 of attraction and repulsion first discovered in amber. Subse- quent observers have established the fact that under certain conditions, all substances exhibit, to a greater or less degree, the same properties. Fig. 6 illustrates these phenomena. A glass rod, G, having been excited by rubbing with a silk handkerchief, is brought near two straws, a 5, suspended by fibers of silk thread. They are attracted by the glass for an instant and then repelled, not only by the glass, but by each other, in the direction marked by the dotted lines + +. Again, rub a stick of sealing-wax or shellac with flannel and bring it near the straws : they will behave as before. If, however, the wax be presented to them while repelled by glass, they will be instantly attracted by the wax. If an excited rod of glass be brought near one straw and another of wax near the sec- ond straw, while being respectively repelled from the excited rods, they will be mutually attracted ; hence the law of elec- trical attraction : Bodies electrified alike repel^ those electrified unlike attract each other. The phenomena of attraction and repulsion are exhibited by all forms of electricity, but franklinic electricity excels them all in exerting this influence at a distance. Its force varies inversely as the square of the distance between the bodies, through which this influence is exerted. POSITIVE AND NEGATIVE ELECTRICITY. The form of electricity developed by rubbing glass was for- merly called vitreous^ because it was erroneously supposed that the opposite kind could not be produced from glass. That kind 50 FEANKLINISM. developed from resin was called resinous for a similar reason. It is now known that the kind of electricity depends not alone upon the substance rubbed, but also upon the substance with which it is rubbed. Resinous electricity may be excited in glass by friction with fur, and vitreous from resin, when rubbed with amalgam spread on leather. Vitreous electricity is now called positive, and is marked with the sign -}-, while resinous electricity is called negative, and marked with the sign — . Since bodies in a like electrical state repel, and those unlike attract, it is easy to determine by comparison whether an electrified body is posi- tive or negative. THE ELECTROSCOPE. This is an instrument for detecting minute quantities of static electricity, and determining whether a given charge is positive or negative. It consists of two strips of gold-leaf, hung together by the upper ends to a metal rod. This rod passes through the stopper in the neck of the glass bottle within which the gold-leaves Fig. 7. hang. The upper end of the rod terminates ELECTROSCOPE. . • i i i ^ i i, t Ht.i2in. Diain.4i4in. ^ nickel-plated Drass disc. PHENOMENA OBSERVED ON ATTEMPTING TO TEST AN ELECTRIFIED OBJECT. 1. Rub a glass rod briskly and bring it near the disc, the gold-leaves will become charged with the same kind of electricity, and repel each other. 2. While they are mutually repelled, touch the disc with the finger, they will instantly collapse. 3. Remove the finger, and then the glass rod, the leaves will separate again owing to their being similarly electrified. 4. Now bring the glass rod near, they collapse. 5. When brought nearer still, they separate again. FRANKLINISM. 51 6. Remove the rod a little, they collapse. 7. Remove it further, they separate again and remain apart, showing that there is now a charge in the electroscoi)e. 8. Xow bring near the disc -a rod of sealing-wax or hard rub- ber, electrified by rubbing, the leaves fly still further apart. 9. Take the rod away, and they resume their former diver- gence. TO TEST AN ELECTRIFIED OBJECT. To discover which hind of electricity it is charged loith^ proceed as above described, except 8 and 9. After having secured a charge in the electroscope from a glass rod, bring the object to be examined near the instrument. If it is charged with negative electricity, the gold-leaves will behave as when the rod of sealing-wax was presented to the disc ; if positive, it will not disturb the gold-leaves. To discover if an object is electrified at all. Bring it near the disc when the electroscope contains no charge, and the leaves are not divergent. If the object is electrified, the leaves instantly fly apart ; if it is not electrified, they are not disturbed. EXPLANATION OF THE PHENOMENA OBSERVED. 1. At first the plate and leaves are not electrified, and the glass rod (being -y) attracts — electricity to the disc, and repels -f electricity to the leaves, and they repel each other. 2. The hand and body become a part of the electroscope . when the disc is touched, and the -f electricity repelled by the glass passes through the body to the earth, the — electricity being retained in the disc chiefly by the attraction of the glass rod. 3. Removal of finger and glass rod permits the — electricity to spread over disc and leaves, and the latter again diverge. 4. The glass rod brought near now attracts the — electricity to the disc ; there is none left free in the leaves, and they collapse. 52 FRANKLINISM. 5. The glass rod, on approaching nearer, sets more electricity free in the disc and leaves, and the same process is begun, and continued in 6th and 7th, as took place at first. 8. When the leaves are divergent from the positive charge produced by the glass rod, if a rod of sealing-wax, or a piece of rubber electrified by friction, be brought near, being negative it repels the — electricity from the disc to the leaves, and they diverge still more. The electrical condition of a patient after receiving a charge may be determined in the same way, provided the electroscope is not brought near enough the machine to be influenced by the charge escaping from its surface. CONDUCTORS AND NON-CONDUCTOES OR INSULATORS. Bodies that have been electrically excited return to a neutral condition after a time, under the influence of the surrounding air, but they may be made to do so instantly if touched by the hand, a metal wire, etc. A rod of glass or sealing-wax held in contact with them does not lessen their electrical excitement. Those objects, such as the hand, metal wire, etc., which readily permit the passage of electricity over them, are called conductors. Glass, resin, and other substances which resist the passage of electricity, are called non-conductors or insulators. Heat lessens the con- ducting power of metals, while it increases that of most other substances. These terms are relative, as there is no such thing as perfect insulators, or perfect conductors. The presence of moisture de- posited by the air upon its surface converts the best insulator into a conductor. DISCHARGE. When an object is restored to a neutral condition by the touch of a conductor, it is said to be discharged. Any excited or FRANKLINISM. 53 charged body may be discharged by connecting it with the ground by a good conductor, or by passing it through a flame. INSULATION. A body is said to be insulated when it is supported or sur- rounded by some badly conducting substance which prevents free escape of electricity ; when it is important to keep electricity from escaping, supports of glass, shellac, india-rubber or other non- conducting substance, are used. ACCIDEXTAL INSULATION OF A DWELLING-HOUSE. . An instance"^ of this was reported some years ago as having occurred in New York city. ''A new house was so thoroughly insulated in its construction, that the electricity set free by fric- tion of carpets and furniture by the inmates, having no way to escape, accumulated to such an extent, that shocks were felt, and, in the dark, sparks were seen proceeding from the fingers, on touching the door-handles and other metallic objects in the house, and even when shaking hands. A ground connection being made from the interior of the house, the annoying phenomena ceased." A similar instance was reported in the local papers as having occurred in Iowa last year, and in this city as least one instance of the kind has come to our knowledge recently. Many bodies formerly supposed to be incapable of being elec- trified are found such good conductors, that electricity flows away as fast" as excited, and when they are properly insulated are easily electrified. Glass, when kept dry and clean, is one of the best insulators for practical purposes ; and if coated while hot with shellac varnish, deposits of moisture on its surface will interfere but little with its insulating power. Prof. Loomis, 1850. FRANKLINISM. INDUCTION. A body may be charged with electricity without touching it, by bringing near, but not in contact with it, an electrified body. This is electrifying hy induction^ and the charge received will be opposite to that possessed by the inducing body. Newton was the first to discover that when one surface of a plate of glass is charged with positive electricity by friction, a negative charge appears on the opposite surface without friction. DIELECTRIC. The plate of glass or other substance through which the charge is propagated is called a dielectric. CONDUCTION. When a body is charged with electricity by actual contact with an electrified body it is called charging bj^ condueUon. INDUCTION AND CONDUCTION COMPARED. BY INDUCTION. 1. The inducing body does not lose any part of its electricity. 2. The opposite kind of electricity is given to the induced body. 3. The object to be electrified must be in contact with the earth, either directly or by means of a good con- ductor. BV CONDUCTION. 1. The conducing body loses part of its electricity. 2. The same kind of electricity is given to the body acted upon. 3. The object to be electrified must be insulated from the earth. RETURN SHOCK. Sometimes when a charged conductor is suddenly discharged a shock may be induced in persons standing near. This is called a "return shock" or "back stroke," and is sometimes felt by persons standing on the ground at some distance from an object struck by lightning. FRANKLIXISM. 55 DISTRIBUTION OF ELECTRICITY. Electricity may exist on a surface as a charge, or flow over it as a current. Tlie charge is the amount of electricity produced, excited or set free in any body. When two bodies are rubbed together, the one whose particles are most easily moved by friction becomes negatively electrified ; the harder body, positively electrified. Two plates of the same material may become oppositely electrified when they difier in temperature, the warm one becoming positive, the cold ,one negative. A charge is not spread uniformly over a surface ; there is more on the edges and corners than on flat surfaces. Good conductors allow electricity to move freely over or through them ; and if a charge be given to one part it instantly spreads over the whole surface. A charge given to a poor conductor takes a long time to distribute itself, and in many instances is practically confined to the part that received it. When a charge of electricity is constantly carried oft* and as constantly renewed, it constitutes a current. RESISTANCE. Resistance is the converse of conduction. It may be defined as that quality of a conductor that impedes the passage of electricity. ELECTRO-MOTIVE FORCE. Electro-motive force is the power that urges electricity for- ward, or causes it to move from one point to another. It may be called the propelling force. POTENTIAL OR TENSION. Potential or tension may be briefly explained as the electric levels and usually refers to the diffierence between the electric 56 FRANKLINISM. distribution or condition of any object and that of the earth. When the potential of the object is above that of the earth, electricity tends to escape from it to the earth. When it is below that of the earth, electricity passes from the earth to the object. It is evident that the greater the surface over which electricity is diffused the less its potential at any given point. DIFFERENCE OF POTENTIAL. When any two objects are compared, the ditference in electric level is called difference of potential ; the greater this difference, the greater the electro-motive force, or power of over- coming the resistance, between them. Whenever a difference of potential exists between two objects that are brought within the sphere of mutual attraction or repulsion, there is a ten- dency for electricity to seek an equilibrium. An example of extreme difference in potential may be found in violent thunder- storms, when the earth and clouds have so great a difference of electrical level that electricity can no longer pass silently between them on the trees, spires, and other natural conduc- tors, but darts in forked streaks or enormous flashes over miles of surface at every discharge. MUTUAL POTENTIAL. The mutual potential of two objects is measured by the amount of work done when allowed to separate under the influ- ence of mutual repulsion, or to come together under the influence of mutual attraction. Induction can only take place between objects of different potential. QUANTITY. Quantity refers to the amount of electricity required to re- store the equilibrium between two unequally electrified bodies. FRANKLINISM. 57 DENSITY. Density is the amount of electricity on a given surface at any moment while quantity is the total amount generated by the machine. Density is the same on all points of a ball, but on a plate it is greatest at the edges, and on a pointed conductor, at the points. AN ACCUMULATOR. An accumulator is an apparatus for receiving and retaining large quantities of electricity. THE LEYDEN JAR AND DISCHARGER. The Leyden jar, or jar of Kleist, used with modern electrical machines as an accumulator or condenser, was invented nearly at the same date both at Leyden and by Kleist, of Cam- min. As usually made, it consists of a wide- mouthed, glass jar, J, with a coating of tinfoil pasted inside and outside to within three or four inches of the top. The mouth is closed with a wooden stopper through which passes a brass rod, K, terminating two or three inches above the jar in the ball B. To the lower end of the rod is fastened a strip of foil or chain which extends to the bottom of the jar. The tinfoil coatings are two conductors, which are insulated from each other by the glass jar upon which they are fastened. If the outer coating be connected with the earth, either by holding it in the hand or attaching it to a metal chain, and the brass knob be brought near to the conductor of an electrical ma- chine, bright sparks will pass between the knob and the con- ductor. The positive electricity conveyed to the inside of the jar acts inductively, through the glass^ upon the outer coating, pro- ducing a negative charge in it, and driving off its positive elec- 58 FRANKLINISM. tricity through the hand or chain to the ground. It is more cor- rect to say that the positive and negative charges are on the opposite sides of the glass {dielectric)^ for the tinfoil coatings serve merely as conductors to distribute and carry off the electricity. THE DISCHARGER. The one shown in Fig. 8 consists of a curved brass rod, C, terminating in the brass balls A A. The handle is of hard rubber. To use it^ hold the lower ball near the outer coating of J and bring the uppei- ball near B, when instantly a brilliant flash, accompanied by a sharp report, will be seen to pass between the knob and the ball. This restores the electrical equilibrium or discharges the jar. If the fingers are brought in contact with the knob and the outer coating at the same instant, a sudden painful jarring sensation, termed an electric shock, is the result. It has been found that the charge moves in curves when the jar is discharged, similar to the lines of magnetic force shown in Figs. 2 and 3. RESIDUAL CHARGE. If, after being discharged, the jar be left to itself a few minutes, it will be found to have again acquired a small charge. This is called the residual charge. The flash from a thunder-cloud is exactly analogous to the discharge from a Leyden jar. The cloud and surface of the earth form two coatings of the insulating layer of air between them, while a tree or a steeple, or other projecting object, acts the part of the discharging rod. FRACTURE OF JARS. A Leyden jar may become so intensely charged that the strain occurring at the instant of discharge may overcome the cohesion of the molecules of glass and a fracture occur. This is more likely to take place if the jar is ver}^ clean and dry. FRANKLINISM. 59 Yarious measures have been recommended to avoid destruction of the glass, which does not very frequently occur when the manufacturer is careful to select well annealed jars. Breathing into them through a glass tube occasionally will keep the inner surface sufficiently moist. Instead of this, a slip of writing- paper, about one inch broad, may be pasted on the inner sur- face of the jar, so as to cover the uncoated space to the height of half an inch above the upper edge of the inner coating. This is believed to accomplish the purpose by extending the charged surface through the medium of an imperfect conductor, and thereby diminishing the intensity of the charge at that part which has the greatest tendency to fracture. MODE OF DISCHARGE. Franklinic electricity has immense potential or power of overcoming resistance, and tends to escape in three ways : 1. Conduction. 2. Disruptive discharge. 3. Convection. When electricity is drawn silently from the clouds or machine by a pointed conductor, it is an example of a dis- charge by conduction. When lightning produces a flash of light and heat, accompanied by sound, or a jar is fractured by an electric spark, it is called a disruptive discharge. The glow sometimes seen on the top of masts and light- ning conductors during a thunderstorm is an example of con- vection. The same thing may be seen about the points of an electrical machine in motion in a dark room ; the particles of air around these points become electrifled, and, being repelled, others take their place, forming currents. When electricity is discharged by convection (through pointed electrodes) upon any part of the body, it produces the sensation of a wind blowing upon the part. 60, FEAl^KLINISM. THE CONDENSER. The Leyden jar is sometimes called a condenser because it was formerly supposed that the strong electrical effects pro- duced by it were due to the condensation of an electric fluid or fluids. There are many other forms of condensers, but as they have not been employed for medical apparatus, no descrip- tion is needed here. CAPACITY. The capacity of a condenser is measured by the quantity of electricity of unit potential which it can contain, or it is equal to the charge divided by the potential. ELECTRIC MACHINES. The first machine constructed for producing frictional elec- tricity, of which we have any record, was invented by Otto von Guericke, a burgomaster of Magdeburg, in 1672. It con- sisted of a globe of sulphur, set on a wooden axle, turned by a handle and rubbed by a cloth pressed against it by the hand. In 1709 Hawksbee invented a machine in which a glass cylinder replaced the globe of sulphur. After the discovery of the Leyden jar it was utilized as an accumulator. The machine was greatly improved from time to time, but owing to its uncertainty during unfavorable weather, and the great care required to keep it in order at all times, it was almost universally neglected for many years after the dis- coveries of Galvani and Yolta had led to the construction of what is now known as the galvanic battery. Reynolds, of England, Arthius, Charcot and his pupil Yigoureaux, revived Franklinism, to which Holtz and Topler added impetus by their valuable improvements in the electrical machine. Prof. Atkin- son, of this city, has added later improvements; so that now FEANKLINISM. 61 there seems nothing more to be desired in an apparatus for administering franklinic electricity except portability, which has not yet been satisfactorily accomplished. Fig. 9. THE IMPROVED TOPLER ELECTRIC MACHINE. Size of base, 12x26 inches. B. Stationary plate supported by hard-rubber insulators. N. Cap with rubber insulator to hold upper edge of B firmly in place. A. Revolving plate ]4: inch from B. M. Axis on which A revolves. It is attached to the upright post through an opening in the center of plate B. E& F. Brushes attached to plate B through holes near its edge. 62 FRANKLINISM. T&X. Tinfoil and paper inductors on the surface of plate B next the upright post which supports it. The tinfoil inductors are represented by the dark shade, and the paper inductors by the light shade. V & H. Uninsulated combs with brushes in front of A. % inch from its surface. They are screwed to a brass core at the center of the hard-rubber disc M. D & C. Ley den jars. P &R. Rods sliding through the knobs, which convey electricity to the internal coating of the Leyden jars. L & K. Insulated combs connected with the sliding rods P and R. W & Z. Two of the six discs or carriers attached to plate A. S. The switch for obtaining the induced current from the outside coatings of the Leyden jars. O. Adjusting screw to tighten or loosen the belt. The arrow indicates the direction the drive-wheel must be turned. CLAIMS OF THE INVENTOR. Mr. Atkinson* has clearly and concisely stated his claims for the superiority of his Improved Topler Electric Machine over any static machine in the market at the present time, and the points of difference covered by his patents, as follows : 1. The outside coatings of the Leyden jars C and 7>, are of sheet brass, nickel plated, and are screwed firmly to the base, forming cups into which the jars fit closely, and are thus held in a fixed position, affording a firm support to the parts connected with them, and preventing liability to accident or injury to the jars or plates. 2. The induced current from these outside coatings is con- veyed down by the brass screws which attach them, and along copper wires underneath, to the terminals of the switch S, through which, w^hen closed, it passes from one jar to the other ; but when open, as in the cut, it passes by the brass sockets, seen on the edge, which are also connected with the terminals, out through the conducting cords, and a person, or other object, connected with their outer extremities. As this induced current flows simultaneously with the direct current from the inside coatings, the switch and sliding rods place it completely under control of the operator, either for medical * The Electrician, October 1883. FKANKLINISM. 63 or scientific purposes. With the switch open, a slight separa- tion of the electrodes, P and produces a smooth, gentle current ; this may be increased to any desired strength, a sepa- ration of one-half inch producing a current too severe for the strongest nerves. Geissler tubes, attached to the cords, show the beautiful effects of the interrupted current. Also the induced spark below, simultaneous with the direct spark above, is shown when the switch is open about one-half inch, as in cut. 3. The brush-holders, E and are attached to the plate B. through holes near its edge ; thus giving a direct passage to the electricity from the carriers on the plate where it is generated, through the glass, to the tinfoil and paper induc- tors T and X. By passing the electric charge tlirougli the glass inside its edge^ an insulating margin is interposed be- tween the conductors and the edge, thus preventing loss from leakage, which is unavoidable when the brush-holders are attached by clamps or ears on the edge. 4. The carriers on the plate A are of sheet brass, with raised centers, and nickel plated, making them both durable and ornamental. The hard nickel surface is not affected by the action of the brushes, or the electricity, while tinfoil soon becomes defaced; and the carrier, being practically one piece, and its entire surface cemented to the glass, its raised center cannot become detached, as may happen when the center is put on separately over a tinfoil base. 5. The combs V and also II and Z, radiate at an angle of 45 degrees from the central disc Jf, to which the}^ are attached ; so that any possibility of error in regard to their position, or of displacement, is practically impossible. The following improvements may also be noticed : The base is made of two-inch strips, glued together length- ways, and heavy cleats screwed on underneath ; giving all 64 FEANKLINISM. the advantages of iron as to freedom from warping, with the insulation and elegant finish of the wood. The iron casting, on which the driving-wheel is mounted, slides in grooves on an iron plate, and is moved by the ad- justing screw to tighten or loosen the belt. The hard-rubber insulators, which support the plate have soft-rubber packing, to ease the pressure on the glass. The Leyden jars, C and Z>, have wooden caps, with cork attached, making a neat ornamental cap, and affording a firm support to the brass conducting rods which support the sliding rods P and and the combs K and Z. The machine thus described has only two plates, but four or more plates may be used if desired. Better results are obtained by increasing the size rather than the number of the plates. Machines with plates sixteen and eighteen inches in diameter respectively are very efficient ; plates twenty-five and twenty-eight inches in diameter give great energy. The smooth- ness of the induced current increases with the size of the plates. The energy of the discharge depends chiefly on the size of the Leyden jars, as increased size gives increased storage, and, consequently, greater energy and less rapidity of discharge. THEORY OF ITS ACTION. To comprehend the action of any electric generator, these essential principles, in their construction, must be kept dis- tinctly in mind. 1. To generate electricity is to create a difierence in electric potential or level. 2. The efficiency of all generators^ whether batteries, dy- namos or glass-plate machines, depends on the difference of potential which each is able to create and maintain within the apparatus itself. FEANKLINISM. 65 3. The worh to he done by such an apparatus is the restora- tion of equilibrium through an exterior circuit, and may consist in producing heat, light, chemical, mechanical or physiological action. PRINCIPLES APPLIED. As the plate A revolves, the raised centers of the six discs or carriers are brought into contact with the wire brushes attached to the holders E and each opposite pair of car- riers touching opposite brushes successively at the same instant. The friction generates electricity^ which diffuses itself over the carriers on A and the inductors on with which they are at the instant of contact in electric connection. The potential of carrier and inductor during contact will be the same ; at the next instant the carrier passes on and is insulated from the inductor, and carrier and inductor now act inductively on each other, and multiply the initial charge given by the friction of contact. As it accumulates it spreads over the paper in- ductors ; these act on opposite surfaces of the glass till both surfaces of both plates become charged, the initial charge being still continued by the constant friction of carriers and brushes. The question now arises as to how any difference of poten- tial can be accounted for, since both sides of the machine are of similar construction, and the mode of action on both sides is apparently the same. It will be noticed that the position of the plates being vertical, their lower halves are nearer to the earth, by their semi-diameter, than the upper halves, and consequently more under the influence of its inductive action by the square of that distance. (A horizontal or any other position would not prevent this result ; it could only be done by placing them between two worlds of equal size, and equally distant from both). The lower halves are also in close proximity to the Leyden jars, the driving-wheel and the belt, and are subject 66 FRANKLINISM. to their inductive influence : the plate B is supported on two hard-rubber insulators, while the upper half has but one, and hence has the advantage of the better insulation of the air. To this lower half of and subject to these influences, is attached the brush-holder while E is attached to the upper half, and remote from them : hence the carriers brushed by and descending toward Z, must acquire a higher potential than those brushed by and ascending toward K. An accumula- tion of electricity must also occur at the lower ends of the inductors T and from the inductive influence of the earth ; and as the brush-holder F is placed at the lower end of X, it furnishes an outlet to a portion of this charge, as seen at night by the brushes of light from this holder to the outside of the jar and other parts in close proximity. The lower end of T, on the contrary, is well insulated : hence the potential of T from the heavier charge at its upper end, and the better insulation at its lower end, must be much higher than that of where the influences are just the reverse. This accumulation, or high positive potential, at the lower end of Tmust produce a high negative potential at that point on the plate A and its carriers as it revolves; and this is shown by the brush of light marking the flow of electricity on to the plate from the uninsulated comb H ; the outflow of the current received through Y from the opposite side and upper half of A. This brush of light extends upward, as the charge increases almost to the comb Z, showing the high nega- tive condition of the plate and carriers after having parted with their electricity through Z to the jar D. And here let it be noted, that a brush of light between comb and plate would have the same appearance whether the flow were from comb to plate or from plate to comb. Hence a similar brush extends u])ward from the comb Z, as the plate and carriers descend charged from E^ and gives ofl* their electricity to Z. FKANKLINISM. 67 Following any opposite pair of carriers, as W and Z, we find that as Z passes under the brush i^, W passes under and as Z moves on to the insulated comb IT, Wat the same instant arrives at Z: but TFJ as already shown, has a higher potential than Z, and at this point a peculiar adjustment takes place. IT gives up its charge through the comb Z, to the inside of the Leyden jar D. This creates a positive charge on the inside of which induces a negative charge on its outside. The electricity thus repelled passes to the outside of O, making it positive, and inducing negative on its inside ; and this repelled electricity flows through the comb ^to the carrier Z. Z then passes on with a positive charge to the uninsulated comb while W, having become negative, as previously shown, arrives at IT. Each now passes under the wire brush attached to its respective comb, and the combs being attached to the brass core at the center of Jf, the carriers are put in electric con- nection with each other, and their potential equalized by the flow of electricity from V to H; so that each arrives at the original position of the other at the same potential, ready to repeat the same process. The combs IT and "PJ Z and ZT, have also performed the same oflice for the several sections of the plate Ay as it has passed them ; so that the section from V to Z" is now at the same potential, from center to circumference, as the section from Hto F\ each section having, like the carriers, performed its work on the Leyden jars. The section from E to II having given up electricity, has become negative, while that from Z^ to 1^ having received elec- tricity, has become positive. This positive potential on the front surface of J., at this point, induces negative potential on its corresponding back surface ; positive on the front of and negative on the back 68 FRAXKLINISM. and on the inductor X. In the same way, but in reverse order, similar conditions occur on the opposite side. It will thus be seen, that while the brushes F and E act as generators, the brushes Y and H act as dischargers ; and while the combs K and L create a difference of potential in the jars, the combs Fand like their brushes, discharge, and restore equilibrium. When the difference of potential between the inner coatings of the jars becomes sufficient to overcome the resistance of the air, a discharge from the inner coating of D to that of C takes place through the sliding electrodes JR and P ; and, at the same instant, a discharge from the outer coatings takes place through the switch and connections, from C to to restore equilibrium between them, and thus complete the circuit. A spark and snap, from the resistance of the air, accom- panies the discharge between the inner coatings ; and the same will occur between the outer coatings if the switch is open ; but, if closed, the discharge takes place silently. The plates and other parts being, at the same instant, relieved of strain, there is a restoration of equilibrium in the whole machine. The above explanation applies to the machine when it is put in operation from a state of absolute rest ; but when it is in a high state of activity, there frequently occurs a reversal of poten- tial after a discharge, as shown by the reversal of the brushes of light from the combs. To account for this it must be considered, that after the primary discharge, a residual still I'emains ; this, from unequal resistance, may be greater on one side than the other, and after being relieved from strain by the primary discharge, will operate to give a slight preponderance of potential to that side, which is rapidly multiplied by induction, as the rotation of the plate continues. A reversal can also be produced by touching the inductors, or parts connected with them, while in action, which would reduce FKANKLINISM. 69 the potential at that point. Special conditions may also exist in certain machines, which will reverse the ordinary mode of action ; as, for instance, a difference of thickness on opposite sides of a glass plate ; or in opposite jars. The condition of the air, as to its insulation, influences the whole operation of this machine. An air space insulates the plates, and also the jars, with their rods and balls, from each other ; and as a damp atmosphere lessens this insulation, it will decrease the energy of the machine in like proportion. A film of moisture, settling on the plates, will often so reduce the insu- lation, that the slight initial charge by the action of the brushes is conducted over the damp surface as fast as it is generated ; so that no difference of potential, and consequently no charge, can occur. And as the machine is much more sensitive to such influences than the operator, the latter is often puzzled to know why it will not generate. The simple and effectual remedy in all such cases is to dry it. From this it is easy to see why a Holtz machine is so much more liable to stoppage than a Topler ; as the Holtz receives only a small initial charge, which is then discontinued, while that of thie Topler is constant, from the continuous action of the carriers and brushes ; so that a well-constructed Topler is per- fectly reliable in any kind of weather. The views here given are not mere theory, or hasty deduc- tions from imperfect data. They are the result of constant, daily experiment and observation, for several years, with both Holtz and Topler machines, of almost every conceivable style, size and variety, including a large number of the very best machines in use. CARE OF THIS MACHINE. It should be kept free not only from damp, but dust and dirt of every description. Since the attractive influence of electricity affects the floating materials in the air surrounding the machine, 70 FRANKLINISM. the latter should be inclosed in a case. When dampness inter- feres with its working, wipe the glass-plates dry, and set a lighted lamp in the case a few minutes, removing it as soon as sparks can be obtained. An alcohol lamp is not suitable, since the com- bustion of alcohol produces moisture, which will increase instead of remove the difficulty. A small lump of unslaked lime kept in the case when the machine is not in use, pre- vents any deposit of moisture on the plates. If it becomes necessary to place the machine before an open fire or hot stove to dry it, always turn the edge of the plates to the fire, as they are less liable to break than when the side is directly exposed to the heat. ANIMAL ELECTRICITY. J. J. Hemmer^ carried out with great perseverance nearly five hundred experiments on men, women and children, from which he arrived at these conclusions : 1. The human body always possesses electricity — but its strength is not the same in all ; in some it is positive^ and in some negative. 2. The intensity and nature often varies in one and the same person. 3. The natural electricity of the body is positive, for this is always its character when there has been no violent exertion. 4. This normal positive electricity is changed into negative by exposure to cold, or else is greatly enfeebled. 5. The same change occurs from over-exertion or lassitude. 6. The natural electricity is also changed into negative by sudden, rapid and violent motion. 7. Prolonged mental exertion increases positive electricity. S. Positive electricity is increased in winter and diminished in summer, ceasing entirely during perspiration. * Green's Journal of Physic, 1791, iii, p. 267. FRANKLINISM. 71 9. This electricity is not clue to the friction of the clothing, since it was still observed after remaining for hours on an insu- lating stool, without clothing. Ahrens,"^ in 1817, also experimented extensively in the same direction, verifying the conclusions of Hemmer, and also adding that during rheumatic attacks the electricity peculiar to the body disappeared, and as the disease gave way, gradually re- turned. PHYSIOLOGICAL AND THERAPEUTICAL EFFECTS OF FEANKLIXISM. This form of electricity very early in its history acquired the reputation of quickening the circulation, promoting the glandular secretions and insensible perspiration. The first authentic cure by means of the electrical machine occurred in 1744 in the prac- tice of M. Kratzenstein, at Halle. He succeeded in curing a contracted finger in one-quarter of an hour. Experiments in treating the sick were carried on in nearly all countries simulta- neously. M. Jallabert, of Geneva, in 1747 had acquired a repu- tation for curing a great variety of paralytics, and the following year published a treatise on the ' ' Eifects of electricity upon the living body," in which he stated that it increases the circulation and heat. Mauduyt four years later published a complete work, from which is borrowed the bulk of the literature of the present day, on the subject of the therapeutical applications of frank- linic electricity. • In the Philosophical Transactions f we find the first record of an accident happening during treatment. A young person being electrified for paralysis of the right arm was seized with general paralysis, which was removed by subsequent medication, but the arm remained incurable. * Deutches Archiv. fur die Physiologie, von Meckel, Bd. iii, p. 161 (1817). fVol. 48, partii, p. 785. 72 FEANKLINISM. Dr. Franklin describes an accident which occurred to himself while treating paralysis. A number of persons joining hands with the patient and each other, he sent shocks from a battery, composed of several Leyden jars, through the circle. At one time, inadvertently stepping backward under an iron hook which hung down from the ceiling to within two inches of his head and communicating by a wire with the outside of the jars, on attempting to discharge them, he was knocked senseless, while the company received no shock. Mr. Singer had a charge passed through his head which gave him the sensation of a violent blow, followed by transient loss of memory and indistinctness of vision. Mr. Morgan says that if a strong shock be passed through the diaphragm, sudden contraction of muscles acts so violently on air in lungs as to pro- duce a shout ; a small charge produces a violent fit of laughter. Persons of great nervous sensibility are aifected more readily than others. A small charge through the spine instantly de- prives the person, for a moment, of muscular power, and he generally falls to the ground. If the charge is very powerful instant death occurs. Bodies of animals killed by lightning undergo rapid putrefaction. The blood does not coagulate. Dr. Watson"^ described the case of a child seven years old, who had suffered from universal rigidity of the muscles since infancy, so that her entire body felt more like that of a corpse than a living person. He electrified her at frequent intervals from the middle of November, 1762, to the end of January, 1763, when every muscle had become flexible and she could stand and walk like other children of her age. Another casef of very great contraction and rigidity of the sterno-mastoid muscle, was cured by sparks and shocks directed to the afiected muscle. Dr. Wilson gave electricity a trial in deafness ; he * Phil. Trans., vol. 53, p. 10. t Phil. Trans., vol. 48, part i, p. 97. FRANKLINISM. 73 cured one case of seventeen years standing, but failed in all other trials. Mr. Wesley employed electricity extensively for the benefit of his followers and wrote an excellent book on this subject. He regarded it as almost a specific for obstinate headaches, toothache, sciatica, cramp, rigidities and wasting of muscles, although he acknowledges that he failed to give relief in any case of paralysis of over one year's standing. It proved useful in infiammations ; dispersed extra vasated blood ; hastened suppuration in obstinate swellings, or dispersed them without suppuration. His method of application was simple electrifi- cation, or charging the patient while insulated at first one-half hour morning and night, especially in hysterical or nervous disorders ; this was followed after a few treatments by drawing sparks, and afterward moderate shocks. Tertian and quartan ague were usually completely cured by giving shocks to all parts of the body. Dr. Antonius de Haen* states that trembling of the limbs, chorea, and some cases of deafness, are cured by electricity. Mr. Hey, surgeon of Leeds, successfully used it in several cases of amaurosis. He applied it twice daily ; the patient being insulated, sparks were drawn from the eyes and around the orbit, and especially at the points where the superciliary and infra-orbital branches of the fifth pair of nerves divide. After this operation had continued half an hour, slight shocks were directed to the affected parts, sometimes across the head from one tem])le to the other, but chiefiy from the superciliary and infra-orbital foramina to the occiput. Mr. Ferguson had excellent success in rheumatism by drawing sparks from the painful parts until the skin was red and pimpled ; glowing warmth succeeded the application. Old sprains were cured the same way. In 1744 it was recommended, as an aid in restor- *Dr. Priestley, History of Electricity, vol. 1, p. 485 74 FKANKLINISM. ing the drowned, to pass vigorous shocks through the body, especially through the heart and lungs. This procedure formed one of the measures recommended by the humane society of England. The method recommended for curing toothache was to connect one wire with the inner coating of the Leyden jar, another with the outer coating, and include the tootli be- tween the ends of these wires. In recounting the experiments, successes and failures in the use of static electricity, we must not omit the occurrences in our own country. In 1758 Benj. Franklin relates his experience as follows: * ''Some years since, when the newspapers mentioned great cures performed in Italy and Germany by electricity, a number of paralytics were brought from different parts of Pennsylvania and the neighboring provinces to be electrified. My method was to place the patient in a chair on an insulated stool and draw a number of strong sparks from all parts of the aifected limb or side, repeating the treatment three times a day. The first thing noticed was an immediate increase of warmth in the parts treated, and the next morning the patients usually stated that they had felt, during the night, a pricking sensation in the flesh of the paralytic limbs. Sometimes a number of small red spots were observed, apparently caused by the shocks. The limbs seemed to have more strength ; for instance, a man that could not on the first day lift his lame hand from his knee could the next day lift it four or five inches, the next day a little more, and so on, until the fifth day he could usually, with a feeble, languid motion, take ofi* his hat. Franklin never observed any change after this, and suggests that the journey, excitement, etc., might have done as much. The cases usually relapsed after a short time, although he adds, it is possible that * Phil. Trans., vol. 1, part 2, p. 481. FRANKLINISM. 75 if they had been in charge of a medical man, who would have directed proper medicines and diet, much more would have been accomplished." Brvdone,* in a letter to Dr. Whytt, a professor in Edin- burgh University, relates, among other cases, that of a woman deaf six months in consequence of a cold, whose hearing was entirely restored by the following measures : She was uninsulated while the operator was insulated ; he held a wire within her ear and drew sparks. This brought on profuse perspiration about the head, which was promoted by wTapping the head in flannel. At the end of five days the cure was complete. FORMS OF FRAJNKLINIC ELECTEICITY. • Franklinism may be administered in two ways. 1. The j^atient, seated on an insulated stool, receives elec- tricity direct from the accumulator of the machine, and is said to be positively or negatively electrified or charged according as he is connected with the positive or negative jar. 2. Induced franklinism, or the franklinic current, consists in placing the patient in the circuit whicli electricity must tra- verse in passing from one jar to the other. The physiological eff'ects already referred to belong to franklinism administered as a charge. The franklinic induced current produces effects very similar to tliose of the secondary faradic current, to be hereafter described. It excites vigorous muscular contractions with a minimum amount of pain, and on some persons produces an exhilarating eft'ect wholly wanting to any other form of electricity - * Phil. Trans. 76 FKANKLINISM. Fig. 10, METHOD OF ELECTEIFYING A PATIENT. POSITIVELY OR NEGATIVELY. Attention is called both to the arrangement of the machine and the relative position of patient in the above illustration. The Machine. Draw the horizontal rods apart as far as possible, and connect the jar that is not to be used with the ground. This is done by inserting the tip of one conducting cord in the ball at the end of the rod which passes into the jar, while its free end lies on the floor ; or, better still, is connected with a gas or water pipe, which will allow the ready escape of FRANKLINTSM. 77 electricity to the earth. This is sometimes called a ground connection. It is not essential ; but since it is possible for the potential of the charge to become so great as to cause it to leap across from one rod to the other, thereby at the same time causing a severe shock to the patient, it is advisable to do so. The switch should he closed. The Platform. The one represented above has hard-rubber legs, but glass may be used for the same purpose. Wooden legs encased in glass insulators, such as are used in telegraphy, answer a good purpose. If a film of moisture or dust is allowed to collect on these insulators, electricity will escape, and the operator will fail to electrify the patient. They may be var- nished with shellac or coated with parafiine while warm, and the deposit of moisture will be prevented. The conducting portions of the platform must not touch table, chair, or clothing of the operator, during treatment. The platform may be made large enough to contain several patients, and all can be treated at once. The Patient. The patient, without removal or disarrange- ment of clothing, is seated on the platform. No conductor should be in contact with or near the dress. If tables, chairs, etc., are accidentally brought near, electricity wjll escape, either in the form of sparks or silently, and the result of treatment will be a failure. The conducting cord or chain, which must be well insulated, is attached to the ball surmounting the positive or negative jar, according as the patient is to be electrified positively or negatively. The cord may be attached directly to the patient outside the clothing, unless that be of silk (in the illustration it is fastened to the dress at the nape of the neck) ; it may terminate in an ordinary battery handle, which can be held by the patient without inconvenience ; or the con- ductor may be fastened to the platform on which the patient is seated. After the patient is in readiness, the drive-wheel of the 78' FRANKLTNISM. machine is turned in the direction of the arrow ; an assistant is necessary unless the machine is run by a small motor. The potential, or intensity, of the charge depends upon the number and rapidity of the revolutions of the revolving glass plate. It is customary to note the number^ of turns of the driving-wheel in a first treatment, and on subsequent occasions it serves as a guide in regulating the charge. The machine may he completely discharged after the patient is disconnected from it hy moving the horizontal rods together so that their halls touch. Remembering this point, the operator will be saved many a severe shock in readjusting the machine. CONDUCTORS. Conducting cords and chains are both used to convey frank- linic electricity, but the ease with which it leaps off from its conductor to surrounding objects makes it essential that the insulation be very perfect. Conducting cords must have a double-woven silk cover ; yet this does not wholly restrain electricity from escaping ; therefore in treating patients it is important that the cords be prevented from touching them, or other conductors. Some operators prefer chains, varnished and inclosed in rubber tubing, which may be still further insulated by a coating of paraffine. ELECTRODES. When electricity is to be localized, an instrument of some form is required unless the operator chooses to employ his fingers as a conductor. The electrodes employed for franklinism. differ but little from those used in the early days of its application to medical treatment. They are usually made of metal, attached to, or held by, a long handle of insulating material, covered with FRANKLINISM. 79 cloth or sponge. The handle should be made of glass or rubber, to which metal points, balls or rollers may be attached. These may be covered with cloth or sponge ; if the latter is used it must be moist. It should be remembered that elec- tricity is seeking to escape from the patient to the ground to equalize potential, and it may be concenti-ated at any point on the body to which a good conductor is presented, provided that conductor has (/round coniwction. By reference to Fig. 10 the electrode is seen to be connected with the floor by a chain, which latter must not be allowed to touch either patient or platform, lest electricity escape direct to it and prevent a portion of the charge from being localized at the part to be treated. Length, 15 inches ; width, 7^^ inches. also USed tO detacll the COrd from the machine, or to replace it, if accidentally detached, since any approach of the operator's hand to the machine, while in motion, would draw off the charge and occasion an unpleasant shock. This electrode should not have ground con- nection. The second terminates in a metal roller, with which the muscles may be rapidly and uniformly compressed or kneaded. The third terminates in a metal ball for drawing sparks. The fourth has a slender, pointed metal tip ; its use will be described on the next page. The last three have a socket in the metallic portion to receive a cord for ground Fig. 11. Electrode Case. Fig. 11 illustrates a conve- nient case of electrodes, which are sufficient to meet all the requirements of franklin ism as at present administered. The first in the case terminates in a hook ; its use is shown in Fig. 10, to hold the conductors away from the patient. It is 80 FRANKLINISM. connection. The depression in the back part of the case holds conducting cords, and at each end is a space for the metal handles which accompany the machine. THE ELECTRO-POSmVE OR ELECTRO-NEGATIVE BATH. When the patient is charged with electricity as described, and no conductor is brought near, the air will gradually carry off the charge from all parts of the surface, and in a few minutes, the time varying according to the potential of the charge, it will be found to have entirely disappeared. This con- stitutes the bath which may be continued as long as desired by recharging the patient .at frequent intervals while on the platform. It will be positive or negative, according to the jar with which the patient is connected. The time occupied in treatment should not exceed half an hour. The charge escapes from every part of the surface, more or less, but more particularly from angles or projections — as the elbows, knuckles, knees, face and hair — creating a sensation as though air were smartly blowing upon the skin. The bath is employed to improve the circulation, promote perspiration, to relieve nervousness, pain of neuralgia, rheuma- tism, spasms, and various hysterical affections. This was one of the earliest methods of treating paralysis. Mauduyt re- ported excellent success by the employment of it in this disease. Effects of the Electric Bath. — They are claimed to be these : Acceleration of pulse, ease of respiration, increase of temperature, increased urinary secretion, tranquillity of the nerves, improved innervation, stimulation of the absorbents, stimulation of all the functions. Some authorities advise that the conductor from the machine should be always located at the nape of the neck, from the FRANKLINISM. 