Rush Medical College, Chicago, Ill.
Electricity is a useful and important therapeutic agent, and an
understanding of its effect when applied to the human body is as
essential as a knowledge of any other therapeutic measure. Too often
the therapeutic use of electricity is committed to those having very
little knowledge of it, and consequently good results are not obtained.
It is a great mistake to allow or advise patients to use electricity
themselves; no greater mistake would be made or more harmful results
follow if they were advised to go to the drug store, and help
themselves to any drugs they might choose. Electricity should be
administered by a physician, or under the directions of a physician by
a nurse who has been thoroughly taught its use.
In medicine we have usually considered three different forms of
electricity: First, Galvanism or Chemical Electricity; Second, Faradism
or Induced Electricity; Third, Franklinic or Static Electricity. Now,
we add a fourth and a very important one—namely, _X_-ray. A nurse
should have a general knowledge of these different manifestations of
electricity and their effect when applied to the body.
In electricity we have units of measurements as we do in weights
and measures. For instance, the force that drives the current of
electricity along, as we might express it, is called the electromotive
force, and its unit of measurement is a volt. The resistance which
the current must overcome is measured in ohms, and the strength of
the current is measured in amperes, or, as we measure it in medical
electricity, the thousandth part of an ampere, a milliampere.
Galvanic or chemic electricity has certain properties not obtainable
in the other forms. Comparatively speaking, it is a current of
considerable quantity, but low electromotive force. The galvanic
current passes always from the positive to the negative pole. It
possesses the power to decompose various compounds, such as water, the
tissues of the body, etc. This is called the electrolytic action, and
may be used to destroy certain tumors, for the removal of superfluous
hair, etc. Again this current has the power to convey certain
substances in solution into the tissues. This is called cataphoresis,
and is used to produce local anesthesia by the use of cocain applied
to the positive pole. This is one of the best methods we possess of
obtaining local anesthesia.
The effect of iodin may be obtained by the use of a solution of
potassium iodid, and the negative pole may be used to affect local
swellings, etc. Muscular tissue may be made to contract by the
application of the current, either when applied to the motor nerve
supplying the muscle or when applied directly to the muscle. Upon
sensory nerves the positive pole is sedative, and may be used to
relieve pain in cases of neuralgias, etc. The negative pole is
stimulating, and may be used in conditions requiring increased
nutrition, etc.
In using galvanism a good battery and outfit are essential. First, it
is necessary to have a milliampere meter, an instrument to measure
the strength of current used. The quantity of electricity used should
be measured the same as the quantity or dosage of drugs prescribed.
Another essential instrument is the rheostat, by which the current
strength may be gradually increased or decreased without interrupting
the current. The electrodes which are attached to the poles of the
battery may be metal, metal covered with sponge, cotton, etc.,
preferably cotton, which may be renewed with each application, thus
avoiding the possibility of infection, always present in the use of a
sponge-covered electrode, which cannot be changed with each application.
In the use of galvanism we may speak of two different methods. First,
what is called cerebral galvanism, second general. By experimentation
it has been clearly demonstrated that all the deeper tissues and
organs of the body, such as the brain, spinal cord, liver, etc., may
be influenced by galvanism. In cerebral galvanism the object is to
influence the brain and spinal cord. In applying it to the head, a
sponge or cotton-covered electrode 4-5” in diameter may be used. The
positive electrode is applied to forehead, the negative at nape of
neck, using a current of 5-10 milliamperes for from five to fifteen
minutes, care being taken not to suddenly make or break the current, as
this would produce a disagreeable shock to the patient. The circulation
of the brain may be affected also by placing an electrode at the nape
of the neck, and a smaller electrode (1-2” in diameter) passed up and
down along the border of the sternocleidomastoideus muscle, using a
current of 3-5 milliamperes. Galvanism used in this way is beneficial
in such conditions as cerebral anemia, neurasthenia, insomnia, etc. In
applying to the spine, one electrode may be used at the upper and the
other at the lower part of the spine; or a large-sized electrode may
be placed over the abdomen, and the other electrode moved up and down
the spine without breaking or interrupting the current, the strength
of which may be from 10-20 milliamperes, and the duration of each
application varied to suit the condition of the patient. This treatment
is indicated in such disorders as neurasthenia, infantile spinal
paralysis, locomotor ataxia, etc.
General galvanization may be given by placing a large-sized electrode
at the spine, over the abdomen, or at the soles of the feet, the other
electrode, smaller in size, being passed over the entire surface of
the body without interrupting the current, which may be from 5-8
milliamperes. This procedure will stimulate the peripheral circulation,
elimination, and nutrition. The muscles may be exercised by using an
interrupted current of sufficient strength only to cause contraction.
General galvanization is very beneficial in such conditions as
neurasthenia requiring the rest treatment, convalescence from various
diseases, paralysis, multiple neuritis, etc. In the use of electricity
it should be remembered that patients show idiosyncrasies as in the use
of drugs, so that each case should be given the amount of electricity
best suited to individual peculiarities. Unless this point be kept in
mind, we will be surprised to find at times that the use of electricity
aggravates the patient’s condition.
Faradism, or the induced