81 belief that by this plan electricity will pass directly to the nerve centers, and from them along the nerves from their origin to the periphery. ELECTRIC WIND. When a patient seated on an insulated platform is fully charged with electricity, and a pointed electrode, like the one shown in the electrode case, is passed over the surface near to it, but not in contact with it, a sensation like a current of -air blowing on the parts over which the electrode is moved will be felt. This is called ''electric wind." The clothing being an imperfect conductor, small sparks will be seen, and a slight stinging or prickling sensation be felt. The electric wind is a suitable treatment for the eyes, ears, and highly sensitive parts. It improves the nutrition when frequently applied, ahd is valuable in some hysterical com- plaints, where the patient is unusually sensitive to the slightest shock. ELECTRIC FRICTION. An electrode terminating in a ball instead of a point brought near the surfaces, produces sparks with more or less shock, according to the intensity of the charge and the nature of the clothing. When the skin is covered only with flannel and the ball is held near, as it passes over the surface a multitude of minute sparks are produced, accompanied by gentle prickling or stinging and contraction of muscles, this is called electric friction. The electrode instead of the skin may be covered with flannel, and the result will be the same. This is a valu- able stimulant. It also produces a reflex action through its influence upon the cutaneous nerves. It is specially useful in spasm ; if this arises from irritation within the brain, electric friction of the head and back of the neck is indicated ; if of local origin, friction of the aftected part ; if due to sympathy with 82 FRANKLINISM. some distant organ, the friction must be applied, as before, to the diseased part. ELECTRIC MASSAGE. This consists in kneading and rolling the muscles with the roller electrode, as shown in Fig. 10. When applied over the clothing, it produces a succession of prickling or tingling sensa- tions ; applied directly to the skin, it produces no distinct sensation apart from that due to the mechanical effect of the roller. Electric massage excites the functions of organs and special senses, stimulates the skin, strengthens muscles and improves the nutrition of all parts to which it is applied. ELECTRIC SHOCKS. An insulated patient, thoroughly electrified, experiences a severe shock when an electrode is brought within a few inclies. The greater the distance at which the electrode is held, pro- vided it is not removed beyond the influence of the charge, the stronger will be the shock. In the earliest applications of electricity to invalids, this was the only method employed. The powerful shocks which first experimenters did not hesitate to apply to the eyes and head, seem to us now but little else than barbarous. Shocks of reasonable degree of severity are useful in some forms of paralysis to arouse sensation, but should be employed with caution at all times, as profuse perspiration, trembling of the knees, or mental confusion, may follow. Caution. — When charging a patient positively, the person turning the drive-wheel is liable to receive a disagreeable shock from jar unless it be connected with the ground. If the cord connecting patient with machine is allowed to touch the table, clothing of operator or any conductor, the electricity may be all drawn ofi* and the patient will receive none ; and since the patient perceives no sensation from a metal FRAi^KLINISM. 83 electrode in direct contact with the sldn, this "leak" may not be noticed, and the operator may be at a loss to account for his failure to obtain sparks on presenting his electrode. If ground connection with the electrode is not made, no sparks will be obtained. Patients should not expose themselves to the open air immediately after this form of electrization, but delay at least ten minutes. Violent shocks must be avoided. Fk;. 12. METHOD OF APPLYING INDUCED FRANKLINISM. The arrangement of the machine and position of patient, both differ from that shown in the previous illustration. 84 FRANKLINISM. The Machine. — This is shown in a glass case. The switch must he open^ and the balls terminating the horizontal rods be brought very near together, not more than one-eighth of an inch intervening between the balls for a first treatment in a very sensitive patient. Neither jars nor electrodes require ''ground connection." To obtain a current from the outside of the jars^ the cord tips are inserted in the metal sockets in the base of the machine, — as shown above. To obtain a current from the inside of the jars^ the cords are inserted in the balls surmounting the jars. The Patient. — The patient does not require insulating, but the cords should be held away from the clothing; electricity readily leaps off the conducting cord in a shower of fine sparks. All forms of franklinic electricity pass readily through ordinary clothing, with the exception of silk. The patient above is shown with his stockings on. Boots or shoes, unless very thick or containing nails in the soles, need not be removed. Any ordi- nary foot-plate may be used, although the one shown in figure 76, with insulating soft-rubber cover between the metal and tlie floor, is preferable. The electrodes handle used for gal- vanism and faradism are not suitable to use for franklinism, as they are not sufiiciently insulated. Franklinic electricity produces a 'sharp cutting or stinging sensation in the skin, when given with the horizontal rods very near together ; when drawn some distance apart, violent shocks are produced, which if directed to the head or neck are capable of destroying consciousness altogether. The strength of the current is increased by separating the horizontal rods, which should be done with a screw-like motion, and very slowly, to avoid unpleasant shocks. Any well moistened sponge electrodes may be used when the current is applied directly to the skin, but they must be attached to long insulating handles. FRANKLINISM. 85 DIRECTION OF THE CURRENT. It is doubtful if the franklinic current has a definite direction, being probably propagated in waves in both directions at the same time. According to the indications of the electroscope the ball surmounting jar C (Fig. 9) is negative, and the one at D is positive, or the current from the inner coatings of the jars may be regarded as passing from D to C, while that from the outer coatings passes from C to D. Muscular contractions may be greatly increased without pain or unpleasant shock by placing a hydro-rheostat (Fig. 51) in the circuit. Caution. — When treating a lady with either direct or in- duced franklinism the operator should avoid presenting the electrodes over the metal portions of crinoline or corset, as a series of unpleasant shocks to all j^arts beneath will be the result. "When applying an induced current through thick clothing the horizontal rods should not be drawn further apart with the idea of increasing the power of electricity to overcome the resistance of the clothing. Such a proceeding greatly increases the pain and the disagreeable effects of the shocks produced and will -detract from the beneficial effects of the treatment. A current that is not disagreeable when applied direct to the skin some- times becomes very unpleasant when compelled to pass through a poor conducting material before reaching the skin. Dr. Birch, an eminent surgeon of the latter part of the last century, considered franklinic electricity, in the form of a cur- rent, a sedative ; sparks or friction, a stimulant, and a shock a deobstruent. Dr. Cull en considered it, when properly applied, one of the most powerful stimulants of the nervous system. The following precepts will be found useful: 1. Give electricity at first in its mildest form, and increase it gradually as the patient can bear. 2. Use electrodes attached to long insulating handles. 3. Do not neglect the employment of other means while electricity is being tried. CHAPTEE III. GALVANISM. Galvanism is that form of electricity generated by chemical action. It is referred to by different authors under various names, such as voltaism or voltaic electricity (after Prof. Yolta, of Pavia), chemic (produced by chemical action), primary (direct from the elements), and continued or constant (because the current flows without interruption). When it is artificially interrupted, it is then known as the interrivpted galvanic current. The first recorded observation of this form of electricity that we find was made by Swammerdam, the Dutch naturalist, in 1687. During a visit to Tuscany, he showed the grand duke that when a portion of the muscle of a frog's leg, hanging by a thread of nerve from a wire, was held over a copper support so that both nerve and wire touched the copper, the muscle imme- diately contracted. About sixty years afterward, Sultzer noticed the following fact: If a piece of lead and a similar piece of silver be laid together, and the edges of both be brought into contact with the tongue, a taste of copperas is perceived, when these metals separately have no such taste. He concluded that some peculiar vibrations took place from the contact of metals that induced this sensation, and his explanation was accepted as correct during many years. In 1786 Galvani published the results of twenty years'* Although it has been repeatedly stated that Galvani's discovery was accidental, and due to a physician's prescribing frog broth for his sick wife, we find that, like most other important discoveries attributed to accident, it was the result of laborious research. There is no more " royal road " to the discovery of scientific facts than to other branches of knowledge. GALVANISM. 87 experiments which had led him to the conclusion that the con- traction of the frog's leg when brought into contact with two dis- similar metals was due to electricity generated in the leg itself. Yolta pursued the investigation of these phenomena with ardor, and after ten years of experimenting was able to prove that the electricity arose not from the muscle or nerve, but from the contact of two dissimilar pieces of metal, and the only part the muscle of the frog had in the work was to supply moisture. He showed that opposite kinds of electricity were produced on the two surfaces, one becoming positively and one negative^ electrified. This discovery enabled him shortly afterward to construct the voltaic pile, from which all the galvanic batteries of the present day have been developed. Many authors, regarding the researches of Yolta of more inportance than those of Galvani, continue to give the name of Yolta to this form of electricity, although in this country it is generally called galvanism. THE VOLTAIC PILE. The pile, as origitially constructed, consists of pairs of zinc and copper plates, with pieces of flannel or blotting-paper, moistened with an acid or saline solution, between each pair, and when the pile is complete, zinc will form one end and copper the other ; attach a copper wire to each end of the pile, bring the free ends together, and a current will be set up proportional to the number of pairs. If the free ends of the wires are brought near each other, not in contact, and are immersed in water, they will decompose a portion of it. 88 GALVANISM. THE GALVANIC CELL OR BATTERY. The simplest form of cell consists of two pieces of dissimilar metals, partially imm.ersed in dilute sulphuric acid.* The metals shown in Fig. 14 are zinc and copper. If the zinc is perfectly pure, no action takes place so long as the metals are not connected. If they are made to touch by a single point, either within or without the fluid, or if they be connected by a wire, chemical action at once begins at the surface of the zinc, electricity is generated, which passes across the liquid to (or appears at) the copper. THE GENERATING PLATE. This is the name given to the zinc or other substance sub- stituted for it in the cell, because by the chemical action occur- ring between it and the fluid, electricity is generated or set free. It will be found, after the action has continued for some time, that the zinc or its substitute has lost weight. In every combi- nation that plate most easily acted upon by the fluid becomes the generating plate. THE CONDUCTING OR COLLECTING PLATE. This name is given to copper, carbon, platinum, or other substances substituted for them in the cell. It is essential that the collecting plate shall be acted upon by the fluid very slightly, if at all. After chemical action has continued some time, the weight of a carbon collecting plate will show no loss, copper or platinum a very slight loss. * Unless otherwise stated, dilute sulphuric acid means a mixture of seven parts (by- measure) of water with one part of commercial acid. GALVANISM. 89 THE ELEMENTS. One generating and one collecting plate form a pair of elements. It is essential that one shall be acted on by the fluid more readily than the other. Fig. 15. COMPOUND BATTERY. Several cells may be united to form a com- pound battery, as shown in Fig. 15. This illustra- tion represents the copper of one cell united to the zinc of the next by a short wire, and the current pass- ing in the direction of the arrows. The current from the first C and last Z will represent the total strength of current ob- tained from such a combination. THE CIRCUIT. This includes the fluid within the battery, the elements the connecting wires and any intervening body with which the free ends of the wires may be in contact. A SHORT CIRCUIT. When the first C and last Z are united by a short wire, as in Fig. 15, so that the current outside the cell passes di- rectly from the copper to the zinc, it constitutes a short circuit. When the current passes to and fro between the copper and zinc within the fluid it is also called a short circuit. CLOSED CIRCUIT. The circuit is said to be closed or complete when the ele- ments are connected outside the fluid. This may be done 90 GALVANISM. directly^ as when a wire joined to the first copper element is brought into contact with a wire joined to the last zinc ele- ment ; or indirectly^ as when any substance or body (which permits the passage of a current through it) is placed in con- tact with the ends of the wires. OPEN CIRCUIT. The circuit is opeyi or hroken when the current is arrested bv disconnecting the wires attached to the elements. DIRECTION OF CURRENT. For all practical purposes, the current may be regarded as starting at the zinc, passing through the fluid to the copper or its substitute, from thence through the connecting wires and any substance intervening, back to the zinc. It may be briefly stated thus : "The direction of the current in the fluid is from zinc to copper; outside the fluid, from copper to zinc." The rela- tive size of the elements has nothing to do with the direction of current, which will be the same if the zinc has a surface of a square inch, and the copper a square foot. The kind of ma- terial used for elements determines the direction of current, which always passes within the fluid, from the element where chemical action takes place 'most freely, to the element where chemical action is slight. THE POLES. The ends of the elements where the current leaves and re- enters the cell are called poles. POLARITY OF THE CURRENT. It is possible to show by the electroscope (Fig. 7) that the current from the collecting plate is positive ; it is com- monly marked P or +. By the same test the current from GALVANISM. 91 the zinc is negative ; it is marked N or — . These letters P and N refer only to the poles, and not to the elements within the fluid. POLARITY OF ELEMENTS. Since like electricities repel each other, and unlike attract, it follows that the portion of copper within the fluid at which positive electricity collects is electro-negative, and that part of the zinc within the fluid from which it was repelled is electro- positive. A CUKRENT IN BOTH DIRECTIONS. There is really a current passing through the circuit in both directions at the same time, but on account of the physiologi- cal and chemical effects as well as for convenience, electro- therapeutists unanimously agree in ignoring the fact that the negative current is coming from^ instead of going to the zinc, and the current direct from the battery cells is always spoken of as passing from the positive to the negative poles outside the fluid, and from the positive to the negative elements inside the fluid. POLARIZATION. At the moment the elements within the cell are connected, the acid in the fluid at- tacks the zinc and dissolves a portion of it. This chemical action generates a current of electricity which decomposes a portion of the water in the fluid, and separates the oxygen from the hydrogen. Gases, as well as metals and all other substances, exhibit polarity when AtomVof hydrogen Compared with each other. Oxygen is always marked + collected . , . i i i • - • / , a mi upon— copper, atoms negative ( — ) and hydrogen positive (+). Ihe of oxygen marked - ^ ^ ^ J b i \ ^ J ^4r^ow9 ehow^dtre?- electro-ncgativc O therefore appears or is set poiariiSnoccuS!^^ fi'ee at the electro-positive zinc with which it Fig. 16. 92 GALVANISM. lunites to form oxide of zinc (the latter again unites with the sulphuric acid and forms sulphate of zinc). The electro-positive H is set free at the electro-negative collecting plate, and collects in bubbles on its surface, forming a film over it in a short time if not prevented. Hydrogen being more easily acted upon than zinc, by the fluid of the battery, will now form the generating plate, and zinc will become the collecting plate; the result will be that the current will pass back and forth entirely within the fluid, and cease to flow through the wires or any part of the exter- nal circuit. The battery is now said to be polarized. Since the working power of a battery is destroyed by polarization, it is very important that it be prevented, and various methods of doing this have been devised, varying according to the kind of battery used ; among them may be named the following : 1. Shaking the elements or fluid occasionally when in use to disengage the gas bubbles, and cause them to escape from the fluid. 2. Blowing air over the surface of the conducting plate for the same purpose. 3. Adding some ingredient to the fluid which will unite with the hydrogen as fast as formed, such as bichromate of potash, sulphate of copper or nitric acid. 4. By employing two fluids instead of one, as in the gravity cell. 5. Making the collecting plate with an irregular surface. The platinum element is an example of this kind. It consists of a silver plate corrugated, and covered with a layer of granu- lar platinum, so that a multitude of points will prevent ad- hesion of the gas to its surface and facilitate its escape from the fluid. GALVANISM. 93 6. Allowing the battery to rest by opening the circuit a few minutes, permits the hydrogen gas to escape, and restores the current through the external circuit. 7. This will be hastened if a current can be passed through the cell in an opposite direction for a moment. LOCAL ACTION. A piece of pure zinc dipped into dilute sulphuric acid is not attacked by the acid, but the ordinary commercial zinc is not pure, and dissolves when placed in dilute acid. The par- ticles of impurities, usually iron or arsenic, lying in contact with atoms of pure zinc, form a closed circuit when immersed in fluid, and chemical action is set up, which generates minute currents of electricity, precisely like the current between the elements. These minute currents use up the fluid, destroy the zinc, and interfere with the main current. When local action is violent, a buzzing or. hissing sound will be heard within the cell. AMALGAMATION. Since chemically pure zinc is too expensive for battery pur- poses, a substitute for it is found in common commercial zinc coated with a thin film of mercury. The zinc is then said to be amalgamated. Although the presence of the mercury hin- ders local action when the circuit is open, it does not interfere with the chemical action of tlie fluid upon the zinc when the circuit is closed. Amalgamation is accomplished in two ways: 1. The zinc being moistened in acidulated water, quick- silver is brushed over it. 2. Bisulphate of mercury may form one ingredient of the battery-fluid, its purpose being to keep the surface of the zinc coated with mercury. (This must not be used with platinum elements.) 94 GALVANISM. Whichever method is chosen, the result should be the same ; that is, the surface of the zinc should be bright as silver. In single-fluid cells, it is found that not even amalgama- tion entirely stops local action, when the circuit is open ; therefore, to prevent waste of zinc, some device is necessary for removing the elements from the fluid when the battery is not in use. POTENTIAL. A B This term has the same significance when applied to dynamic as to static electricity ; in both cases referring to the Fig. 17. ' " clectric level. " The method of comparing difterence of potential with difl'erence of water- level, as illustrated in Fig. 17, gives a tolerably clear idea of the subject. Two reservoirs, A and B, containing an un- equal amount of water, are joined by a small pipe C ; water will flow from B to A until it stands at the same height in both, when the flow through C will cease. The diflerence in the original height of the two columns of water may repre- sent the difference in the potential of two elements immersed in battery fluid. This diflerence of potential is developed by the chemical action within the cell, and a current of electricity is set up throughout the circuit in the effort to equalize the potential, or, in other words, to restore 'the electric level.' The difference of potential grows gradually less and less from the moment the circuit is completed, and when the fluid is used up (exhausted) or the battery polarized, the potentials are at an equilibrium and the current ceases. As the length of time required to bring the water to the same level in both reservoirs depends upon the length of pipe C, the diameter of pipe C, the freedom of C from dirt or debris, the difference GALVANISM. 95 in level to start with, so the electric current is similarly modi- iiecl by the length of the circuit, the diameter of the conduc- tors, the freedom from debris, such as rust, dirt, deposits of crystals, and other resistance throughout the circuit, and the difference of potential between the elements when the battery is freshly started. Difference of potential does not depend upon the size ; it may be just as great between small as large elements. JklATERIALS OF WHICH THE ELEMENTS ARE MADE. Many different metals, and even two fluids of different densities, have been used for battery elements. Zinc is com- monly preferred for the positive plate in ordinary batteries, while either copper, platinum or carbon is selected for the negative plate. That metal which is most easily acted upon by the battery fluid becomes the positive plate in any combi- nation. It must be borne in mind that the terms positive and negative here refer only to that part of the plate immersed in fluid. Yolta made the following ingenious table, showing the relation of the metals to each other. A few, discovered since his day, have been added by recent investigators. He called it the CONTACT SERIES, because each metal in the list becomes positive when placed in contact with each one named below it, and the further tliey are separated on the list the greater tlieir difference of potential. -f Zinc, Silver, Lead, Gold, Tin, Platinum, Iron, — Carbon. Copper, 96 GALVANISM. For example, if zinc and lead are used as the two elements of a battery, zinc is + and lead is — . When lead and till are used together lead becomes + and tin — . The difference of potential between zinc and lead is less than between zinc and tin. It keeps on increasing between zinc and the others named in their order until carbon is reached. Between zinc and carbon the difference of potential is so great that it equals the sum of all the differences of potential between the other combinations on the list. For this reason tlie zinc and carbon combination is pre- ferred for batteries which are required to furnish a current possessing great power of overcoming resistance. * ELECTRO-MOTIVE FORCE. A . ; B . This is the same force referred to under static electricity as the "propelling power." It is that force which tends to move electricity through its circuit. Electricity is not propelled as a ballet on its course, but rather propagated in waves from point to point in its circuit. Referring to Fig. 18, it will be noticed that reservoir B, having the higher level, propels the current with greater force than A. B not only drives the current branches further on a straight line, but causes them to separate more widely and cover a greater surface. The greater the difference of "electric GALVANISM. 97 level" between the elements, the greater will be the electro- motive force with which the current will be driven forward ; and it is supposed that in sending a current through so great a resistance as the human body, it is broken np into branches or lines of force, which pass by dilferent routes between the points of entrance and exit ; the stronger the electro-motive force, the greater the number of these branches that will be able to overcome the resistance in their path, and come together to complete the circuit. The total availahle strength of current for therapeutical purposes depends largely upon its electro- motive force. THE ELECTRO-MOTIVE FORCE IS MODIFIED I 1. By the nature of the elements. By reference to the "con- tact series," it will be seen that zinc and carbon furnish the greatest difference of potential, and consequently the strongest electro-motive force. 2. By the quality of the lattery fluid. Strong fluid, which causes violent chemical action, produces the greatest electro- motive force. If, however, the elements are encrusted with salts, or partially worn out, only a small portion of their surface can be brought into actual contact with the fluid, and the electro- motive force will be lessened. If the zinc is not properly amal- gamated, thus permitting local action, or if the carbon, from long use, has its pores filled with impurities, the same result occurs. 3. By the number of cells in the circuit. The number of cells, not their size., determine the amount of electro-motive force developed. "The electro-motive force of forty elements the size of a tumbler is no greater than from the same number the size of a thimble."* *M. Cyon, " Principles d'Electrotli6rapie," 7 98 GALVANISM. 4. By the length of time the hattery has heen in use. In all single-fluid cells the electro-motive force is the greatest when the circuit is first closed. The electro-motive force is greatly increased when strong fluid is used, but the zinc is consumed I'aster, and the fluid being used up in the same proportion as the zinc, the current will lose strength sooner, or the battery may be said to run down more rapidly than one which possesses less electro-motive force, and consequently less power of overcoming resistance. QUANTITY. The total amount of electricity passing through a circuit in a given time is called the quantity. It can be increased : 1. By increasing the size of the elements. 2. By bringing them closer together. 3. By exposing a larger portion of their surface to the action of the battery fluid. CELLS ARRANGED IN MULTIPLE ARC (QUANTITY ARRANGEMENT). When electricity is required for producing cautery, and certain chemical effects, a current pos- sessing large quantity must be selected. The cells for producing such a current are arranged in a special manner. For example : If we have one large cell contain- ing elements, each four inches square, immersed in fluid, an inch apart, and connected outside the cell by a wire, a current is excited ; in five minutes a certain amount of zinc will be dis- solved, and a certain amount of hydrogen gas will be collected at the copper element. Let these same elements be cut into four parts, each four inches long and one inch wide, and arranged in pairs in separate cells, the elements in each cell being one GALVANISM. 99 inch apart, and immersed to tlie same depth in the fluid as in the lirst instance. Connect the elements of the separate cells as in Fig. 19, all the zinc-plates being joined together, and all the copper-plates joined together. When the wires from the first zinc and last copper are connected, the same current will traverse the circuit as before. The same amount of zinc will be dissolved, and the same amount of hydrogen be collected as from the single surface. The quantity obtained is large, the heating and magnetic properties are increased, but the power to decompose chemical compounds and affect the animal system is very slightly, if at all, increased. POTENTIAL AKRANGEMENT. The same cells arranged as in Fig. 20, that is, with the elements joined in alterna- tion, the zinc of one cell with the copper of the next, give a greater difference of potential than the one previously described. When the terminal wires from the ends of the series are connected, the amount of zinc dissolved and of hy- drogen set free will be the same as before. The current must now cross each cell in succession, and therefore encounters greater resistance than in the arrangement shown in Fig. 19. The power now starts from four separate points, and each one adds energy or exerts an impulse in driving the current on- ward ; hence the propelling power, or electro-motive force, is increased fourfold. Difference of potential does not depend upon the size of elements, but it does depend upon the num- ber of them, provided they are united alternately. The total difference of potential is as many times that of a single cell as there are cells in the series. For instance, if the difference 100 GALVANISM. of potential in one cell be represented by 10, the difference in potential of four similar cells, joined as in Fig. 20, will be 40. In uniting cells in series they should be exactly alike ; otherwise, instead of the force bearing relation to the area of ]3late in each section, it will only be proportional to the smallest effective area, — that is, to that element which has the least surface immersed in fluid. In illustration may be cited the well-known result of forc- ing water' through a series of pipes of different calibre ; the force of flow from the last pipe will only equal the force with which it flows through the smallest pipe in the series. The potential arrangement is the one used for all ordinary applications of the galvanic current, and for electrolysis. It requires great electro-motive force to send the current to all parts of the human body, the resistance of which ' ' is more than twice as great as that of the Atlantic cable."* RESISTANCE. Whatever impedes the passage of a current through its circuit, constitutes resistance. Resistance is of two kinds : 1. Internal or Essential^ due to {a) The composition and condition of the battery fluid. (b) The condition of the elements. {c) The size and arrangement of the elements. 2. External or non-essential^ due to {d) The conducting cords or wires. {e) The connections. {f) The substance or body introduced into the external circuit. {a) Fluids which contain a large amount of acid conduct better than more dilute solutions. Deposit of salts in the cell * Text-Book of Electricity in Medicine and Surgery. [Poore.] GALVANISM. 101 as well as dirt or grease in the fluid interfere with the passage of the current. (b) The elements, when incrusted with salts, do not permit the passage of electricity freely. Carbon, being very porous, may, after long usage, become filled up with impurities, and this may escape notice. (c) Large elements offer more paths for the current than small ones, hence afford less resistance. When placed near together, the resistance is still further diminished, just as water flows more easily through a large pipe than through a small one, or through a short pipe than a long one. {d) The resistance of the conducting cords, or wires, de- pends upon (1) The length. If a current of the same strength be made to pass over wires of the same metal and diameter, but of different lengths, it will be found that the current loses power in proportion to the length of wire over which it is made to pass. (2) The diameter. If a current be sent over wires of the same material and length, but of different diameters, since electricity is supposed to pass over the surface of the conduc- tor, it is evident that the greater the surface the less will be the resistance ; therefore the power of the current will be greatest in the wire of largest diameter. For instance, a copper wire one hundred feet long and one-twelfth of an inch in diameter offers the same resistance as a copper wire two hun- dred feet long and one-sixth of an inch in diameter. For this reason the arm of a man ofters nearly the same resistance as a leg, since the length and diameter of the latter are nearly double that of the arm. (3) The material. Silver conducts best, but copper so nearly equals it that for practical purposes it is preferred. Platinum offers more than five times the resistance of copper. 102 GALVANISM. (4) The temperature. As the metals conduct best when cold, the warmer the temperature the greater the resistance of the wire. The resistance of copper increases almost 30 per cent between freezing and boiling points. {e) The elements should be securely fastened to the metal connections, and the conducting wires should be in even and firm contact with the same connections, otherwise the path for the current will be lessened, and also minute independent currents will be set up by the difference of pressure of the contact points, all of which increase resistance to the main current. Dirt, grease or rust between contact points increases resistance, which may thereby become so great as to stop the current. (/*) The resistance of bodies interposed in the circuit out- side the battery varies according to their composition. They may be divided into three classes : 1. Those that offer least resistance, which include the metals and carbon. Heat increases their resistance. 2. Those which are decomposed by the passage of the cur- rent, which are principally the liquids. The resistance of these is diminished by heat. It is extremely difficult to discover the actual resistance of liquids, but Cavendish found that the elec- tric fluid meets with as much resistance in passing through a column of water one inch long as through an iron wire of the same diameter 400,000,000 inches long, and that water con- taining in solution one part of salt conducts a hundred times better than fresh water, and that a saturated solution of salt conducts seven hundred and twenty times better than fresh w\ater. It has been estimated that the human body, owing to the salts which it contains, conducts nearly twenty times better than water, when the skin is well moistened. 8. Those whose resistance is so enormous that the strongest electro-motive force can hardly send the feeblest current through GALVANISM. them. They include the gases, air, glass, paraffine, shellac, india-rubber, and some oils. The resistance of these is les- sened by heat. (4.) Resistance in the circuit. (a) If many cells, exactly alike, are joined in series with a large wire, and with no other resistance in the external circuit, no greater quantity of electricity will pass through it than if a few such cells are joined. Although each additional cell adds its share of electro-motive force, it also adds resistance, which tends to counterbalance the gain in electro-motive force. (6) Large cells joined together in series with great resist- ance, as the human body in the external circuit, send no greater quantity of electricity through it than the same num- ber of small cells do. The electro-motive force of large cells does not exceed that of small ones, as already explained, while the resistance is less ; but the internal resistance in cells of either size is so small as compared with the human body, that practically the gain by increase of size need not be taken into account. ((?) For decomposing chemical substances, for performing surgical operations, and for electrolysis, many cells of medium size in which chemical action is powerful are required. The re- sistance of the skin is very great, but in these operations the current is carried beneath the skin by means of needles or wires placed near each other. (cZ) When a short platinum wire in a short circuit is to be heated, as in galvano-cautery operations, a few large cells joined in multiple arc or a single very large cell is preferable to a large number of small cells. ELECTRIC MEASUREMENTS. We cannot conceive of a force that does not possess qualities that can be detected and measured, and for the other modes of 104 GALVANISM. motion, as heat, light, etc., we have terms by use of which ideas may be conveyed that are readily understood. Electricity has not been so fortunate until within a very recent period. Although electricians have long made use of special language in writing of this science, there has been a lack of uniformity in choice of terms and an obscurity of definition which pre- vented its general use. ohm's law for determining the strength of current. Prof. Ohm, of Nuremberg, in 1827, discovered the law which bears his name, and which is now made the foundation of all electrical measurement. It is this : ' ' The strength of the current passing through any part of a circuit varies directly as the difference of potential between its elements, and inversely as the resistance in the circuit itself." If there w^ere no resist- ance, the quantity of electricity passing as a current would be exactly proportional to its electro-motive or propelling force. Since there is always resistance, both within the battery cell, and in that portion of the circuit outside the cell, it must be taken into account in estimating strength of current. If the resistance be doubled, only one-half the quantity (other con- ditions being equal) will pass through the circuit ; if the resist- ance be trebled, there will be only one-third the quantity ; that is, the quantity is inversely proportional to the resistance. Beard and Rockwell ^' have clearly illustrated this point in the following manner: ''Suppose a current of water is 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 with electro-motive force. The friction will corre- spond to the internal and external resistance of the battery. * Medical and Surgical Electricity. GALVANISM. 105 Now, if we divide the one bj the other, we have a 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 sec- ond of time, just as we can find the number of coulombs (or units of quantity) of electricity, that flow through the circuit. It follows, of course, that if the electro-motive force be very greatly increased, the resistance being the same, the total strength of current must be increased ; but if the resistance be increased in proportion to the increase of electro-motive force, the current strength will not be any greater." Another mode of expressing the law of Ohm is by the following formula, in which C represents the strength of the current, E the electro-motive force, and K the resistance both within and without the battery. Before resistance, the difference of potential is not easily restored. UNITS OF MEASUREMENT. Writers are now adopting the terms agreed upon at the International Electrical Congress, and it is necessary to be acquainted with those which represent qualities of currents employed in medical practice in order to understand the elec- trical literature of the day. The units of measurement are based on the French unit of length (centimetre), unit of mass (gramme), unit of time (second). These are usually referred to as the Centimetre- Gramme-Second or C.G.S. system of units. The Volt (dynamic) is the unit of electro-motive force. It represents a force capable of generating a velocity of one metre per second through a mass of one gramme. The Daniells cell is selected as the standard for one volt. This is an approximate 106 GALVANISM. measure only ; the Daniells cell varies in electro-motive force from .097 to 1.079 volts. The Grenet cell fm-nishes a current of about two volts. The Ohm (dynamic) is the unit of resistance ; it is very nearly equal to the resistance of a cylindrical wire of pure copper two hundred and fifty feet in length and one-twentieth of an inch in diam^eter. The Coulomb (dynamic), formerly called the Weber, is the unit of quantity. It is equal to the quantity of electricity transmitted in one second through one ohm by one volt. An Ampere (dynamic), also formerly called the Weber, is the unit of current. It is a current of one Coulomb per second, and is due to the electro-motive force of one volt working through a resistance of one ohm. Milli-ampere^ the thousandth part of an ampere. The Farad (static) is the unit of capacity. The standard is the amount of electricity accumulated in a unit Leyden jar which holds one Coulomb at a potential of one volt. The Coidomh (static) is equal to the charge produced in a jar of one Farad capacity by an electro-motive force of one VOit. RELATION OF CELLS TO STRENGTH OF CURRENT. This depends, as we have seen, upon size of cells, number of cells, method by which they are joined in circuit, kind of elements, and resistance in the circuit. Single-fluid and two-fluid cells in great variety are em- ployed for medical purposes. In this country the single-fluid cells in common use are represented by the Smee and the Grenet ; the two-fluid, by the Daniells and the Gravity. THE SMEE CELL. The elements of this cell consist of two plates of zinc and one of platinized silver. A thin silver plate is corrugated GALVANISM. 107 and coated with platinum in coarse powder ; this furnishes a multitude of points from which hydrogen is more readily dis- engaged than from a smooth surface. The exciting fluid is dilute solution of sulphuric acid. The zinc plates are arranged parallel, with the platinized plate suspended between them. By this method both surfaces of the platinum serve as a col- lecting plate ; but this arrangement does not furnish so power- fnl a current as tlie cell next described, in which the zinc is placed between two collecting plates so that both surfaces of the zinc are rendered effective in generating electricity. BICHROMATE OF POTASH CELL. The elements consist of a single pair of zinc and carbon plates and the fluid of a solution of bichromate of potash in water, acidulated with sulphuric acid. Chromic acid, which has great affmity for hydrogen, is set free by decomposition of the bichromate of potash, and prevents polarization. A useful form of single cell for experimental purposes or for brief applications of a power- ful current is represented in Fig. 21. THE MC-INTOSH GRENET CELL. a, is a globular glass bottle with cylindrical neck par- tially filled with fluid. C C, pieces of carbon forming the collecting plates. Z, zinc generating plate attached to a sliding rod; it can be lifted out of the fluid, or lowered to any depth. S, binding screw for retaining the rod at any point. e e, hard rubber cover to which the elements are fastened. A, binding post with which both carbons are connected by a strip of metal. B, binding post with which the zinc has metallic connec- tion. f f, soft rubber lining of e e, which covers and protects the metallic connections. R R R, hard rubber insulators. Fig. 21. Size No. 1, 5 ozs., 53^ inches high. Size No. 4, 2 qts., 10)4 inches high. Nos. 2 and 3 are inter- mediate. 108 GALVANISM. The special feature which distinguishes this from the ordi- nary Grenet cell, is the insulation of the metallic connections of the elements. The difficulty hitherto experienced in keeping this cell in good working order owing to the rapid oxidation of the connections, is completely overcome. The rubber is put on the elements in a soft state and vulcanized, which causes it to adhere so firmly that neither fluid nor its fumes can pen- etrate between the insulator and the metallic connections which it incloses. The Mcintosh Grenet cell is suitable for dental purposes, such as treating diseased teeth and obtunding the pain of ex- tracting them ; producing an electrolytic effect upon ulcers, etc. ; supplying a current for an electro-magnet to extract par- ticles of metal from the eye, and for testing battery connec- tions. The zinc is but one-half the length of the carbons and can be drawn up above the fluid ; it can be lowered in an instant, and on completing the circuit the current at once starts. As soon as its work is done, the zinc should be immediately raised out of the fluid and fastened there ; with that precaution it will always be ready for use, until the fluid is exhausted. BATTERY FLUID. The composition of battery fluid is of great importance in securing the best working condition of any battery, and it must be adapted both to the special combination of elements employed and to the work to be done. It should be capable: 1. Of producing the greatest possible difference of potential. 2. Retarding polarization or preventing it entirely. 3. Offering little resistance to the passage of the current. 4. Giving forth no corrosive fumes. All manufacturers determine by repeated experiments the kind of fluid best adapted to their own batteries, and the best GALVANISM. 109 results will be obtained by following their formula. Operators frequently are disappointed in consequence of using a fluid unsuited to the special combination of elements with which their instruments are supplied. The fluid for the Mcintosh Grenet cell should be made as follows : Sulphuric acid, three fluid ounces. Bichromate of potash, two ounces (avoirdupois). Bisulphate of mercury, two drachms (avoirdupois). Water, sixteen fluid ounces. Dissolve the bichromate of potash in hot water ; when it is cold, add the bisulphate of mercury, and lastly, very slowly, the sulphuric acid. It is dangerous to pour water into sul- phuric acid. This fluid should be prepared in an earthen or stoneware vessel, because the heat developed by the mingling of acid and water is so great as to damage glass or rubber cells. The fluid may be preserved indefinitely if kept in well stop- pered bottles. It shoidd he labeled Poison. It has a deep-red color, or an orange-red when looked at across its surface, which turns brown, dark-green, or black, when it is exhausted. TWO-FLUID CELLS. Although the galvanic current is commonly called a con- stant current, yet that obtained from a single-fluid cell varies constantly, owing to variable resistance, polarization, and rapid destruction of both fluid and zinc. The great merit of having constructed the first cell from which a really constant current could be obtained, belongs to Becquerel, who proposed to immerse copper and zinc in sep- arate fluids with a porous diaphragm between them which would permit communication between the two fluids, although keeping them apart. He used a bladder for the diaphragm. HQ GALVANISM. THE DANIELLS CELL. Daniells modified the cell invented by Becquerel. He replaced the bladder with a porous cup, and made other minor changes. Since a Daniells cell has been adopted as a comparative standard in estimating the electro-motive force of a galvanic current, a brief description of it may be of interest. A glass jar of about one gallon capacity is two-thirds filled with a concentrated solution of sulphate of copper. A thin cylindrical sheet of copper is immersed in this solution within the jar which it completely lines. A porous cup, of the same height as the jar, nearly filled with a mixture of one part sulphuric acid to eight parts water, is placed in the center of the jar and a rod of amalgamated zinc is immersed in the cup. When the poles of this pair are connected, the following reaction occurs : Both water and solution of sulphate of copper are decomposed. One part of the liberated oxygen combines with the zinc to form oxide of zinc, which combines again with sulphuric acid to form sulphate of zinc ; another part of the oxygen combines with hydrogen to form water, and finally a thin film of copper is deposited upon the surface of the co])per cylinder, which, therefore, remains unchanged. The zinc being well amalgamated, resists local action, and the elements can be left in the fluid if their poles be disconnected when not in use. GRAVITY CELLS. The gravity cell is a modification of the Daniells, and is constructed on the principle that two fluids of different density can be arranged so that the heavier shall form a stratum at the bottom of the ceil with the lighter floating upon it. This separation is never perfect, since the heavier fluid slowly diffuses upward. The elements are placed horizontally. When once charged and connected, these cells will run for months, GALV^ANISM. Ill the only attention required being to supply water as it evap- orates, and occasionally a little sulphate of copper. They are employed for stationary apparatus of every kind, for which a Fig. 22. GRAVITY CELLS. Capacity, Yi Gallon. galvanic current is desired, such as office, table or cabinet batteries, electric chair, electric bath, vapor bath, etc. TO PREPARE THE GRAVITY BATTERY FOR USE. Fill each jar three-fourths full of clean soft water (three pints), add six ounces sulj^hate of zinc, stir to dissolve it, and remove the scum that rises. Unfold the copper element and place in the bottom of the jar. Suspend the zinc by means of the tripod, so that its upper surface is just below the surface of the water and parallel with it. Add six ounces sulphate of copper crystals to the fluid, taking care not to drop any upon the zinc. A convenient, though not essential, mode of accomplisliing this is as follows : A glass tube of sufficient size to permit the passage of the copper crystals is inserted vertically in the cell to a level w4th the upper surface of the copper element and the sulphate of 112 GALVANISM. copper dropped through. This gives a deep blue color and greater density to the lower stratum of the fluid. It can reach the zinc only by diffusion upward, provided the cell is kept stationary, and free from jarring or shaking. The blue tint of the lower stratum should extend just over the copper element, but should not be permitted to reach the zinc. The fluid around the zinc has a very slow downward motion and helps to retard upward motion of the copper solution. The mixing of the two layers of fluid may be still further hindered by inserting a syphon consisting of a glass tube filled with a cotton wick, one extremity being midway between the zinc and copper elements and the other in a vessel outside the cell, so that the liquid is very slowly drawn off near the middle of its depth. This, however, is seldom employed. TO CONNECT GRAVITY CELLS. Tlie cells are ■ connected in series by fastening the wire attached to the copper element of the second cell in the socket on one arm of the tripod of the first cell, where a thumbscrew may be seen in Fig. 22 ; the copper element of the third cell is connected in the same way with the tripod of the second cell, and so on ; each copper element except the first being joined to the tripod'^of the preceding cell in the series. Tlie cells are connected with the apparatus thus : The wire from the copper element in the first cell is joined to a post or button which represents the positive pole. A wire from the zinc of the first cell (fastened in the same socket of the tripod arm as the wire from the second copper element) is connected with a post or button representing one negative pole, a wire similarly attached to the second zinc element is connected with a second button, and so on until the entire series are connected with corresponding buttons on the apparatus. GALVANISM. 113 THE REACTION IN THE GRAVITY CELL. When the elements are connected by closing the circuit, the sulphate of copper is decomposed into copper and sulphuric acid. The copper is deposited upon the copper plate, and the sulphuric acid travels slowly through the liquid to the zinc, with which it combines, forming sulphate of zinc. In this way the liquid at the bottom becomes less dense by the deposition of the copper, and the liquid at the top becomes more dense by the addition of the sulphate of zinc. To prevent this action from changing the order of density of the strata, and so producing instability and visible currents within the cell, it should be kept well supplied with crystals of sulphate of copper, and water must be supplied to replace loss by evaporation. The water must be added gently to the top of the liquid, so as to prevent jarring or stirring, which may set up currents that will mix the two liquids. The need of more blue vitriol may be known by fading of the blue color. A hydrometer is convenient for testing the strength of the solution. When the specific gravity is less than 15°, there is too little sulphate of zinc ; when it is 30° or over, there is too much in solution, and it must be diluted. These cells require no attention, except to supply water as it evaporates, for months at a time; but once or twice a year it will be necessary. To recharge the grmity cells. When the elements become coated so as to interfere with the action of the battery, they must be removed, scraped, and rinsed clean ; the jars also should be washed out and refilled. The clear portion of the fluid may be drawn off and used to recharge the cells ; this solution contains so much sulphate of zinc, that after filling each jar one-half full, clear water can be used to fill up with. 114 GALVANISM. TO KEEP GRAVITY CELLS IN ORDER. Since the final result is that the sulphate of copper finds its way to the zinc and spoils the battery, to retard this as long as possible it is necessary to use certain precautions : 1. They must be placed so that their contents cannot be shaken up, as the action ceases when the two fluids become well mixed together. 2. If it is not convenient to keep a siphon in place to draw oiF the copper solution gradually, when it rises too high, a syringe may be used to draw a portion from the bottom of the jar. 3. Fresh water may be added to the top by a syringe, taking care to use little force. 4. The collection of salts about the top of the jar may be prevented by painting the inner surface foi about one inch below the top either with paint or melted parafiine. 5. The tripod connections may also be kept free from deposits by coating them with parafiine. They should be warm when it is applied. 6. When the cells are used but little, say an hour a day^ the current direct from the cells should be run through a rheostat, or resistance coil, for a few hours occasionally, to keep The tray cell con- sists of a square wooden box, lined with sheet lead, upon which copper is de- posited by the elec- tro-plate process. The zinc element is made in the form of a grating, to allow the gas to escape and give more surface. It them in perfect working condition. Fig. 23. Tray Cell. Size inside, 18X18X8 inches. GALVANISM. 115 is supported by wooden blocks placed at the four corners of the cell. To prepare this cell for use. — Make a solution of sulphate of zinc in the proportion of six ounces (by weight) to each gallon of water (Epsom salts may be used instead of sulphate of zinc, it answers the same purpose and is much cheaper), and fill the cell so that the zinc grating is submerged an inch or two. Lift out the zinc element, add sulphate of copper crys- tals in the proportion of six ounces to each gallon of solution, and remove any scum that rises. Do not stir the fluid after the sulphate of copper is added^ since this is a form of the gravity cell, and its action depends upon the ditference of gravity between the upper and lower strata of the fluid. The connec- tion between this cell and the apparatus is made with two large insulated copper wires, one of which is fastened to the binding post attached to the copper lining, and the other to the binding post attached to the zinc grating. The resistance within this cell is very small, being only .2 ohm. Sometimes several of these trays are placed one above another, the copper of one being connected with the zinc of the next, and the appa- ratus being connected with the first and last in the series, in the same way as with the ordinary gravity jars. A single tray cell is used only for the faradic current. The only attention it requires is to empty the cell once or twice a year, and scrape off any salts that may have accumulated on the elements. A part of the fluid poured out of the cell may be used to recharge it. If the copper at any time reaches the zinc, take out the zinc, rinse it off, add more water to the cell and replace. SINGLE-FLUID AND TWO-FLUID CELLS COMPARED. Since large cells do not necessarily give a more powerful remedial current than very small ones; the size to be selected 116 GALVANISM, must be determined by other considerations than the strength of current required. A comparison of their relative excellencies and defects is the best guide to selection : SINGLE-FLUID CELLS. ( a ) They become polarized rapidly. (6) The electro-motive force is great. (c) The electro-motive force is greatest when freshly charged. {d) The electro-motive force stead- ily declines from the first. {e) The cells may be small and portable. (/) Best adapted to frequent short applications and general practice. The great E. M. F., of the zinc and carbon cells, makes them best suited for electrolysis. TWO-FLUID CELLS. (a) They polarize very slowly. (6) The electro-motive force is small. (c) The electro-motive force in- creases for several days before its maximum is reached. {d) The electro-motive force con- tinues for months with little varia- tion. {e) The cells must be comparatively large and heavy. It is essential that they be stationary. (/) Best suited to office practice where many treatments must be given daily, and it is important to have the battery always ready. TO DETECT THE PRESENCE OF THE GALVANIC CURRENT. Since the galvanic current, when uninterrupted, passes silently through its circuit without producing shocks, flashes of light, or other phenomena that mark the presence of static electricity, it is frequently important to be able to determine whether a current is present. This must be determined from the effects produced when subjected to certain tests, among which are the following : 1. Heat^ which is produced when tlie current is carried through very fine wire. 2. Light. If pieces of carbon are used for the poles, on bringing them together sparks are visible ; these may usually GALVANISM 117 be obtained on touching the electrodes, or even the tips of the cords together, to complete the circuit. The sparks will be seen onlj when the current is interrupted. 3. Sensation produced. If the electrodes are held against opposite sides of the face or tongue, strong burning, stinging, or pricking sensation, will be felt on interrupting the current or moving the electrodes. 4. The cheraical effect. A simple apparatus for determin- ing this can be improvised from materials found in any medical office, on the principle of the voltameter. An ordinary test tube has a cork fitted into its neck, through which are passed two needles, or wires, connected with the poles of the battery by conducting cords. When the circuit is complete, the water will be decomposed, provided the current has an electro-motive force equal to nearly two volts (it requires that amount of force to overcome the affinity of oxygen and hydrogen), and the amount of gases set free will be a measure of the working power of the current. fig.24. , , THE VOLTAMETER. 5. Deflection of the magnetic needle. Sir H. Davy discovered that every conducting wire is a magnet while the current is passing, whether the latter comes from a static or galvanic machine. The effect is proportioned to the quantity of electricity that is passing through a given space, and the finer the conducting wire the stronger the magnetic force. This was the long-sought link connecting magnetism and electricity, and proving that they are but different properties of the same force, or different manifesta- tions of the same power. The conducting wire is capable of exerting magnetic attrac- tion and repulsion so long as the current is passing, whicli properties have been utilized in the construction of the gal- vanometer. / 118 GALVANISM. THE GALVANOMETER. A galvanometer is an instru- ment for measuring a galvanic current and showing its direc- tion. A galvanoscope is an instru- ment which indicates the pres- size from point to point z]4xi inches, ence of a galvauic Current. These instruments are constructed on the principle (first discovered by Prof. Oersted, of Copenhagen) that if a wire conducting an electric current be placed in the magnetic meridian, it will cause a magnetic needle freely suspended above it to deflect from the magnetic north and south poles. The amount of deflection bears a relation to the quantity of electricity traversing the circuit, and the direction of the de- flection depends upon the direction of the current. Elaborate instruments are required for accurate current measurement, which are altogether too delicate, bulky or expensive for medical use. The instrument shown in Fig. 25 affords an approximate measurement, which is sufficiently accurate for all practical purposes. It consists of a magnetic needle, freely movable over a graduated circle, fastened to a hard-rubber base, beneath which is a large coil of extremely fine wire. Each end (;f the coil is connected with one of the binding posts on the rubber base. It is an important adjunct to the galvanic battery, for in many therapeutical applications it is of the greatest impor- tance to know the working condition of the cells and the direction of the current. The purchaser will be saved some disappointment if it is borne in mind that the instrument above referred to does not measure the actual strength of the current. It is designed only to indicate : GALVANISM. 119 1. The direction of the current. 2. Its polarity. 3. The relative strength of cells tested separately. 4. The variation in strength of any one cell at different periods, to determine when it has run down or needs replenish- ing. The first cell connected with this galvanometer deflects the needle a certain number of degrees, hut joining a second cell to the first does not give twice the deflection^ or a thirds three times as much as one alone. The reason of this may be found given under the head of arrangement of cells, where it was shown that' joining cells, with elements in alter- nation, increases the electro-motive force greatly^ hut increases the quantity slightly. The electro-motive force of a current bears no direct relation to its magnetic force, but quantity of a current does bear a direct relation to its magnetic force; therefore, increasing electro-motive force does not increase the deflection of the needle, but increasing the quantity does in- crease the deflection up to a certain limit, beyond which it is impossible to increase the deflection by any number or arrangement of cells. TO DETERMINE THE PRESENCE AND DIRECTION OF A GALVANIC CURRENT. Place the galvanometer in such a position that O (or N) is toward the north, and the needle is pointing directly to N and S. Connect that pole of the battery supposed to be positive with binding post next O, and the negative with the other. The instant this is Fig. 26. done, if there is a current, it passes through the coil beneath the base and deflects the north (loaded) end of the needle to the east. If the negative bat- 120 GALVANISM. tery pole be connected with the binding post next O, and the circuit be completed with the positive at S, the north end of the needle will be deflected to the west. Wo Deflection indicates either that the fluid is exhausted or the connections are defective. THE COMPARATIVE STRENGTH OF THE CURRENT. When the circuit is first completed, the needle moves rap- idly to and fro, but soon becomes quiet at an angle with its former position. This angle is a measure of the deflection and a comparative measure of the strength of the current. The deflection will difler in two similar cells, provided, {a) The elements in one are immersed deeper in fluid than the other. (b) If the elements in one have been used longer than those in the other, {c) If the fluid of one has been used more than the other. The following table is given as an example of the varia- tions of this galvanometer when testing a series of cells which separately gave the same deflection, namely, 60°: 2 cells gave 3 " 4 « u 5 " 68^ 74c 78^ 80' 6 to 13 inc. gave 14 and 15, " 16 to 24, " 82= 83= 84= A subsequent test of this same series by electrolysis proved that the deflections of the needle were not an accurate meas- ure of the working power of the current. Since the addition of cells one by one, from 6 to 13, did not increase the de- flection, it might be supposed that there was a defect in the connections, but the amount of electrolysis performed each time a cell was added showed a regular increase. The amount of deflection caused by a freshly charged cell is a guide to its subsequent condition. When it commences GALVANISM. 121 ''to run down," the deflection grows less and less, and it ceases altogether when the fluid is exhausted or the elements destroyed. THE DEFLECTION OF THE COMPASS-NEEDLE. Minute quantities of electricity are suflicient to disturb the position of a compass-needle ; and this fact is frequently taken advantage of by dealers in various so-called electrical appli- ances to convince the ignorant of the enormous amount of electricity furnished by them. A magnetized penknife will disturb the needle equally as much, and possesses fully as much therapeutical power, as many of the electrical devices put on the market in the guise of belts, jackets, discs, etc. etc. BINDING POSTS. Fig. 27. A, B and C represent binding posts, which are usually made of solid brass, and in the better class of batteries are nickel-plated to preserve them from rust, corrosion, etc. They terminate below in a screw, by which they are fastened upon the battery base and connected directly or indirectly with the elements. They serve frequently to fasten the elements to tlie lower surface of the base. Their upper part contains a hole or socket to receive the tips of conducting cords. A repre- sents the style preferred for measuring apparatus, and other purposes where a very perfect connection is important. The 122 GALVANISM. cord tip is inserted in the side and the thumbscrew is turned firmly down upon it, giving firm and perfect contact over proportionately a considerable surface. B represents a com- mon form of binding post, which receives the cord tip in the socket indicated by the dotted lines. This makes good connec- tion, provided the tip fits tight and the socket is clean. Fluid dropped upon the post may cause rust in the socket, and as the current does not pass readily through rust, it is evident that its strength may easily be impaired by carelessness in this particular. Binding post C is similar to the others, except that it has a slot in addition to the socket. It is used on the end of battery bases to receive a movable bar which forms the connection between them as hereafter described. CONDUCTING CORDS. Every part of a battery circuit must be of metal, with the exception of the substance or body included between two points of the circuit upon which the current is expected to act. The connection between the binding posts and electrodes may be composed of a single wire, or a bundle of wires. In either case it is essential that they be well insulated, otherwise a portion of the electricity may escape, if acci- dentally brought in contact with a good conductor, and the operator will fail in securing the full strength of the cur- rent at the point where it is needed. When a single wire is employed, it is usually coated with gutta-percha or a woven covering saturated in parafiine. It should be of sufficient size, pure and well annealed. All conducting wires lose a portion of their conducting power by being frequently bent. For medical application outside the bath, the conducting cords were formerly composed of a bundle of very fine wires, inclosed for insulation in a double woven covering of cotton, GALVANISM. 123 worsted or silk. Silver wire ranks as the best conductor, per- fectly pure copper the second, and alloy the third on the list. When great heat is required for any purpose, as in galvano- cautery, that part of the circuit between the conducting cords must be composed of a wire which offers great resistance to the passage of the current. Platinum, being a very poor con- ductor, is usually selected. At present, the best conducting cords for medical purposes are composed of alloy in the form of ex- ceedingly fine flattened wire resembling foil, wound around a stout thread to give it strength, several of these threads being twisted in a strand, and several strands being twisted together after the manner of a cable, all being inclosed in a double woven covering. By this means a very large metallic surface is obtained in a very small space, which is perfectly flexible and less liable to breakage than conductors composed of a bundle of fine copper wires. Bifurcated cords. A short cord is joined to a long one at such a distance from the end as to make two equal branches. It is used for two distinct purposes. 1. A current selector, to bring any number of cells in a given series into the circuit. 2. To divide the current. The single end of the cord is inserted in one binding post as usual, and the double end is attached to two electrodes, which are located on the points between which the current is to be divided. The single cord from the alternate pole is attached to an electrode that is usually located at some indifferent point. Since every conducting cord, or wire, becomes a magnet while the current is passing, and ceases to be a magnet the instant the current stops, these changes in magnetic polarity after a time partially overcome the cohesion of the atoms, especially near the ends of the cords where the magnetic force is greatest; consequently they become brittle and easily 124 GALVANISM. break. This source of current interruption is frequently over- looked. When a battery is in good working order, and a current can be detected by the fingers placed on the binding posts, while a current cannot be obtained from the electrodes, it is almost certain that the metallic connection within the cord is severed. Cord tips. It is necessary that there be close contact be- tween the metal tips of the conducting cords and the sockets of the binding posts over their entire surface, or as much of it as possible. The tips should be adjustable, so that the operator can repair the cords when broken without the delay of sending them to the shop. There are two styles of ad- justable tips. One is merely a thick wire turned up at one end to form a ring, to which the metallic portion of the cord is fastened by fine copper wire, the insulating cover being drawn back to expose it, and afterward drawn up close to the tip and fastened there. A C B Fig. 28. THE MCINTOSH TIP FOR CONDUCTING CORDS. The style of tip shown in Fig. 28 is a convenient one, and gives very complete contact with the binding post. A shows it adjusted for use ; B and C, the separate parts when unscrewed to mend the cord. After locating the break, C is moved past the point an inch or two and the cord cut off at the broken point ; the metallic cable is exposed by drawing back its insulating cover and is tied in a knot to prevent its slipping through C. The cover is drawn up to the knot and fastened down with a thread, just behind the knot and trimmed off. C is now moved up to the knot, but not over it. B is screwed in place and the cord is as good as GALVANISM. 125 ever, except that it is shortened. It is important that the metallic threads of the cord should be in contact with the socket of B ; if bv any oversight the insulating cover be included in the knot so as to cover it in the socket, the passage of the current will be partially or wholly prevented. A The Connector is a convenient device for connecting- conducting cords having tips of different size with various styles of instruments used in applying an elec- trical current. A is a small socket in which the cord tip is firmly fastened by the thumbscrew. B B is a large socket cut in threads to receive the Connector, screw which terminates the instrument. Several styles Length l^^ . . inches, g^^^^j ^\z^^ of this useful little connector are made. A Fig. 30. SECTION OF THE McINTOSH GALVANIC BATTERY. A, base and elements. Base 3^X7 inches. Elements Vy<.^%. B cell section. Length, m in.; width, 3% in.; height, 4 in. P & N, positive and negative poles. 1, 2, 3, etc., binding posts. c, z, c, etc., carbon and zinc elements. D, drip-cup. C, C, cells. Element section A is composed of a polished hard-rubber base, lined with soft rubber, which serves the purpose of a hydrostat. The elements are fastened direct to metal bridges, 126 GALVANISM. and these are attached to the base by the screws, which ter- minate the binding posts. They are arranged so that post P is connected with a single carbon, and post N with a single zinc ; the remaining posts are each connected with a pair of elements. The cell section B is composed of vulcanized rubber. It is divided in halves by a partition of the same material; one-half is subdivided into six equal parts called cells, which receive the fluid. The undivided half forms the drip-cup, in which the elements are placed when they are not in use. Arrangement of Elements in the Fluid. When the ele- ments are immersed in the fluid, their arrangement is as fol- lows : The first cell contains the single carbon attached to post P 1, and the zinc attached to post 1. The second cell con- tains the carbon attached to post 1, and the zinc attached to post 2, and so on, the last cell containing the carbon attached to post 5 and the zinc attached to post 6. Direction of current when one cell is in circuit. The cur- rent generated by the zinc in the first cell passes across the fluid to the carbon ; from thence up through post P 1 and the circuit back to post 1 and down to the zinc. Binding post P 1 is the positive pole, and binding post 1 the negative. When any number of cells are in circuity the post to which the last zinc in the series (the one farthest from P 1) is attached forms the negative pole, while P 1 remains, as before, the positive pole. Suppose three cells are included. The current generated by the zinc in the third cell passes through the liquid to the carbon, up this to the metal bridge fastened to post 2, over the bridge to the zinc in cell 2 ; the zinc in cell 2 generates a current to which impetus is added by that received from cell 3. This augmented current passes across the fluid to the carbon, up to the metal bridge attached to post 1, and over to the zinc in cell 1, adding to it the GALVANISM. 127 additional impetus gained from the two preceding cells ; this passes across to carbon connected with PI, up through this post and the conducting cord attached to it, through the circuit to post 3, and thence to the zinc element where the current originated. Fig. 31. THE Mcintosh galvanic battery. TWENTY-FOUR CELLS. Length, 18 in. ; width, 8% in. ; height, 114 in. ; weight, 18]4 lbs. The physician who uses electricity in general practice has oc- casion frequently to apply the galvanic current at a distance from his office. For this purpose, a compact instrument capable of giving a current strong enough, not only for general application, but for any case of electrolysis that may be presented, is essen- tial, and it is also essential that such an instrument be not too heavy to be conveniently portable. The galvanic batteries in- vented by Dr. Mcintosh meet these requirements fully. They are not only compact, perfectly portable, and easily kept in order, but they are the most powerful galvanic batteries made, with the exception of those intended solely for galvano-cautery. 128 GALVANISM. Each cell, when freshly charged, has an electro-motive force of two volts. These cells are arranged in sections of six, so that only six pairs of elements are exposed to the action of the fluid at once, and of these, any single pair may be used separately. By this ingenious arrangement, the fluid and ele- ments throughout the entire battery may be used up uniformly, instead of having the bulk of. the work fall upon the first cells in the series, as is usually the case. As the full number of twenty-four cells are rarely required for any operation, all sec- tions not actually needed should be omitted from the circuit, to serve as a reserve force^ ready to be brought into service when more power is required, or when the current from those in use falls below that necessary to accomplish the work in hand, either from polarization, exhaustion of fluid, or destruc- tion of elements. As all single fluid cells, without exception, fall constantly from the power they possess, when the circuit is first closed, fresh cells may be added, one by one, to keep the strength of the current uniform. The foUowing features of these admirable instruments need only to be referred to, as their value will be at once apparent : 1. When fhe battery is closed, each cell section is tightly covered, so that no liquid can escape from the cells. 2. When the battery is not in use, the elements are con- tained in empty drip-cups, thus preserving them from all possibility of waste from local action. 3. The electrode box is so placed that the battery cannot be closed so long as any section of elements remains in the fluid. 4. The current is started by simply lifting a section of elements to the right so as to immerse them in the fluid. The handles on the bases serve to lift the sections, and also as springs to press them down firmly on the cells when the battery is closed. GALVANISM. 129 5. If at any time during treatment the current fails, new sections may be made read}^ in an instant, and those already used may be omitted from the circuit. This is an inestimable advantage in certain electrolytic operations. New cells may be added during the operation without shock to the patient, and without breaking the circuit, by using the bifurcated cord as a current selector. 7. The cells, being of hard rubber, are not injured by leaving the fluid in them constantly. 8. Since the available strength of current depends, among other conditions, upon uniformity of element surface immersed in fluid, a glass measure is sent out with these batteries, graduated to show the amount of fluid required for one cell, so that all may be filled alike. 9. When it is necessary to clean the cells, they can be lifted out, emptied, and washed like an ordinary cup. Since the connections between elements are not disturbed in the process, the work of cleaning the battery may be intrusted to any one who is sufficiently careful not to spill the fluid upon the metal work. AUTOMATIC KHEOTOME. K R. The cylinder containing clockwork. A P. Vibrating Pendulum. P. Movable ball to regulate length of vibration. B B. Binding posts for connecting Avith battery. K. Key for winding clockwork, -f^^r> W. Winding post. S. Starting and stopping post. Length of base, li in. ; width, 4i in. The automatic rheotome is designed to produce regular interruptions of the galvanic current. To introduce it into the circuit. Connect one binding post B with the positive pole of the battery, and the other 9 130 GALVANISM. post B with an electrode that is applied to the patient. The negative pole of the battery is connected with the patient in the usual manner. To start the rheotome. Turn post "W with the key in the same direction as when winding a clock. Remove the key to post S, turn it slightly to the right, and A P will immediately begin to vibrate. To regulate the interruptions. Moving P nearer A shortens the vibrator and increases the rapidity of the interruptions ; moving P farther from A causes slower interruptions. They may be stopped instantly by turning post S to the left. Fig. 33. POLE CHANGER. Length, 6% in.; diameter, 1 in. The pole changer not only changes the direction of the current, but also produces the effect of a current interrupter while the change in polarity is being made. This instrument consists of a hollow polished-rubber cylinder, containing within it a long movable arm which carries a pair of parallel metal springs. At each end of the cylinder are two binding posts, which have metallic connection, with two brass buttons just within the cylinder, with which the springs make contact. The thumb- screw M is attached to the movable arm, and when moved the length of the slot, in the cylinder, carries the arm with it. When M is at one end of its slot, the metallic connec- tions through the instrument are parallel ; that is, the cur- rent which enters at A comes out at B, passes through the circuit and back to D, emerging at C. When M is moved to the other end of its slot, the current entering at A passes out at D, and, returning through the circuit at B, emerges at C. GALVANISM. 131 To use the pole changer. Connect A and C with the two poles of the battery, B and D with two electrodes, and com- plete the circuit as usual. Move M to and fro to change the polarity at suitable intervals. THE MCINTOSH GALVANIC BELT. Fig. 34. Weight of belt, lOJ^ oz. The Mcintosh galvanic belt is constructed on the prin- ciple of the voltaic pile. It consists of a series of cells placed in pockets on a belt. The cells are com- posed of vulcanized rubber, lined with cop- per. The rubber serves two purposes ; it pre- vents leakage and in- sulates the cells so that the electricity genera- ted within cannot es- Section of Belt Cells. Actual size. capc except through the conducting wires. The copper lining forms the collecting plate. The generating plate is zinc, wrapped in a porous material which absorbs the exciting fluid and prevents any accidental escape from the cells. The zinc element in one cell is joined to the 132 GALVANISM. copper of the next by a short copper wire, so fastened as to permit a hinge-like motion between the cells, making the belt perfectly pliable. The helt is charged by dropping a little diluted vinegar or acetic acid * in each cell. A drop-tube is furnished with the belt to facilitate this process. The porous material of each cell (that is to be included in the circuit) must be thoroughly wet with fluid. Caution. It is not unusual for those unfamiliar with the principle of the voltaic pile, to endeavor to increase the strength of the current by using a larger proportion of acid, or pure acid ; the result is a sharp current and chemical action of such intensity as to produce rapid polarization, in consequence of which the current ceases to pass through the conducting cords. 2'he strength of the current. This varies constantly from the time the circuit is closed until the fluid becomes exhausted. When all the cells are in circuit and freshly charged, the current has a strength of about four volts, and, if kept working through a resistance equal to that of the human body, will retain this strength for nearly twelve hours ; it then perceptibly decreases, but is capable of producing a therapeutical effect for about twenty- four hours after it is charged, or until the porous filling of the cells becomes dry. This belt furnishes a current of sufficient potential to decompose water, and this experiment is the best mode of testing the relative strength of the belt. The Electrodes are thin plates of metal, covered with flannel, sponge, or chamois skin, connected with the cells by means of conducting cords, and are fastened on the parts to which the current is to be conveyed. Elastic bands, which fasten with a convenient clasp, are used to retain the electrodes in place. The cover of the electrodes must be moistened with * Dilute acetic acid here referred to contains one part acid to ten parts water. GALVANISM. 133 water (in rare cases with salt and water or acidulated water), and placed in contact with the skin. The current loill not pass through dry cloth^ sponge or chamois. Tlie metal elec- trodes applied without a cover directly to the skin produce considerable irritation, and if left long in direct contact will blister, especially under the negative. Metallic instruments of any form, such as needles, metallic discs, etc., may be connected with the cords, and the current conveyed through them the same as through ordinary electrodes. Conducting Cords. — These are similar to the conducting cords used with batteries. Two conducting cords can be attached to either pole when the current is to be divided between two parts, as the feet or arms, etc. To increase or decrease the number of cells in the circuit. Always remove the cord in connection with the zinc to make any change in the number of cells in circuit, and replace it between the zinc and its cover in the last cell of the series to be used. For example, if live cells are wanted in circuit, leaving the cord attached to the copper undisturbed, connect the negative cord with the zinc in the fifth cell. The practical advantages of the helt. The belt is especially adapted to those cases that require either a general or local application of an uninterrupted galvanic current of small quan- tity for a long time, either to improve nutrition (innervation) to excite absorption^ or to produce a chemical change in secretion. For the first purpose named, one electrode (to which a large sponge should be attached) is placed over that portion of the nerve-centers to be influenced, and the other over the special organ most implicated in the constitutional derangement. When applied to single organs, to reduce irritation the positive electrode should be placed over the nerve-roots, as shown in Fig. 73, and the negative over the organ to be 134 GALVANISM. influenced ; the best locality for this can be determined by- consulting the ''landmarks" on Fig. 74. If the male sexual organs are to be treated, a suspensory bandage specially made to accompany the belt can be used for one electrode, while the other pole is placed over the pelvic ganglia. To stimulate or to excite absorption, the current must be carried through the nerves in the opposite direction, that is, the negative over the brain, spine, or nerve-roots, and the positive over the periphery of the nerves. In the treatment of ulcers, to change the nature of the secretions it must be remembered that those in contact with the positive pole are changed to an acid state, and those in contact with the negative to an alkaline, as a piece of litmus paper will readily show. If it is thought desirable to apply this current to a single muscle, or group of muscles, the electrodes should be very small, and should be located according to the motor points of the special muscles to be treated. Duchenne discovered that certain forms of paralysis re- ceived most benefit from electricity when its application was accompanied by what he termed "mental gymnastics," that is, when the patient exerted his will to produce contraction of the paralyzed muscles at the same time that a current was passing through them. The belt furnishes a current that may be conveniently applied for this purpose. Dr. Poore* claims priority for the "combination of a con- tinuous galvanic current with voluntary muscular exercise." His clinical observations lead him to believe that during the passage of the polarizing current the voluntary mental stim- ulus acts with greater effect on the muscles, or, in other words, the contracting power of the muscles is increased. Other uses of the belt will be suggested under electrolysis. * A Text-Book on Electricity in Medicine and Surgery. G. V. Poore, M.D., M.R.C.P., etc. . GALVANISM. 135 THE MCINTOSH GALVANIC SUPPORTER. This consists of a metallic attachment to the Mcintosh Uterine Supporter Cup, for the purpose of conveying a galvanic CC. Cells similar to the belt cells, fastened directly to the sup- porter belt. A morocco flap, which covers them, is shown partly lifted up. E. Electrode (a little too high on the cut), located over the ova- rian region. M. The metal lined uterine cup which conveys the current to the cervix. N. The end of the metal rod which extends through the rubber stem to M. It is enlarged in the cut to make it visible. W W. Conducting cords. SS. Soft-rubber cords which retain the cup in position. Two conducting cords may be connected with O, to divide the current between two electrodes, so that one may be applied over each ovary, or one over the median line in front and the other over the sacrum. The cup, being of hard rubber, is a perfect insulator; the current passes only to that part of the cervix in contact with the metal lining the cup. The cervix should be examined from time to time to guard against too much action on the tissues. There exists great difference of opinion as to the value of an electrical current thus applied ; the evidence for and against it is so incomplete that it is not deemed advisable to enter into a discussion of the subject here. This method is sometimes adopted in the treatment of atony, ulceration, prolapsus, etc., with alleged success. THE PHYSIOLOGICAL EFFECT OF THE GALVANIC CURRENT. The first definite knowledge of the effect of galvanism on muscular and nervous fiber, which we have, is derived from current directly to the cervix. Fig. 36. 136 GALVANISM. the experiments instituted by Humboldt. Aldini, pupil of Galvani, was the first to api^ly galvanism to the treatment of disease, and in 1804 he published a book at Bologna entitled Theoretical and Experimental Essay on Galvanism." Prof. C. Matteuci, of Pisa, made a long and thorough series of experiments to determine the influence of the galvanic current upon the animal tissues, and his conclusions are regarded as authoritative, having been repeatedly confirmed by others from time to time since he originally announced them. Tliey may be brieflj^ summed up as follows : 1. It excites sensation at one time and contraction at an- other, according to the direction in which it traverses a nerve. 2. It does not excite a nerve when passing through it transversely. 3. Neither contraction nor sensation is produced when its influence upon a nerve is prolonged. 4. It alone has the property of increasing or diminishing the excitability of a nerve, according to the direction in which it is made to flow. 5. It has the power of awakening the excitability of a nerve after all other stinmlants have ceased to act. 6. When a galvanic current is sent through a limb in the opposite direction to the nerve current, a muscular contraction takes place. 7. When the electrical current passes in the same direction as the ramifications of the nerves, a stronger contraction takes place. Posenthal states that there is a great similarity between muscles and glands in this respect. If a nerve which is con- nected with a muscle is irritated, the muscle becomes active ; that is, it contracts ; and if a nerve that is connected with a gland is irritated, the gland becomes active ; that is, it secretes. GALVANISM. 137 ELECTROTONOS. It was claimed by Matteuci that the galvanic current exerts an inlliience over the nerves it traverses only at the time when the circuit is closed or opened, since at those instants only can a muscular contraction be produced. Subsequent observers, among them Du Bois-Keymond, confirmed this opinion, and it was accepted as a fact until Ritter reported the following observation : During a long and persistent closure of a strong galvanic circuit, if the current be carried through both arms, the band and arm in contact with the negative pole become less and less mobile until, finally, complete rigidity sets in ; whereas, on the contrary, the hand and arm in contact with the positive become more and more mobile and easy to move. To this changed state of the nerve-current, during the continued passage of a galvanic current, has been given the name electrotonos. Pfliiger explains the fact, viz : The arm on the positive side is traversed by an upward, and on the negative side by a down- ward, current ; no perceptible error occurs in considering it the same as if the positive pole be set on the shoulder of the down- wardly traversed arm, and the negative in the hand of same ; while in .the upwardly traversed arm the position of electrodes is reversed. When the will acts out from the brain on both arms simultaneously, it acts ctbove the anode in the downwardly traversed arm, or in the same direction as the current and behind it, while in the upwardly traversed arm, above the cathode^ or opposite to the electric current. This experiment was the first discovery of, electric law in the living human being. ANELECTEOTONOS AND CATELECTEOTONOS. Pfiiiger has also shown that when a galvanic current traverses a certain length of ney've it divides the latter into 138 GALVANISM. two sections or zones which physiologically differ, the portion nearer the negative pole having its irritability increased, and. the portion nearer the positive having its irritability decreased. That condition of the nerve next the negative pole has been named catelectrotonos / that next the positive, anelectrotonos. These conditions pass into each other at a point between the poles called jpoint of indifference. LOCATION OF THE POINT OF INDIFFERENCE. This depends upon 1. The size of the electrodes, 2. The distance they are apart, 3. The electro-motive force of the current, 4. The length of time the application is continued. The altered or polar condition of the nerve extends only to a certain distance from the electrodes, and when they are very small or far apart a considerable extent of the circuit between them may constitute the ''point of indifference," since the current traverses the fluids rather than the solids of the body. When the current is feeble (has small electro-motive force), the point of indifference is moved toward the positive pole, and almost the whole extent of nerve between the two electrodes may be in a state of increased excitability (catelectrotonos) ; with a strong current the reverse is true. When the current passes for a long time without interruption, the "point of indifference" is moved toward the negative pole, or the section of diminished irritability (anelectrotonos) is increased ; and if the electro-motive force of the current be at the same time increased, the zone of increased irritability may be reduced to the small space in the immediate vicinity of the negative pole, and after this maximum condition is reached it is useless to continue the current longer. GALVANISM. 139 Reaction. Immediately after breaking the connection reac- tion takes place in both sections of the nerve, the one which during the passage of the current was in a state of diminished irritability (anelectrotonos) assuming the catelectrotonos state, and vice versa. This gradually subsides and the nerve resumes its natural condition. Alteration in conducting power of nerve. The galvanic current also changes the faculty of the nerve to transmit stimu- lation ; that portion of the nerve which has its excitability diminished offers greater resistance to the transmission of the stimulation, and this resistance increases with the duration and electro-motive force of the polarizing current. Effect of a strong current. Repeated and strong electrical shocks weaken and invert the nerve-current. It should be remembered that galvanic stimulation is the first step in the electrolysis of the nerve. LAW OF GALVANIC STIMULATION. The law of galvanic stimulation has been investigated by Du Bois-Reymond, and his conclusions are briefly these : 1. The motor nerve is stimulated not so much by the density or quantity of any given current as by its variations from one instant to another. 2. The more rapid and sudden the fluctuations of the cur- rent, the greater the effect produced by a minimum quantity of electricity. 3. Frequent change in direction is required in galvanic stimulation of a nerve, because the conductivity of a current flowing long in the same direction is decreased, while a change increases it. 4. There is no doubt that the brain and spinal marrow may be affected by the galvanic current, even through their 140 GALVANISM. boii}^ covering. The latter point has been confirmed by Ziemssen. METHOD OF APPLYINO GALVANISM. Certain terms are applied to the galvanic current to dis- tinguish the method of its application. 1. Stabile current is the name given it by Eemak when the electrodes are kept stationary during a sitting. 2. Labile current, when the negative is made to glide over the surface in the direction of the nerves and muscles to be acted upon. 3. Descending current is the name given it when the posi- tive electrode is placed over the plexus or roots of the nerve, and the negative at the extremities. 4. Ascending current^ when the negative is placed over the roots of the nerves and the positive at their extremity or periphery. 5. An increasing current. A current from a circuit that is being increased by joining more cells in the series from time to time during a sitting. 6. A decreasing current. The current from a circuit from which cells are being disconnected from time to time during a sitting. 5. General galvanization is a term indicating that the cur- rent is applied to the whole surface during a sitting. It is some- times called the percutaneous method. Beard and Rockwell have given the name central galvanization to that particular method of employing general galvanization which is original with them. Its object is to bring the brain, spinal cord, sympathetic and pneumogastric nerves under the influence of the galvanic current. The negative electrode is placed over the epigastrium while the positive is passed over the fore- head, top of head, along the inner border of the sterno-cleido GALVANISM. 141 mastoid muscle, from the mastoid fossa to the sternum, and at the nape of the neck and down the entire length of tlie spine. 6. Localized galvanization. This includes cutaneous galvan- ization, galvanization of nerves and muscles, and galvanization of special organs and senses. This is usually accomplished by placing one metal or sponge electrode over the part to be treated and the other over the root or trunk of the nerve supplying it. Another method, called by its inventor galvano- pimcture^ is supposed to have been first used by Fabre-Pala- prat, in 1828. Its first scientific use, however, was made by Magendie. It is a combination of electricity with acupunc- ture, which is little used at present. DETAILS OF TREATMENT. To prepare the patient for general galvanization. Dynamic electricity does not possess sufficient potential to overcome the resistance of the clothing, therefore the conductors or electrodes used to convey the current to the body must be in direct contact with the shin. Since the current flows only when the circuit is complete, two separate parts of the body or tissues treated must be connected with the battery, one connection being made with the positive and the other with the negative pole of the battery. The clothing should be loosened, so that the current may be carried by suitable conductors down the whole length of the spine and over the principal organs of the body ; and if the legs are to be included in the treatment, the feet should be bare and in contact with one of the conductors. The room in which the treatment is given should be sufii- ciently warm, so that there can be no danger of the patient's becoming chilled ; for the same reason the conductors or elec- trodes should be warm. AW exposure of the person should be 142 GALVANISM. avoided so far as possible. It is convenient and customary to provide a sliawl or blanket to be thrown over the patient if the sitting is to be long and the application very general. The battery should be tested before commencing to ascertain whether it is in good working order or not. A galvanometer introduced into the circuit will be deflected if a current is passing, as already described. An excellent test that has several advan- tages over all others is to apply the current from the smallest number of cells to be used to the operator's tongue, and the current from the largest number to the back of his hand. Strength of current. It is best to commence with a current from a very few cells, adding others, one by one, to the series, if necessary, to increase the strength. The galvanic current, unless ver}^ powerful, produces no marked sensations when uninterrupted ; frequently the patient does not feel it at all except at the instant the circuit is closed or opened ; therefore, when it is desirable to prevent all shock, the electrodes should be placed in position before the circuit is closed, and at first include not more than two or three cells in circuit ; as soon as the current is started cells may be added, one by one, without causing shock, and the electrodes may be moved over the surface without producing disagreeable sensations, provided their contact with the surface is not broken during the applica- tion. Before removing them or breaking the circuit the current should be decreased, cell by cell, until reduced to its original strength. This mode of regulating the strength of the current (except for very sensitive patients) should be reserved for special cases, because the therapeutical effect of the increasing and decreasing currents differ from those which are maintained at a uniform strength during an entire sitting. It may he laid down as a general principle that a feeble current used for a short time produces the greatest therapeutical GALVANISM. 143 effect. A very powerful current almost always does harm instead of good., and more especially so when it is applied for a conslder- ahle length of time. Fig. 37. ONE STEP IN CENTRAL GALVANIZATION. A Mcintosh eighteen-cell combined galvanic and faradic battery is shown in this illustration. The positive pole is con- nected with the electrode on the head of the patient. Three cells are in circuit, and the operator is taking the fourth cell into circuit, showing the method of using the bifurcated cord as a current selector, and of producing an increasing current. The long-handled electrode beside the battery is used in Fig. 38 for applying the current to the skin under the clothing. A hydro-rheostat is in the circuit (see Fig. 51) to prevent the current from producing an unpleasant effect upon the brain. It is not used with the galvanic current, except when the latter is interrupted. The electrode on the head is faced with sponge, which should be moist, and the hair also, dry hair being a non-conductor. It should be pressed evenly and firmly over as large a space as 144 GALVANISM. possible. It should be located before the circuit is completed. The negative electrode is placed over the stomach ; the vest should be unbuttoned and the underclothing drawn aside to permit the electrode to rest on the skin. The application to the brain should not exceed one or two minutes, if a stabile current is used ; with a labile current it may be four minutes. Caution. All applications of electricity about the head should be made with every precaution, if made at all, in cases where the symptoms indicate that apoplexy or paralysis may be impending. Dizziness should be a warning that the current is too strong, applied too long, or is unsuitable to the case. Galvanization of the neck must be practiced with caution, since giddiness and faintness are occasionally produced. While applying currents about the sides or front of the neck, the sensations excited in the patient must be carefully observed. Acts of swallowing and coughing are frequently produced, especially when the negative electrode is on the neck, being caused, probably, by the irritation of the superior laryngeal nerve. Fig. 38. ANOTHER STEP IN CENTRAL GALVANIZATION. GALVANISM. 145 A twelve-cell combined battery is shown in Fig. 38, with twelve cells in circuit. The sections are united by a bar, which may be seen between them, next the battery top. An automatic rheotome is in circuit to produce an interrupted galvanic current. It is not an essential feature in this treatment, but, being sometimes used, it is introduced in the illustration to show the method of employing it. A lady patient should loosen her clothing at the neck sufficiently to permit the free passage of the long-handled electrode down the entire length of the spine, and also over the stomach to permit locating the sta- tionary electrode. When the liver, spleen, etc., need a special application of the current, the dress-waist and corset may be removed, and a shawl be thrown over the shoulders to avoid exposure. As a rule, that operator will be most successful in pleasing lady patients who manages to give the necessary treat- ment with least disarrangement of clothing. Localized galvanization. This method of employing the galvanic current will be described in the chapter treating of the physiological and therapeutical efiect of electricity upon the various nerves, muscles, and organs of special sense. CHAPTEE lY. ELECTROLYSIS. This is the process of decomposing a compound substancG by passing electricity through it. One portion appears at the point where the current enters, and the other at the point where the current leaves the compound. Faraday gave it the name electrolysis, which is understood to refer only to the changes effected in a substance subjected to^ but not giving rise to, the current. The points at which the electricity passes in and out are called electrodes (from a Greek term signifying "way"). The point of entrance, connected with the collecting plate of the battery, is the anode (upward way) ; the point of exit, con- nected with the zinc, is the cathode (downward way). The substances acted upon, or decomposed, are called the electrolytes. The elements into which electrolytes are separated are called ions. Those which appear at the positive electrode are called anions ; those at the negative electrodes the cations. "Since like electricities repel, and unlike attract each other," the anions which appear at the positive electrode must be electro-negative, and the cations that appear at the negative electrode must be electro-positive. LAWS OF ELECTROLYSIS. The amount of decomposition that takes place in any givea case and the products of it depend upon : {ci) The strength of the current. (J) The nature of the substances acted upon, (c) The material of which the electrodes are composed. (146) GALVANISM. U7 The amount of chemical effect produced on water, saline solutions, etc., will be in proportion to the strength of the current. It has been estimated that for every 32.7 grs. of zinc dissolved in any cell, provided local action is prevented, 9 grs. of water are decomposed. If the current developed by the decomposition going on within the cell could all be applied without loss, it would effect an equal amount of decomposition in the electrolyte. Electrolysis can only occur when the substance is in a liquid or semi-liquid state, so that the particles can move freely. Gordon * gives this explanation of the electrolytic pro- cess. The molecule next one electrode is broken up, one atom going to the near electrode ; the other either travels across to the opposite electrode or else changes partners with its adjacent molecule, setting free a portion similar to, and equal to, itself, which in turn combines with the next in the same manner, until the last molecule is reached ; the last atom set free, finds nothing to combine with, and appears alone at the negative electrode. It will be seen that the mobility of the particles is a necessary condition. All substances are decomposed by electricity in exactly the same proportions as they are chemically united, or in proportion to their atomic weight. Water is composed oi 8 parts (by weight) of oxygen chemically united to 1 part (by weight) of hydrogen. When decomposed by electricity there appears at the negative electrode 1 part of hydro- gen, and at the positive 8 parts of oxygen. Common salt consists of sodium 23.3 parts by weight, and chlorine 35.5 parts. When electrolyzed, the 23.3 parts of sodium appear at the negative electrode, and 35.5 of chlorine at the positive. It must be remembered that the human body is a mass of cells, and that these cells contain and are bathed in a * Electricity and Magnetism. 148 GALVANISM. saline solution, and it is not unlikely that, when a galvanic current is passed for some time in the same direction through the body, some of the resulting phenomena may be due to electrolytic changes in the tissues acted upon. The material of which the electrodes are composed, their size, and distance apart, are of practical importance in certain therapeutical applications. Fig. 39 is designed to represent the branches into which a current is supposed to split up on passing through a sub- FiG. 39. stance. When a large electrode is used, these branches have a larger surface for entrance or exit, and are consequently not so dense or crowded together as in the case of the small electrode. As each branch is believed to do its part in the work to be accomplished, it is evident that the greatest decomposition must occur at the small electrode where the greatest number of current branches act together upon a comparatively limited space. Fig. 40 represents what occurs when one of the electrodes is very small, and the distance between them is great. Fig. 40. Many of the current branches starting from the flat electrode, being unable to overcome the resistance, are lost, and the decomposition will be much less at the needle than when they are placed nearer together. It is a question whether those currents possessing sufficient power to dissolve or break up tissue, and destroy tumors, may not be capable of pro- ducing serious injury to other and healthy tissues through GALVANISM. 149 which they must be carried when the electrodes are widely separated. It is, therefore, recommended, in all electrolytic operations, to place the two electrodes near together. The materials of which electrodes are composed may be adapted, in certain cases, to the work to be done, since a substance which in combination with oxygen is capable of producing some special effect, can be selected for an electrode. This is done occasionally in treating stone in the bladder, tumors, etc. It must be recollected, in this connection, that during electrolysis the acids set free appear at the positive pole, and the alkalies at the negative. The immediate effect of decomposing the fluid of the body is that the oxygen and chlorine set free (acids) attack the needle, or positive elec- trode, inserted in the tissues^ changing a portion of it into metallic salts. Since metals are not acted upon by hydrogen, or free alkali, the negative electrode remains bright, whatever may be the strength of the current, or the length of its appli- cation. When it is desirable to introduce salts of iron, copper, silver, gold, or any other metal, into a morbid growth, insert into it needles, or pointed electrodes, of the metal selected, and connect them with the carbon or copper element of the battery. When it is desirable to preserve the needle from cor- rosion, or to avoid introducing any foreign substance, insert the negative needle attached to the zinc battery element. Since the art of electro-plating proves that materials resulting from decom]30sition of the anode are carried to and deposited upon the cathode, this fact should be borne in mind when attempt- ing to remove stricture, otherwise the trouble may be increased by the very means used to remove it. TO DETECT THE DIRECTION OF THE CURRENT BY ELECTROLYSIS. When a solution of common salt is exposed to the action of the current, as we have seen, both water and salt are 150 GALVANISM. decomposed, oxygen and chlorine appearing at the positive, hydrogen and sodium at the negative, electrode. A piece of blue litmus paper immersed at the negative electrode, where the alkaline atoms collect, will be rendered more intensely blue ; but immersed at the positive electrode, where the acids go, will be reddened. A solution of iodide of potash and starch, when brought under the influence of the current, will give a blue color at the positive electrode, where the iodine is set -free, while at the negative pole the solution remains colorless. When a substance is electrolyzed, those atoms which travel toward the positive electrode are electro-negative, and are known in chemistry as metals. Those going to the negative electrode are electro-positive, and are known as non-^netals. They gradually shade into each other. TABLE SHOWING THE RESULT OF ELECTROLYZING A FEW COMMON SOLUTIONS. ELECTROLYTES. CATIONS. ANIONS. Water + Hydrogen — Oxygen. Salt + Sodium --Chlorine. Iodide potash + Hydrogen — Iodine. POLARITY OF IONS OR ATOMS OF ELECTROLYTES. Nitric acid — Oxygen. Sulphurous acid — Oxygen. Muriatic acid Chloride of lead. . . Sulphate of copper + Hydrogen + Lead + Copper . . . — Chlorine. — Chlorine. — Sulphuric acid» GALVANISM. 151 When electrolysis of tissues lying beneath the skin is to be performed, the galvanic current is conveyed to them through needles of suitable size and shape. Those shown in Fig. 41 are made of steel, gold-plated ; they are called respectively straight, half-curved and curved. They are triangular like a surgical needle, and may be fastened directly to the cord by a needle-holder (see No. 4), or to a needle conductor (Fig. 42). The length varies from one inch upward, according to the mass to be acted upon, and the depth at which it is located. Eound needles are also used for electrolysis, and the material may be any metal that can be made into a needle. Very fine platinum or steel needles are nsed to remove hairs. Fig. 41. NEEDLES FOR ELECTROLYSIS. To iise electrolysis needles. 1. Connect with one pole of the battery, and insert them in the tissue to be acted upon. Complete the circuit by placing a large moistened sponge (con- nected with the alternate battery pole) outside, on the skin near by. 2. Instead of having the alternate pole represented b}" a sponge it may be connected with a needle, which is also carried into the tissues near, but not in contact with, the first. 152 GALVANISM. To insulate an electrolysis needle. When it is desirable to prevent any action of the current upon the skin, the needle should be insulated, except at the point that is entirely within the tissues to be operated upon. It may be coated with rubber dissolved in collodion, or shellac. The last named forms an excellent insulator ; it is prepared and applied as follows : Pulverized white shellac is covered with alcohol and allowed to stand over night, when it is ready to use ; that part of the needle to be insulated is coated w^ith a thin layer and held in a flame to evaporate the alcohol ; the process is com- plete when bubbles cease to form. If any bubble does not immediately burst, it must be brushed off with the finger, the spot smoothed down, and again held in the flame, otherwise the coating will be rough when finished, and the needle unfit to use. If the surface is not smooth when finished, the shellac must be dissolved in alcohol, the needle cleaned and a new coating applied. A little practice will enable the operator to apply this insulator quickly and successfully. It may also be used for metallic sounds, catheters, or any other instrument to be inserted in the cavities of the body, when the current conveyed through them is to be localized at any particular part of the cavity. EFFECT OF ELECTROLYSIS UPON ANIMAL TISSUES. Althaus, during 1866 and 1867, made a series of microscopical observations on the changes which animal structures undergo, under the influence of the electrolytic action of the galvanic cur- rent. He studied its eflect upon the intimate structure of the skin and cellular tissue, muscular fibers and tendons, cartilages and bones, liver and pancreas, spleen and thyroid body, kidneys and suprarenal capsules, testicles, breasts and ovaries. The general result of these investigations has proved that no anwuil tissue whatever ca/)i witJistand the disintegrating effect of the GALVANISM. 153 negative pole^ and that the force and rapidity with which this disintegration is hrought about are directly proportional to the electrcHnwtive force which is employed^ and to the softness and vascularity of the structures acted upon. Thus ten cells of a battery have a more thorough and rapid effect than five, fifteen more than ten, and so on ; as regards the tissues, those contain- ing most water, such* as the muscles, the cellular tissue, the spleen, etc., are more rapidly disintegrated than those which contain less fluid. Bones and teeth withstand the action of the current for a considerable time. The effect at the negative pole. Experiments on animals showed that needles attached to the negative pole of a battery could be inserted into and removed from the body without causing any loss of blood ; the current used did not appear to cause much pain beyond what was due to the introduction of the needles through the skin , the parts operated upon shrank sensibly after the operation, but there was neither inflammation, suppuration, nor sloughing. If the current was made to act upon the bloodvessels it was found that they were filled w^ith a foreign body, due to disintegration of the blood, and round which afterward a slow deposition of lamellated fibrine took place ; they were thus changed into solid strings wherever the current had been made to act. It appears fair to conclude from these obser- vations that the current can be safely and successfully applied to those parts of the body where shrinking and disintegration of tissue and obliteration of the bloodvessels may be required for surgical purposes. The sores produced on the skin by the nega- tive pole resemble those ])roduced by caustic potash, and the same may be said of the scars, for these latter are soft, and after some time wholly disappear^ A tivofold effect is produced. 1. Under the microscope it may be seen that the mechanical action of the hydrogen forms no inconsiderable part of the eflect produced at the negative pole. 154 GALVANISM. Innumerable bubbles arise as soon as the circuit is closed, which force apart the structural elements of the tissues. 2. Alkalies^ soda, potash and lime are also developed at the negative pole of the batterj^ The effect produced at the positive jyole. There is no collec- tion of oxygen at the positive pole, because it unites with the metal of which the needle is composed. To the chlorine and acids which are developed at the positive pole, together with the metallic salts resulting from oxidizing of the needle, is due whatever changes are effected there. Fig. 42. / NEEDLE CONDUCTOR. The needle conductor is composed of from one to six slender conducting cords, about four inches in length, attached at one end to a single metal holder for the conducting cord which connects it with the battery. Each one terminates at the free end in a metal needle holder. To use the conductor. Introduce the needles one by one into the tissues to be operated upon, then fasten the needle holders upon them and connect the conductor with the bat- tery. Complete the circuit with a single large moist sponge electrode placed on the skin at some indifferent point near by. The introduction of needles through the skin. This is usu- ally painful, and some means of lessening the pain must be adopted. When a large amount of work is to be done rapidly, which requires a powerful current, it is advisable to use ether by inhalation, or apply it in spray to render the skin insensible to pain, before introducing the needles. Beard and Rockwell state that a mixture of ether and carbolic acid GALVANISM. 155 in equal parts has a positively benumbing effect upon the skin where applied. The mixture can be localized upon a very small spot ; the benumbing effect begins to be felt in less than five minutes. It is frequently quite difficult to in- troduce the needles, when the tissues to be acted upon are firm, or where the skin is thick, in which case it is best to introduce them only a little way before completing the cir- cuit. As soon as electrolysis begins they can be pushed in more easily, provided they are connected with the negative pole of the battery. Effect of electrolysis upon the needles. When decomposi- tion of blood or animal tissues is effected by electrolysis, the positive needle (anode) is changed into a metallic salt, by the oxygen and chlorine set free. On the other hand, the necja- tim needle (cathode) retains its brightness, because hydrogen and free alkali do not attack metal. It is desirable, when but one needle is introduced, that it be the negative, except when the secondary effects, resulting from the presence of acids and metallic salts, are required, because the positive becomes roughened and firmly imbedded, so that its removal is frequently attended with considerable difficulty. When both a positive and negative needle are inserted, the positive should be first introduced where it is to remain during the operation, and whenever it is necessary to change the relative position of the needles the negative should be moved. Prof. Groh,* of Olmtitz, employs zinc needles for the positive pole, when the parts to be destroyed are highly vas- cular, so as to secure the secondary effect of the chloride of zinc, resulting from the action of chlorine upon the needle. The eschar under these circumstances resembles that produced by chloride of zinc paste, being greyish white, firm and dry. *Die Electrolyse in der Chirurgie. 156 GALVANISM. He employs electrolysis in two ways, either a powerful cur- rent for a short time under an anaesthetic, or a gentle current applied for days and nights consecutively. THE MCINTOSH NEEDLE-CASE FOR ELECTROLYSIS. A convenient case for electrolysis needles is shown in Fig. 43. It con- tains needles of various shapes and sizes, from the exceedingly fine plati- num or steel needle, for removing hairs, to the long and large needle suitable for operating upon uterine fibroids. A three-strand needle conductor is shown in the back part of the case ; also a connector by means of which a single needle may be attached to any electrode that terminates in a screw. Many styles of needle-cases are made, so that the physician who wishes to be prepared for electrolytic operations will have no trouble in securing one which contains an assortment adapted to the demands of his practice. BATTERIES FOR ELECTROLYSIS. Galvanic batteries in which the elements are arranged in series (the zinc of one pair connected with the carbon of the next) are suitable for electrolysis. The zinc and carbon combination give a much more powerful electrolytic current than any other, for reasons already given. It is essential, when large masses are to be operated upon, that the bat- tery have a sufiicient number of cells to enable the operator to add more cells from time to time, to keep the current at an approximately uniform strength. For short operations, four to six zinc-carbon cells will be sufiicient. A considerably greater number of zinc-copper or zinc-platinum cells will be required to accomplish the same work. GALVANISM. 157 The pain produced within the tissues by the electrolytic current is not severe, but at the alternate electrode applied to the skin, the burning or stinging sensation may be very un- pleasant. When an anaesthetic is not employed, the current at first should not be very strong ; it may be gradually in- creased without inconvenience. Fig. 44. Mcintosh twelve-cell galvanic battery. Length, 10% in. ; width, 8% in. ; height, T^^ in. ; weight, 12 lbs. The battery represented in Fig. 44 is adapted to all the smaller electrolytic operations, for which a few cells only are needed. An apparatus supplied with a less number of cells is not to be recommended, because it is important that in any operation there should be a few reserve cells to add, as needed, to the circuit. The battery shown in Fig. 45 is preferable for the general practitioner who wislies to apply electrolysis to a large variety of cases. It furnishes a current sufficiently powerful for any operation to which electrolysis is adapted, except certain 158 GALVANISM. malignant growths, for whicli the twenty-four-cell galvanic in- strument (see Fig. 31) will be required. DISEASES IN WHICH ELECTROLYSIS IS OF VALUE. The diseases in whicli electrolysis has been successfully em- ployed are chiefly tumors, serous efl'usions, strictures, wounds Fig. 45. Mcintosh eighteen-cell galvanic battery. Length, 143^ in. ; width, S% in. ; height, 1}4 in. ; weigbt, 15J^ lbs. and ulcers. It is also useful in the permanent removal of hairs. Disadvantages of electrolysis. It is not always easy to introduce the needles so as to destroy as much as possible in the shortest time ; and where extensive growths are to be destroyed, the applications must be frequently repeated or continued for a considerable time. The accumulation of hy- drogen at the negative pole causes a swelling of the tissues, and, if the operation is carried too far, the separation of GALVANISM. 159 Structural fibre by the hydrogen may cause too great destruc- tion, so that the tissues do not recover themselves after the operation, and disfiguring scars result. Advantages of electrolysis. According to Prof. Groh, tiiey are as follows : Very extensive tumors may be destroyed without the loss of a drop of blood, which is important in cases where there is prostration of strength. In three of his patients, the use of electrolysis enabled him to do with- out resection of the lower jaw, which otherwise would have been neces- sary, and would have caused great disfigurement. In a case of cancer of the rectum, where subcutaneous injections of morphine produced only slight and temporary relief of the intense pain, and where there was a most offensive smell from the ulceration, both fetor and pain disappeared after the first electrolytic operation. In a case of epithelioma of the lip, where the right submaxillary gland was considerably swollen, this swelling was dispersed a few days after one electrolysis. Finally, all cases progressed favorably without accident. The pain never continued beyond the application itself; there was only slight local and general reaction; the eschars which had been formed were rapidly thrown off: there was copious granulation, and such an amount of cicatricial con- traction as to cover the loss of substance caused by the removal of the growth. THE EXACT VALUE OF THE ELECTROLYTIC METHOD. Dr. A. D. Eockwell'^ offers the following summary of the exact value of the electrolytic method in surgical diseases, -according to his own experience : 1. The success to be met with in the treatment of malignant growths in general is but trifling. The size is sometimes reduced, and the pain is abnost always greatly alleviated. In the class of cases, however, termed epithelioma, when the disease does not extensively involve the subjacent tissues, and where it is easily reached, it is probable that in the majority of cases the very best results will follow thorough and persistent treatment. 2. Fibroids, being dense and comparatively dry, do not readily shrink under electrolysis, and it is seldom that we can accomplish more than *New England Medical Monthly, December, 1883. 160 GALVANISM. some slight diminution in bulk. The results following this limited in- fluence, however, are especially valuable in the case of uterine fibroids of an intramural character where the knife cannot be used. The press- ure upon the bladder and rectum is in these cases greatly lessened, or entirely dissipated, and the relief that follows is immense. 3. It is in erectile and small cystic tumors that electrolysis is most effective. In these conditions it is indeed a specific. The cure that follows is complete, and with proper care scars can be avoided. 4. The ordinary form of goitre acts somewhat capriciously under electrolytic treatment. Goitres that are small and soft may not only be treated effectually by the introduction of needles, but external applica- tions alone will sometimes cause them to entirely disappear. Even when they are quite large, if their density is not too great, a perfect cure may follow. Where they do not entirely disappear, they may almost in- variably be reduced in size, affording in many cases marked relief from the pressure that is so distressing. 5. By this method hairs may be permanently removed. The nega- tive pole and a weak current are to be used. 6. In many cases of urethral stricture permanent relief is afforded. A more extended experience, however, is necessary to establish its exact value. CHAPTEK V. GALVANO-CAUTERY. GALVANOCArTEKY, also Written galvano-causty, electric cau- tery, etc., consists in substituting a platinum wire or plate heated by electricity, for the ordinary actual cautery. This process is frequently confounded with electrolysis, from which it dif- fers in important particulars. It requires special apparatus that is not adapted to any other application of electricity. Electrolysis is the decomposition of com])ound substances by the chemical action of the galvanic current. During this process the needles or wires which convey the current to the tissues are not heated. Galvano-cautery is the burning of tissues by the heat de- veloped in a suitable instrument by the passage of a galvanic current through it. The effect produced is in no respect due to the action of the current on the tissues, and does not dif- fer from that produced by a cautery instrument heated in the usual manner. When the poles of a galvanic battery are connected by a conductor incapable of transmitting the current as fast as gen- erated, the conductor becomes heated, the degree of heat being proportional to the quantity of electricity and the resistance of the conductor. Platinum is a poor conductor, both of heat and electricity, and when introduced into a metallic circuit between the two poles of a suitable battery may be raised to a white heat. Advantages of galvano-cautery. 1. The great advantage ot galvano-cautery is that we can manage the currents with pre- cision and deliberation; very different from the haste required (161) GALVANISM. in using a red-hot iron. If the bottom of a cavity is to be cauterized, the instrument, while cold, is introduced slowly and gently; then, when located exactly where it is needed, the circuit is completed and cauterization begins. Breaking the circuit instantly arrests it. 2. This method of cauterizing occludes the vessels by clots, and thus not only guards against primary hemorrhage, but it also appears to lessen the liability to secondary hemorrhage. 3. It is infinitely less alarming to patients than the appa- ratus employed in ordinary cauterization, and protects them from any injury in the introduction or withdrawal of the cautery instrument. 4. It can be used in places where the employment of the knife would be inconvenient, if not impossible ; as in the neighborhood of delicate organs or in the depth of some natural cavities. 5. The operation is comparatively painless ; there is no shock to speak of, and the danger is reduced to a minimum. When the radiant heat is allowed to act, or the instrument is moved slowly, the pain may be quite severe ; but during the operation the extremities of the nerves are destroyed, there- fore there is no pain after it is completed. 6. It frequently preserves parts that would have to be re- moved in operating by the knife. 7. It is especially valuable in those cases where cauteri- zation of the wound is indicated after the operation. The eschar is very firm and renders the wound less liable than a moist granulating surface to miasmatic, putrid or purulent infection. CASES TO WHICH GALVANO-CAUTERY IS APPLICABLE. 1. Hemorrhages, which can be arrested in localities where i\ red-hot iron cannot penetrate and where vessels cannot be conveniently ligated. GALVANISM. 163 2. Neuralgia, in which it is desirable either to destroy a nerv^e (as a dental nerve) or to cauterize certain parts of the surface of the body (as in sciatica). 3. Certain paralyses. 4. Gangrene of ulcerations. 5. Cancers and other malignant growths. 6. Fistulse, sinuses, etc. 7. Kemoval of vascular tumors, such as nsevi, external hemorrhoids, etc. 8. Removal of polypi and other tumors from situations where ordinary instruments cannot penetrate. 9. Small amputations, as of the tongue, cervix uteri, penis, etc. 10. Strictures, especially when very firm, and un dilatable. Disachantages of galvano-ccaitery. There is considerable difterence of opinion in regard to the range of cases in which galvano-cautery is to be preferred. Some restrict it to a limited field, while others are disposed to extend it, on account of its simplicity and convenience, to a large variety of opera- tions. Certain disadvantages have prevented a more extensive employment of it by the surgeon, which are partially due to defects in the batteries designed for the purpose of furnishing a cautery current. 1. The galvano-cautery frequently cauterizes tissues very superficially, and consequently sometimes gives rise to hemor- rhages. 2. The small mass of platinum that can be heated by the galvanic current, except by employing batteries out of propor- tion to the work to be accomplished, renders it unsuited to cases where voluminous tissues are to be destroyed. It is not impossible, however, to perform all amputations by it. Dr. Burns, of England, records twelve amputations, eight of the thigh, two of the leg, one of the fore-arm, and one of 164 GALVANISM. the finger, performed by galvano-cautery. Bourdon, of Paris, has used it in eight cases of tracheotomy. With properly con- structed batteries, the current keeps the cautery heated suffi- ciently, so as to compensate by the continuity of its action for what is wanting in regard to the mass that can be heated. 3. The great difficulty in the way of maintaining a uni- form heat is due to contact of the tissues, bathed with liquid which prevents the wire arriving at the high temperature that it would possess in the air, not only by withdrawing heat from it, but by rendering it, in consequence of this cooling, a better conductor and less susceptible of becoming heated under the action of the current. 4. It is not impossible to raise a platinum wire to a white heat in the substance of the tissues gorged with moisture, but we are between two rocks, either not to heat the wire sufficiently, or to run the risk of melting it. This fusion is brought about in the small part of the wire which comes out close to the skin and which is more heated in proportion as the portion that is plunged into the tissues is more cooled by contact with the liquids. 5. Even when the wire, while still becoming greatly heated, does not melt in its entering and exit points it may only cauterize these points and not the interior, as we should expect. GALVANO-CAUTEEY EATTEKIES. The first requirement of a battery for galvano-cautery is that it furnish a current of large quantity^ in order to develop the necessary heat. Consequently a large element surface must be exposed to the action of the fluid. The elements are united in multiple arc and are brought very near together. The hat- teries constructed for galvano-cautery are unsidtahle for elec- trolysis or any other purpose than tJie one for which they are designed. GALVANISM. 165 Since it is important to be able to use conductors of variable volume, the current provided must be capable of raising dif- ferent sizes of platinum wire to a white heat, and of maintain- ing it there as long as is necessary to complete an operation of ordinary length. A galvano-cautery battery must therefore be provided with more than one cell, and a convenient current- selector for introducing additional power into the circuit as the current declines in strength, to maintain an even temperature in the platinum wire. When it is necessary to avoid the flow of blood, the wire must not be heated above a dull red, and the battery should be easily controlled in this respect. In brief, the essential requirements of a galvano-cautery instrument are portability, constancy, reliability, and simplicity of construc- tion. The storage battery, when it was first announced, was expected by continental authors to fulfill all requirements of a cautery battery ; but for some reason it has failed to meet their expectations, in its present state of development. Numerous instruments have been contrived for this purpose, but the difficulties to be overcome in constructing one that shall pro- vide a current just powerful enough to do the work required, without occasionally becoming uncontrollable, and either sud- denly fail in the midst of an operation, or fuse the platinum, have seemed almost un surmountable. Dr. Mcintosh has been experimenting for several years with a view to constructing an instrument that shall be satisfactory in every respect, and has been rewarded with a degree of success that promises well. He has now completed a Cautery Battery that is being tested by several well-known surgeons to determine how it meets the demands of practice ; and if future tests shall confirm those already made, it will prove to be the most desirable instrument yet constructed, and will add a new impetus to the practice of galvano-surgery. 166 GALVANISM. The instruments necessary for galmno-cautery. That por- tion of the circuit which is brought into contact with the tissues is made of platinum, and is usually in the form of a loop^ pointy Tcnife or dome. The handle is made to thoroughly insu- late the current, and at the same time to resist the heat. The connection of the platinum with the conducting cords is made with pure copper wire, of large size, which passes through the handle. The conducting cords are composed of a large bundle of fine copper wire, or a single copper wire of sufficient size to convey a large quantity of electricity. The loop is managed like the ecraseur, to which it is superior in that it sears as well as divides the tissues. It is used for pediculated tumors principally ; it may be used for tumors without a pedicle, by introducing needles through the base, and adjusting the loop between the needles and the sur- face to which the tumor is attached. Platinum points may be introduced into vascular tumors and afterward rendered incandescent. The tissue should be thoroughly cauterized before withdrawing the points, to avoid the possibility of hemorrhage. They may also be used to destroy dental nerves, granulations, to open abscesses and fistu- Ise, to cauterize the prolapsed recti of children (using a director if necessary). The platinum knife is simply a very small thin plate ; the best method of using it consists in successively repeating the contact of the incandescent metal with the parts operated upon. It is an error to suppose that this instrument will cut directly through a mass of tissue, like a surgical knife. It is extremely difficult to regulate the heat in a piece of platinum of this shape, so that it shall be just hot enough to do the work required, and at the same time not do injury to surrounding tissue by radiating heat, or even setting it on fire. The plati7iiC7)i dome consists of wire wound spirally in the form GALVANISM. 167 of a dome, as its name would imply. It is used as a eauterizer^ where a larger surface is to be acted upon than the points are adapted to, and as a moxa for counter-irritation. HISTORY OF GALYANO-CAUTERY. Dr. Fabre-Palaprat was the first to employ a platinum wire heated by a galvanic battery to produce moxas. A long time after, in 1845, M. Heider employed the same method to cauterize the dental nerves when painfully affected. In 1846, M. Crusell, of St. Petersburg, conceived the idea of cutting and cauterizing the tissues by means of a wire, or a thin plate of platinum, rendered incandescent by a powerful electric current, making it act after the fashion of a saw, by means of a backward and forward motion. Mr. Marshall, of England, soon after made numerous experi- ments in cauterizing the tissues of animals, corpses, and then of patients. He succeeded in curing a fistula of the cheek by means of a platinum wire of an inch in diameter ; he afterward used it for small tumors, cauterizing wounds, etc. M. Nelaton, from the year 1850, used it in the cure of erectile subcutaneous tumors, while preserving the skin. Dr. Amusat, Jr., by means of a platinum wire of an inch in diameter and 5 or 6 inches in length, removed cancerous tumors ; he also used thin plates, or ribbons of platinum, heated in the same way, and to which he imparted a backward and forward sawing motion to separate the tissues. Prof. Middeldorpfi", of Breslau, published the first important work on this subject in 1855. Dr. Maas* has collected 130 cases of noevus^ treated by galvano-cautery, most of which were operated upon by Dr. Middeldorpfi", in which the loop was used 39 times, the dome * Langenbeck's Archiv. fiir Chirurgie, 1871, p. 520. 168 GALVANISM. IT, and other forms in the remainder. In 112 cases there was a complete cure, 11 improved, three died, and in 4 the result was not known ; 4 cases relapsed ; death resulted once from hemorrhage, twice from lockjaw (once trismus and once tetanus). Duration of treatment was short ; in many cases the eschar separated between the fifth and tenth day, and a good cicatrix was formed without perceptible suppuration. M. Zielewicz'^ has collected fifty cases of amputation of the penis by the galvano-cautery loop. The operations were performed for cancer, gangrene, and once for an enormous papilloma ; 8 of the patients died ofblood poisoning in hospital ; none died in private practice. No hemorrhage ever occurred, in spite of numerous introductions of the catheter or bougies ; no surgical fever followed the operation. Contraction of urethra took place only in one case, which easily yielded to the use of bougies. Dr. Yoltolini, of Breslau, f was the first to use the galvano- cautery loop for the removal of a tumor from within the larynx. This operation has since been successfully repeated by others. Tracheotomy has been performed with the galvano-cautery knife. Mr. ErichsenJ has employed it in a considerable number of cases of cancer of the tongue with success. He considers the galvano- cautery loop one of the most valuable of modern applications of physical science to medicine. He emphasizes this point — amid undue haste^ and screw up the instrument slowly in 'proportion to the mscularity of the part operated on, Mr. Bryant, of Guy's Hospital, successfully removed an epithelial cancer of the perineum, and also a spreading lupus of the face^ by galvano-cautery. The former was accomplished after this manner without the loss of a drop of blood : It occupied the perineum, involving the anus and a portion of the * Langenbeck's Archiv. fiir Chirurgie, 1871, p. 589. tibid, 1865, p. 693. IBritish Medical Journal, February 15. 1873. GALVANISM. 169 recto-vaginal septum. He isolated the base by passing three large pins beneath it into the healthy tissues, the patient be- ing under the influence of chloroform. A strong platinum wire was next passed around the base of the tumor beneath the pins, and fixed to the ecraseur, was screwed home ; junc- tion was then made with a cautery battery, and with a few careful turns of the screw the growth was removed, leaving an ash-colored surface. Rapid recovery followed. Galvano-cautery has been used by oculists for cauterizing granular lids, and in diseases of the lachrymal ducts. Aurists have employed it for removal of polypi and other tumors from the auditory canal. It is so well adapted to nearly all the minor operations in surgery, and the advantages in its favor are so many, that only the want of reliable and con- venient battery has hitherto prevented it from coming into universal use. CHAPTER YI. FARADISM. When a current of electricity from one or more galvanic cells is passed through a coil of wire, the galvanic properties are modified and practically a new current is obtained, which is known under the various names of induced^ interrupted or faradic current. Among those who sought to explain the N principle discovered by Fig. 46. Ocrsted (see p. 118 gal- vanometer) was Arago, who found that the electric current im- parted a strong magnetic force to pieces of soft iron, steel, etc. He showed that if copper wire covered with silk or gutta-percha be coiled around a bar of soft iron, and a current be passed through the wire, the soft iron, although it does not form a part of the circuit, becomes powerfully excited. Each winding of wire increases the magnetism of the iron, and by employing a large number of windings a magnet of enormous power may be produced. Tills magnetism is not permanent; it ceases at once when the circuit is broken. In an instant the electric current may magnetize a bar by its passage and demagnetize it by its ces- sation. The same result follows if the coiled wire is separated from the bar by an insulating cylinder, as shown in Fig. 46. A bar magnetized in this way is called an electro-magnet. Electro-magnets possess much greater lifting power than natural (170) FARADISM. 171 magnets of the same weight. Prof. Henry describes one that oonld lift thirty-five times its own weight, while the most powerM natural magnet known at the present day sustains but six times its own weight. Nearly all the practical applications of electricity have been made by combining electricity and magnetism. No telegraph sends a message from one place to another, no telephone acts, no electric motor or electric light can be operated, with- out a magnet of this kind. Its great usefulness lies in the fact that its magnetization is wholly under the control of the current. In 1831 Faraday discovered that a galvanic current pass- ing through a wire induces a current in another wire near to and parallel with it. The wire through which the galvanic current passes is called the primary wire, and the current primary or direct. The parallel wire is called the secondary or induced circuit, and the current passing through it an induction^ secondary or faradlc^ in honor of its discoverer. These wires are usually arranged in coils composed of many, layers of wire, the primary coil lying within the secondary, from which it is separated by insulation. A steady flow of electricity through the primary coil will produce no effect over the secondary so long as it flows without inter- ruption ; yet if it be suddenly broken, a momentary wave or current will instantly flow through the other in the same direction as the original current. If now the current be re- established through the first coil, another momentary wave will pass through the second coil, but in an o])posite direc- tion to the one passing through the first coil. Increasing or decreasing the current affects the direction of the momentary current in the same way as starting or stopping tlie primary current. 172 FARADISM. INDUCED CUERENTS. Induced currents include primary^ secondary^ tertiary and extra currents. They are distinguished from galvanic or direct currents by certain properties, that will, be considered in the following order : 1. Direction. 2. Magnetic induction. 3. Self-induction. 4. Potential. The direction of the primary current. The moment the circuit, including one or more galvanic cells, is completed, a current passes through it from the positive to the negative pole, as already explained, and indnices a current in a wire near and parallel to some portion of the wire of the circuit. The direction of the secondary ciirrent. This induced cur- rent is in an opposite direction to that passing through the circuit, as may be shown by a delicate galvanometer, but it is momentary only, and the needle, at first deflected, quickly resumes its natural position. As soon as the needle is at rest, break the circuit to arrest the current from the cells : the needle will be again deflected, but in a direction opposite to its first deflection, showing that, at the instant the circuit is broken, a current is induced in the parallel wire in the same direction as that passing through the circuit. The direction of the second- ary or induced current varies continually, as follows : {a) At the instant the galvanic circuit is closed the induced current moves from negative to positive, or opposite to the "primary current. (5) At the instant the galvanic circuit is opened the induced current moves from positive to negative, or in the same direc- tion as the primary current. (otential of the galvanic current from a single cell is enormously increased by induction, and the potential of induc- tion currents is still fuiiher increased by introducing into the cavity of the coil a center-piece of soft iron which is called the core. RHEOTOME OR CURRENT INTERRUPTER. It is necessary that the primary current be constantly in- terrupted in order to secure a secondary current ; therefore some mechanical device must be employed which shall auto- matically keep u]) a regular succession of interruptions. Mode of Action. When the elements are immersed in Huid and the external circuit is closed, the current from the conducting plate jDasses directly to and through the primary coil of wire, w4ueh renders M a magnet. M then attracts FARxVDISM. 175 H and draws the spring away from X', against which it nat- urally rests. This breaks the current, for the circuit is com- plete only when X' touches X. Fig. 47. Fig. 47 represents a current interrupter or rheo- tome, also called a "make and break," a "vibra- tor," etc. M, the end of the core within the coil, com- posed of a bundle of soft iron wires. H, the hammer on a moderately stiflf spring, fastened to post R, which has direct connection with the primary circuit, as may be seen in Fig. 48. X, a platinum point on the spring. Platinum is used because it does not easily corrode. X', the platinum tip of screw, Avhich merely touches X. T, the thumbscrew, which may be turned to regulate the contact of X' with X. When the current is broken, M loses its magnetism and no longer attracts H, therefore the spring is free to rest against X'. The instant the spring flies back to permit X to touch X' the circuit is complete again. M becomes a magnet, attracts H and the current is interrupted ; thus II is kept rapidly vibrating back and forth between M and X' and gives rise to a buzzing sound. These constant interrup- tions keep up an induced current in the secondary coil, through which, as we have already seen, the current passes in one direction at the instant the circuit is complete, and in the op- posite direction when the circuit is opened, hence the induced current must move equally "to and fro," instead of princiiDally from positive to negative points, like tlie primary current. If the vibrating spring is too weak, the current will be broken at a time when the core has but small magnetic strength, and a feeble induction current is produced. If the spring is suffi- ciently stiff it may be so arranged, by increasing or decreasing the pressure of the screw T, that the current is not broken till the core has received nearly its full amount ot magnetism, and 176 FARADISM. consequently a much stronger induction current is generated. When a current, with an electro-motive force too great for the capacity of the coil, is sent through it, the platinum points, X' X, may be fused by the heat of the sparks produced, and the coil itself be damaged, since wires become heated when a current of greater quantity than they are capable of readily conducting is carried over them. For this reason but one or two cells are employed for producing a faradic current. THE HELIX OR FAKADIC COIL. Fig. 48 represents the arrangement of the coils of wire forming a helix. It will be noticed that the inner coil alone is connected with the elements. The outer coil is connected only with the binding posts, from which the secondary current is obtained. The vibrator attached to R magnetizes and de- magnetizes the core with great rapidity. Fig. 48. a a, several layers of coarse insulated copper wire wound around an insulating spool. This is the primary coil. b b, many layers very fine insuated copper wire wound over a a, from which it is separated by an insulating material. This forms the secondary coil. M, the core or magnet, composed of soft iron wires inclosed within the insulating spool. S, the shield covering the core, which can be drawn out when necessary. C, the conducting plate of the battery, connected with one end of the coarse wire forming the inner coil. Z, the generating plate connected with the post R. R, the post of the current interrupter or rheotome. H, hammer at end of rheotome spring. The wire above H is the outer end of the coarse wire coil connecting R with the post holding screw T, and also with P, the posi- tive pole of the primary current. N, the negative pole of the primary current, is connected with R. X X, platinum points on tip of screw and on spring. P 2, positive pole of secondary current. N 2, negative pole of secondary current. FARADISM. 177 The primary or inner coil is composed of comparatively coarse wire, in order that it may offer little resistance to the pas- sage of the current from the cell, and at the same time exert a powerful magnetic effect upon the core and layers of the outer coil. The secondary or outer coil is composed of a great length of fine wire (the length and size of which must be proportioned to that of the primary), because the potential of the induced current is proportional to the length and fineness of the wire over which it passes. This coil is completely insulated from the primary coil, and receives its electricity purely by induction. The quality of the faradic currents depends not only upon the length of wire composing the two coils, but also upon the relative size^ perfect insulation^ the care with which the windings are made^ and the connections. The value of a faradic battery depends very much upon the skill of the mechanic who makes the helix and connects it with the base. The strength of the faradic current depends almost entirely upon the construction of the helix ; the strength of the galvanic current^ upon the kind and number of cells in the circuit. There is seldom any advan- tage to be gained by using more than one or two cells for the faradic current, since, as before explained, a current possessing greater quantity than a wire can easily conduct, heats it in passing, and, in consequence, is liable to damage the insulating covering of the wire ; or the current may overcome the resist- ance of the insulation, and pass across from one layer of wire to another, completing the circuit within the helix itself, in which case it will cease to pass through the external circuit. T/ie primary current. The current passing through the pri- mary coil is called the primary current. It is direct from the cell, and passes in the same direction as the galvanic current, from positive to negative ; it deflects the galvanometer needle, and possesses feeble electrolytic power. 12 178 FARADISM. The secondary current is that which is obtained from the secondary coil. Its direction at the instant of closing the circuit is opposite to the primary current, at the instant of opening the circuit in the same direction ; therefore it is appropriately called a "to and fro" current. The core or magnet. The primary current has its inductive power greatly increased by putting a bar of soft iron or a bundle of iron wires through the center. At the instant the primary current starts, it renders the central bar a magnet, but the magnetic power is lost instantly on arresting the current. At the instant of acquiring and losing its magnetism, it induces a current in the primary coil in the same direction as the jprimary current., and therefore strenghtens it. A bundle of wires is superior to a solid bar of iron for the central core, because the former acquires and loses its magnetism more readily than the latter. The shield. Prof. Dove, of Berlin, has shown that the potential of an induced current is much diminished by covering the core with a closed tube of non-magnetic material, such as brass or copper. Induced currents are developed in the shield, whereby the magnetism of the soft iron core is counterbalanced ; as the shield is withdrawn to permit the inductive influence of the core to act upon the primary coil, the strength of the current is increased. NUMBER OF CURRENTS A BATTERY SHOULD FURNISH. Since attention is frequently called to batteries which are said to furnish ten or more distinct currents, it may be well to explain how these numerous currents are obtained. The secondary coil being composed of many layers of wire is tapped at intervals throughout its length, and each branch wire is connected with a binding post. The post, to which the inner extremity of the secondary coil is attached, is always FARADISM. 179 used as one pole, while each of the other posts in turn may serve as the alternate pole. By this method it is possible to obtain as many currents as there are layers of wire in the coil ; these only differ in having passed through different lengths of wire; they are all "to and fro" currents, and do not differ therapeutically from the various modifications of the secondary current from the entire coil produced by withdrawing the shield from or replacing it over the core. aAKEn-cn Fig. 49. Mcintosh physicians' faradic battery no. i. Length, 8 in. ; width, 6^ in. ; height, 7 in ; weight, 7 lbs. A simple and convenient form of a physicians' faradic bat- tery is shown in Fig. 49. The hase^ upon which is fastened the helix, rheotome and binding posts, is made of polished black rubber. It is covered on its lower surface with a sheet of soft rubber, which insulates and protects the connections lying beneath the hard-rubber base. The connections consist of copper wires that join the pri- mary coil with the elements, and both primary and secondary coils with the binding posts. 180 FAKADISM. The hinding posts, rheotome, and metal parts on the base, are heavily nickel-plated, which enables them with reasonable care to resist corrosion or tarnishing for years. The helix is skillfully constructed of a great length of well insulated pure copper wire ; the two coils are perfectly insu- lated from each other ; their relative size and length is such that the currents furnished are exceedingly smooth and yet possess great potential ; they can be graded perfectly, so that currents suitable for the most delicate applications to the eye, ear or brain, or too powerful to be endured by a healthy per- son, are alike at the command of the operator. The primary current is obtained by inserting the conduct- ing cords in binding posts P (positive) and N (negative), at each end of the word ''primary." The secondary current. The electrodes in Fig. 49 are shown connected with the binding posts from which the secondary current is obtained. Both currents are increased hy withdrawing the shield from the helix. 1 he elements are a single pair of zinc-carbon plates fastened beneath the base to the screws seen in the illustration beneath the rheotome hammer. The cell. This is a hard-rubber section comprising a cell and drip-cup, which is illustrated and described on page 198. The hattery fluid is made after the formula given under the Grenet cell. The battery in Fig. 49 is ready for use, the elements being immersed in the fluid of the cell. When the battery is not in use, the base should be reversed, which places the elements in the empty drip-cup. The spring on the top of the helix serves as a handle, by which to lift the base, when the battery is open ; when it is closed, the top of the cover presses on this spring and holds the base firmly over the cell; the soft rubber lining the FAKADISM. 181 base acts as a hydrostat and prevents any spilling of fluid when the battery is carried about. A space each side of the cell section affords room for the conducting cords and a pair of electrodes like those in the illustration. Fig. 50. Mcintosh physicians' faradic battery No. 3. Length, 8 in.; width, 8 in.; height, 1%in.; weight, 1^ lbs. B B, bars connecting the elements with posts on large base. E E, posts having direct connection with the primary coil. 1, 2, binding posts. D, indicator which points out the polarity of the current. C, pole changer. L, switch which connects the primary and secondary coils with the binding posts. The lock and hooks which fasten the cover upon the bat- tery are heavily nickel-plated, of special design and extra strength. They are manufactured by the Mcintosh Galvanic & Faradic Battery Company expressly for this purpose, and are much superior to similar fastenings usually found on bat- 182 FARADISM. teries. The instrument illustrated in Fig. 49 is a type of the simplest form of medical battery. It is sufficient for most general applications of faradism, but certain other accessories are convenient, and for localized faradization sometimes essential. The helix, rheotome, elements and cell section of No. 3 battery are the same as in the battery last described. The hase in this instrument is divided, the narrow portion serving as the hydrostat, and the wide as a cover for the elec- trode space, which is considerably larger than in battery No. 1, and affords room for several additional instruments. The elements are attached to the narrow base, and connected with the helix through the bars B B ; they are removed from the cell to the drip-cup by reversing this narrow base only. They are insulated over the upper fourth of their surface after the same manner as the elements in the Mcintosh Grenet cell, so as to perfectly protect their connections from corrosion or deposits of salts, and insure perfect connection until the zinc is worn out. (The fluid has little effect upon the carbon.) The switch L turned upon the button next the coil, as shown in Fig. 50, sends a secondary current through the binding ]>osts ; turned upon the button next the front edge of the base, it sends a primary current through the binding posts ; turned on the central button, no current passes through the binding posts. When it is desirable to locate the electrodes before sending a current through the circuit, as is sometimes the case, the battery may be made ready, and everything adjusted, while the switch is on the central button, and either current may then be sent through the patient by moving the switch forward or backward. Switch L may be used as a current interrupter when it is desirable to artificially regulate the rapidity of the faradic interruptions ; it is moved back and forth between the central button and the one from which the current is taken, at suitable intervals. FARADISM. 183 The pole changer 6^ is a double switch, which in the cut is represented moved toward binding post 2, so as to uncover button D, upon whicli is a hand pointing toward binding post 1, indicating that the latter is positive, and consequently post 2 is negative. Moving C toward post 1 uncovers a button, upon which is a hand pointing toward binding post 2 as positive, when post 1 becomes negative ; by this means it is possible to change the polarity of the current in an instant without removing the electrodes from the patient. The binding posts are of the style represented by A in Fig. 27, which give the most perfect and durable connection between conducting cords and battery. The nickel-plated metallic parts of this battery, contrasted with the polished black rubber base, make a beautiful appearance, while its light weight and perfect construction render it a most desirable instrument for those who employ faradism only. R The hydro-rheostat is used to interpose resist- ance in the circuit, so as to delicately modify or soften the current for applications to the eye, ear, brain, or in the treatment of patients who are excessively sensitive to electricity. Fig. 51 consists of a glass tube, 0^2 inches long, for holding water, securely fastened to a hard-rubber base below, and a metal cap above. M is a metal plate that closes the lower end to prevent the escape of water, and affords a metallic connection with one binding post. R, a metal rod passing through the center of the glass tube ; it may be raised any distance above M. S, a setscrew to fasten R at any height required. a a a, nuts terminating metal rods that hold the rubber base and metal cap firmly against the glass tube. B B, binding posts, one of which is connected with the metal cap through the rods, and the other with M as before stated. To use the hydro-rheostat. Connect one pole HYDRO-RHEOSTAT. Height, 914 inches, of the battery with a binding post B ; connect the other binding post with any suitable electrode. The alter- nate pole of the battery is connected directly with another elec- 184 FAKADISM. trode. Locate the electrodes precisely the same as when no rheostat is used. The method of introducing it into the circuit is illustrated in Fig. 37. The rod R is raised to interpose two, three or more inches of water between its lower end and M. Raising R increases the interposed resistance ; lowering R lessens it. The operator can test the effect it produces by holding the electrodes while a current is passing through the circuit and R is being moved. METHODS OF EMPLOYING FAKADIC CURRENTS. The application of faradic currents to the treatment of disease began in 1832, within a year after their discovery, and has continued in use ever since, having been probably more extensively employed both by the profession and public than any other form of electricity. This is owing, in a measure at least, to the simplicity of the apparatus for its production, as compared with those for franklinism or galvanism. The decline in professional favor of franklinism has been attributed by some authors to the circumstance that electrical machines used to be hauled about the streets on carts and exhibited at fairs for the purpose of " shocking the curious by scores," as a cure for all imaginable ailments. The same objection may be urged against faradism, with equal justice. The "peripatetic electrician" now uses an elaborate street battery, ornamented with the legend "Electricity is Life," by which the faradic current is administered to the public pro- miscuously. While it is natural that the professional man, conscious of superficial attainments, and correspondingly jealous of any assumption of his peculiar privileges, should, in self- defense, ignore or condemn everything that smacks of what he may deem charlatanry ; yet it is nevertheless true that those who possess the qualification for deciding upon the com- parative merits of remedial measures do not reject an agent FARADISM. 185 that is of value from fear that they may be styled a specialist in the use of that agent, or be classed with charlatans in con- sequence of using it. There is scarcely an article of value in the materia medica that, between the patent medicine vender and the ignorant self-prescribing of the laity, has not perhaps accomplished more harm than good, and yet this is not offered as a pretext for rejecting all drug medication ; neither should an agent that is capable, in skillful hands, of accomplishing such excellent results as electricity be discarded by the pro- fession for any other reason than its failure to accomplish the purpose intended. To Duchenne is due the honor of reducing faradism to a system. In the year 1855 he published a work^ describing his method of localized far adization^^^ ^hich. he had been engaged nearly ten years in developing. He carefully studied the func- tions of the muscles in the living body, and succeeded in producing contractions of all the muscles separately and in groups ; mapped out those which give expression to the face, and made some remarkable discoveries in regard to the con- dition of the muscles in certain forms of paralysis. He pointed out that there is a difference both in the physiological and therapeutical effect of the primary and secondary cur- rents. PRIMARY AND SECONDARY FARADIC CURRENTS COMPARED. (a) The primary current is com- (a) The secondary current is com- posed of a single induced current, posed of two currents going alter- always going in the same direction, nately in contrary directions. (6) The primary exhibits galvanic (6) The secondary does not de- properties, in that it deflects the gal- fleet the galvanometer, although it vanometer, and possesses feeble elec- may cause a very delicate magnetic trolytic power. needle to oscillate slightly. * " De r Electrisation Localis^e, et de son Application £i la Physiologic, a la Pathologic, et 1 a Th6rapeutique." 186 FARADISM. (c) The primary has more power (c) The secondary excites more to excite the sensory and motor acutely the cutaneous nerves, and nerves of the muscles. penetrates more deeply into the tis- sues. (d) The primary is relatively less (d) The secondary possesses dis- rapidly interrupted. tinct properties in virtue of its rapid interruptions, and far surpasses any , other form as a stimulant to the nerves of sensation. LOCAL FARADIZATION. This term should not be understood to mean that the cur- rent can be confined to the electrodes and the limited place between them. Every form' of electricity is propagated in waves from the electrodes in every direction through the tis- sues ; and although it may follow the course of nerv(i or muscle a little way from the electrodes, the fluids of the body are so much better conductors, that electricity traverses them in pref- erence to the solids. Duchenne claimed that the faradic cur- rent could be made to influence the skin only, without pene- trating to the organs beneath, or it could be made to pass through the skin without irritating it, and act on the nerves or muscles \>eneatli. He employed induction currents accord- ing to four methods : 1. Faradization of the skin. 2. Direct muscular faradization. 3. Indirect muscular faradization. 4. Faradization of the internal organs and special senses. 1. According to the first method, the skin and elec- trodes should be dry ; if the former is naturally moist, starch or lycopodium powder must be dusted over it to absorb the moisture. 'Various names have been given to the different methods of faradizing the skin, among which are the follow- ing : The elecl/ric nail^ a small metal disc, held at one point for some time, while a faradic current ])asses through it, produces FARADISM. 187 a sensation like a red-hot nail pressing into the flesh, hence the name. Electric cauterization^ a wire brush moved over the skin produces a sharp, burning sensation, that has been compared to that caused by cautery. Electric furtigation^ a tinsel brush struck lightly against the flesh; it is exceedingly painful, and has been compared to the sensation produced by beating with sticks. ElectHc nwxa^ the same brush held steadily against the skin produces a burning sensation, which increases as long as the brush is held there, hence the name moxa. It is very painful. 2. Direct muscular faradization ma}^ be performed in either of two ways : {a) The percutaneous method^ in which the electrode is placed on the skin. {b) Electric acupuncture^ in which needles are passed di- rectly into the muscle. The first is the usual method. The skin and electrodes should both be well moistened with warm water, and the con- tact be firm and even, so as to lessen, as much as possible, the resistance of the skin. Electric acupuncture was introduced into practice by Salandiere more than fifty years ago. He employed static electricity through needles. Fabre- Palaprat was probably the first to apply the galvanic current in this way ; it is not certain who first employed the faradic current in electric acupuncture. It was revived some years ago in England by Dr. Morgan, with such remarkable success in certain cases as to prove that it is worthy a place as an accepted mode of applying electricity. The needles used were the finest manufactured, about two to four inches in length, terminating in a knob at one end. They are 7iot insulated, and are inserted in the muscle to be contracted. One elec- 188 FABADISM. trode, usually the positive, is placed at some indifferent spot, and the negative metallic electrode is touched to each needle separately, and in succession. The instantaneous upward and downward movement of the needle shows contraction of the muscle. 3. Indirect muscular faradization consists in localizing the current in the nerve plexuses or branches which supply the muscles. Duchenne discovered that at certain points on the skin, muscular contractions could be produced more readily than at others. Eemak pointed out that these spots were located wherever a motor nerve enters a muscle. Ziemssen* demonstrated the precise location of these points, first by marking the points on the living body where the current produced muscular contraction, and afterward by dissecting the motor branches of the nerves in dead bodies, marking their points of entrance into the muscles, these mark- ings were found to exactly agree ; therefore a knowledge of these motor points is now regarded as essential to the scien- tific faradization of the muscles. 4. The last method, treatment of special organs and senses, requires suitable instruments adapted to the parts, so that the current may be carried direct to their tissues, or to the origin of their nerve supply, and will be described in connection with the diseases of those parts. GENERAL FARADIZATION. M. Dropsy, of Cracow, published in 1857 what he termed ^'a new method of applying electricity," which consisted in dividing the current from one pole, by means of a bifurcated conductor, placing one electrode over the head, the other over the stomach ; while the current from the alternate pole is divided in the same manner between the hands and the feet. * Die Elektricetat in der Medecin, 1857, Berlin. FARADISM. 189 M. Gubler, in 1863, proposed a better method of general fara- dization, which was to place both hands and feet in four sepa- rate basins of salt water, with which the four conductors were 6>5zY/t'6 current applied through the electrode at the neck. The electrodes are located, and then the circuit, in- cluding from six to ten zinc-carbon cells, is closed ; after two to three minutes the current is gradually reduced in strength by disconnecting cells one by one from the circuit. On the contrary, when there is a paralytic condition of the vaso-motor nerves, shown by fullness of the bloodvessels and injected eye, the electrode at the neck should be negative^ and the current should be interrupted, or in some cases repeatedly reversed, by means of a pole-changer. This treatment usually brings a sense of comfort and relief in a very short time, and in some cases it appears to produce a lengthening of the interval between attacks. Fig. 89. CARBON ELECTRODE. Diana, of disc, 1% in. The handle of this electrode is made of polished black rubber, in the same style as the universal handle, to which it is superior in that it is not affected by moisture. A is a disc of carbon, insulated, except on its anterior face, with hard rubber. B represents the carbon face of the disc. A sponge may be attached to it in the same manner as described under Fig. 86, or it may be used with the cover shown in Fig. 79. When located over a point that has little sensitiveness, it may be used without a cover. Carbon is superior to all other substances employed for electrodes in cleanliness and freedom from corrosion. Faradism. Frommhold and Fieber recommend the induced current. The former ])refers the primary faradic, with one pole high up the back of the neck in the median line, and the other over the forehead or over the eyebrows. Fieber prefers 282 ELECTEO-THERAPEUTICS. the electric hand. The patient holds one electrode and the operator the uninsulated portion of the other, while his free hand is passed over the patient's head. Forms of headache, de- pendent upon disease of some other organ, require treatment applied at the seat of the disease, instead of to the brain exclusively. General faradization and central galvanization are both beneficial in many cases where headache is a frequently recurring symptom. Inctpiekt Insanity. — Galvanism possesses great value as an adjuvant, when properly applied, in antagonizing various con- gestive states of the brain, which, if unchecked, would undoubt- edly result in organic disease. Typical cases of nerve exhaustion, accompanied by congestion of the brain, impaired nutrition, dullness of perception, melancholia, inability to bear stimulants, with restlessness, sleeplessness, perspirations, and loss of elasticity of the skin, are relieved by applying the galvanic current to the head daily for a period of not more than five minutes at each sitting, as a rule, but repeating the application twice daily if necessary. Ame- lioration follows, which lasts longer each time, and results finally in a cure. The most severe forms of cerebral congestion are amenable to this treatment, even when accompanied by a loss of consciousness. A proper tonic contraction of the cerebral bloodvessels is secured, thus heading off, perhaps, mental disease. In the application of the constant current to the brain to antagonize various congestive states, the positive pole is to be placed at the level of the first cervical vertebra, and the negative at the level of the superior ganglia of one of the cervical sympathetic nerves. The current should be interrupted, since vascular contraction occurs most markedly at the opening and closing of the circuit. — Dr. Mann. Dr. Arndt, of Greifswald, has thoroughly tested electricity in many forms of insanity, and has arrived at these conclusions : Faradism is a powerful stimulant upon diseased nervous centers, and should therefore not be employed where the symp- toms point to increased excitability, i.e.^ in all so-called primary cases. It also does not answer in secondary cases, if they are marked by a high degree of irritable weakness and a tendency ELECTROTHERAPEUTICS. 283 to reflex actions. It is an excellent remedy in cases of simple atony of the brain, depression, or paralysis of function. It must not be forgotten that some conditions of excitability are not owing to irritation, but to paralysis; and some forms, of stupor may be caused by spasm and not by depression. The latter may be looked for when there are symptoms of irritation in other organs ; for instance, where respiration is sighing or jerky, where there is much hiccough or gaping, irregularity of the heart's action, dilatation of the pupils or difference in their size, spasms of voluntary musics, etc. When no such symptoms are present, the condition may be looked upon as one of depression, which faradism will relieve. Faradization of the dry skin, and especially electric Instiga- tion of the upper half of the body, sometimes proves an excel- lent measure in disease of the brain, through its reflex action. Arndt recommends faradization of the phrenic nerves at the neck (see Fig. 72) in depression of the nerve centers. This rule has been given for the use of galvanism in insanity: Recent cases and functional diseases are benefited hy it^ while old cases and structural diseases resist its influence. Melancholia. — Franklinism. Dr. Blackwood^ reports a case illustrating the beneficial effects of franklinic electricity in suitable cases. A B, a case of melanchoha persistent for four years, in all except the mental state, healthy, and not at any time hysterical or excitable. Drugs failing, she was referred to me for electrical treatment, her physician being glad to drop the case. I put her on general faradization four times a week, with some benefit after a month's trial, but, not being satisfied myself, I substituted static electricity, and her improvement in another month was decidedly greater, and then she was at times not only cheerful, but her interest in surrounding affairs was noticeable to her associates. This method of treatment, without any auxiliary, in four months did more toward recovery than all former plans combined, and so far the improve- * Medical Times, October 22, 1881. 284 ELECTRO-THERAPEUTICS. ment is permanent. She was treated by simple charging when insulated, triweekly, the condition being maintained for half an hour at each time ; and although to my mind she is yet abnormally depressed at times, she is in every way better, and her friends consider her recovery perfect. Neuralgia of the brain will be considered in connection witli neuralgia of other organs. Morbid Depositions in the Brain. Gal/oanism has been used by Althaus to remove morbid depositions from the brain. Hughes'^ states that he has seen paralysis of one side of the body, loss of voice, and difficulty in swallowing, from disease of the brain, disappear under its use combined with internal medication. Dr. Barraquer has employed magnetism in a case of paral- ysis from cerebral hemorrhage occurring three years previously. A powerful electro-magnet, weighing 250 to 300 pounds, was held within an inch of the crown of the head for a few min- utes. There was visible improvement after the first sitting, and after four the patient could fully extend his forearto and fingers. Sleeplessness (Insomnia). — Cases of sleeplessness frequently prove very difficult to relieve, and it sometimes occurs that after drugs have failed to overcome it, electricity proves suc- cessful. It is a desirable substitute for hypnotics, where it can be made to answer the purpose, and precludes all danger of rendering the patient a victim of opium or chloral. Franklinism, galvanism and faradism have each proved suc- cessful, and no general rule can be given for selection, unless this may be regarded as one. That form of electricity best adapted to the disease which gives rise to insomnia should be given the first trial : frequently an application to the diseased organs will be followed by sleep. "When insomnia is produced *G. H. Hughes, M.D., St. Louis, in a paper read before the Association of American Institutions for the Insane, at Toronto, Canada, June 14, 1881. ELECTRO-THERAPEUTICS. 285 by mental anxiety or exhaustion, electricity may temporarily produce sleep, but in all cases the removal of the cause is an essential factor in treatment. A prolonged application of a very mild current is advisable when the trouble is due to an ex- cited or irritated condition of the brain or nerves; no muscular contractions should be produced when the faradic current is used, and no burning or stinging sensations with the galvanic. Faradism. Apply a mild faradic current, one electrode over the solar plexus, the uninsulated portion of the other in the left hand of the operator. The whole person of the patient is then gently stroked with the dry right hand of the operator; the sponges or electrode covers must be well moistened. The most grateful effects are obtained v/hile brush- ing over the back and limbs. A very mild current may be applied half an hour; a current that will produce the crackling of dry cuticle is enough. Galvanism. When the above measure fails, galvanism may succeed. Two to four zinc-carbon cells are sufficient. The negative pole is placed over the solar plexus, and the positive is applied through the hand of the operator to the top of the head (avoiding the forehead), down the neck on each side as in central galvanization. [Blackwood.] THE EYES. Effect of the galvanic current. The eyes, owing to the large amount of water they contain, are excellent conduc- tors. Volta, so long ago as 1800, discovered that the galvanic current has a special effect upon the optic nerve. The current from a single pair of elements, when an elec- trode is placed on each eye, produces a faint flash of light at the commencement of the current ; while the current is passing, a luminous appearance is present to a person with sensitive retina, and there is again a distinct flash when the circuit is broken. Heimholtz made a real advance in electro-physiology. He observed that the descending current (the positive electrode on the ELECTRO-THERAPEUTICS. forehead and the negative held in the hand) produces not only irritation, but alteration of excitability, external objects becom- ing less distinct. The eifect of the ascending current (the positive electrode in the hand and the negative to the forehead) is to render objects more distinct. To carry the current directly to the optic nerve, according to Brenner, the most favorable arrangement is to place one electrode over the eye and the other at the nape of the neck. Fig. 90. SPONGE-COVERED EYE ELECTRODE. This electrode is to be used when the current is to be applied equally to both eyes at once. The fiat sponge-covered plates are moistened in warm water and placed on the closed eyelids, and connected through the binding post with one pole of the battery. The bow is insulated with hard rubber. This electrode is retained in place by means of an elastic cord passing around the head and tied in the small loops projecting from each eye-piece. Effect of the faradic current. The primary current pro- duces no appreciable elfect, but the secondary gives a more or less rapid succession of slight blue flashes, or glimmer, similar to that observed in hyper^esthesia of the retina. Caution. The fact thai the physiological effects of galvanism differ from those of faradism cannot be made too emphatic. Duchenne, being unaware of this important fact, after treating a patient suffering from paralysis of the facial nerve with faradism without accident, afterward applied a galvanic current. Immediately after the circuit had been completed, the patient cried out that the whole room was in a blaze, and found his sight on the side ^vhere the electrodes had been applied ELECTRO-THERAPEUTICS. 287 was lost, and he never regained it. Faradism has much less effect on the retina than galvanism, and is not so likely to do harm. Fig. 91. EYE-CUP ELECTRODE. This is a glass eye-cup with a metal binding post attached and projecting a little into it. When used, the cup is filled with water and connected with one pole of the battery. It is very useful in treating paralysis of the muscles of the eye. The water serves as a rheostat to modify the current. DISEASES TO WHICH ELECTRICITY HAS BEEN SUCCESSFULLY' APPLIED. Amaurosis, Amblyopia, Atony of optic nerve. Blindness following fevers, etc., Double vision (diplopia), Granular lids. Strabismus (cross-eyes), Hallucinations of sight. Nsevus of eyelid, Opacities of cornea and vitreous humor. Paralysis of the muscles, Removing fragments of metal, Spasm of eyelids, Trichiasis (inverted eyelashes). Electricity may he applied, 1. Directly, one pole being applied to one or both eyes, and the other at some distant point. 2. Indirectly through the sympathetic nerve. 3. Indirectly by reflex action of the fifth nerve. Amaurosis. — Gaha/nism. A mild current may be passed through the eyeball so as to traverse the retina, or confined to those twigs of the fifth pair of nerves that ramify on the forehead. When these nerves are to be stimulated, interrupt the current with a rheotome introduced into the circuit. Grapengresser introduced a nasal electrode, connected with the positive pole, into the nose, and placed the negative upon the 288 ELECTRO-THERAPEUTICS. forehead. It is rare, when sight is completely gone, that it can be restored by any means; yet Magendie cured one case of complete amaurosis by galvanism and electro-puncture. M. Ptirjinke believed that the direction of the current is impor- tant. When the amaurosis is at its commencement, and is accompanied by subjective pains, he placed the negative as near as possible to the eye upon which he desires to act, while it is the positive electrode which he thus places when the amaurosis commences by a weakening of the sensibility of the retina. The opposite pole is placed near, as, for instance, in contact with the buccal gland. Amaurosis, accompanied by congestion of the brain, should not be treated by electricity. FranMinism. De Saussure cured a case by shocks direct- ed from eyeball to the neck. After filling the cup full of water, let the patient bow the head, close the eye, and press the cup up firmly around the eyeball, so that when the head is raised water will cover the eyelid. If the patient remembers to bow the head before the electrode is removed, not a drop of water need be spilled. Warm water conducts better than cold, and should be used when not contra-indicated. Amblyopia. — Fa/radism. Weakness of sight, with aching of the eyes when used before breakfast, or at twilight or in reading fine print, is frequently accompanied by general fee- bleness, dyspepsia or hysteria. Beard and Eockwell recom- FlG. 92. METHOD OF USING THE EYE-CUP. ELECTRO-THERAPEUTICS. 289 mend, for this condition, to place the negative pole at the back of tlie neck and move the positive electrode over the closed eve, using a mild faradic current (labile faradization) for five to ten minutes. Galvanism. If faradization, both local and general, fails, try a galvanic current from a few cells only ; in this case the positive electrode must be kept stationary. Dr. Mitten dorf has found that galvanism is best adapted to amblyopia caused by tobacco or loss of blood, probably from the beneficial efiect produced upon the bloodvessels, and consequently upon nutrition. Fig. 93. SMALL EYE ELECTRODE. Length, 2,% inches. The stem of this electrode is insulated and fits the universal handle. It termi- nates in a small, thin spatula-shaped plate. It may be used in treating the muscles, or margins, of the eyelids. Atony of the Optic Nerve. — Galvanism. Benedict, Erb and Driver recommend placing the positive pole to the nape of the neck and the negative over the closed eyelids, and moving it gently over and around them, for one or two min- utes, not to exceed three minutes. The number of cells at first should not be more than two or three ; in subsequent sittings they may be increased to twelve. If dizziness occurs during treatment or headache after, this treatment w^ill do harm. Better a very short application every day than a longer one at longer intervals. Blindness^ originating in a protracted attack of chills and fever, cerebro-spinal meningitis, and other acute diseases, have been reported cured, in a few cases, by the downward gal- vanic current, the negative pole being held in the hand or 290 ELECTKO-THERAPEUTICS. against the spine, while the positive was placed on the top of the head, the hair being moistened. Granular Lids. — Electrolysis. Dr. Areola, of Palermo, has employed electrolysis with success in removing granulations of the conjunctiva. Dr. Kohn, of Berlin, has also reported many successful cases. The negative current is applied by means of a suitable electrode (Fig. 93) to the inverted surface of the upper lid. The positive is applied over the nape of the neck. The first operation continues about ten minutes. Dr. Schivardi publishes three cases of old granulations, lasting, respectively, two, three and eight years. The first was cured in five sittings, the second was greatly improved after two sittings, the third was cured in nine sittings, and the sight, previously obscured, was regained. It requires three persons to perform this operation — one to hold the head steady and lid reversed, one to hold the negative pole, one to hold the positive and manipulate the battery. Cystic Tumors of the eyelid are effectually destroyed either by electrolysis or galvano-cautery. Hallucinations of Sight. — Galvanism. Flashes of light before the eyes, dimness of sight, hallucinations of sight, etc., not dependent upon organic disease, have been relieved by a downwojrd galvanic current, beginning with a current from two cells and increasing from day to day as it can be borne, to twelve cells. The sittings may be repeated daily. N^vus OF THE Eyelid. — Electrolysis. This has been success- fully removed after the following method : Introduce the negative pole into the tumor and close the circuit with a large sponge for the positive, located on the neck: use a current from six to ten zinc-carbon cells (this to be decided by the size of tumor and condition of cells). Let the current operate for two minutes and withdraw the needle ; unless the patient is very sensitive an anaesthetic is unnecessary. ELECTRO-THERAPEUTICS. 291 Opacities of the Vitreous Hu^vior. — Galvanism. M. Teulon, in writing upon opacities of the vitreous body, gives the results in twenty-four cases observed by him and treated by the con- tinued current ; he reckoned twenty-two as radically cured. He employs a very small number of elements, and applies the positive pole upon the closed eyelids, and the negative upon the mastoid process, or upon the superior cervical ganglion. The application lasts only two or three minutes. M. Teulon con- siders that in every opacity of the vitreous body, no matter what be its degree or extent, provided that its development has not assumed the confirmed form of hypertrophy, the constant continued current is the most efiicacious treatment. Le Fort and Onimus have also advised the use of the galvanic current as an aid to clearing up vitreous opacities. Galvanism has also been employed to remove opacities of the cornea and produce absorption of iritic membranes. Yon Graefe claimed quick absorption of cataract^ but others have not been so fortunate. Four freshly charged zinc-carbon cells are sufficient, as a rule. There is danger of increasing the opacity by a too careless use of the current. Paralysis of ocular muscles. Electricity, both faradization and galvanization, is often of great service in the treatment of paralysis of the muscles of the eye, especially if the cause is peripheral. The negative pole is placed on the closed eyelid, in a situation corresponding to the affected muscle, the positive being located on the temple or back of the neck, the sitting not to last beyond two or three minutes. Gal/canism. Benedict applies a feeble current from a few cells (three to seven zinc-carbon are sufficient) as follows : Paraly- sis of the muscle that draws the eyeball outward ; place the positive on the forehead and stroke the cheek bones for several minutes with the negative. *Medical Press and Circular, November 9, 1881 . 292 ELECTRO-THERAPE [JTICS. Paralysis of the muscles that turn the eyeball in toward the nose and obliquely downward ; apply the negative to the skin on the side of the nose near the inner angle of the eye. Paralysis of the muscle that raises the eyelid (ptosis) ; apply the negative to the upper eyelid, over which it may be moved while the current is passing. Paralysis of the muscle that moves the eyeball downward ; apply the negative to the lower border of the orbit. Paralysis of the muscle that raises the eyeball upward and inward ; apply the negative to the inside of the nose in the neighborhood of the inner angle of the eye. The alternative electrode in each case being located on the forehead. Faradism is recommended by Althaus, M. Meyer and Soel- berg Wells. The positive pole is placed below the ear and a small moistened sponge electrode connected with the negative is placed on the closed eyelid, as near as possible to the paralyzed muscle, sending the current through it for two or three minutes. In some cases improvement follows in one or two sittings, and in others it may not appear until fifteen or twenty. Persistent treatment will sometimes be rewarded with success in very obstinate cases. Dr. Mittendorf has observed that pain which frequently accompanies weakness of the internal recti muscles has been greatly relieved by faradism. Diplopia. — Gcdvanism. The field in which double vision is present, according to Benedict, is lessened immediately by the treatment above described. When this is not the case, a longer continuance and increased strength of the current is not indi- cated, but rather a change in the kind of electricity employed. In one case Duchenne applied a moist electrode over each eye, closed, and opened the circuit twice at intervals of a second ; the patient saw a dazzling flame, and on opening the eyes discovered that he was cured. ELECTROTHERAPEUTICS. 293 Strabismus. — Faradism. Cross-eyes, dependent merely upon debility oi the muscles, may be relieved by faradizing the muscles that are at fault. Dr. Poore reports a case of paralytic strabismus in which localized faradization aided in the cure. After tenotomy had been performed and the wound healed, the eye was found in the old position of extreme inversion. The external rectus was faradized for some weeks by an electrode placed on the muscle. The patient steadily improved. Spasm OF THE Eyelids. — Galvanism, Apply the positive to the eye through the eye-cup, and the negative to the palm of the patient's hand. Trichiasis. — Electrolysis. Dr. J. Elliott Colburn,*in a paper read before the Chicago Medical Society, describes the usual method of removing inverted eyelashes by electrolysis, which he had used in fifty cases at the State Eye and Ear Infirmary and at the Central Free Dispensary, twenty-two of which had been under observations through periods of from six months to three and a half years. The instruments necessary for this operation are a battery which furnishes six or more zinc-carbon cells, a light needle-holder and a suit- able needle. The patient being placed in a strong light, the surgeon fixes the lid in a Desmarc's or Knapp's clamps. The patient holds the handle of a positive electrode in the right hand, and places the moist sponge on the palm of the left, after the needle is introduced into the hair gland. The needle may be withdrawn after about ten seconds. The patient should remove the sponge from the left hand simultaneously with the withdrawal of the needle. The number of cells to be used should be decided by the surgeon's knowledge of the condition of his battery. I use from six to ten cells of a zinc-carbon battery. Where the hairs are very fine and obscure, the use of three-inch lens will be found quite serviceable. After electrolysis, the hairs should be removed with epilation forceps. The only objection to the operation, in my expe- rience, is, that when there is a large number of hairs to be removed the pain becomes somewhat tedious ; though with the clamp I find the pain * The Weekly Medical Review, November 1883. ^94 ELECTKO-THERAPEUTICS. is not so great. Only about fifteen per cent of the hairs return. The irritation following the operation is slight. The lids will be swollen for a day or two. In one case from which I removed but two or three hairs, the operation was followed by the growth of fifteen or twenty minute hairs, which were promptly removed. The results in all cases were good and permanent. The method of performing this operation will be more fully described under Hirsuties. Fig. 94. Mcintosh eye magnet. Weight, 2% oz. The core of this instrument is made of soft iron, and is surrounded by many convolu- tions of insulated copper wire, all inclosed in and insulated by a black hard-rubber cover. It may be connected with a single Grenet cell, or with any number of the zinc-carbon cells- of the Mcintosh galvanic battery. The size of a magnet should be in proportion to the body acted upon. Large magnet^ capable of lifting many pounds weight offer no advan- tage over small ones magnetized to saturation, where small fragments of metal are to be removed. To Eemove Fragments of Iron or Steel from the Eye. — The electro-magnet is extensively used at present for this pur- pose. The method of applying it is as follows : The point of the magnet is brought in direct contact with the foreign body, and then moved away to the distance of a fourth of an inch ; this maneuver is repeated several times, and if the case is seen before the corneal wound has had a chance to heal, the foreign body will finally be found adhering to the point of the instrument. If, however, the wound has healed, a change in the procedure is necessary. While keeping the magnet in close proximity to the foreign body, an incision through the wound is to be made for the purpose of allowing a free exit, the maneuver of touching and withdrawing the instrument must be gone through with again and again, and ultimately the foreign body will be easily removed. These two methods are entirely sufficient for the extraction of all frag- ELECTROTHERAPEUTICS. 295 ments in this tissue, as long as any part of them is in the cornea, even though the greater portion of their bulk projects into the anterior chamber. The anterior chamber may be the resting-place of a fragment, and if so, it should be drawn to the margin of the cornea, and extracted through an incision in that region, either by the forceps or magnet, at the option of the operator, who should bear in mind the importance of keeping the magnet in close proximity to the metal to be extracted if forceps are used, in order that the fragments may not be lost by means of the forceps slipping. Fig. 95. METHOD OF USING THE McINTOSH EYE MAGNET. The patient should be seated in a good light, and, as a rule, the eyelids should be kept far apart, and the eyeball fixed. Fine particles of metal lying on the conjunctiva can usually be picked off by the magnet with the greatest facility by the method shown above. One important point in regard to all incisions made for the entrance of the magnet and the removal of a foreign body from the eye, is that the cut should he not one with parallel edges, but T-shaped ; as, in the former case, when the extraction of the foreign body takes place, it is invari- ably stripped off the end of the magnet, and is retained at the site of the wound, or drops into the interior of the eye. This is a foregone conclusion unless the lips of the wound be held apart, and no amount 296 ELECTROTHERAPEUTICS. of skill or carefulness upon the part of the operator can guard against it unless the incision is of the above-mentioned shape. — [Dr. Bradford.] * The difference of opinion among writers in regard to the relative value of the different forms of electricity in the treat- ment of diseases of the ear is greater than in regard to any- other part of the body. The difficulty of localizing a current in the ear is the probable cause of the difference in results obtained. Galvanism. Brenner claims that the faradic current, while it is capable of producing unpleasant effects upon the nerves of sensation, does not produce any effect upon the nerves of special sense ; therefore the galvanic current only is of value in restoring sensitiveness to the nerve of hearing. Faradism. The application of a faradic current within the ear gives rise to an unpleasant metallic taste on the corre- sponding side of the tongue, and an increased flow of saliva, and according to some observers, a roaring or rushing sound in the ear, with a tickling or prickling that may become unendurable by increasing the current. In cases of congestion of the middle ear, electricity is liable to aggravate the con- , THE DISEASES IN WHICH ELECTRICITY HAS BEEN EMPLOYED. Chronic suppuration of the ear. Relaxation of the auricle. Methods of Applying Electricity to the Ear. — Purjinkef observed that a current sent through both ears at once causes fullness of the head and general dizziness. Benedict recom- the ear. gestion. Inflammation of the drum. Nervous deafness. Stricture of the Eustachian canal. Tinnitus aurium. * Mass. Eye and Ear Hospital. fiJMS^'s Magazin fur Chirurgie. ELECTROTHERAPEUTICS. 297 mends one electrode applied in or over the ear, and the other held in the patient's hand to interpose the resistance of the arm. Beard and Rockwell describe two methods which they term — 1. The internal. 2. The external. By the internal method, the current from either pole may be directed to one ear, or divided between both, the alternate electrode being placed at the nape of the neck, on the mastoid process, in the hand, or applied to the oriiice of the Eustachian tube. (See Fig. 73, location of electrode c.) The external method. Press one electrode firmly on the tragus, the other electrode being held in the hand of the opposite side. The ear may be filled with warm water, although it is not necessary. In regard to this method Beard and Rockwell say: "We have used it for several years with both the galvanic and faradic 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 internal method, however skillfully employed. The sitting should not usually be more than five or ten minutes, and in some cases even less, especially if the galvanic current be employed." Chronic Suppuration of the Ear. — Galvanism. A very mild galvanic current may be used to change the nature of the secretion. If the reaction is acid, introduce the negative pole ;■ if alkaline, the positive, the alternate electrode being held in the hand of the patient. Inflammation of the Drum. A rheostat should be in the circuit when a galvanic current is employed in a case of this kind. The positive may be applied to the ear, and the nega- 298 ELIJCTRO-THERAPEUTIOS. tive to the hand- Only two or three cells should be included in the circuit. Nervous Deafness. — Fmadism. M. Duchenne succeeded in curing, almost entirely, one child born deaf and dumb. The current within the external ear was sent through warm water, and a sponge electrode placed at the nape of the neck. He used a very mild faradic current for a few minutes at a time. He repeated this treatment in a large number of cases, with almost as many failures as successes, but his experience in ameliorating cases of nervous deafness, which had previously been regarded as incurable, were such as to show that elec- tricity is of considerable value, and its application should be tried in these cases. This electrode consists of a rubber speculum fastened in a wire frame, into which the wire-spring fastened to the same frame may be pressed to close the capillary opening in the speculum. The latter is filled with warm water when used ; the spring prevents its escape while being placed in the ear. This electrode fits the universal handle. Dr. Edward C. Mann * reports an interesting case of blind- ness and deafness resulting from cerebro-spinal nleningitis, successfully treated by him with the galvanic current. Deafness caused by Muscular Paralysis. — Faradism, Dr. Woakes f believes that muscular paralysis is an important * London Jour. Physiol. Med. and Ment. Pathology, Vol. VII, Part 2. t British Medical Journal. ELECTKO-THERAPEUTICS. 299 factor in causing deafness in adult life. Such cases will be benefited by a mild faradic current applied to the paralyzed muscles, the positive electrode being placed at the insertion and the negative at the origin of the muscles. Ducheime's Points are convenient electrodes for this purpose. After the ?ar electrode is introduced the spring is released, flies back and leaves a column of water interposed between it and the drum of the ear. The current from the battery passes through the spring and column of water to the ear. In the illustration the alternate pole is held on the nape of the neck by the neck electrode already described. Dilatation of the Eustachian Canal. — Electrolysis. Mons. J. Mercie* has been applying with success electrolysis in dilatation of tlie Eustachian tube. He first introduces an ordinary Eusta- chian catheter, and passes through it a fine bougie while the patient pronounces the syllable mi^ and allows it to remain in position five or ten minutes. This process is repeated from day to day until it has been found that the sound has reached the middle ear. When the tube has been dilated to this extent, the elastic sound is replaced by a flexible metal one connected with the negative pole of a galvanic battery, while a tuft of wet sponge, connected with the positive pole, is placed in the Fig. 97. EAR ELECTRODE IN SITU. *Rev. de Therap. 300 ELECTROTHEKAPEUTICS. external auditory canal. This procedure is unaccompanied by any danger if the current is weak and great care is exercised in inserting the metal sound. Although it has not been very frequently employed, the success was such in those instances as to encourage its subsequent use. Fig. 98. DOUBLE EAR ELECTRODE. This electrode is formed of two curved insulated metallic rods, terminating in small sponge cups. One of the curved rods is fastened to a binding post, and the other slides through it, so as to adjust the electrode to heads of different size, and can be fastened at any point by a thumbscrew ; the sponge cups may be separated 8}/^ inches. The sponge is securely fastened to prevent its being left in the ear; but it can be removed and replaced in a moment, so that there is no necessity for using the same sponge on different patients. This electrode conveys the current from one pole of the battery equally to both ears: the other pole may be located on the neck or in the hand. Deafness from Aural Catarrh. Dr. H. Campbell * recom- mends a galvanic current for the cure of accumulations of mucus in the middle ear, which are caused by aural catarrh and followed by deafness. He introduces a catheter, as already described, injects a little warm water, then inserts a metal wire through it, and applies a gentle current to decompose the water. He claims that the condition of the mucous membrane is so altered that there is no tendency to a relapse. mm Fig. 99. small aural and nasal electrode. Length, 4% in. This is simply a nickel-plated rod, terminating at one end in a screw that fits the universal handle, and at the other in a roughened point, to which bits of sponge or lint may be securely fastened. It is useful in localizing the current either within the ear or nose, since it may be introduced through a rubber tube, and the extent of contact with the tissues be limited to a single point if desired. Tinnitus Aurium. — Galvanism, l^oises in the ear may fre- quently be relieved, even when dependent upon disease of the * Electro-Surgery, London. ELECTRO-THERAPEUTICS. 301 brain, by a very mild galvanic current. A rheostat should be included in the circuit ; the direction of the current cannot be definitely stated, for in some cases the positive, and in others the negative, gives most relief. As a rule, the positive is found to be more quieting and the negative more stimulating in diseases of the ear. THE NOSE. Galmnism produces an impression upon the olfactory nerve which is followed by giddiness and a peculiar acid odor. During and immediately after the passage of the current, it is impossible to sneeze. Meyer noticed that when the nega- tive pole is applied within the nose and the positive to the hand or back of the neck, there is an increased mucous secretion as well as a prickling, stinging sensation in the nose, and an alkaline taste on the tongue. By reversing the current there was a sour taste, on the tongue. Faradism and Fmnklinlsm produce a stimulating effect when carried directly to the mucous lining of the nose, and frequently are accompanied by sneezing. Diseases in which electricity has heen employed : Loss of smell (anosmia), Coryza, Catarrh, Polypi. Obliteration of nasal duct, The manner in which electricity produces a favorable effect upon mucous membranes, whether of the eye, ear, throat, or other passages, is explained by the language which Stellwag used in describing the effect of irritants upon mucous inflamma- tions : The irritation which they set up in the sensory nerves being carried over to the vaso-motor nerves may cause a contraction of the calibre of the vessels, when they are in a condition of relaxation. This is done by the excitation and invigoration of the atomic muscular fibers. The resolution of inflammation is favored by the lessening or removal of the congestion, which is one of the causes of the unfavorable course. 302 ELECTRO-THEEAPEUTICS. Loss OF Smell. — Faradism. A moist sponge electrode is placed over the nape of the neck, and a nasal electrode (Fig. 100) carries the current to all parts of the nasal passages. A gentle current should be employed, and shocks should be avoided ; therefore it is advisable to locate the electrodes before completing the circuit. Another method is to apply a poAverful current on each side of the bridge of the nose, near the eyes. Kepeat daily. Galvanism. The nasal electrode is employed to carry the negative current into the nose to the branches of the cerebral nerves, while the positive is placed on the clieek and the cur- rent continued for five minutes. It must not be strong enough to produce flashes or other unpleasant effect upon the optic nerve. Catakrh. — Faradism. A mild faradic current applied through electrodes located respectively on the nape of the neck and bridge of the nose, for about five minutes, re- peated daily, or twice daily, relieves the disagreeable sensa- tion attending both catarrh and coryza. Galvanism. The same rule applies in this case as in other applications of galvanism. When an irritable condition of the mucous lining exists, apply the positive through a moist sponge (see Fig. 99), and the negative at a distant point, as the palm of the hand. When a debilitated condition exists, which needs stimulating, apply the negative current through the metal- tipped nasal electrode directly to the membrane, and the posi- tive through a large sponge, located on the clieek. When the nature of the secretions need changing, it should be remem- bered that acids are set free at the positive and alkalies at the negative pole. Galvano- Cautery, In cases which have undergone great structural change, Dr. Pipino* recommends galvano-cautery *Dr. W. C. Pipino, of St. Louis (St. Louis Medical and Surgical Journal, 1881). ELECTRO-THERAPEUTICS. 303 lor the removal of hypertropliied tissues. The cicatricial con- traction of the tissues from the heated wires deprives it of its erectile nature, removes the obstruction, allowing the free pas- sage of air through the nose. He cautions against mistaking deflection of the septum to the right or left for hypertrophy of membrane covering it. Since Dr. Wm. Meyer's effort to direct the attention of the profession to the frequency of the hypertropliied glandular tissue in the posterior nasal region, and its influence in the production of organic and functional changes in the conditions and uses of the upper air passages, galvano-cautery has fre- quently been employed to remedy the condition. Dr. R. P. Lincoln, of New^ York, has reported, through the Medical Record^ a number of cases in which this operation, aided by therapeutical measures, has relieved hoarseness, cough, defective enunciation, and in a few instances, a "growing stupidity,'* evidently due to long obstruction of the nasal passages. Length, G inches. The nasal electrode is an insulated metal rod, terminating in an uninsulated nickel- plated tip. Its size and shape adapt it to conducting the current either to the anterior or posterior nasal passage, when electricity is to be localized. The one shown in Fig. 99 is to be preferred when the current is to be diffused over a larger space. Naso-Pharyngeal Polypi. — Electrolysis. Dr. Bruns* has successfully employed the galvanic current to destroy these tumors. He considers that this operation should be tried before proceeding to a more serious operation. There is no risk of bleeding, no danger, and very little liability to a relapse after electrolysis. * Berliner Klinische Wochenschrift. 304 ELECTRO-THERAPEUTICS. Fungoid Growths are also removed by electrolysis when accessible. Galvano-cautery is, however, the most radical meas- ure for the removal of polypi, granulations, and all foreign •growths from the nose. Closure of the Nasal Duct. — Electrolysis. Dr. Tripier has successfully operated for obliteration of the nasal duct. The probe should be insulated, except at the point, and con- • nected with the negative pole of the battery. Only a few cells will be required. the mouth. Galvanism. The sensation of taste can be excited only by the galvanic current. One electrode placed against each cheek produces a strong metallic taste, when the galvanic circuit is complete. The positive at the sacrum and the negative at the nape of the neck will frequently cause a metallic taste in the mouth ; applied directly to the tongue, the galvanic current not only excites the sense of taste, but the optic nerve also, pro- ducing flashes of light. Whatever has a tendency to blunt the sensibility of the tongue, such as acids, pepper, liquor, etc., diminishes the eflect of galvanism. Franklinism produces effects similar to galvanism. Faradism produces pain and muscular contractions, but no taste. Electricity has been employed for Paralysis of the tongue, Toothache, Loss of taste, Extraction of teeth, Tumors in the mouth, Eemoval of the tongue. Paralysis of the Tongue usuall}^ accompanies paralysis of other parts, and may depend upon disease of the brain, in which case caution should be exercised in applying electricity, that reflex action be not set up with unfortunate results. After paralysis has existed some time, or when not of central origin, ELECTRO-THERAPEUTICS. 305 electricity may be applied as follows : A tongue plate (Fig. 101) connected with the negative pole is placed on the tongue, and a sponge electrode (Fig. 108) pressed firmly upward, beneath the lower jaw on one side of the oesophagus, when the paralysis is confined to one half of the tongue ; if both halves are affected, divide the positive current by a bifurcated cord between two electrodes, and locate them on each side of the oesophagus. Another method is to locate one electrode on the tongue and the other at the nape of the neck. If the faradic current does not produce contractions of the tongue, employ the inter- rupted gal/vanic current, taking care not to use it of such a strength as to unpleasantly affect the optic nerve. Fig. 101. TONGUE PLATE. Length, 5 inches. The stem of this electrode is insulated, and the uninsulated portion is nickel-plated. Loss OF Taste is usually due to an affection of the third branch of the fifth nerve, or the glosso-pharyngeal nerve, or the chorda tympani. Galvanism. Locate the negative elec- trode on the tongue, and the positive at the nape of the neck, beneath the jaw or below the ear. Fhradism. When loss of taste is due to an affection of the chorda tympani, one electrode may be placed on the tongue and the other within the ear against the drum ; this not only excites a sensation of taste, but produces an abundant flow of saliva. A very mild current should be employed with a rheostat in the circuit, not to exceed two or three minutes. Toothache. Franktinism was formerly much used to relieve toothache. The patient was insulated, charged with electricity, 306 ELECTRO-THERAPEUTICS. and sparks drawn from around the affected tooth. Sometimes the operator was insulated and charged, then directed the charge to the tooth of the patient through the finger. Galvanism^ applied through a suitable dental electrode (Fig. 102), will frequently relieve pain by putting the nerve in a state of anelectrotonus, the positive current being directed to the tooth and the negative electi'ode being held in the hand. Five to ten minutes are usually sufiicient for one application, and a mild current should be used ; it may be repeated two or three times daily. When there is swelling and threatened suppuration, the negative pole applied to it and the positive on some distant part is said to be a preventive. The current should be continued from ten to fifteen minutes, as strong as can be borne without exciting the optic nerve. M Fig. 102. Y DENTAL ELECTRODE. Length, horizontal, 5 inches. Vertical length, 1 inch. This consists of an insulated metal rod terminating in a nickel-plated point, by means of which a current may be localized upon a nerve or motor point. Faradism. A faradic current will sometimes relieve the pain instantly. The current is conducted to the tooth through the dental electrode, and the alternate pole applied at the nape of the neck. If a mild current for a few minutes does not relieve, it is useless to repeat it. The faradic current ap- plied through a sponge which covers the tooth and gum is also credited with preventing suppuration, and reducing swelling about a diseased tooth. Extraction of Teeth. The faradic current has been em- ployed to lessen the pain attending extraction of teeth. It seems to benumb the nerve, in a measure. The patient holds the uninsulated portion of one electrode in the hand while ELECTRO-THEKAPEUTICS. 307 the forceps are made the other electrode, being joined to the conducting cord by a suitable connector. When the forceps grasp the tooth the circuit is completed. Fig. 103. METHOD OF EMPLOYING ELECTRICITY IN EXTRACTING TEETH. The dental battery here shown is operated by a Grenet cell. It can be used with any other form of cell. A strong secondary current is required. The method of com- pleting the circuit is sufficiently obvious without further explanation. Tumors in the Mouth. — Electrolysis. Small vascular growths may be eifectually destroyed by electrolysis. The dispersion of tumors is sometimes brought about by passing a mild galvanic current through them from ten to fifteen minutes at a time, the positive being applied direct and the negative at some indifferent point. Faradism, It has been claimed that the faradic current is capable of exciting absorption of growths within the mouth, even when of a bony nature (osteo- sarcoma). Gcdvano-caiitery furnishes the most satisfactory method of removing these foreign growths. Removal of the Tongue. — Galvano-cautery. By this method all hemorrhage may be avoided. It is considered the most effectual method of eradicating cancer of the tongue. 308 ELECTRO-THERAPEUTICS. Mr. Bryant* recommends this procedure : Isolate the growth by introduction of curved needles beneath the base, fix the mouth open with a gag, draw the tongue forward by a tongue forceps or a ligature passed through the tip of the tongue. The cautery loop is passed around the base of the disease, behind the pins, and gradually tightened, the circuit being complete as soon as the loop has been adjusted, but not sooner. The wire must not be heated beyond a dull red, and the drawing up of the loop should be done very slowly. Hemorrhage never occurs unless the wire has been used at too high a temperature, or has been tightened too rapidly. D Fig. 104. DENTAL CONNECTOR. Length, in. Slot, 3-16 by % in. This is a nickel-plated clamp. C receives one handle of the forceps, which is fas- tened by the thumbscrew. D is a socket to receive the conducting cord. THE PHARYNX AND LARYNX. Electricity may be applied to the treatment of diseases of the throat in three ways : 1. Internally, by placing one or both elec- trodes directly on the diseased tissues. 2. Externally, by placing one electrode on the neck in front of the larynx, and closing the circuit by placing the other on the nape of the neck, or on the sides along the inner margin of the sterno-cleido-mastoid muscle. 3. Through the nerves, distributed to the pharynx and larynx. *0f Guy's Hospital. ELECTRO-THEEAPEUTICS. 30^ Caution. In all applications of electricity about the neck, the operator should be very careful, when the electrodes are lo- cated over the pneumogastric nerve, to use a very mild current A rheostat in the circuit is advisable. Prolonged syncope is sometimes produced, and other exceedingly alarming symptoms. Several observers have reported accidents of this kind, which may also result from the accidental displacement of electrodes applied within the throat ; with care, however, the current may be safely applied to this nerve, and with advantage in disorders of parts to which its branches are distribntedo Diseases in which electricity has proven useful: Anaemia, Spasm of glottis, Enlarged tonsils, Loss of voice (aphonia), Clergyman's sore throat, Paralysis, Hyperaesthesia Nervous cough. Fig. 105. SPONGE-TIPPED LARYNGEAL ELECTRODE. Length, inches. This consists of an insulated stem, to which, by a simple device, a piece of sponge, or absorbent cotton, may be fastened securely. It is removable, and can be exchanged in an instant. By using a very small piece of wet sponge, a current may be localized almost as closely as Avith electrode in Fig. 106, and with less pain or irritation If a comparatively large piece of sponge is used, the current may be distributed over a larger surface, which is sometimes advantageous. By warming the insulated covering of the stem over a lamp, it may be bent in suitable shape to carry a current to the posterior nares. Anemia of the throat usually accompanies general debility, and is improved by general electrizations, and such other thera- peutical measures as improve the strength of the patient. Faror dism may be applied directly within the throat through the moist sponge-tipped electrode (Fig. 105) connected with the negative pole, the positive being placed on the nape of the neck, or on 310 ELECTRO-THERAPEUTICS. the sides along the inner margin of the sterno-cleido-mastoid muscle. The interrupted galvanic current sometimes proves serviceable, the poles being located as before. Inflammation and irritation of the throat, on the contrary, are benefited by applying the positive directly to the tissues and the negative outside. This is not, however, an invariable rule ; very much depends upon the other conditions present in a given case. According to Ziemssen, hypersemia of tissues is more lasting after a long application of the negative pole, while anemia follows a similar application of the positive pole ; but in either instance there occurs sooner or later a reaction, followed, in favorable cases, by a normal condition. Length, 7% inches. This consists of a curved insulated stem, terminating in a nickel-plated knob, for localizing electricity upon single muscles. Paralysis of the muscles of the throat may give rise to difficulty in swallowing, and, if the muscles of the larynx are involved, loss of voice. The method of applying electricity direct to the affected muscles requires considerable skill. The fauces, root of the tongue, uvula, etc., must be avoided, as the slightest touch will render them intolerant of treatment. The electrode shown in Fig. 106 conveys the current direct to the muscle, while the alternate one is applied on the nape or sides of the neck. McKenzie and Ziemssen recommend a double electrode, attached to an interrupting handle, by means of which both the posi- tive and negative poles are applied directly to the paralyzed muscles. The reader who wishes to employ this treatment is referred to standard works on laryngoscopy, etc., for information in regard fiL£CTRO-THERAPEUTICS. 311 to the delicate manipulations necessary to localize the current. A method which has the merit of being simple, and often quite as efficacious, is to locate both electrodes outside the neck, employ- ing a wire brush (Fig. 107) for the one applied to the sides of the neck. The prognosis in these cases is favorable when the disease is ot a purely functional character. If the muscles re- spond to stimulation by the faradic current, that is the form of electricity to employ ; if they fail to respond to it, galvanism alone can produce a curative effect. Sometimes electrization of the laryngeal nerves is indicated. A reference to Figs, 72 and 73 will indicate where the electrodes must be located. Fig. 107. METALLIC BRUSH. Length, 4 inches. This is composed of a bundle of stiff metal wires. It divides the current into rays each of which produces a separate impression on the sentient nerves of the skin. To pro- duce reflex influence, merely touch the end of the brush to the skin ; to transmit this divided current to the deeper tissues press the brush firmly on the skin. The wires may be separated considerably to cover a larger surface, but in that case the impression produced will be proportionately less intense. Aphonia. — Faradism. Robert Torrance, L.Tl-CP.,"^ reports a ease of five years' standing, the result of an ulcerated sore throat. All the usual remedial measures had been exhausted, including galvanism. The cords were then faradized by a double electrode through which the current from both poles was localized at different points on the vocal cords, and the voice was permanently restored after a number of sittings at varying inter- vals. Loss of voice due to paralysis of the recurrent laryngeal ' * Surgeon to the Newcastle-on-Tyne Throat and Ear Infirmary. 312 ELECTRO-THERAPEUTICS. nerve requires galvanism. The motor points to which the current should be applied are shown on Figs. 72 and 73. Meyer recommends the electric moxa applied to the larynx in these cases. Aphonia, due to spasm of the muscles of the throat, will require a current in an opposite direction to that which is indicated in paralysis. Hysterical aphonia has been cured by every form of electricity. Aphasia. Loss of speech from disease of the brain has never been cured by electricity, according to Althaus. On the contrary, Arthius claims to have relieved it in a measure by franklinism, administered daily in the form of electric bath, for two or three months. Fig. 108. EXTERNAL LARYNGEAL ELECTRODE. Length, 4}/^ inches. Diameter of Disc, 1% inches. This is a curved insulated stem, terminating in a sponge-covered disc, designed for application about the neck. Stammering. The galvanic current applied two or three times a week through the laryngeal nerves, accompanied by daily gymnastic education of the vocal and respiratory organs, has proved of benefit. The Tensor Palati may be electrized by a laryngeal elec- trode applied over the soft palate in the course of the muscle on each side of the uvula, the circuit being completed by placing the other pole over the mastoid process of that side corresponding to the side of the palate to which the laryngeal electrode is being applied. Nervous Cough and HYPERiESTHEsiA must be treated accord- ing to general principles, as already described. Central galvani- zation is usually indicated. Franklinism is also recommended. ELECTRO-THEKAPEUTICS. 313 Whooping-Cough. Dr. Beard made a series of experiments in the Sheltering Arms Institution in Brooklyn, and Dr. Rockwell in private practice, in the treatment of this disease by electricity. The method which proved most successful was central galvaniza- tion. The paroxysms were diminished in frequency and violence, and in some instances the duration of the disease was shortened. Hay Fever. The method of arresting this disease is by gal- vanization of the pneumogastric nerve. The location of the electrode is shown in Fig. 74. Keftel, Hutchinson and Beard and Rockwell recommend this method. The latter recommend as a prophylatic a prolonged course of central galvanization or general faradization. Caution should be observed, however, in applying a current to the pneumogastric nerve. Spasm of the Glottis. Central galvanization and faradiza- tion of the larynx have both been successfully employed. Dr. Strassman* reports the case of a boy eight years old who had with each expiration a sound like that of a dying animal, with some tickling in the throat and pains in the abdomen. It was a constant crying about every five minutes. During the night there was perfect rest. The galvanic current cured him completely after the second sitting. Clergyivian's Sore Throat. — Galvcmo- Cautery. When the follicles of the throat are enlarged for any length of time, medi- cines have no effect upon them. The only means of relief is to destroy them, and galvano-cautery is to be preferred for this purpose, as it is effectual and causes little pain. The platinum point is suited to this purpose. The operator stands by the side of the patient, whose head is thrown backward; the tongue is depressed and each follicle cauterized. It produces a slight prickling only. The inflammation set up produces cicatrix and contraction of the follicle. * Berlin Klin. Woch. 314 > ELECTRO-THERAPEUTICS. Tonsillitis has been reported relieved by the application of an electric current, but as the articles describing the method of its application failed to state what kind of electricity or the strength of current used, we give but a passing mention. Enlarged tonsils have been reduced in some instances by means of a very mild galvanic current, the positive applied direct, the negative externally to the side of the neck. The current is better borne if carried through a rheostat. Fig. 109 is an electrode of suitable shape to localize the current. Fig. 109. TONSIL ELECTRODE. Length, 5 inches. Diameter of cup, 1 inch. The peculiar curve of the insulated stem of this electrode makes it possible to apply the nickel-plated cup closely over the tonsil, without producing irritation of any other part of the pharynx. Diphtheria. The galvanic current has been applied to change the nature of the secretions, and reduce the swelling of the tissues. Dr. G. K. Smith* claims remarkable success in its use. Diphtheritic paralysis affecting the muscles of the throat has been relieved by faradism. Stricture of (Esophagus. — Electrolysis. Some cases of im- passable stricture of the oesophagus have been relieved by electrolysis. The electrode required is a flexible insulated instrument, terminating in a blunt olive. It is connected with the negative pole of the battery while the positive electrode of large size is placed to the left side of the spine, at a level with the eighth or ninth rib. A mild current is passed through the circuit for two or three minutes. A sound is then passed * Proceed. Med. Soc. King's Co.,. Aug. 1881. ELECTROTHERAPEUTICS. 315 through the stricture, if possible. This can be done after a few sittings, if not at first, and the remainder of the treatment may be by dilatation, as usual. Dr. Boeckel operated after this plan on an impassable cicatricial stricture, and after the second sitting passed a IN'o. 13 sound through it ; after the tenth, a No. 16, and one month later, No. 19. Dilatation was kept up for some time regularly, and afterward once a month. Seven years later the patient could himself pass a No. 23. He also successfully treated a child for the same difficulty. After the first sitting he could pass a urethral bougie No. 6, and after the second, a No. 10. After five more sittings, at varying intervals. No. IT passed the stricture. He recom- mends a weak current in order to guard against exciting inflammation in neighboring parts. Tumors, etc. Galvano-cautery is especially adapted to the removal of foreign growths, both benign and malignant, from within the fauces. THE HEART AND LUNGS. Electricity is believed to influence the heart through the nerves, and the lungs directly through the nerves and indirectly through its action upon the muscles of the chest. The pneumo- gastric nerve, when stimulated by electricity at the right side of the neck, acts more energetically upon the heart ; at the left side upon the respiratory movements. The cervical ganglia and the pneumogastric nerve are the points to which electricity should be applied to reach the heart; the twelve dorsal ganglia, the phrenic and pneumogastric for the lungs. Faradization of the pneumogastric by a strong current, as we have seen, arrests the heart's action. Prof. Rosenthal states that faradization of the superior laryngeal nerve arrests respiration. Prof. Yon Ziemssen lately had a patient, a woman, aged forty-six, who had lost the greater part of the precordial structures, exposing the heart ; and 316 ELECTRO-THERAPEUTICS. he commenced a series of experiments to determine the effects of the galvanic and faradic currents respectively on that organ. He distinctly discovered that the faradic current had no effect whatever, while the galvanic current acted as a powerful stimulant. He therefore believes it is useless in cases of chloro- form syncope to waste time in applications of the faradic current, as is commonly done. Diseases of the chest in which electricity has heen employed : Angina Pectoris. — Galvanism. Dr. Lowenfeld^ relates a case of angina pectoris in which galvanization proved bene- ficial. The patient, a man aged forty-seven, was subject to attacks of the disease occurring every month or two. These were characterized by excited respiration, oppression, small, frequent pulse, sternal pain radiating to the left arm, and con- vulsive tremors of the limbs, which lasted about one l^our. The heart was normal. The constant current was applied for one minute to each side of the neck, along the course of the pneu- mogastric. The sense of oppression was immediately relieved. Ten such applications in the course of three weeks were fol- lowed by complete freedom from the attacks for more than two years. Faradism. M. Duchenne removed the pain during an attack of angina pectoris in two cases by applying one electrode over each nipple, using a strong faradic current. Cutaneous fara- dization at intervals completely removed the angina. Asthma. — Faradism. Dr. Max Schaeffer, of Bremen, ad- vocates the treatment of asthma according to the following method: The morbid state upon which asthma depends may Angina pectoris, Asthma, Consumption, Asphyxia, Cardiac pain, Pleuritic effusion. * Aerztl. Intelligenzhl., No. 39, 1881. ELECTROTHERAPEUTICS. 317 affect — 1. The nerve itself. 2. The coverings of the nerve. 3. The tissue adjacent to the nerve. He lays great stress on the last condition. Tumors, such as nasal polypi, hypertrophied tonsils, swollen cervical or bronchial glands (temporary hyper- aemia of these glands), can, according to their position, cause irritative pressure on nerve-filaments connected with tlie respi- piratory centers. He found that many of liis asthmatic patients were the subjects of nasal catari'h, or pharyngeal catarrh, or laryngo-tracheal catarrh. He noticed that swellings of the mucous membranes of these parts were attended with asthmatic paroxysms, and patients would constantly refer the seat of their discomfort lower or higher in the throat, according to the seat of the swelling, and he concludes that all the symp- toms of asthma are symptoms of irritation brought on by pressure on nerves which are in connection with the pulmonary portion of the vagus, and especially in the upper part of the respiratory tract — the pharynx, larynx and trachea. He examines carefully the nose and throat, and applies the electrodes according to the seat of the disease. Usually the two electrodes are placed on each side of the neck about f of an inch below the angle of the jaw, and sometimes a little lower down in front of the sterno-cleido-mastoideus. The current must be of good strength, so that the patient can feel the stream go across the larynx and soft palate. In bad cases it should be applied twice a day, from fifteen to thirty min- utes each sitting. He states that in the most severe cases it has acted "like witchcraft." Althaus advises faradization of the phrenic nerve as above described in chronic cases, where the asthmatic attack is pro- longed and followed by bronchial congestion, with insufiicient expansion of thorax and imperfect aeration of the blood. Galvanism. Asthma due to a morbid state of the nerve or its coverings is relieved by placing the positive pole over 318 ELECTRO-THERAPEUTICS. the pneumogastric in the left side of the neck and the negative over the nape of the neck. A very mild current should be employed, lest the heart's action be arrested or the difficulty in breathing increased. Asthma due to reflex action of the nerves, caused by disease of other parts than those named, cannot be permanently relieved by electricity until the disease giving rise to it is removed. Habitual asthma has been greatly benefited by a continued galvanic current administered through the galvanic belt, the positive pole being located at the nape of the neck and the negative over the stomach. During an attack, counter-irritation over the neck and upper part of the thorax, by means of the wire brush, has proven of advantage. Franklinism. Arthius states that when asthma exists with- out organic lesion, the franklinic electric bath, the patient being seated upon an insulated platform, will cure it. When due to catarrh, electricity alone will not cure, but is the surest means to obtain a notable amelioration and to make life endurable. He advises an electrization for ten minutes daily, and in some cases three or four times daily, during the paroxysms. Consumption. — Galvanism. The well known influence of a mild galvanic current in relieving inflamed and ulcerated tissues ought to make it a valuable agent in alleviating many of the distressing symptoms accompanying chronic disease of the lungs. It is stated that this effect is produced by a current from a very few cells ; only two or three cells should be used at first, and not continued beyond ten minutes. One* small metal electrode is placed in the depression behind the angle of the lower jaw, and the other over the pneumogastric, near the sterno-clavicular articulation. The efifect is to dilate the lungs and increase the respiratory movements. It increases the expectoration consider- ably at first, but after a few sittings lessens it, unless there is extensive softening and destruction of lung. The fever is lessened and the condition of the blood improves ; the appetite ELECTRO-THEEAPEUTICS. 319 returns, night sweats disappear, and in a few cases the process of repair begins. Faradism. Bastings, of Brussels, claims marvelous results from faradization of the muscles of the chest. "This is not done with a view to directly affect the tuberculous deposit at all, but, bj 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." Each muscle is faradized for about half a minute in turn, about five minutes being consumed at a sitting. Prolonged treatment was found injurious. Dr. Mcintosh has found the hot-air electric bath exceedingly efficacious in allaying the distressing symptoms, improving the general health and apparently prolonging life. In one remarkable case, the particulars of which cannot be given for want of space, it restored a patient apparently in the last stage of the disease to a degree of health that enabled him to attend to business for nearly two years longer. It should be added that the treatment also included a strict attention to hygiene and much open-air exercise. Asphyxia. Suspended animation, whether resulting from inhalation of chloroform or coal-gas, poisoning, drowning, disease, or in new-born children, should not be treated by electricity alone. As an adjunct to other active measures the latter is invaluable. It is employed principally to stimu- late the heart, lungs and diaphragm through the nerves that supply them. Formerly franklinism was used by pass- ing powerful shocks through the chest in various direc- tions. After the discovery of galvanism some physicians carried canes which were ingeniously contrived to inclose a large number of small elements, a vial of acid, a tiny cup, the size of a thimble, in which to mix the fluid, with connecting 320 ELECTRO-THERAPEUTICS. wires, etc., complete f(^r the production of a galvanic current of sufficient power to relieve asphyxia. Galvanism. To produce respiration, place the negative pole over the cartilage of the seventh rib, to bring it as near as possible to the great head of the diaphragm, and apply the positive to the phrenic nerve in the neck. Onimus and Legros recommended that the negative pole be placed in the mouth and the positive in the rectum, and the current be applied from eighteen or twenty cells continuously, till the heart's action is quite re-established. According to Du Bois, in sudden syncope from chloroform, the muscles of the heart lose their contractility within four minutes, but in suspended animation from other causes they retain contractility for ten minutes ; therefore it is advisable to apply electricity simultaneously with other measures, that no time may be lost. Faradism. Friedberg^ restored a boy, aged four, after res- piration had ceased, under the influence of chloroform, by applying the electrodes over the phrenic nerve and diaphragm. He closed the circuit for one second at a time with regular intermissions. After ten such applications the child began to breathe, when faradization was discontinued and methodical compression of the abdomen was substituted. In twenty minutes restoration was complete. One electrode may be applied at the nape of the neck instead of over the phrenic at the side. The operator should know the exact location of the motor point of the phrenic nerve on the side of the necTc^ otherwise he is liable to apply the electrode over the pneumogastric^ which may destroy the last chance of restoration. (The reason for this is explained under "action of arrest.") it is better to err on the side of safety when the motor points are not well known, and place the electrode on the nape of the neck, or on the spine between the shoulder-blades. By *Virchow's Archives. ELECTRO-THERAPEUTICS. 321 reference to Fig. 73 it may be seen where to locate the elec- trodes over the roots of those nerves that send branches to the heart and lungs. The following suggestions may be found useful in these cases : 1. Do not omit artificial respiration. 2. Use either the faradic or interrupted galvanic current intermittently, closing the circuit for one second, opening it for one second, and so continue, and persevere in the application until the patient breathes naturally. 3. If the muscles fail to respond to faradism, it will be useless to continue it. Galvanism should be immediately sub- stituted. NERvons Cardiac Pain near the apex of the heart, a common and distressing symptom, is alleviated by central galvanization. Chronic Pleuritic Effusion. Dr. Gunther^ places the posi- tive pole over the breastbone and the negative over the effusion. A galvanic current from any number of zinc carbon cells up to eighteen may be used, according to the sensitive- ness and condition of the patient, to promote absorption. Paralysis of the Muscles of the Diaphragm. M. Duchenne made a special study of this lesion. It consists in an alteration of the regular movements of the chest and abdomen, during in- spiration and expiration, which produces a short respiration insufficient for the wants of the voice ; this is not a fatal disease of itself, because respiration is not completely prevented, but the most simple bronchitis is able to occasion death by suffocation, expectoration being difficult and even impossible. The remedy is electrization through the phrenic and cutaneous nerves ; in the latter case, to exert a reflex influence upon the paralyzed muscles. * Centralblatt fur Chir. Med. 322 ELECTRO-THERAPEUTICS. DIGESTIVE ORGANS. A ction of electricity upon the salivary glands. Claude Ber- nard states that faradization of the lingual and auriculo- temporal nerves, the chorda tympani and posterior parotideal branches of the facial nerve causes an abundant flow of saliva, while faradization of the sympathetic nerve arrests salivary secretion. The current applied to the drum of the ear for the purpose of stimulating the salivary glands through the chorda tympani should be very mild, and should be carried through a rheostat. Galvanization applied only through the sympa- thetic nerve in the neck is sufficient to influence the secretion in these glands. The oesophagus. Faradization causes a contraction of both the longitudinal and circular fibres, and if the current is kept up some time, the action is not limited to the part directly operated upon, but proceeds downward to the stomach. One electrode may be located over the oesophagus in front, and the other, a large moist sponge, over the middle and inferior cer- vical and upper dorsal ganglia. (See Fig. 73.) Galvanization of the left pneumogastric nerve also produces contraction of the muscles of the oesophagus. (See A, Fig. 74.) This action of electricity upon the oesophagus is of value in treating difficulty in swallowing (dysphagia) not due to stricture. The stomach responds to electric stimulus by shortening of its diameter. When one electrode is placed over the stomach in front, and the other on the spine in the position to influence the solar plexus (see N, Fig. 73), the transverse diameter is shortened. When one electrode is placed at the left over the point where the oesophagus joins the stomach (cardia), and the other at the right where the stomach joins the intestinal canal (pylorus), the longitudinal diameter is shortened, but in either case the direction of the movements is from the cardia to the pylorus. ELECTRO-THEKAPEUTICS. 323 The liver. As a result of very carefully conducted experi- ments, Dr. Sigrist came to the conclusion that faradization of the liver makes its circulation more active, and consequently leads to an increase of the excreted urea. In one case the amount of urea was raised from 18-20 grms. to 35 grms., and the size of the liver became perceptibly larger. The gall-bladder. A current sent through the point indi- cated by G, Fig. 74, contracts the gall-bladder, and throws out a part of the bile into the duodenum. The sjpleen. There is much diiference of opinion in regard to the power of electricity to produce contractions of this organ. Thie experiments of Bernard indicate that a powerful faradic current does cause contractions. Chvostek claims that he has reduced enlargement of the spleen, caused by ague, by faradi- zation of the skin over this organ. The intestines. Peristaltic action is the term applied to the constant motion within the intestinal canal. It is due to the alternate contraction of the circular and longitudinal fibres ; the former close the tube, while the latter draw back the walls of the tube, thus providing for the propulsion of the contents. It takes place along the whole digestive canal from the throat to the anus, and effects the forward motion of the food, and the expulsion of the undigested residue. This motion can be stimulated by electricity, either by irri- tating some part of the digestive canal directly or by irritating the nerves supplying it. The most striking feature is the slow- ness with which these motions take place. Kot only does a long time elapse after the application of the irritant before the motion begins, but even if the irritation is sudden and instan- taneous, the motion excited at one point passes along gradually, slowly increasing up to a definite point, and then gradually decreasing. In 1856 Pfiuger discovered that faradization of * VroJLicK 1880, No. 2. 324 ELECTRO-THEKAPEUTICS. those nerves that take their rise from the six lower dorsal ganglia arrests the peristaltic action of the small intestines. According to Aldini, a feeble galvanic current, applied by means of the positive pole in the month and the negative in the rectum, will cause contraction of the abdominal muscles, and the contents of the bowels are propelled toward the rectum. The small intestines are more easily excited by electricity than the colon or rectum^ although the latter also respond to elec- tric stimulus. When the electrodes are placed very near each other on the intestines, and afterward removed, the canal becomes constricted at the points upon which the electrodes were applied. This constriction reaches its maximum a few minutes after the elec- trodes have been removed, then slowly •disappears. There is at the same time increased secretion of intestinal mucus. The contractions may be studied during life in patients afflicted with hernia. This practical fact in regard to the action of electricity upon the digestive organs should not be lost sight t^f Those mus- cles that are not subject to the vnll {involuntary) aire not affected hy electricity until a little time after they have heen acted upon. The movements excited hy electricity continue for a time after the application ceases^ and extend in each direction heyond the parts included between the electrodes. The diseases of the digestive organs to which electricity has been applied with more or less benefit include almost the entire list of disorders that affect these organs ; the methods of treat- ment varying with different operators, but may all be included under these four divisions : 1. The application of electricity to the muscles. 2. To the nerves of the organ to be treated. 3. Chemical changes produced by electrolysis. 4. Destruction of morbid tissue by galvano-cautery. ELECTRO-THERAPEUTICS. 325 No fixed rule can be given for the selection of current, the length or direction of its application, that can be invariably fol- lowed. The operator must be guided by the circumstances of the case ; but the following suggestions, based on principles already described, may prove useful : When spasmodic action is to be arrested by the application of electricity to the muscles^ a mild current should be selected, with the positive on the organ and the negative at some indifferent point ; when applying electricity through the nerves to allay irritation, that portion of the nerve near the diseased organ, when accessible, may be put into a state of anelectrotoiios by placing the positive over the organ and the negative on the nerve some distance away, and employing a very mild current for fifteen or twenty minutes. When the nerve is not directly accessible, place the positive over the ganglia, from which the organ receives its nerve supply, and the negative over the organ affected. The location of the electrodes should be re- versed when the muscles or nerves are to be stimulated, to in- crease the functional activity of an organ. Beard and Rockwell state this as a fundamental fact : " The faradic current is usually preferable to the galvanic for applications to the stomachy spleen^ liver ^ intestines and uterus.''^ A new method of applying electricity to the stomach : Dr. Kussmaul has suggested a method of localizing a current upon the interior walls of the stomach that has been tried to a limited extent only. The patient having filled the stomach with water, an instrument like an oesophageal bougie, insulated, except at the tip, is passed into the stomach through the oesophagus and connected with one pole of the battery ; the alternate pole is placed outside on the skin over the stomach. Vomiting. Dr. Leven ^ reports several cases of persistent vomiting successfully treated by the application of electricity in the interior of the stomach by the method above described. *Progres Medical. 326 ELECTRO-THERAPEUTICS. Four or five applications have checked it in cases that had re- sisted all other measures. No other particulars were given. Faradism. Obstinate vomiting from any cause is often promptly relieved by placing the electrodes respectively on the pit of the stomach and over the lower dorsal ganglia. It is frequently necessary to use as strong a current as the patient can comfortably endure, and to prolong the sitting be- yond the usual limit ; twenty to thirty minutes will sometimes answer better than a shorter time. Dr. Lente, of Cold Spring, New York, reports a large number of cases relieved of the most troublesome and intractable vomiting by this method. Galvanism. Bartholow recommends a galvanic current ap- plied by placing the positive pole in the depression behind the angle of the jaw and the negative over the stomach ; or the positive may be applied over the spine instead of behind the jaw. YoMiTiNG OF PREGNANCY has been relieved by both forms of electricity. Each case requires special treatment. Faradism. A mild primary faradic current may be used with the positive electrode on the pneumogastric in the neck, and the negative over the pit of the stomach. The caution already given in regard to electrizing the pneumogastric should not be forgotten. The sitting should not be more than five minutes in duration, and may be repeated for three or four days in succession. Electricity applied to the interior of the stomach has entirely relieved vomiting from this cause that had resisted all other treatment. The method already described, of passing a strong current directly through from the pit of the stomach to the spine, sometimes succeeds. Galvanism applied through the pneumogastric has also re- lieved a few cases. A very mild current should be used. Another method is to apply a feeble galvanic current, from two or three cells only, for several hours in succession. A ELF.CTRO-THERAPEUTICS. 32T broad, flat, moist sponge electrode is fastened over the stomach, and another opposite to it over the spine, extending from the seventh to the tenth dorsal vertebrae. The patient may lie on her back during the passage of the current; when it is im- possible for the patient to remain in bed during treatment, the galvanic belt may be worn to supply a current. Hysterical VomriNG Attended by Epigastric Pains. Dr. Apostoli has successfully treated cases of this kind as follows ; The positive pole is applied in the subclavicular region and the negative pole over the seat of the pain. It is continued for five to fifteen minutes; the gastralgia and epigastric pains have been stopped after ten to fifteen applications. Yoi^HTiNG from Gastric Atony. The repeated application of a mild galv^anic current by placing the positive electrode over the pneumogastric alternately at each side of the neck, and the negative over the pit of the stomach, sometimes re- lieves. The sitting should be very brief. To Produce Yomiting. Dr. Fox* has used faradism to pro- duce emesis in the case of two children, who were in a state of collapse, and unable to swallow in consequence of having eaten poisonous fungi. One was apparently dying and insen- sible to the vapor of ammonia. He applied one electrode to the top of the oesophagus, and the other over the stomach. Vomiting immediately followed, and both children were evi- dently saved by this means. Gastrodynia or Nervous Cardialgia. Those painful affec- tions of the stomach not dependent upon perceptible changes in structure sometimes called neuralgic stomach-ache, and due to functional derangement of the solar plexus of nerves, are generally relieved by galvanism. Relief is frequently imme- diate, but treatment should be persevered in for some time to render it permanent. Faradism with a strong current some- * British Medical Journal, vol. ii, p. 49J;. 328 ELECTRO-THERAPEUTICS. times gives relief. The current in either case may be carried through from the dorsal ganglia to the pit of the stomach. It is sometimes advantageous to combine general faradization and central galvanization with the local treatment, especially in the intervals. Gastralgia, Enteralgia, Hepatalgia are treated in the same manner. Yizioli relates the following as an example of what can be accomplished by galvanism in some cases : * A woman, thirty-five years old, haa been bitten ten years previously by a supposed mad dog. The patient was at first intensely excited, but became calmer after a few days, though she lost her appetite and strength, menstruation ceased, the senses of hearing and smell became abnormally acute, and paroxysmal attacks of intestinal colic set in. The latter became more and more frequent, and so violent as to cause the patient to shriek with pain, sometimes causing fainting-fits, or violent tonic and clonic convulsions. For the relief of the gastralgia, cauterization of the cervix uteri was practiced. At this stage, when the affection had existed for more than ten years, Yizioli began to treat the patient with the constant current of twenty- four to thirty-six cells, placing one pole over the stomach. The sittings were given every other day. Amelioration was rapid. After the twentieth sitting the paroxysms ceased alto- gether, though there were faint reminders when the uterus was cauterized. Franklinism^ in the form of electro-positive or electro-nega- tive baths, has an excellent reputation in the neuralgic affec- tions of the stomach, liver and bowels, and also m nervous vomiting. The bath may be combmed with local treatment by drawing sparks from the painful region. Immediate relief occurs in cases to which this form of electricity is adapted. * Mcd.-Chirurg. Rundschau, August 1881. ELECTRO-THERAPEUTICS. 329 Dyspepsia dependent upon spinal exhaustion will be relieved by a mild galvanic current applied to the spine, one pole being located high up over the superior cei-vical vertebra, the other over the end of the coccyx. The current need not be applied directly to the stomach. Dyspepsia arising from atony or weakness, should be treated with a strong faradic current. Some of these cases will be greatly improved by simply hold- ing one uninsulated electrode in each hand, while as strong a faradic current as can be endured is passed through the circuit. The first sitting may be about five minutes, and subsequent ones may be increased until they occupy twenty minutes. A sensation of soreness in the muscles of the arm indicate that the application was continued too long. The treatments may be repeated daily for one month, then omitted for the same length of time, and again repeated if necessary. The muscles of the arms and chest are considerably developed by this means, the appetite and digestion improved. It is scarcely necessary to add that in all diseases of the digestive organs the diet should be regulated. Dyspepsia caused by over-eat- ing, indulgence in intoxicating liquors, or where poisons have been taken, is usually accompanied by a congested condition of the walls of the stomach. A mild faradic current may be employed to excite contraction of bloodvessels and lessen con- gestion. Sometimes a mild galvanic current applied through the nerves will be needed. The treatment of dyspepsia of every form should be conducted according to the general principles already given. A carefully regulated diet and patient appli- cation of the indicated form of electricity for a considerable period of time will almost invariably be rewarded with success, provided the disease is not attended by organic changes. The electro-thermal hat/is are undoubtedly better adapted to the treatment of chronic disorders of the digestive organs than any other method which the profession has yet adopted. 330 ELECTKO-THERAPEUTICS. Acidity of the stomachy loss of appetite^ nausea^ waterbrash (pyrosis), and all the other disagreeable symptoms with which dyspeptic patients suffer, may be treated by some one of the methods described for dyspepsia. A galvanic belt with the electrodes fastened respectively over the nape of the neck and pit of the stomach is sometimes beneficial, the current being continued for weeks. In severe cases the electrodes may be applied without a cover to produce strong counter-irritation. Many years ago it was customary, in cases which could not be relieved by milder measures, to apply a blister, and fasten upon the sore a disc of silver for the positive electrode, and employ a mild galvanic current, to keep up a discharge. Electric fustigation with the wire brush on the dry skin over the stomach, the other electrode being located on the spine, is especially adapted to cases suffering from a persistent gnaw- ing, burning sensation in the stomach. Dilatation, and Catarrh of the Stomach. The method of applying electricity within the stomach is highly recom- mended both by Kussmaul and Ziemssen in these cases. Congestion of the Liver. Passive cases may be relieved in a few days by famdism. Place a broad moist sponge posi- tive electrode over the spine in the lower dorsal region, and draw the negative over the liver, making firm pressure, which may be gradually increased during the sitting so as to carry the electrode partially under the ribs ; lift it off in front and carry it back to the starting-point without contact with the skin. Caution should be used in regulating the current to start with, which should be very mild until the tolerance of the organ to electricity is known. In some cases severe cramps will be caused by non-observance of this rule, and if they occur it is difficult to persuade the patient to risk their recur- rence by permitting any further electrical treatment. Cases in which the liver has given the impression of stony hardness ELECTKO-THERAPEUTICS. 331 on palpation, have been materially relieved in a few days by this course. The electro-thermal baths are also to be recom- mended in liver complaints arising from disordered circulation of blood through the organ. CiKRHosis OF THE LivER. Beard and Rockwell state that the pains accompanying this disease are alleviated by electrical applications. Hydatids of the Liver. — Electrolysis. At Guy's Hospital and the Royal Infirmary for Children, a number of cases have been operated upon by the method described in the following case : "Two needles were introduced into the most prominent part of the swelling, one piercing the space between the eighth and ninth costal cartilages and the other about two inches be- hind it, between the ninth and tenth ribs. The needles were passed in to a depth of two or three inches, so as to be free in fluid. Both needles were attached to the negative con- ductor ; the positive being connected with a large sponge was placed on the skin near the needles ; a current from ten freshly charged cells was allowed to pass for twenty-five minutes. There was some pain for four or five hours after- ward. Twenty days after, all traces of the abdominal tumor had disappeared." The surgeons at the hospitals referred to claim that this operation is free from danger, and not liable to set up suppuration within the cyst. It has been suggested that the transformation of chloride of sodium into caustic soda by the chemical process which electricity sets up within the cyst renders its contents poisonous to the parasite. Spleen. Enlarged spleen, the result of malarial poison- ing, has been relieved by the same measures described under congestion of the liver. It is believed that the effect produced is due partly to the mechanical action resulting from the con- tractions of the abdominal muscles and partly to the reflex 332 ELECTROTHERAPEUTICS. action of the current, especially if a metal electrode be used on the dry skin over the spleen. Catarrhal Jaundice. Prof Gerhardt, of Wtirtzburg, recom- mends faradization of the gall-bladder for this disease. One electrode is placed over it (see G, Fig. 74) and the other on the back, opposite to it. A strong current is passed through it for several minutes. This will be more effective if the cur- rent is interrupted by removing and replacing the electrode over the gall-bladder at intervals of a few seconds. Some- times a disappearance of the dullness occurs during the sitting. Success is certain if a bilious stool is passed within the next two days. Generally the vaso-motor nerves of the kidneys are excited at the same time, and consequently the urine that is passed within twenty-four hours after treatment is paler and more dilute than usual. Catarrhal and Ulcerative Inflammation of the Coi-on. Dr. Karetzky"^ adopted the following plan of treatment in a case of chronic colitis, with ulcerations and atony of the in- testines, which had resisted for five years every mode of treat- ment : The positive pole was introduced into the rectum, while the negative was moved along the entire length of the colon for a few minutes. After each application he also faradized with the brush the skin over the affected region. After the first few seances, a very marked improvement was noticed in patient's general and local condition, and he recovered entirely after fifteen applications had been made. Constipation caused by impaired peristaltic motion, loss of power in the abdominal muscles, protracted diarrhoea, the abuse of aperient medicines, and in some cerebral and spinal disorders, may be relieved by electricity. * Vratch, 1880, No. 43. ELECTROTHERAPEUTICS. 333 Faradisin. Habital constipation is treated by connecting one pole with a rectal electrode, or placing a large electrode on the perineum, while the other is carried along the course of the colon in the direction of the arrows on Fig. 74 from K J to L J. The electrode should be moved slowly in one direction only, a mild current being employed. A powerful current produces distressing cramps in the abdomen ; they also result from a very mild current occasionally in a subject who exhibits the muscular reactions peculiar to some forms of paralysis. It is unnecessary to employ a current of sufficient strength to came pain. Dr. Blackwood * expresses his views on the subject of consti- pation in these words : Electricity is beyond question intrinsically more valuable than any other remedy we possess in restoring tone to the intestine in long- standing cases. Contrary to general rule, faradism is here preferable to galvanism ; but care is requisite in its application, that painful parietal muscular contraction does not occur. The current should be rapidly ap- plied over the whole abdomen, one pole brushing gently the parietes, the other being located over the solar plexus or anus. Flatulence, colic, tympanites, are relieved by faradism, the positive being inserted in the rectum and the negative carried over the abdomen. The condition which gives rise to the forma- tion of gas in the intestinal canal should be treated in the inter- vals between attacks. Central galvanization will sometimes permanently cure. It maybe applied two or three times per week. Althaus relates a case of excessive flatulency, the result of an attack of dysentery fifteen years previously, which he perma- nently cured in three weeks ; the positive pole was inserted in the rectum and the negative passed over the abdominal muscles, tvjenty-five cells being included in the circuit. He does not name the kind or condition of the cells employed ; but any physician * Neurologist and electrician to the Presbyterian Hospital, physician to St. Mary's Hospital, etc. 334 ELECTBO-THERAPEUTICS. who has experimented upon a piece of beef with a galvanic cur. rent from a large number of cells and noticed the effect produced at the poles, would hesitate to apply a current from twentj-hve freshly charged zinc-carbon cells anywhere about the body except for the purpose of electrolysis. The treatment described for dyspepsia is appropriate in cases here referred to, to prevent the recurrence of attacks. DiARRHCEA. — Faradization. Beard and Rockwell give par- ticulars of treatment which proved successful in several obsti- nate cases of chronic diarrhoea. The method pursued was general faradization, averaging three times per week, with local application to any tender spots in the abdomen. The treat- ment was prolonged, and the current strong. Immediate improvement was observable in favorable cases. Excessive peristaltic action upon which diarrhoea sometimes apparently depends may be lessened by applying a strong current to the lower dorsal ganglia to influence the splanchnic nerves. Cholera Infantum. Dr. O'Reilley, of Louisville, Ky., has successfully employed faradization in the treatment of this disease. The method of applying it is similar to that described for vomiting and diarrhoea. Intestinal Obstruction. — Fa/radism. A case of this kind in the Hotel-Dieu of Rheims was apparently saved by elec- tricity. A laborer, aged sixty years, fell upon a heap of stones, receiving slight contusions on the right side. Four days after he was brought to the hos- pital in a state of profou nd collapse ; there was considerable tympanites, but no tenderness on pressure. He had two hernias, complete on the right, with the inguinal ring enlarged to admit three fingers ; on the left, a very small hernia. All the usual means were made use of without effect. Stercoraceous vomiting persisted, and on the next day recourse was had to electricity — the first application of twenty minutes' duration was made at noon ; one pole was placed in the anus, while the other was moved over the abdomen. No effect being obtained it was repeated ELECTROTHERAPEUTICS. 335 at five o'clock p.m. At nine p.m. the patient had a considerable stool ; he had a better night, the vomiting having ceased. Next day he had two electrizations, and in the afternoon the bowels were thoroughly cleared out. His recovery progressed without interruption, and four days later he was well. Mr. Cauhet* reports a similar case occurring in a man aged forty- five. Six days after the attack began, electricity was tried according to the same method, but without relief. The seventh day a negative elec- trode w^as introduced into the anus, and the positive moved over the surface of the abdomen for fifteen minutes. A few hours after free evac- uation occurred, and the patient recovered. Reduction of Hernia. — Faradism. A large number of cases are reported in medical literature of strangulated hernia reduced by faradism. The usual procedure is to place one electrode in the rectum and the other either upon the hernia or at different points over the abdomen. Dr. Suprunenko f reports the following case : A slight inguinal hernia, which had been three hours strangulated resisted half an hour's taxis. A moderately strong faradic current was then used. The positive electrode was pressed against the tumor, while the negative was applied first against the lumbar vertebrae, afterward over the umbilicus. The hernia at once diminished, and in two minutes disappeared. In a second case, reported by Dr. Pergamin, the patient, a man of eighty, suffered from strangulated hernia for twelve hours. Tvvo hours' persistent taxis failed. The faradic current was used for fifteen minutes without success. The current being still maintained, manipula- tion was tried, and in about two minutes the bowel returned into the abdomen with a gurgling sound. Ascites. — Faradism. Dropsy of the abdomen, due to vari- ous causes, has been successfully treated by faradization alone. PopowJ reports a case of persistent anasarca and ascites in a patient sixty-three years of age, who for many years nad been a sufferer from malaria. On admission to the hospital he nad considerable oedema of feet and legs, and oppressive ascites. Jaborandi and Fowler's solution * Revue Medicale de Toulouse. t Wratsch, No. 40, 1882. X Vratsch, 22, 1880. 336 ELECTRO-THERAPEUTICS. were given, and slight improvement noticed. The induced current was then daily applied over the abdomen and the region of the spleen. The urinary secretion was found to become much more abundant, and, as soon as faradization was discontinued, again grew less. Albumen, after awhile, ceased to appear in the urine, the patient's general health improved, his abdomen became flat, and he was soon discharged cured. The spleen, however, remained large. Dr. Sigrist* reports a second case of ascites successfully treated in this manner. Ascites was due to hypertrophic cirrhosis of liver. Every muscle of the abdomen was made to contract from fifteen to twenty-five times ; two seances per day. Under this treatment the patient began to lose in weight about 200 grms. per diem; amount of urine became double, and' abdominal circumference was diminishing from one-half to one centimetre per day. On the tenth day an abdominal bandage was applied. In three weeks ascites entirely disappeared and had not recurred when seen three months later. Skibnewskif has recently reported two additional cases; the first, a little girl, set. 9, very ansemic and with* marked ascites. For ten days the patient took digitalis and iron without any diuretic effect, and dur- ing these ten days the circumference of the abdomen sensibly increased. The digitalis was then discontinued, the iron being kept up. Faradism was applied to the abdominal muscles two or three times a day. Each seance lasted fifteen or twenty minutes. The currents were sufficiently strong to produce muscular contraction. During the same seance each muscle was made to contract fifteen or twenty times. After twelve days the circumference of the abdomen was reduced from thirty-six and four- fifth inches to thirty ; the quantity of urine was considerably increased. After three weeks the circumference of the abdomen was only twenty- four inches, and the quantity of urine normal. A month and a half after leaving the hospital, the patient had a return of the ascites. As before, medication had practically no effect, and faradization was resorted to with the former result. The second case was that of a young man, set. 17. Ascites and aug- mentation of the spleen commenced after an infectious disease. The urine was small, and contained no albumen. Faradization was performed twice a day for fifteen days, and then thrice a day, until within four weeks a cure was effected, both of the ascites and splenic enlargement. * Medic. -chir. Rundschau, January 1881. i Revue des Sc. M6d., July 1883. ELECTRO-THERAPEUTICS. 337 Pendulous Abdomen (Physconia). — Faradisnn.'^ One elec- trode is placed at the motor points of the rectus abdominis (Fig. 72, 90 to 94), while the other is carried up and down the muscle. The current should be strong enough to forcibly contract the biceps. the rectum. Electricity is applied so frequently through the rectum, not only for disorders of the intestinal canal, but also for those of ad- jacent organs, that it may not be out of place in this connection to call attention to its peculiar shape and direction ; this seems especially necessary, in view of the fact that the majority of electrodes intended to convey electricity within it are so illy adapted to the purpose. The length of the rectum in the adult varies from four to eight inches; the lower third, averaging one inch in length, curves forward from the anus ; the middle third curves backward along the sacrum ; the ujpper third is one- half the length of the entire tube, and bends toward the left. The shape of the lower and middle may be compared to an exaggerated letter S, with its lower curve one inch long and its upper three inches. It is obvious that any considerable force used to insert a rigid rectal electrode several inches in length into a tube curved as described, may cause serious and even fatal in- jury. A flexible electrode, terminating in a ball or oval-shaped body, is preferable, when it is to be used simply as a director for the current. The nerves which supply it being derived from the plexus and ganglia, represented by P and G, Fig. 73, it is possible to treat some local disorders of the rectum through its nerves by locating the electrodes at the points named. Large, moist sponge-electrodes are best, and the effect of the current is most apparent when applied through warm water, as in the electro-thermal bath. * CentralbldU, 1883. 338 ELECTRO-THERAPEUTICS. Diseases of the rectum for which electricity may be employed : Hemorrhoids (piles), Paralysis of the sphincter, Prolapsus ani, Stricture, Pruritus ani, Tumors. Fistula in ano, Fig. 110. INSULATED RECTAL ELECTRODE. Length, 5 inches. This is the usual form of rectal electrode. It is insulated for nearly one-half its length with polished hard rubber. The metal part is nickel-plated. Various sizes are made so that it forms a suitable instrument for dilating strictures either with or without elec- trolysis. Hemorrhoids. — Galvanism. Before each sitting direct the rec- tum to be well cleansed with an injection of hot water ; anoint the rectal electrode before inserting it. If the tumors do not involve the sphincter, it is best to have that portion of the instru- ment in contact wdth the sphincter insulated. When the piles are very sensitive, or ulcerated, connect the rectal electrode with the positive ; if not sensitive, and especially if they have existed a long time, connect it with the negative pole. The external elec- trode should be large, and may be moved over the liver, stomach and abdomen, in the direction of the colon. Faradism is indicated to improve the venous circulation and prevent recurrence. Electrolysis has been employed to destroy old tumors that resist other treatment. After bringing the tumor into view, insert the negative needle and apply the positive pole over the nates or any convenient place, and carry a current from four to six cells through it for twenty minutes. Galvam^o-cautery is pronounced by far the most efficient and satisfactory method of operating upon piles for their radical re- moval. The patient is put under the influence of an anaesthetic, ELECTRO-THERAPEUTICS. 339 the rectum having been previously cleared by an injection. Forcibly dilate the sphincter. The tumors are brought below it, if possible, but if not they are encircled by the loop and removed after the method for removing tumors described in the chapter on galvano-cautery. When they are of such a shape that they can- not be inclosed in a loop, they must be destroyed with the platinum point. Dr. Butler directs attention to these points in operating. 1. Apply the loop snugly around the diseased tissue before heating. 2. Tighten slowly, so that the mechanical action of the tightening loop may not anticipate the cauterizing action. 3. Protect the adjacent parts from being burned by radiation. Hamilton recommends running into the tumors platinum needles heated to a dull red heat, which obliterates the vessels without setting up active inflammation beyond ; atrophy follows. It is well to protect surrounding parts with cotton saturated with water. Fig. 111. BALL RECTAL ELECTRODE. Length, 5 inches. This electrode consists of a rod of metal, insulated with hard rubber, and terminat- ing in a nickel-plated ball. It is preferable to the one shown in Fig. 110 as a conductor, owing to its blunt extremity, but is not suitable for treating strictures. Prolapsus Ani. — Galvano-cautery. The operation for this disease does not differ in its details from the one performed with actual cautery. It is fully described in textbooks on surgery. Famdism. This disease in children may sometimes be cured by persistent treatment with a faradic current locally applied, the negative within the rectum or against the anus. Pruritus Ani. A mild faradic current applied through elec- trode 112 to and within the anus, with a sponge electrode upon 340 ELECTBO-THERAPEUTICS. the lower part of the spine, frequently gives temporary relief. Permanent relief can be had only through a cure of the disease which causes it. Occasionally a galvanic current ap- plied the same way has been successful. Paralysis of Sphincter Ani. When this disease accompanies paralysis of other parts, electricity locally applied will produce little effect. When it is the result of local causes, such as pressure during labor, forcible dilatation, etc. , it may be relieved by applying the positive electrode within the sphincter, and the negative on the spine at the point indicated by G, Fig. 73. The secondary faradic may be employed, as strong as can be borne comfortably, for five minutes daily. If improvement does not follow after two or three treatments, the slowly inter- rupted galvanic should be substituted. Galvanism will not need to be repeated more than three times per week, and six to twelve freshly-charged zinc-carbon cells will be sufficient. Stricture of the Rectum. — Electrolysis. An electrode similar to Fig. 110 is selected of suitable size to engage in the stricture. The instrument should be insulated except at the point which is to act on the tissues. The process described for insulating electrolysis needles may be employed. Hamilton recommends the following formula : Gum shellac (brown) 1 drachm. Solution india-rubber (Squibb's) " Wood naphtha 2 " On account of Tripier's observation that the scars which form at the point where the negative pole is applied are softer and contract less than at the positive pole, it is customary to connect the rectal electrode with the negative pole of the bat- tery, while the positive is applied to the nates. A very mild current is more efficient than a powerful one in giving perma- nent relief. In this operation the shape of the rectum must ELECTRO-THERAPEUTICS. 341 be taken into account, otherwise the instrument may produce electrolysis of the healthy membrane, an accident to be avoided. Tumors, Foreign Growths and Malignant Affections have been removed from the rectum both by electrolysis and galvano- cautery. In the case of malignant disease, although a radical cure cannot be expected, yet suifering is diminished, and life has been prolonged. Fig. 112. NEW STYLE RECTAL ELECTRODE. Length, 2% inches. Diameter, % inch. This is unquestionably the best form of electrode for localizing the current in the lower portion of the rectum. It is insulated for a little more than one-half its length with hard rubber. The portion of it in contact with the sphincter is so small that not the least irritation is produced during the treatment, and the curve follows the natural curve of the rectum. A socket in the base receives the conducting cord. Fistula in Ano. — Electrolysis. It has been recommended to destroy the lining membrane by inserting a wire through the entire length of the canal, and connecting it with the posi- tive pole of the battery, the negative being placed on an indifferent point on the skin. A current from six to eight cells is employed for fifteen minutes. One application is suffi- cient. It causes little pain, and an angesthetic is not required. Some authorities recommend that the bowels should be confined for several days after the operation. GahMno-cautery. Insert a platinum wire in the fistula through a suitable director ; with the finger that is in tlie rectum hook the end of the wire downward through the anus and remove the director; both ends of the wire are connected with the battery, and the loop is slowly drawn up, after the circuit is completed. The adjacent tissues must be protected by lint saturated with water. The subsequent treatment is the same as after an operation with the knife. 342 ELECTEO-THEKAPEUTICS . THE URINARY ORGANS. Electricity may be applied to these organs through the pneumogastric and phrenic nerves at the motor points in the neck ; through semi-lunar ganglia by placing a broad electrode on the lower dorsal vertebrae; through the solar plexus by pressing an electrode firmly against the empty stomach. General faradization and central galvanization increase the amount of urine excreted. The Jcidneys may be directly elec- trized by including them between two electrodes placed on opposite sides of the body. A galvanic current carried to the base of the brain is said to exert a direct influence over the amount of sugar found in the urine. The ureters respond readily to both kinds of electricity. They are shortened and constricted. The contractions proceed in the direction from the kidneys to the bladder, and continue long after the application has ceased. The hladder contracts vigorously when its muscular fibers are directly faradized. It has been shown that electric stimu- lus applied to certain parts of the brain can cause contractions of the bladder, and that this stimulus is transmitted through the anterior columns of the cord. A current applied through the posterior roots of the sacral nerves also produces contrac- tion of the muscular fibers of the bladder by reflex action. Another nervous center for the bladder is found in the lower portion of the lumbar cord, motor fibres from which pass through the hypogastric plexus on their way to the bladder. An electric current may be applied directly to this plexus through an electrode in the upper third of the rectum. This electrode is also in contact with the j)osterior wall of the bladder, in males. A current may be applied to the bladder by placing a broad electrode on the lower part of the abdomen, directly over the pubic arch, and another on the spine at the point ELECTRO-THERAPEUTICS. 343 indicated by G, Fig. 73, or within the bladder through an insulated electrode like those shown in Figs. 113 and 114. Both poles may be introduced into the bladder through the electrode illustrated by Fig. 116. The sjyhincter of the hladder is, physiologically speaking, not a sphincter at all. Faradization of any part of the blad- der causes urine to be voided, but faradization of those whitish elastic circular fibers that surround the neck of the bladder, and to which the name sphincter has been given, does not arrest the flow of the urine. It may be checked immediately by direct- ing the current to the membranous portion of the urethra. This may be accomplished by the introduction of an electrode into the urethra, or into the lower third of the rectum. Diseases to which electricity has heen applied. Addison's disease. Chronic inflammation of the Bright's disease. bladder (cystitis). Diabetes insipidus. Frequent micturition. Catarrh of the bladder. Parab^sis. Incontinence of urine. Addison's Disease. — Faradism. Dr. Rockwell describes a remarkable case of this disease in which general faradization relieved the symptoms, and imparted so great vigor to the patient that considerable doubt was expressed in regard to the correctness of the diagnosis by the gentlemen of the association to whom the patient was presented. He lived two years in the improved condition at which he had arrived under the influence of electricity, and at last died quite suddenly. A post-mortem confirmed the diagnosis. Bright's Disease. — Galvanism. Dr. Hughes recommends galvanization of the spine for both Bright's and Addison's disease, believing they are associated with disease of the renal ganglia. Albumen and tube casts have disappeared under this treatment. 344 ELECTKO-THEKAPEUTICS. Diabetes Insipidus. — Galvanism. Althaus* has success- fully treated this by galvanizing the medulla. Hughes reports a case of this disease, associated with profound melancholia and sexual apathy (loss of sexual desire without spermatorrhea for six months), cured by galvanization of the head and spine conjoined with proper medication. Each application was con- tinued six minutes. Faradism. Dr. Clubbef reported a case treated with a faradic current applied over the kidneys about twenty minutes at a time, every day. The amount of urine was reduced more than one-half, and the patient's condition greatly improved for a number of months. Catarrh of the Bladder. — Galvanism. The bladder after being emptied is partially filled with warm water, and an elec- trode (Fig. 114) is introduced and connected with the negative pole ; a broad flat electrode applied over the bladder or sacrum is connected with the positive. A very mild galvanic current is carried through the circuit for a few minutes only. If the bladder be full, the gas set free at the negative might cause disagreeable distention. The presence of urine may, by its decomposition, produce great irritation. It has been suggested that certain drugs be added to the water, which, after decom- position, are capable of exerting an alterative influence upon the lining membrane. Dr. K. M. Murray J oflers these hints as to the mode of conducting the application of galvanism to the bladder. 1. The current employed must be of the very gentlest, and the increase must be slow and gradual. The bladder is often morbidly sensitive, and anything like a violent shock may produce a very acute cystitis. * Med. Times and Oaz. t C. P. B. Clubbe, in London Lancet. X Edinburgh Medical Journal, April 1881. ELECTKO-THERAPEUTICS. 345 Faradism has been employed externally with good effect in some cases of vesical catarrh. Chronic Cystitis. Galvanism is best adapted to this con- dition. . ^ AVhen erosions or ulcers of the vesical mucous mem- brane are present, faradism must not be applied. When there is thickening of the walls, and incontinence without ulceration, one pole may be placed on the perineam, the other over the symphysis ; or one over symphysis and the other inserted as a catheter into the bladder. Fkequext micturition, where no special cause appears, is best treated by passing a weak galvanic current from the lumbar region to the region of the bladder. Calculi. It is more than eighty years since experiments were begun to determine the feasibility of dissolving calculi witiiin the bladder by means of electricity. Prevost and Dumas made the most complete experiments on animals, and suc- ceeded in one or two instances. Dr. Bence Jones, following out their experiments, determined that a concentrated solution of nitrate of potash is the best in which to plunge calculi of any composition in order to dissolve them by the galvanic current. There are no reliable records of, experiments made upon living human beings to determine whether this operation can be performed with safety. Dr. Melicher, of Vienna, claims to have done so, but no particulars are reported. The dis- tressing pains in the neck of the bladder attending inflamma- tion, with or without the presence of stone, are materially alleviated by faradism applied to the dry surface over the bladder through a metallic brush, also by a mild galvanic current from a belt. In the latter case a metal electrode, without a cover, con- nected with the positive pole, is fastened over the os pubis, and the negative, enclosed in a moist cover, is fastened to some indifferent ])oint. It must be applied until irritation is pro- * Cenlmlblatt,fiirChir. Med., No. 30, 1880. 346 ELECTRO-THERAPEUTICS. duced, and may be worn continually, changing the location of the positive a little from time to time to prevent the formation of a troublesome sore. Paralysis. There is little to be expected from electricity in paralysis of the bladder due to brain or spinal disease ; but when due to other causes, such as operations on the bladder or rectum, pressure during childbirth, or to certain drugs, electricity will nearly always produce a cure. Galvanism. If the cause is located in the brain, place the negative electrode on the back of the head and the other over the OS pubis ; if due to spinal disease, place the negative on the spine below the diseased portion and the positive as before ; when the disease is from other causes apply the electrodes as in the last case, or both may be applied over the bladder a little distance apart. The current is more eifective when interrupted. Five minutes is ordinarily sufficient for each sitting. Faradism may be applied with the electrodes located respec- tively over the lumbar vertebrse and the os pubis. Both forms of electricity are applied internally according to the following method : The bladder is first emptied and afterward filled with warm water ; the patient lies upon the back with an electrode applied to the small of the back ; a urethral electrode is intro- duced within the bladder, the water diffuses the current to all parts of the vesical membrane. The current must be very mild and the application short. When paralysis is caused by over- distention, this method of applying a faradic current within the bladder will be the most successful. When there is inability to expel the contents of the bladder from this cause, requiring the use of the catheter, the electrode shown in Fig. 118 will be found a serviceable instrument for the double purpose of conveying a current to the bladder and relieving it of its contents. ELECTRO-THERAPEUTICS. 347 Franklinism^ according to Artliius, is exceedingly efficacious in paralysis of the bladder not due to organic disease of the brain or spinal cord. Incontixence of Urine. — Faradism. A primary farad ic current, with one pole applied in the lower third of the rectum in the male, or to the meatus urinarius in the female, and the other over the os pubis, will sometimes relieve when the trouble is the result of debility, and especially if there is almost no control over the bladder. Sometimes it answers an excellent purpose to employ the electric brush on the dry surface over the hypogastric region, the opposite pole being on the spine. Galvanism. The galvanic belt sometimes proves useful in these cases, one broad flat electrode being fastened over the bladder and an oblong one over the lumbar spine, and both con- nected with the belt. Only a few cells should be included in the circuit at first ; the number may be increased as the current falls. This application of galvanism is continued for weeks at a time, with a view to bringing about nutritive clianges in the muscular tissue. Hypertrophy of the Prostate. — Electrolysis. Dr. Bredert* reports five cases of senile hypertrophies of the prostate, in which either one or both lobes of the gland were enlarged ; and in all of these catheterization was impossible or could only be performed with great difficulty by bending the instrument. He inserted a needle electrode, insulated except at the point, which he pushed into the enlarged gland. This was connected with the negative pole of the battery, while the positive was applied to the abdomen. The diminution of the organ took place with astonishing rapidity. In one case it occurred after the third application. Hypertrophy of prostate, in recent cases, may be reduced by the measures recommended for the reduction of other hypertrophied glands. The electrode intro- ^ Berlin Klin. Woch. 348 ELECTRO-THERAPEUTICS. duced into the middle third of the rectum conveys a current directly to the prostate. Irritable Urethra. — Galvanism. This condition of the urethra can be relieved by a properly applied mild galvanic current. In some cases, where it is impossible to make a local application, owing to the excessive sensitiveness of the urethra, a few galvanic water baths will subdue the sensitiveness suf- ficiently to permit the introduction of the sound, Fig. 119. This instrument should be warmed and oiled before attempt- ing to introduce it. The negative pole may be connected with the sound after it is in place ; the circuit must be closed by placing the positive on the lower part of the spine, and opened by removing it before the sound is withdrawn from the urethra. Two or three zinc-carbon cells are sufficient, and it is advisa- ble to carry the current; through a rheostat to prevent elec- trolysis of the urethral canal. The current should not be continued longer than five minutes. Gleet. — Galvanism. Dr. Blackwood^ advocates the treat- ment of gleet by electricity. He proceeds as follows : A sound (see Fig. 119), slightly oiled, and which fully distends the stricture or canal, is passed. The negative pole is attached to the sound. The positive pole or sponge should be wet with warm water, and a current which is plainly felt, but not pain- ful, used. If an area is found more sensitive than the remain- ing tract, this portion should receive especial attention. The application should last from fifteen to thirty minutes. The bowels should be kept lax, all excesses prohibited, and non- stimulating food be taken. Stricture of Urethra. — Electrolysis. The results of treat- ing stricture are veiy satisfactory and more permanent than when dilatation alone is employed. Its advocates claim for this operation freedom from pain, hemorrhage, febrile reac- *PMa. Med. Times, November 1882. ELECTKO-THERAPEUTICS. 349 tion, or any ill effect, if conducted with ordinary skill. The patient is not confined to his bed after the operation and can pass water immediately after it. Dr. Newman,* who has done most to direct the attention of the profession to this subject, makes these valuable suggestions : 1. Before operating, the susceptibility of the patient to the electric current should be tested. 2. The problem is to produce absorption, and not cautery therefore, weak currents at long intervals are best. 3. The best position for the patient to assume during the operation is that which is most comfortable to him and the operator. It may be either the erect or recumbent. 4. Anaesthetics are to be avoided, as it is better to have the patient conscious and able to tell how he feels. Care must be taken to keep the electrode in line, so that the point will not deviate and make a false passage. 5. Force should never be used. The bougie must be guided in the most gentle way, and electricity alone be allowed to do the work. 6. During one seance two electrodes in succession should never be used. 7. It must not be forgotten to stoj? the current 'before with- drawing the electrode^ otherwise acute pain will be induced in the course of the urethra, which often remains some time. Pain should never be inflicted during electrolysis ; therefore it should not be applied when the urethra is in an acute or even subacute inflammatory condition. 8. It is well to leave a little urine in the bladder. It serves to diffuse the stimulus and is more agreeable to the patient than when the bladder is empty. Dr. W. H. Dukeman,f of Olean, N. Y., reports a remark- able case treated successfully after this method : The patient, *iV. E. MecL Montfdy. ^The Medical Becord, June 23, 1883. 350 ELECTROTHEK APE [JTICS. aged sixty-five, had suffered from stricture twenty-five years. Four distinct strictures were discovered. An insulated urethral electrode, tipped with a No. 9 olive (French scale), was intro- duced and arrested at the third stricture. The negative pole of a Mcintosh galvanic battery was connected with the urethral electrode, six cells were included in circuit and the circuit completed by placing a large wet sponge electrode on the left thigh ; after eighteen minutes it passed through the third stric- ture but was arrested at the fourth, which it failed to pass after fifteen minutes' steady application of the current. The patient returned next day for further treatment. A No. 3 French filiform bougie on trial failed to pass the fourth stricture, and the current was reapplied as on the previous day ; the current was increased cell by cell until twelve were included in circuit ; the electrode entered the bladder at the end of nine- teen minutes. The patient did well in every respect, and at in- tervals of one week were passed a No. 13 olive (French scale), a No. 17 and lastly a No. 21, when the operation was considered complete, the patient being entirely relieved. It is im^portant that the negative pole he connected with the urethral electrode^ othericise it will hecome glued to the tissues so that it cannot he removed without violence^ and the cicatrix^ which forms vjhere the positive has heen applied^ is liable to contract and form a worse stricture than the one it was intended to remove. " Impotence. — Galvanism. Dr. Robert Newman* has pub- lished a series of valuable articles on impotence, which he defines as ''any deviation from the normal status of sexual vigor." He prefers galvanism, and when an interrupted current is needed, he makes use of the automatic rheotome. He ex- cludes from the cases to which electricity is adapted — 1. Males in whom sexual vigor never existed, as in con- genital malformations. * The Planet, Nov. 15, 1883. ELECTRO-THERAPEUTICS. 351 2. Those cases dependent on the decay of age. 3. Mutilation, or loss of parts by accident. 4. Diseases of testicles. 5. Those cases in which impotence is only a symptom of other grave diseases, as ataxia, diabetes, etc. We have three centers governing erection : 1. Xerve centers in cerebrum {Psychical). 2. Lumbar plexus, presiding direct over erection. 3. Peripheric nerves of genitals. The rrechanism of erection is not merely a retention of venous blood, but more an afflux of arterial blood into the elastic erectile tissues of the penis, which is well recognized by our modern physiologists.* But this mechanism cannot take place by itself, and is induced and governed by the power of the nervous system, as explained. This knowledge is of the greatest importance in making a correct diagnosis, and select- ing the course of an intelligent treatment, both of which can be accomplished by electricity. He uses a galvanic battery of twenty or more zinc-carbon cells. The electro-sensibility will decide how many cells are needed. The current of six cells ma}^ be sullicient, while another case needs thirty cells. Twelve to sixteen cells are used generally as an average. The strength of the current must always be regulated, and on some points of applications in the ^ame patient, made stronger or weaker, according to his sensibility. The duration of each seance is about ten minutes. The electric brush has done excellent service in those patients who had lost almost the entire sensation in genitals, with impaired nutrition and atrophy of the parts. Strong cur- rents of galvanism made no impression, and caused no sensa- tion, but the cautious use of the electric brush, alternated with galvanic interruptions, restored the power and finally cured. ♦Flint's Textbook on Physiology, page 108. 352 ELECTKO THERAPEUTICS. He mentions another method, which is even more powerful in its tonic action than any other. The positive sponge electrode is placed on the back, and as negative pole an insulated urethral electrode is introduced into the urethra (Fig. 113). The duration of such a seance is from five to ten minutes, as a rule. Such applications are not repeated often, and only given in intervals of one to three weeks. Meanwhile, the external appli- cations are given as described before, about four times a week. If an insulated electrode is used, the jDower of galvanism is concentrated at one point, covered by the olive, and this place has the full benefit, and may be even cauterized if the current is strong enough. The simple nickel-plated sound (Fig. 119), not insulated at all, as negative pole in the urethra is preferable when it is desired to diifuse the electric current through the whole urethra, or even to the whole member. The advantage of this procedure is that it exerts a tonic effect on a large surface and groups of muscles, while at the same time the current can be used stronger. If the penis is cold, numb, atrophied, in fact almost lifeless and useless, this method will give the best chance for recovery, in combination with other applications referred to before. The prognosis of these cases of impotence under considera- tion is favorable in almost all instances; this means that impaired vigor, or functional impotence, will be cured under judicious treatment, if there is not complete paralysis. Faradism.. Dr. William F. Hutchinson^ remarks that for nearly ten years he has used the faradic current in the treat- ment of impotence. He prefers a current as strong as a patient can bear without pain and without shocks. He applies a large negative sponge electrode under the lumbar vertebrae, the *N, E. Med. Monthly, October 15, 1883. ELECTEO-THERAPEUTICS. 353 patient being comfortably recumbent, and for the positive a pad of surgeon's sponge moistened is pressed against the glans. The result is a strong stimulation of those branches of the sacral plexus composing the genito-urinary tract, and a cor- responding increase in muscular nutrition. The penis becomes turgid, the dartos contracted, and a close watch must be kept upon the patient, lest by continuing the application too long an emission be produced. By discontinuing the current after five minutes, or by increasing the electro-motive force until it becomes painful, this result may be avoided. By a steady per- sistence for several months in this form ot treatment, he had succeeded in completely restoring several patients. The appli- cations should be made daily. Dr. A. Gunther, of Zurich, places the testes between two wet sponge electrodes, or applies the faradic current direct to the glans, according to the indications. Fmnklinism furnishes a most valuable means for the relief of impotence, according to Dr. Yance. Spermatorehea. — Gal/vcmism. All sources of irritation of the genital organs, such as stricture, piles, constipation, acrid urine, must be removed before any treatment will relieve sper- matorrhea except temporarily. Non-stimulating diet should be insisted upon ; intoxicating drinks, excessive use of tobacco and all excesses must be prohibited, and the bladder thoroughly emptied before retiring. In some cases it will be well to direct the urine to be voided whenever the patient awakes during the night. A mild galvanic current should be applied three times a week, the positive electrode at the lumbar sacral promontory, and the negative to the perineum and supra-pubic region alternately. It will require about three months to effect a cure. Neuralgia of the Testes. — Galvanism. This very painful affection may be relieved by the uninterrupted galvanic current. 354 ELECTEO-THEEAPEUTICS. The testicles are extremely sensitive to electricity, and the pains excited by a careless application extend to the loins and are exceedingly disagreeable to the patient. The best method of electrizing them is to immerse them in warm water contained in a cup of suitable shape, which is connected with one pole of the battery in the same manner as the eye-cup. A very mild current should be employed. The positive pole may be connected with the cup, and the negative be held in the hand or placed on the thigh, or the positive may be placed on the lower part of the spine and the negative connected with the cup. Hydrocele. There are three methods employed : 1. Elec- trolysis^ needles attached to both poles being introduced into the sac. 2. Electrolysis with the negative needle only intro- duced. 3. Earado-puncticre, i.e., a faradic current applied to needles introduced into the sac. Whichever method is selected it is essential that the needles penetrate into the fluid, and that they be insulated at the point where they pass through the coverings of the testicle. The Galvanic Bandage. Mr. S. Osborn read before the London Medical Society notes of two cases of hydrocele cured by single tapping, with the subsequent use of the galvano- suspension bandage. The first was a case of hydrocele of the tunica vaginalis, which had been present for seven or eight years; and the second was a case of double encysted hydro- cele, present for six years. Both patients were affected with rupture on the same side as the hydrocele, showing a preter- natural weakness of the parts in the vicinity. The ages were seventy and sixty-three respectively. After tapping and manipulation the galvanic suspensory bandage was applied. The galvanism was believed not only to cause contraction of the muscular fibers of the scrotum, but to impart a healthy action to the serous sac, aiding absorption. Mr. Osborn recom- mended a trial of this bandage in other diseases of the testicle, ELECTRO-THERAPEUTICS. 355 such as varicocele and neuralgia. The galvano-suspension bandage referred to is supplied with the Mcintosh Gal- vanic Belt. THE UTERUS AND ITS APPENDAGES. Eohrig* demonstrated that the center of uterine action is in the lumbar spinal cord. Stimulation as high up as the medulla, and even as far as the crura cerebri and optic thalmi, also gives rise to slight uterine contraction, probably due to indirect stimulation of the lumbar center. f Experiments on lower animals indicate that impulses may pass from the cen- tral nervous system to the uterus along the sympathetic, from the inferior mesenteric ganglion, and also along branches of the sacral nerves, respectively, to the hypogastric plexus.:!: M. Dembo§ has endeavored to decide the question, upon which authors differ, as to the influence of electricity upon the uterus, whether empty or pregnant. His conclusions are that it is impossible to excite contractions in the non-pregnant uterus by a faradic current applied through the abdominal walls. If both electrodes are applied to the anterior (vesical) wall of the vagina, a manifest contraction is produced in both parts of the uterus, vermicular in character, passing from below upward. If the current be applied to either lateral wall of the vagina, a contraction is produced only in the corresponding cornu. Fara- dization of the vaginal wall caused pallor of the mucous mem- brane and also of the whole uterus, due apparently to contraction of the vessels, but no contraction of the substance of the uterus occurs. Frankenhauser found that stimulation of the aortic plexus (see Fig. 73) caused a manifest contraction of both comua. The hypogastric plexus lying in front of the sacrum *Virchow's Archiv., 1879. fKorner, Studien Phys. Inst. Breslau, iii, 34. X Basch and Hofman, Wien, Med. Jahrb., 1877. 'i The Lancet. 356 ELECTRO-THERAPEUTICS. furnishes the nerves distributed to the uterus and vagina, and here Budge and Wall located the genito-spinal center. Elec- 'tricity mav be conducted to these organs by locating one large electrode on the sacrum and another in front of the abdomen, over the pubic arch, or the current applied in front may be divided by means of a bifurcated cord between two elec- trodes, one being located in each inguinal region. Another method of electrizing these organs is to introduce one electrode into the upper third of the rectum, where the current is divided between the sacral nerves and the posterior surface of the uterus and its appendages, the alternate electrode being located as before. Fig. 113. Length, 11 inches. UTERINE OR URETHRAL ELECTRODE. This is an inflexible metallic rod insulated with hard black rubber. Its diameter equals a No. 9 olive (French scale). It is curved at one end, and terminates in a small screw that fits olives of any size. M. Apostoli^ recommends, instead of the unipolar method of faradization, in which one pole is placed in the uterus and the other pole on the abdomen, the bipolar method, in which both poles are carried into the uterus. It is claimed for this new method ; 1. That it is more easily employed, and does away with the necessity of an assistant. 2. That it is less painful. 3. That it is more active, localizes the action of the elec- tricity in the uterus, permits of an easy elevation of the intensity of the electricity to the maximum point, which was only rarely possible by the unipolar method. * Gazette Des Hopitaux, February 1883. ELECTRO-THERAPEUTICS. 357 4. It is more effective in increasing uterine contractility and in securing tlie therapeutic effects for which it is directed. The electrode illustrated in Fig. 116 may be used for this purpose. DISEASES m WHICH ELECTRICITY IS BENEFICIAL. Atrophy of uterus, Hypertrophy, Sub-involution, Irritable uterus. Menstrual derangements. Labor, Leucorrhea, Vaginismus, Ulceration, Polypi, Fibroids, Displacements. Fig. 114. Length, 11 inches. SPIRAL FLEXIBLE UTERINE OR URETHRAL ELECTRODE The stem of this electrode is made of closelj'--coiled wire, which renders it perfectly flexible while preserving a sufficient degree of firmness. It is covered with soft rubber, which insulates it perfectly without interfering with its flexibility. The terminal screw flts olives of all sizes. The diameter is equal to a No. 16 olive (French scale). ^s'early all the diseases of the uterus and its appendages require the methodical application of electricity for several months before its remedial power will be exhausted. Its chief effect is accomplished through the improved nutritive changes which it sets up, and these are necessarily slow. Functional disorders may be relieved quite promptly by a properly-select- ed current. General faradization and central galvanization will be found especially useful in 'subduing the sympathetic dis- turbances which accompany disease of these organs, and treat- ment should be used not only to overcome or relieve attacks of suffering or check a hemorrhage, but in the intervals to improve the morbid condition upon which the disease depends. The practitioner who relies solely on local applications and a single form of electricity will meet with frequent failures where, under other circumstances, he would have been rewarded with success. Atrophy of the Uterus. Galvanism has been used suc- cessfully, more especially in cases of undeveloped uterus, than 358 ELECTEO-THERAPEUTICS. when atrophy has resulted after the establishment of the monthlies. An insulated electrode, like the one shown in Fig. 114, is introduced into the uterus and connected with the negative pole of the battery ; the circuit is completed by passing the positive electrode alternately over the abdomen in the ovarian region and over the lumbar vertebrae. An interrupted current from twelve to fifteen zinc-carbon cells may be used if it can be borne; the sitting may continue fifteen minutes and be repeated twice a week. If the patient begins to complain of pain in the back, with a feeling of tension and uneasiness in the hypogastric region, indicating an attempt at menstruation, it is well to substitute the famdic current for one or two sittings, discontinuing all treatment on the appearance of a colored discharge for one week, then resume galvanism once a week as before. This method of treatment will generally succeed, although it may require many months to establish a regular return of the menses. Galvanic baths given in the tub, with the current directed through the electrodes opposite the hips, the patient lying on one side meantime, and repeated twice a week for several months, is an efficient and much more agree- able mode of treatment than the one previously described. ® ® ^ Fig. 115. OLIVES. These are made of brass, nickel-plated, and are of all sizes, to correspond with the American and French scales. They contain a socket cut in threads to receive a screw. Caution : Olives should be firmly attached to the electrodes ; if the screw does not fit per- fectly there is danger of losing them off within the bladder or urethra. Amenorrhea. In the case of young girls, it is advisable to apply electricity by the external method, one pole being located over the hypogastric plexus and the other the ovaries ; at the same time the current may be applied through the phrenic nerve. Central galvanization is so useful a measure that the ELECTEOTHEEAPEUTICS. 359 physician is not justified in employing electricity locally in these cases until a faithful trial of the above measures make it evident that there is no other alternative. The hot-air elec- tric bath is indicated if there is reason to believe the non- appearance of the monthlies is due to a cold. This instrument consists of a flattened black hard-rubber tube, 10 inches long, with a diameter equal to a No. 22 olive through which passes two wires 12 inches long, insulated with hard rubber, each terminating at one end in a half olive, permanently and securely fastened to them, and at the other end, in a socket for connection with a conducting cord. Before introduction into the bladder or uterus the wires are drawn back so that the terminal tips touch and form a No. 23 olive at the end of the common tube ; after introduction the wires are pushed through the tube; this separates the terminal tips, which now represent the two poles of the battery with which they are connected. Galvanism. Dr. R. R. Good ^ reports excellent success in the treatment of this affection when it is due to inertia of the utero-ovarian apparatus, distui-bance in circulation, or to defective nutrition. It would be useless to resort to galvanism when the disorder originated in mechanical obstruction. From five to forty sittings are required to eftect a cure. His method is to employ the descending current, with twenty to thirty elements for the upper part of the spine, the lumbar and ovarian regions, and from six to ten elements for the sympathetic nerve, applied along the inner border of the sterno-cleido-mastoid muscle. The method of internal application varies, some operators using the faradic current only, some the galvanic, and others alternate the two. The current may be directed to the vagina through a vaginal electrode (Fig. 121X to the cervix through electrode shown in Fig. 124, or within the cervical canal by those shown in Figs. 114 and 125. The external electrode may be located over the sacrum or any portion of the spine, *Med. Times and Gaz., 1880. Fig. 116. DOUBLE ELASTIC VESICAL ELECTRODE. 360 ELECTRO-THERAPEUTICS. or applied over the uterine or ovarian region on the anterior surface of the abdomen. Amenorrhea in women from thirty to thirty-five, with a tendency to obesity, is sometimes relieved, according to Dr. Goodell^ by the galvanic pessary. This electrode is pronounced, by those who have employed it, better suited to the treat- ment of stricture than any other form. It consists of a black hard-rubber closed tube 11 inches long, within which is enclosed a metal rod that may be connected with the negative pole of the battery. At the closed end of the tube are three long and wide slots ; when the circuit is complete, electrolysis of the secretions within the urethra around these slots takes place, and the stricture is acted upon without direct contact with the metal. It is claimed that there is less danger of making a false passage with this instrument than with the usual form of urethral electrode, and that it is equally as effective. Mexorrhagia. — Famdism. Electricity is especially indicated in those cases of passive hemorrhage not dependent upon organic changes. The current applied to the abdominal muscles so as to produce vigorous but not painful contractions, for fifteen minutes at a time, and repeated two or three times per week, will frequently produce an immediate diminution in the flow, and, if persevered in, a cure. It will sometimes be more effective applied within the vagina or cervix. General applications of faradism or galvanism, selected according to the symptoms of the case, are an important aid in removing accompanying debility. If the patient takes little exercise and has sluggish circulation, general faradization is commonly indicated ; if, on the contrary, she is of active habits, and especially if the con- dition has been induced by over-exertion, central galvanization to improve nutrition is preferable. It may be necessary to continue treatment for several months before the nutrition of the uterus is sufficiently improved to put an end to excessive flow, but as the result is permanent Fig. 117. NEW STYLE ELECTRODE FOR STRICTURE. *Phila. Med. Times, 1883. ELECTRO-THERAPEUTICS. 361 when accomplished by this method, it is well worth the per- severance required in carrying it out. JDysmenorrhea. — Faradism. Karl Kihn,* having had op- portunities to test the value of the faradic current, both in dysmenorrhea and amenorrhea, advises it used in connection with hot infusions of juniperacese and warm foot-baths. He places one electrode in the hand of the patient and the other in the water of the foot-bath. In a number of instances this simple measure increased the flow, relieved the pain, and es- tablished a regular and comparatively comfortable return of the periods. Fig. 118. CATHETER ELECTRODE. This instrument is an ordinary silver catheter, to which is attached a holder a to receive a conducting cord ; a rubber tube may be connected with h to convey the urine into a receptacle. When it is desirable to prevent the current from affecting the urethra, the instrument may be insulated, except at the perforated extremity, with tbe same material that is used for electrolysis needles. Dr. Wm. E. D. Blackwood f is an enthusiastic advocate of electrical treatment in all forms of dysmenorrhea, excej)t the membranous variety. He employs faradism, galvanism and franklinism, and bases his conclusions on an experience of more than fifteen years. He believes the applications should be made directly, one pole being applied to the exterior of the cervix, to the cervical canal at any desired point, to the fundus, or to the ovary (which can be reached near enough by pushing the instrument well up on either side of the cervix), while the other is applied both to the hypogastrium and lumbar spine by means of two sponge-holders attached to a bifurcated cord. * Allg. Med. Cent. Zeitung, Nov. 10, 1880. \Phna. Med. Times, Jan. 1880. 362 ELECTEO-THEKAPEUTICS. The direction of the faradic current is a matter of no mo- ment, but the galvanic current appears to produce different results, according as it is ascending or descending. In neuralgic cases the rheotome is necessary, and more or less frequent reversion of the current heightens its value, while in congestion a downward uninterrupted current is better. Static electricity is a most valuable but neglected method in neuralgia, not alone of uterine origin, but of all types, and will often succeed after the failure of other proceedings. This is an ordinary nickel-plated sound with a screw attachment, which fits a universal handle. Caution is required in conveying a galvanic current through this electrode, lest electrolysis of the entire urethral membrane be produced. Galvanism is sometimes indispensable in these cases. It is employed during the attack to quiet the pain, and two or three times weekly, in the intervals, to prevent a return of suf- fering. One pole may be introduced into the uterus, the other being applied to the lumbar spine, and a current of from ten to twenty volts passed for ten minutes. Electro-thermal baths of all kinds, but especially the water, or vapor electric baths, taken at intervals for several months, relieve cases not depen- dent upon obstruction. Vaginismus. — Galvanism. Cases of excessive hypersesthesia of vagina, accompanied by vaginismus, forbidding all examination of the parts, have been relieved by this procedure : Connect the vaginal electrode (Fig. 121) with the negative post of the battery and apply, after warming it, to the orilice of the vulva. Place the positive electrode in position C, Fig. 120, and close the circuit, including not more than four freshly-charged zinc and carbon cells, or six that have been used some time. Do not exert ELECTRO-THERAPEUTICS. 363 am- force on the negative electrode, but hold it steadily in place with gentle pressure ; after a few seconds it will gradually slip into the vagina ; the current may be continued twenty minutes, and usuall}^ after the second treatment a digital examination may be made without difficulty, provided it be done immedi- ately after removing the electrode. Any exciting cause of the distressing condition that can be found should be removed, after which the persistent use of galvanism will relieve and restore the patient to a normal condition, in a larger propor- tion of cases than any other treatment. Irritable Uterus. — Galvanism. The cup-shaped uterine electrode (Fig. 124) is applied to the cervix and connected with the negative pole of the battery, the positive completes the circuit at the sacrum, or in the ovarian region. Leucorrhea. — Galvanism. This disease, when due to a catarrh of the uterus, or vagina, may be treated by a mild galvanic current applied within the uterus, to produce a feeble electrolytic eflfect upon the lining membrane, with a view of stimulating it or altering the nature of its secretion. Since an acid is set free at the positive and an alkali at the negative, it is important to consider the special effect to be produced in selecting the pole to be connected with the internal electrode. Uterine leucorrhea, without organic disease, may be relieved by a galvanic current applied through electrodes, shown in Figs. 124 or 125 ; vaginal leucorrhea, through electrode Fig. 121. Leucorrhea, both uterine and vaginal, not depen- dent upon ulceration or foreign growths, can be effectually and permanently relieved by the hot-air electric bath. A series of these baths, from twelve to thirty in number, repeated twice a week, with intermission during the menses, has relieved cases of many years' standing without local treatment. The attention of the profession is earnestly called to this method of radically curing an almost universal complaint by a measure 364 ELECTRO THERAPEUTICS. at once agreeable, effectual, and especially desirable in the case of unmarried ladies, where the disease is more likely to be due to constitutional than local causes. Chronic Metritis. — Galvanism. Chronic inflammation of the uterus, with enlargement, may be materially relieved by the use of the galvanic pessary; the external electrode being located over the sacral ganglia. The latter may be retained in place by means of straps of adhesive plaster. Tripier recom- mends that a current from a battery be applied according to this method. One electrode (Fig. 124) is placed against the os, and connected with one pole, while the current from the other is divided between two electrodes, one of which is introduced into the upper third of the rectum to bring it in connection with the posterior wall of the uterus, and the other is placed over the abdomen. An insulated rectal electrode is required for the former, and a large wet sponge for the other. The object of the application is to allay irritation and improve nutrition ; therefore a very mild current should be employed, and for a few minutes only when the battery is used, because electrolysis is to be avoided. When the belt is employed with the pessary, the negative current will be less likely to irritate the cervix. The full number of belt cells should not be wet up at first ; four or five are enough to commence with, and after a few hours one or two more may be charged with fluid and added to the circuit. Engorgements, Hypertrophy, etc., have been relieved by the method described above. In these cases, however, when inflammation is not present, the current should be interrupted. The faradic current applied by a vaginal electrode (Fig. 122), so that the anterior and posterior walls are respectively affected by the current, is sometimes very effectual in reducing the size of the uterus. ELECTEO-THEEAPEUTICS. 365 Faradism applied with an insulated rectal electrode in con- tact with the posterior uterine wall, and a broad sponge on the abdomen is sometimes preferable, but should never be ap- plied when there exists evidence of sub-acute inflammation. OvAKiAx Irritation. — Faradism. When there exists ten- derness on pressure, or dull aching pain, especially in the left ovarian region, the faradic current, applied after the manner described for constipation, sometimes proves curative. Galvanism. Ovarian irritation, accompanied by neuralgia, may be relieved by galvanism when a point can be detected, along the spine or a nerve, where pressure by the finger causes pain. One pole must be located on the tender spot, and the other on one or both ovaries, according as one or both are aflected. Congestion of ovary, attended by hysteri- cal symptoms, is sometimes relieved by the galvanic belt ; the electrodes being located over the ovaries, and the application being continued for several weeks, or months if necessary. Displacements of the Uterus. Simple displacements are easily rectified under the influence of electricity by its external application through the walls of the abdomen. This is believed to be accomplished, partially at least, through the contraction of the abdominal muscles. The general application of all forms of electricity affect the uterine supports through the spinal nerves and hypogastric plexus. The current conveyed to the pelvic organs through these nerves improves nutrition, and consequently lessens the weight of the womb, when the latter is in a hypertrophied state. When the vagina is relaxed, the introduction of the current through a vaginal electrode will be found m^ost efficient to restore its tonicity. The vaginal electrode should be .warmed and oiled before introduction, and the circuit must not he completed until after tlie electrode is in place. The alternate pole may be located on the sacrum, or by means of a divided cord over both ovaries. 366 ELECTRO-THERAPEUTICS. Faradism is used for its mechanical effect ; galvanism^ for its chemical effect. When it is interrupted, the galvanic exerts both a mechanical and chemical effect. This important point should not be overlooked in the treat- ment of uterine displacements by electricity. The patient should be instructed to clear out the rectum, by means of an injection if necessary, immediately before presenting herself for treat- ment, and the bladder must be empty. The uterus should he replaced as nearly as possible to a natural position hefore ap- plying the current. Tripier reports thirty cases of uterine disease treated by faradism locally applied. The plan he pursued for the various forms of displacements are: Prolapsus. One pole applied against the neck of the womb, the other is connected through a bifurcated cord with two electrodes, one of which is applied in each groin. Anteversion and Anteflexion. The negative, an insulated rectal electrode, was introduced so as to carry the current to the upper third of the rectum, and the positive in the vagina. Retroversion and Retroflexion. The positive over the ab- domen or introduced into the bladder (a plan that can scarcely be recommended), and the negative to the neck of the womb. If the application of electricity causes the monthlies to appear when not due, it is an indication that the current was too strong, applied too long, or repeated too frequently. Labor. — Faradism. Dr. W. J. Kilner,* electrician to St. Thomas's Hospital, has made a valuable study of the effects of faradism in forty-one cases of labor. He uses it especially where the pains are short, feeble, and at long intervals, and states that his first experiments were directed to discovering whether the pregnant uterus, like the voluntary muscles, possessed motor points. After many trials he arrived at the con- * Lancet, Jan. 1, 1881. ELECTRO-THERAPEUTICS. 367 elusion that motor points exist, and can bo easily found by bi- secting the line drawn from the umbilicus to the middle of Poupart's ligament. This point is approximate, being only applicable before the head has descended, to allow the head of the child to enter the pelvis, and the spot varies in each case, according to the position of the uterus. The muscles of the uterus are of the unstriped variety (involuntary), and they do not respond to electric stimulation so quickly as the stripe(/ muscles. Fig. 120. METHOD OF APPLYING ELECTRICITY TO THE UTERUS. This illustration shows where to locate the electrodes to convey electricity through the uterus and its appendages. B represents electrode, Fig. 114, connected with one pole, introduced into the cervical canal. A and C are two electrodes connected by a bifurcated cord with the alternate pole ; A and C indicate the points to locate the elec- trodes when external treatment only is required ; also the points where they are located when electricity is employed during labor. When the faradic poles are placed upon the spot just indicated, the first thing observed is the immediate contraction of the abdominal muscles, the intensity of which depends upon the strength of the current. Occasionally, at the instant of contact, uterine contractions commence, but more often a lapse 368 ELECTRO-THERAPEUTICS. of about a quarter of a minute is required, and not infre- quently they are delayed for two or three minutes. But still the current is taking eifect, as the intermittent use, for instance, half a minute on and the same off, rarely fails to induce contrac- tions in a few minutes; these increasing gradually in severity and duration, while the intermissions become less and less. Latterly, however, he has applied the current only during the contraction, to obtain the benefit of the relief of pain. If it be wished merely to prolong any one uterine contrac- tion, the current is best applied near the termination of the pain, when it will commence de novo. Fig. 121. VAGINAL ELECTRODE. Length, 6 in.; diameter, % in. This electrode is made of brass, nickel-plated, and is designed to be used for con- veying a current to all parts of the vaginal wall. It fits the universal handle. The ones most likely to be affected favorably by the induced current, viz: (1) Those of a nervous temperament, who are easily excited, and who usually feel pain acutely. (2) Those who have sympathetic disturbances, such as vomiting and hic- cough. (3) Those who require stimulation. The best way of applying the current is to place the elec- trodes (each being about three inches in diameter) upon the abdomen, over the motor points, these being retained in their proper places by the binder. Large electrodes are preferable to small ones, because the same current spread over a large surface is not felt so acutely as when it is concentrated into a small space. For the relief of pain, a very mild current only is required, but for the pro- duction of uterine contractions, a variable strength is necessary. E LECTRO-THERAPEUTICS. 369 The following conclusions are derived from a total of five Imndred electrizations of the uterus:"^ 1. That faradization of the uterus is entirely harmless. 2. Faradization is a uterine sedative. 3. Faradization abridges considerably the convalescence and accelerates the involution and retraction of the uterus. That it also hastens the restoration, and promotes regularity of function. 4. Faradization guards the woman from the uterine com- plications of labor. 5. That faradization is the correct preventive treatment of uterine malpositions. 6. The action of faradization on the uterus is similar to that of ergot, only its action is more prompt and more energetic. Fig. 122. VAGINAL ELECTRODE INSULATED IN LATERAL HALVES. This electrode consists of two cylindrical halves separated by hard rubber, which insu- lates them so that electricity cannot pass directly from one to the other. A binding post is attached to each half for connection with the conducting cords. It is designed to be used when a positive current is to be applied to one half the vagina and the negative to the other half. The current is localized on the lateral halves, or anterior and posterior halves, according to the direction in which it is introduced. In conclusion, it is a marvelous therapeutic agent in obstet- rics, simple in application, rapid and energetic in action, perfectly harmless, and can be interrupted or renewed at will. It not only restores the uterus to the normal condition, but its use prevents further uterine complications. The method of employing it for this purpose is this : Immediately after the delivery, an induced current is applied to the uterus, and gradu- ally increased in intensity. This operation is repeated from eight to ten times, during about six days after normal labor. * M. Apostoli, in Gazette des Hopitaux. 370 ELECTRO-THERAPEUTICS. SUPERINVOLUTION AND SUBINVOLUTION OF THE UtERUS. Dr. Eockwell has successfully treated a few cases with both gal- vanism and faradism, the applications being made almost daily for a number of months. Dr. Murray* regards the galvanic pessary an efficient in- strument in subinvolution following childbirth. In one case of this kind with retroversion where pessaries had failed to remedy the condition, the introduction of a galvanic pessary was fol- lowed by the reduction of a large flabby uterus nearly to a healthy, natural condition in the course of a fortnight. Fig. 123. VAGINAL ELECTRODE INSULATED IN VERTICAL HALVES. This electrode consists of two short nickel-plated brass cylinders, separated by a cylin- drical piece of hard rubber placed between their adjacent ends. Two binding posts, one having metallic connection with each cylinder, receive the conducting cords. This instrument is designed to apply one pole to the upper and the opposite pole to the lower half of the vagina. Extra-Uterine Pregnancy. — Galvanism. Dr. Rockwell has succeeded in a number of instances in destroying the foetus by electricity, without injury to the mother. One was of an unusual character, the tubal or extra-uterine pregnancy being associated with normal uterine pregnancy. The diagnosis was confirmed by Dr. Thomas and others. The galvanic current was employed, with one pole introduced to the mass through the vagina and the other over the tumor externally ; the current was rapidly interrupted. A current of twenty-four volts was em- ployed and the treatment repeated the first, third and sixth days thereafter. The tumor, at first the size of a billiard ball, gradually grew smaller, while the natural pregnancy progressed favorably. Another case of tubal pregnancy had reached the * The Lancet. ELECTROTHERAPEUTICS. 371 fourth month of development when first examined. One elec- trode was introduced into the rectum ; the other was placed externally over the tumor. On account of the danger of rup- ture, owing to the great distention of the Fallopian tube, a current of only sixteen volts (12 cells) was used when inter- rupted ; the current was increased without interruptions and allowed to pass a moment continuously ; it was then decreased. This treatment was repeated on the following day, and without any further electrization the patient recovered and the tumor disappeared. He states that it is an error to suppose that abortions are readily produced by electricity unless measures are employed that would produce abortion without electricity. This is composed of a curved metal rod, insulated in hard rubber, terminating in a screw, to which may be attached cups of various sizes. The instrument is shown complete in the upper part of the cut; the lower represents the stem and cup separated. The cup is lined with metal, which is connected with the metal rod through the screw. It is designed to localize the current upon the lower external surface of the cervix uteri, the alternate pole of the current being applied externally over the abdomen or sacrum. Faradism. Dr. J. C. Reeves,'^ in one case where diagnosis was positive at the end of the third month, used faradization for nine days as strong as could be borne for ten minutes at a time. One electrode was in the vagina upon the tumor and the other upon the abdomen ; recovery followed. Lusk, Bache, Emmet and others have succeeded with faradism when the diagnosis was made early. Dr. T. G. Thomas, from a study of twenty-one cases, formulates the following rules for guid- ance in treating this condition : * Trans. Ani. Gynecolog. Soc, 1879. Fig. 124. CUP-SHAPED UTERINE ELECTRODE. Diam. of cups, % in. to 1^ in. 372 ELECTEO-THERAPEUTICS. 1. If the diagnosis be well settled before the fourth month of gestation, he would destroy the life of the fcetus by electricity in preference to all other methods. 2. Should the fourth month of gestation have passed, and surgical interference be called for, laparotomy, or, with the tumor low down in the pelvis, elytrotomy should be preferred to electricity. 3. Should the pregnancy be abdominal, the practitioner might watch and wait until full term, and deliver by laparotomy, or by elytrotomy and the forceps, or manual delivery. INTRA-UTERINE ELECTRODE. This is similar to the electrode represented in Fig. 124, with the addition of a metal rod, 1 inch long, which screws into the base of the metal-lined cup. It is designed to be used in localizing a current upon the cervix and within its canal, the alternate pole being applied externally. Caution. It is important that no force be used when introducing this electrode. The cervical canal is slightly constricted at the point where the neck and body of the Avomb unite, and it is here that flexion occurs. When flexion of the Avomb exists, the canal is bent if not completely closed, and since its length averages but three-fourths of an inch to one inch, if force is employed to push this cup into close contact with the external surface of the uterine neck, the prong or projecting rod might be forced into or through the tis- sues, an accident that is liable to prove very dangerous. 4. Should the full term be passed and the foetus be dead, wait and watch and aid nature when she demonstrates the outlet by which she desires extrusion to be effected. If bad symptoms under these circumstances at any time develop, per- form laparotomy under strict antiseptic precautions. 5. Should rupture of the foetal nest have occurred before diagnosis has been fully made, wait and see whether nature is powerful enough to overcome the shock, to control hemor- rhage, and further, if the patient is going to escape the dangers of peritonitis and septicaemia. If these favorable results do ELECTRO-THERAPEUTIGS. 373 not occur, if hemorrhage is about to destroy the patient imme- diately, or if septicaemia attacks her later, laparotomy, followed by antiseptic cleansing, should be promptly adopted. Franhlinism. Dr. Kochmann, of Strasburg, reports a case of extra-uterine pregnancy, six months advanced, in which the foetus was destroyed by a single application of sparks from a static machine. The duration of the sitting was about fifteen minutes, and sparks about one and one-half centimetres long were drawn. Fig. 126. DOUBLE UTERINE ELECTRODE. This electrode is constructed similar to Fig. 125, with the addition of a second insu- lated metal rod, A, parallel with the first; both terminate in a binding post to receive the cord. The rod A is connected with the metal lining of the cup, and B with the pro- jecting rod. The central rod and cup are insulated from each other in this instrument. It is designed to be used in conveying both poles of the current to the cervix, one pole, being connected with A, is applied to the outside, and the other pole, connected with B, is applied within the cervical canal. Hypertrophy of the Cervix. — Electrolysis. When the cervix is found to be in a state of hypertrophy from long- continued irritation, and usual measures for reducing it fail, electrolysis has occasionally succeeded. Two needles connected with the negative pole are inserted, one in each lip of the cervix to the depth of about half an inch. The positive electrode is located on the nates, or some other indifferent point ; four to six zinc-carbon cells are included in the circuit, and the current is continued about fifteen minutes. The operation should not be repeated more frequently than once a month, and the time selected should be midway between the menstrual periods. 374 ELECTRO-THERAPEUTICS. Galvano-cautery has been employed to amputate an elongated cervix, for which it is well adapted. The loop is adjusted and tightened slowly like the ordinary ecraseur chain. Fibroids. — Mectrolysis. When these tumors are attached to the posterior surface of the uteru^ they may be treated through the vaginal wall, when it is important to avoid all discharge through the opening made by the needle. The positive electrode should be large, and may be applied over some indifferent spot. The negative pole attached to a suitable needle is introduced into the growth, and a current from twelve to twenty-four freshly- charged zinc-carbon cells is passed into the tumor for about twenty minutes. The needle should be thoroughly insulated, except over that part that is within the tumor. This operation may be repeated at intervals of ten to twenty days. This plan is only applicable to tumors that are near the surface, where they may afterward be opened to permit the discharge of pus that forms in consequence of the operation. When this plan is ob- jectionable, several very fine needles, insulated, except at the point, may be introduced, using a current from four to six freshly-charged zinc-carbon cells. This produces a limited destruction of tissue that is not followed by suppuration, but the blood supply is interfered with, and absorption is excited. Fungoid growths may be destroyed by electrolysis. Cancers. — Gcdvano-cautery is undoubtedly superior to any other method of performing operations for the destruction of tissue within the uterus, or vagina, because the instrument can be located while cold, the action of the heat can be limited, and hemorrhage can be prevented. The removal of portions of can- cerous growths by galvano-cautery is frequently useful in arrest- ing hemorrhages and retarding their growth. Electrolysis. The introduction of electrolysis needles to destroy a portion of the growth, not only checks the advance ELECTROTHERAPEUTICS. 375 of the disease, but in some instances produces a' notable diminution in the pain attending it. THE SKIN. Faradization produces a prickling or tingling sensation when the skin is dry. The effects are intensified by applying the current through a wire brush, and are most severe when the brush barely touches the skin. The effect of a brush made of tinsel lightly passed over the surface is so painful that an electrode made in this form has been named the electric scourge. Fig. 127. ELECTRIC SCOURGE. Length, 3 in. This consists of a bundle of tinsel-covered threads fastened in a nickel-plated head that fits a universal handle. When lightly brushed over the skin it produces a sharp stinging, exceedingly painful sensation. It is employed to arouse dormant sensibility of either nerve, muscld or cutaneous surface. The effect of the faradic current upon the bloodvessels of the skin has been microscopicall}^ studied by Weber, Pfltiger and others, who agree that it causes, first contraction and afterward dilatation of these vessels, through its action upon the vaso-motor nerves. Intense redness is easily produced in per- sons with delicate skin, and this is more marked at the nega- tive than the jDositive pole. The effects are greater if the skin is dry, for if it is moistened electricity passes through it to the deeper structures, although a very powerful current affects both the skin and the structures beneath. Galvanization. The sensation produced by it has been compared to that produced by mustard paste ; if the skin be dry and the current feeble, the sensation is very slight ; but if 376 ^ ELECTRO-THERAPEUTICS. the skin be moist or previously irritated by blisters, the effects are greatly intensified. The positive enlarges the bloodvessels and reddens the skin ; the negative has an opposite effect. The positive produces a depression of the skin, and the nega- tive a swelling of the epidermis and cutis. Franklinism produces redness of the skin, and, if sparks are taken, a peculiar eruption which resembles nettle-rash, but this form of electricity does not destroy the tissue. Diseases for which electricity has heen employed: AriEesthesia, Baldness, Ulcers, Tumors, Eruptions, Pain and itching, Bed-sores, Hirsuties. It is to be understood that in the treatment of diseases of the skin, as in those of other portions of the body, electricity is most successful when employed as an adjuvant to other indicated measures. The physician who employs electricity alone, to the exclusion of suitable medicines and regimen, will frequently fail where he most confidently expects success. It has not been thought necessary to emphasize this fact in con- nection with every subject referred to in these pages, but it applies equally to all. Galvcmism. Chronic eczema, prurigo, herpes zoster, and all eruptions dependent upon some disturbance of the nervous system, may be materially benefited by electricity applied through the sympathetic nerve. Beard and Kockwell have cured cases of eczema and prurigo by their method of central galvanization without local applications of any kind. Electrolysis. Dr. Hardaway* enumerates the diseases of the skin in which electrolysis may be confidently employed, viz: Pigmented nsevi, small fibromata, miliary nodules of lupus, sebaceous cysts, xanthoma (Fox), warts, cutaneous horns, and some stages of epithe- lioma. From certain observations that he has made in regard to the * St. Louis Courier of Medicine, July 188^ ELECTRO-THEEAPEUTICS. 377 action of this means in hypertrophied scar tissue, he is inclined to look upon it favorably in keloid. In short, it may be confidently stated that whenever it is necessary to use a destructive agent on the skin — one that is readily managed, that causes no hemorrhage, and leaves few scars — there is none better or more efficient than electrolysis. Galvano- Cautery has been successfully employed to remove tumors, destroy malignant ulceration, and for all purposes where radical destruction of tissue is indicated. Anesthesia. It is important to distinguish between cuta- neous and muscular anaesthesia. In the former the patient is insensible to touch or pain, and is unable to keep the lightest substance in his hands ; neither can he determine the weight or temperature of a body ; in the latter case, however, the patient suffering from muscular anaesthesia feels the touch or pain, but the grasp of his hand is powerless ; he cannot hold even the slightest body unless he fixes it with his eyes. Fig. 128. Fig. 128 represents one method of testing the cutaneous sensi- tiveness with Duchenne's points. The operator should become familiar by actual experiment upon the healthy, with the rela- tive sensitiveness of the different parts of the cutaneous surface and the distance apart the electrodes must be applied to detect distinct sensations at both poles. The following points should be borne in mind while treating these cases : 1. They require a divided current applied when the affection is superficial, to 378 ELECTRO-THERAPE UTICS. the dry surface through electrodes 107, 127, or in some cases 129. 2. When the deeper layers of the skin or muscles are in a state of anaesthesia, the skin must be moistened before the brush is applied. 3. With the gradual return of sensi- bility the strength of the exciting current is also gradually diminished. 4. Where anaesthesia exists along with other disturbances of nervous function, whether hyperaesthesia or motor paralysis, the anaesthesia is first to be treated, and the removal of this condition is frequently followed by a disap- pearance of all the other symptoms'. 5. If anaesthesia is the result of section of the nerves, the treatment by electricity should never be begun sooner than four weeks after the acci- dent, as this is the shortest time in which the entirely severed nerves will reunite. 6. Generally in anaesthesia following a peripheral cause, faradism will give a more favorable result. When galvanism is employed, the negative is placed upon the affected portion of the skin and the positive upon the respective nerve-trunk: the latter is moved along the nerve-trunk to the negative repeatedly. 7. Anaesthesia from inflammation of a nerve usually disappears without local treatment through gal- vanization of the affected nerve. Acne Indueata has been cured by central galvanization. Acne Eosacea. — Faradism. Place the positive electrode on the back of the neck and the negative over the affected region. Galvanism applied in the same way has also been reported successful in some instances. Herpes Zoster (Shingles). Galvanism has cured this eruption and relieved the neuralgic pains accompanying it when applied directly, the negative being placed on the erup- tion, the positive over that part of the spine from which the affected part receives its nerve supply. Nagel* says the in- *K1. Monatsbl.. 1871, p. 331. ELECTRO-THERAPEUTICS. 379 tense neuralgic pains are sometimes instantaneously relieved by galvanism. Psoriasis (Scaly Tetter). Galvanism lias cured a few cases. The current is applied the same as for herpes zoster, the negative pole being retained over each patch from one to three minutes. It requires several weeks and frequent sittings to make an impression upon cases of long standing. Ringworm. — Galvanism. A mild galvanic current applied twenty to thirty minutes through a metal electrode in contact with the eruption, and a sponge or carbon electrode near it sometimes cures after only one or two sittings. Franklinism. Dr. Despine d'Aix states that franklinic electricity in the form of sparks is a valuable aid in curing ringworm, which at the same time is receiving suitable medi- cation. Elephantiasis Arabfm. — Electrolysis. Mons. Raynaud* read a communication on the above subject from two physicians at Rio de Janeiro. The writers of that communication had had constructed suitable needles, which were introduced into the affected members to the number of about three to five. Six cells were at first employed, and the number then gradually increased to sixty. Local anaesthesia was produced before inser- tion of the needles, and the latter were washed in antiseptic solutions. This, together with other precautions, constituted, according to the authors, the Listerian electrolysis. The suc- cess following this kind of treatment was said to be very gratifying. Carbuncles and Furuncles. — Galvanism. They may be dissipated in early stages by applying the negative electrode upon them and the positive on a neighboring part. Wounds, Ulcers, etc. — Galvanism. A very weak current is capable of exercising considerable influence over the secre- *At a meeting of the Academy of Medicine {Bull de I' Acad, de Medicine, March 1, 1881). 380 ELECTRO-THERAPEUTICS. tions from wounds, etc. The positive when applied to the wound produces greater irritation than the negative. It should only be applied when the secretions are alkaline ; in this case, when it is kept in constant contact for a sufficient length of time, the tissue is restored to a healthy state. Dr. Apostoli has suggested the use of Potter's clay as an electrode for the treatment of ulcers. When saturated with pure water, or salt and water, it becomes an excellent con- ductor, and as it dries slowly it is well adapted for use with the galvanic belt when a continuous current for many hours'' duration is indicated. It can be readily adapted to the most irregular surface, and as its contact can be close or limited, its value will be readily appreciated. Applied to the epidermis, it diminishes the pain of the application and lessens the tendency to blister. Blisters. — Galvanism. The galvanic current is sometimes applied to a blister to increase the effect of the latter, in the following manner : Snip the skin of the blister, raised in the usual way ; fasten upon it the positive metal electrode, uncov- ered, and the negative with its cover well moistened at some distant point. Connect two or three cells of a battery or twice the number of the belt cells, according to the degree of irrita- tion required. After a few hours the surface of the skin beneath the blister will have a white appearance, as if rubbed with nitrate of silver. In forty-eight hours a decided eschar will appear, which, still keeping on the electrode or disc, will begin to separate at the edges. Remove the electrodes, then a])ply a common poultice, and a healthy granulating sore with well defined edges, freely discharging pus, will be left. If the patient complains of pain or irritation at all, it will be at the negative electrode only. Bed-sores. — Galvanism. Dr. Mills* has been successful * Neurologist to Philadelphia Hospital. ELECTRO-THEKAPEUTICS. in the treatment of bed-sores, which, in spite of the best of care, are apt to form in cases of spinal and cerebral disease. A silver plate connected with the negative pole is applied to the sore ; any ordinary electrode connected with the positive is placed on the surface near. A mild galvanic current is sent through the circuit from live to ten minutes daily. Electricity is very effectual in stimulating granulations. Fig. 129. HAIRBRUSH ELECTRODE. Size of brash, 4X13^ inches. Length of electrode, 9 inches. This electrode consists of a highly-polished black rubber frame, holding a metal plate, to which are fastened flexible metal wires to form a brush. There is metallic connection between the brush and screw at end of the handle. This is not an electric brush which furnishes a current of electricity ; it is simply an electrode, which must be connected with a battery when used. Although designed for the scalp, it is employed for cutaneous stimu- lation when large areas are to be acted upon. The current applied through this is not so painful as through the tinsel or small wire brush. Alopecia (baldness). Electricity may be beneficially em- ployed to improve the circulation through the scalp and stimulate the hair follicles. When caused by parasites, this treatment should be preceded by the application of a parasiti- cide. If the scalp is smooth, shiny and indurated, presenting the appearance of being "hide-bound," the following is an efficient method of restoring it to a natural condition : Let the positive pole of a faradic current be fastened at the nape of the neck, while the operator holds the uninsulated portion of the negative in one hand, and with the other vigorously kneads the dr}^ scalp for several minutes. The fingers sliould be dry ; in some cases they may be lubricated with carbolized oil to advantage. The current should be moderately strong. This 382 ELECTRO-THERAPEUTICS. operation requires repeating once a week until the scalp feels natural and has lost its shiny appearance. During the intervals the patient may advantageously employ a faradic current daily through the liairbrush electrode. If the treatment be so vigorous as to cause soreness of the scalp, it may be omitted a few days. REMOVAL OF HAIRS. A represents the patient in a chair with operator inserting a needle. B represents an enlarged hair follicle, with the needle in the position it must occupy to make the operation successful. Seborrhea of the Scalp. Faradism restores the functions of the glands and partially controls the morbid process. The hair is moistened and the negative pole is applied upon it, while the positive is held in the hand of the patient ; a mild current is kept up for about fifteen minutes. Hirsuties. — Electrolysis. The instruments required for the removal of hairs are a galvanic battery of at least twelve cells, an exceedingly fine needle, or what is still better, a delicate, flexible broach, much finer than those commonly employed by den- tists in extracting nerves, and a convenient needle-holder. The positive pole of the battery should be connected with a sponge- ELECTROTHERAPEUTICS. 383 covered electrode and applied to the nape of the neck ; the neck- let is suitable, as this is self-retaining. The patient may be placed in a reclining chair, or on a lounge, in a good light, in such a position that when the operator is seated his eyes will be on a level with the patient's chin. The needle is connected with the negative pole and introduced into the follicle beside the hair. A few cells only are needed in circuit, from six to twelve, according to their condition, the delicacy of the patient's skin and the strength of the hairs to be removed. In a few seconds a little froth will appear at the mouth of the follicle. If the hair be now seized with a pair of forceps and the gentlest traction exerted, it will be found to be loose in the follicle : this occurs in the course of from ten to twenty seconds. The number of hairs removed at a sitting varies from twenty-five to fifty per hour, according to the location of the hairs and the endurance of patient and operator. It is said to take longer to destroy hair upon the neck than upon the chin or cheeks. It is better at each sitting to operate upon hairs here and there rather than on those close together, as this is less likely to produce scarring. If the operation is not carried too far, there will be very few marks resulting from it. A considerable amount of pain is experienced during the pas- sage of the current through the tissue, which ceases almost en- tirely on the removal of the sponge. Sometimes, in addition to the frothing, the skin surrounding the needle is thrown up into an urticarial elevation, and is greatly reddened. Later the follicle may become inflamed, and form a crust, which adheres to the skin above it for a week or more. Sometimes a hard infiltra- tion may be felt beneath the surface for a considerable time. Ordinarily the after-efiects are very trivial, unless a small area be acted on repeatedly at short intervals. Finally, the parts return to their natural condition, leaving, in some instances, a minute pit or depression to indicate the seat of the operation. Some opera- tors report that 50 per cent of the hairs reappear ; others claim 384 ELECTRO-THERAPEUTICS. that but 10 per cent return. The operation needs only to be re- peated upon those which reappear until all are finally destroyed. If the hair follicle is destroyed, of course the hair cannot reappear. When an extensive hirsuties is to be treated, a long time is re- quired for the successful primary removal of the hairs, and some of the follicles will, without fail, require a repetition of the operation. For the fine, downy hairs occurring alone or interspersed with a stronger growth, nothing had better be done until they attain a more conspicuous development. Galvanism. Dr. J. Crichton Brown, in a lecture on men- strual insanity, referred to a case* seen in consultation many years ago, in which a bearded lady had been benefited by the introduction of a galvanic pessary. The beard subse- quently fell ofi" and the patient's mental condition, which was that of melancholia, improved so that she recovered completely. PARALYSIS. The method of electro-diagnosis in cases of paralysis has already been given, but the attention of those who have never employed electricity in this disease is earnestly called to the following suggestions : 1. When muscles cannot be made to contract by the faradic, galvanic or franklinic current, it is useless to treat them with electricity. If even a few slight contractions can be produced, it will indicate a favorable result under a careful and per- sistent treatment. 2. If contractions are forced, as is very likely to be done by those unskilled in the use of electricity, it will be found at the next sitting no contraction at all can be produced. 3. The slight power of contraction still left in paralyzed muscles is often destroyed by too strong or too frequently repeated electrizations. * Philadelphia Med. Times, 1880. ELECTRO-THERAPEUTICS. 385 4. Before commencing treatment each time, restore ths muscle as nearly as possible to its natural position hy some artificial support^ so that when stimulated to contract it can do so without carrying any weight, 5. The length of application to any one muscle or group of muscles should not exceed five minutes every day or every other day. 6. Do not apply too strong currents. They give rise to over-fatigue, which is just as injurious as if produced by over- exertion. 7. A muscle which refuses to respond to any current may sometimes be made to contract by interrupting the current slowly so as to give time for the impression to be carried to the motor roots and return. Investigations to discover the rate of transmission of nerve force have brought out an im- portant fact, namely, that the rapidity of transmission of nerve force varies in different persons, and in the same person on dift'erent occasions. There is a difference in the quickness with which they receive impressions on the senses. In every case there is slight delay, so that no phenomenon is perceived at the instant of its occurrence. If interruptions occur with greater rapidity than the impressions can be transmitted, the nerve is thrown into a tetanic state, which causes pain and liability to reflex action that in cases due to cerebral hemor- rhage might excite a fresh attack. 8. So long as muscles preserve electric contractility they can be preserved from complete fatty degeneration by judicious use of electricity. Cases resulting from forced or continuous work are most hopeful. The sitting should not exceed eight to ten minutes each day. Electric massage with a roller electrode, like tlie one shown in Fig. 131, will be found very efiective in improving the nutrition of paralyzed muscles 386 ELECTRO-THERAPEUTICS. 9. Some sort of gymnastic exercise, which will bring into action the paralyzed muscles, should be devised by the practi- tioner, and the patient should be instructed to make daily systematic attempts to produce voluntary motion in the afiected parts. This is the most important part of the treatment. 10. The paralyzed muscles should be excited individually, so as to rouse up their movements equally. The current should be made to traverse the nerves in the direction of their length. This is especially important after cerebral hemorrhage. 11. The treatment must not be too prolonged. If the muscles do not recover their movements after fifteen or twenty sittings, discontinue for a time and then recommence. 12. Where the nerves and muscles of the affected side react equally to those on the healthy side under the influence of electricity, the galvanic current will accomplish more than the faradic. 13. Twitchings of the fingers and toes, so often connected with hemiplegia, which occur at night and interfere with sleep, are relieved more certainly by galvanism than by faradism. 14. Althaus concludes, as the result of his observation on out-patients of the hospital, in whom he had an opportunity of witnessing the effects of protracted treatment, that few cases, however bad, are utterly incapable of amendment. Caution. Before treating paralysis of any of the muscles about the head it is important to distinguish between those cases in which the affection is due to disease of the brain and that due to paralysis of the seventh pair of nerves. The latter can be readily relieved by electricity, but great care must be exercised in treating the former lest a fresh attack b6 produced. It is many times very difficult to distinguish between them, but this is said to be a reliable indication : When the contrac- tility of the muscles under the stimulus of the faradic current is perfect, the cause is in the brain ; when the orbicular muscles ELECTRO-THERAPEUTICS. 387 of the eyeball are paralyzed, it is an indication that the paralysis does not originate in the brain, but depends upon the nerve alone. Electrization of nerve-centers, when they are affected by inflammatory action, may cause serious accident. Duclienne relates the following circumstance, which is quoted to emphasize the importance of caution in these cases: "A young man, twenty-two years of age, having suffered from the results of cerebral hemorrhage for one year, thought to reduce the con- tinuous rigidity of some of the muscles, which still persisted, by reflex action instead of localizing the current in the affected muscles. He grasped one electrode in each hand, and caused a strong faradic current to pass through the circuit. He was seized with another attack of cerebral hemorrhage ; his life was for a long time in danger, and when he at last recovered he retained in his right side stronger rigidities than those which he desired to cure." Paralysis Origin atino in the Brain. — Galvanism, The time which must elapse after an attack of paralysis occurs from cerebral hemorrhage, before it is safe to employ electricity, is one upon which authors are not agreed. Remak advises to begin early to galvanize the sympathetic and the cerebral vessels of the side opposite to the paralysis, in order to pro- mote absorption of the clot. Onimus and Legros agree with him, and say that this may be begun within seven or eight days afl;er the attack. The positive pole should be applied to the forehead on the side of the lesion, and the negative at the nape of the neck ; a current of from three to four cells is passed through the seat of injury for two or three minutes. Afterward the superior cervical ganglia is galvanized with a more powerful current (five to seven cells) for about five minutes. All shocks from interruption of the current must he molded. Althaus states emphatically that electric treatment 388 ELECTRO-THERAPEUTICS. should be postponed until all danger of cerebral fever is passed, and if this occurs it comes on in the second or third week ; therefore the application of galvanism is safe after fourteen to eighteen days have elapsed since the attack. Prof. Ftirck, of Vienna, has shown that if the paralysis continues for six months or longer, atrophy of the nervous fibers of the opposite antero-lateral columns of the spinal cord are apt to come on, and when this process has reached a certain stage, an}^ treat- ment will inevitably fail ; this emphasizes the importance of beginning early. If the patient is seen within three weeks after an attack, the method of Onimus and Legros is to be preferred. When several months have elapsed, galvanization or faradization of the affected muscles must be undertaken. It will sometimes occur that a muscle which at first fails to respond to faradism will, after galvanization, exhibit traces of iaradic contractility. In these cases both currents may be advan- tageously employed. FacIxIl Paralysis. When the mouth is drawn toward the affected side, bend a silver wire in the form of a hook, slip it over the angle of the mouth and fasten the other end around the ear, drawing the mouth into its natural position, and then apply the current to the facial muscles one by one by means of Duchenne's Points. Lead Paralysis. This form of paralysis affects certain groups of muscles leaving others intact. The arms and hands suffer, but the lower extremities do not, in many instances ; and in the arm the flexor muscles are spared and the extensors are attacked. The common extensor muscle of the fingers is first affected ; the extensor of the first and little finger in their turn, and at last the tensors of the wrist and ball of the thumb. Faradic excitability is always diminished and often lost, even before the muscles have wasted but slightly. This is regarded as an important means of diagnosis between paralysis due to lead and that dependent upon ELECTRO-THERAPEUTICS. other causes. Wrist drop is frequently the first symptom that attracts attention. Faradism. The treatment by the faradic current, according to Duchenne, is very tedious, requiring from thirty to one hun- dred sittings. Sulphur baths, iodide of potash, shampooing and "nervous gymnastics," should form a part of the treatment. Duchenne coined the latter term, which refers to repeated exer- cise of the voluntary contractility so long as the patient possesses any power over the muscles. Galvanism. When faradic contractility is gone, the galvanic current must be employed. Galvanic baths have been tried with a view of removing the lead from the system. Yergnes in 1852 had an obstinate ulceration of the hands caused by electro-plating. Holding them in an electric bath in contact with the positive pole for fifteen minutes, the negative plate in the bath was cov- ered with gold and silver from the ulcer. A few repetitions of this treatment cured the ulceration. This method has since been tried to remove both mercury and lead frora the body, as well as to convey medicines into the body. It has been suggested that galvanism be used in connection with sulphur baths, the patient being connected with the positive electrode, and the water being made the negative electrode. The positive may be fastened on the nape of the neck, or be held in the patient's hands above the water. Dr. Anstie successfully treated an extreme case of this disease. He employed the galvanic current daily for eight weeks to the aftected muscles ; faradic excitability having returned at that time, faradization for another month almost completely restored the power and bulk of the muscles. Tremors. — Gcdvanism. Dr. M. C. Paul^ reported at a meet- ing of the Societe de Therapeutique fourteen cases from his own practice, which included cases of mercurial trembling, chorea. * Bull, de la Soc. de ThCrap., 1881, p. 123. • 390 ELECTRO-THERAPEUTICS. paralytic ataxia, scrivener's palsy, and trembling of the hands caused by sclerosis in patches. All were greatly benefited. Speaking of the characteristics of mercurial tremor, Dr. Paul says that its onset is sudden and unexpected. The patient perceives that his arm has failed him, and from this moment the tremor invades successively the left arm, and then first one leg and then the other. It preserves during its whole course, and until cured, three characters : 1. The onset is sudden. 2. The tremor is continuous ; once having appeared, it does not cease. 3. It is progressive, the interval between its extension from one limb to another being very brief, though it is longer between the upper and the lower members. In one case the attack first involved the masseter ; but this is rare. In alcoholic tremor the course of the afiection is quite different. It is slow, progressive, and proceeds by successive attacks. Thus, the day after a debauch the patient observes that his hands tremble and fail, but after the efiect of the debauch has passed off* the tremor disappears. At a subse- quent debauch the tremor again appears, lasting this time a little longer. At each new attack the tremor lasts a little longer, until at last the drunkard cannot work. Although slight alcoholic tremor is not rare, yet tremor to such a degree as to prevent work or locomotion or eating, is rare. Both mercurial and alcoholic trembling are amenable to treatment by the galvanic bath. But, while twenty-five baths are required to cure mercurial tremor, six to eight are sufficient to cause alcoholic tremor to disappear. Progressive Muscular Atrophy. — Galvanism. Dr. Neu- mann, of Madgeburg, has succeeded in curing one case which had proceeded to paralysis of all four extremities. A galvanic current equal to that from ten zinc-carbon cells was directed to the sympathetic, the positive being directed to the nape of the neck, and the negative on the throat, five minutes at each side for three months, every day, and then the negative was applied to the upper cervical ganglion, and the positive to the lower ganglion likewise for five minutes each time. It required nearly a year and a half to completely restore the patient. ELECTRO-THERAPEUTICS. 391 Locomotor Ataxia. — Famdism, At the meeting of German physicians and scientists at Eisenach, Dr. Th. Eumpf reported two cases of locomotor ataxia greatly benefited by the use ot faradic electricity applied with the brush, and in whom the symptoms had not returned after several years. He uses a current not quite strong enough to cause pain. The positive pole is applied to the sternum ; the other, represented by the brush, is applied in rapid succession to the back and lower limbs. The duration of the application is ten minutes. The effect upon the lancinating pains is quite marked, and common sensation is greatly improved. In cases where the disturbances of sensibility and pain are very marked, and the disease is not too far advanced, this method gives praiseworthy results, which are unattainable by the older methods of treatment. He has since reported a successful trial of the brush in a series of cases, though more time is required to determine the permanency of the result. Hef described one, however, in which the patient had been in good condition for two years after a six weeks' course of treatment. He had had lightning pains, parsesthesiae and ataxia, impotence and disturbed micturition. The knee-jerk was not abolished. All the symptoms disappeared except the sexual weakness. Galvanism. Dr. Engelskjon found that the galvanic current applied in the same way produces the same effect, and further that it is due solely to the peripheral nerve irritation. He claims that this treatment is of no value when the first symptoms of the disease are referable to atrophy of the optic nerve. Y^v\\Mv%x .—Faradism. Dr. Edward C. Mann;]: reports three cases cured by means of the faradic current in addition to phosphide of zinc and massage. The bromides were not used Berlin Klin. Wochen. ^ Brain, April 1883. t Physician-in-chief to the Sunnyside Medical Retreat for Diseases of the Nervous System, etc. 392 ELECTRO-THERAPEUTICS. at all. He believes electricity in the form of general faradization possesses a special power for good, over the nervous system, in these cases. Galvanism. A few cases are reported cured by the long- continued application of a galvanic current from a belt. The positive electrode uncovered was fastened to the nape of the neck while the negative in a moist cover was placed on the knee (patella). The current continued to act twenty-four hours, when it became necessary to recharge the cells with fluid and clean the electrodes. It required six months of this treatment to effect a cure. Fig. 131. ROLLER ELECTRODE. Handle length, 6 in. Roller diam., \% in. The instrument illustrated above is formed by two separate electrodes : 1. The roller; 2. The interrupting handle. The roller is brass, studded with nickel-plated rounded pro- jections, insulated from each other by black hard rubber. The nickel-plated frame to which it is fastened terminates in a screw which fits the universal handle, with which it may be used when the special effect of the interrupting handle is not needed. The latter is made of polished black rubber. The nickel-spring shown upon the end next the roller when pressed down completes the connection through the handle ; when released, the circuit is broken, therefore the interruptions can be controlled at will. FTanklinism. Arthius relates a remarkable instance of recovery under the influence of franklinism in the case of a boy of twelve, epileptic for ten years, with paralysis and atrophy of right arm. A very gentle application was given at first ; treatment was continued two months. At the end of that time he had partially regained the use of his arm, and from the first treatment he had no return of epilepsy. Six months after he had continued free from any symptoms of the disease. ELECTROTHERAPEUTICS. MISCELLANEOUS DISEASES. Intermittents. Electricity has been employed by conti- nental physicians with excellent success, according to their reports, in various forms of intermittents. Prof. Rienzi* has found that in a majority of cases the fever is stopped, and frequently more promptly than with quinine. In nine cases he had five complete cures, two improved, and two failures. They were treated with the galvanic and faradic current, but the latter has proven the more efficient. He has not been able to ascertain why some cases were rapidly and completely cured, and others but little benefited ; or when electricity is to be preferred to quinine. Fig. 132. ELECTRODE CASE. Size 103^ X 12 inches. This case contains the electrodes ordinarily required for electrization. It is morocco- covered and velvet-lined. The highly polished black rubber and the bright nickel-plated metal forming the electrodes make a beautiful contrast with the blue or crimson shade of the velvet. It is of light weight and may easily be carried in the hand, making not only an attractive but an exceedingly convenient addition to a physician's outfit. Dr. Schroder, of St. Petersburg, reports forty-two cases of intermittent fever, some of which were old, and in most of which the usual medication had proved of little use, in which he had almost uniform success by faradizing the spleen. His * Annals Univerzali, 1882. 394 ELECTEO-THERAPEUTICS. method is to hold one electrode on the left hypochondrium» while the other is carried slowly along the edges of the enlarged spleen for five minutes, daily. Dr. Blackwood* reports thirty cases of ague, including twenty-two of the tertian tj^pe, five quotidian and three quartan, treated by electricity without medicine of any kind, with the exception of a single dose of sulphate of magnesia in water, acidulated with a drachm of aromatic sulphuric acid, to com- mence on. The quartan cases were all adults, the quotidian all children. In eighteen it was their first attack ; the remaining twelve had sufiered from previous attacks, and all the latter had enlarged spleen. The plan of treatment was the same, except that a larger dose of electricity was given to those with enlarged spleen. Faradism was principally used, but in those having large "ague cakes" galvanism was applied at the close of the sitting, not from any attempt to control the disease, but because the reduction of glandular hypertrophy is, in curable cases, more readily secured by galvanism. A cur- rent as strong as could be comfortably borne was passed first, one pole being located over the solar plexus ; the other over the liver, before and behind, for five minutes, and then over the spleen for five more. After that about five minutes were spent in general faradization of the abdomen and spine. He lays great stress on the importance of taking treatment early in the morning. When galvanism was employed, a current from ten to fifteen cells was sent as directly as possible through the spleen, without interruption, for from five to fifteen minutes' duration. Although galvanism promptly reduces tiie size of the liver, it has no eftect in relieving the ague. In the tertian and quartan cases, with few exceptions, they were treated daily without reference to the hour of invasion of the chill. The exceptional cases wei-e treated two or three times daily, * The Medical Bulletin, November 1883. ELECTRO-THERAPEUTICS. 395 and the results indicated that this is preferable to a single sitting. The quotidian cases had two sittings daily. The result of treatment was favorable in all cases, a cure resulting in from six to thirteen days. The most stubborn case was a quartan, the chill returning with full force four times before being checked. Twelve of the tertian subjects had no return after the first application, seven had one chill, and three two chills after commencing electrization. The returning chills were always in children. The disadvantage of this mode of treatment is that the patient must visit the office. He protests against turning the application over to the patient, as the latter is almost certain to repeat too often or fail to reach the solar plexus. He believes that success can be assured only in the hands of the physician who clearly understands the motor points and the method of applying the current in a scientific manner. Neuralgia. — Galvanism. Dr. Moritz Meyer strongly insists upon the importance of carefully searching for spots that are pain- ful on pressure in all cases of obstinate neuralgia. The first case described, the attack afiected the right arm and shoulder. A painful pressure point was found at the upper part of the brachial plexus. The positive pole of a current from ten cells applied to it, the negative being held in the hand, considerably alleviated the pain within five minutes. A repetition of the operation four times during the ensuing week was sufficient to efiect a complete cure. Two other cases in which galvanism applied to the arm had failed to relieve were cured when it was directed to painful pressure-points ; one had suffered nine months and was completely relieved by seventeen applications ; the other, after two years of sufiering, fully recovered after fifty applica- tions. Prof. Meyer does not limit this mode of treatment to neuralgia, but recommends it for sick headache, twitching of facial muscles, paralysis following a sprain, and all neuroses 396 ELECTROTHERAPEUTICS. in which pain is elicited by pressure at any points along the spine or the course of a nerve trunk. Remak and Brenner also emphasize the importance of examining for and treating these points ; in every instance they recommend that the posi- tive be placed on them. M. Magendie was the first to employ needles in the treat- ment of neuralgia. He introduced two platinum needles, one at the origin of the nerve, or in its vicinity, and the other at its termination, using an increasing galvanic current. After the cessation of pain, which does not generally take place until after several sittings, the needles were not immediately withdrawn, but the patient was made to perform some of the movements that generally bring on the neuralgia. He some- times applied the faradic current in the same manner. Famdism. Becquerel was one of the first to recommend the use of strong and very rapid currents. He advised a secondary faradic current with wet sponge electrodes, and directed the positive pole to be placed over the part of the nerve nearest the nerve center and the negative over the branches. If the poles are reversed, the final efiect will be the same, but the pain during the sitting will be much more acute. Neuralgia of the Brain. — Galvanism. This may lead to insanity if not checked. In addition to rest, sleep, and an improved or suitable diet, a mild galvanic current passed through the brain for a few minutes daily will generally improve nutrition of the brain and relieve the nervous pros- tration. Supra-Orbital ^Teuralgta. — Faradism. Becquerel reported the following method successfully employed in numerous cases. A primary faradic current is passed through the head by placing a moist sponge electrode on each temple during the first half of the sitting and between the two supra-orbital ELECTRO-THERAPEUTICS. 397 nerves during the second half. The sittings may be repeated when the pain reappears. Franklinism. Supra-orbital neuralgia has been relieved by electrifying a patient on an insulated platform and then draw- ing sparks from the brow and temple for some minutes. Helief follows immediately, if at all. Tic Doloureux. IS'euralgia of the face is of two kinds ; a mild and a severe form. The former generally comes on after exposure to cold and damp, or after mental emotions, or is owing to caries of a tooth ; it is not made worse by mov- ing the face, and it occurs at all periods of life, while the latter occurs, generally, without any apparent cause, is almost entirely confined to advanced age, and is brought on or made worse by the least movement of the face. The mild form yields to many remedies, and especially to electricity, while the latter defies almost every method of treatment ; yet it sometimes yields to galvanism and franklinism. Each case will require special treatment ; therefore, only general sugges- tions can be given. One pole may be located over the cervi- * cal ganglia, and the other attached to a suitable electrode may be passed over the face, or one may be applied within the mouth against the cheek, and the other to the temple and external surface of the cheek. The direction of the current must be determined by experiment in each individual case. Franklinism is employed by the method of charging the patient and drawing sparks from the affected parts. Brachial Neuralgia. — Galvanism ^hovl^ be applied through the brachial plexus, one electrode being located at the point indicated by electrode B, Fig. 74, and the other being moved repeatedly downward along the course of the pain. Intercostal Neuralgia. — Franklinism. When there is no dis(?bverable cause, and galvanism and faradism both fail to give relief, this form of neuralgia has been cured by charging 398 ELECTEO-THERAPEUTICS. the patient with franklinic electricity, and drawing sparks from the painful region for ten or fifteen minutes. Sittings may be repeated daily. FramMinism. Dr. Y. J. Drosdoff,* St. Petersburg, has tried the effects of static electricity on twenty patients, suffering from various reflex and rheumatic neuralgias or muscular rheumatism. The franklinic currents of all degrees were applied; all the patients were left uninsulated and franklinized during from five to fifteen minutes at a sitting, by the positive pole alone. The conclusions the author arrived at are as follows: 1. The sen- sation of the franklinic current is difierent from that of the faradic and galvanic. The weak currents cause a burning sen- sation, the strong ones a sensation of concussion or stroke, at the point where a spark is produced. 2. The electricity dis- tributes itself all over the body, and, during a sitting, sparks may be produced by contact at any desired point of the surface. The strength of a spark lessens with the increase of distance from the franklinized point. 3. The skin, at the point of franklinization, at first becomes red and anserine, then pale and nearly white ; an artificially produced erythema disappears. 4. The general functions undergo some considerable changes ; the heart's reaction shows retardation (four to twelve beats less in a minute) ; the pulse becomes fuller ; the respiration deeper and slower; the quantity of urine voided after a sitting is often considerably increased. 5. The most striking changes, how- ever, are observed in parts affected with neuralgia or rheuma- tism. Immediately after a sitting, pain and tenderness disappear, and, during the remaining part of the day, the patients feel much better than before a sitting. Each successive franklini- zation brings a further decrease in intensity of neuralgia. In cases of short standing, three or four sittings suffice to com- pletely remove the agonizing pains. Ten to fifteen sittings * Medical Rec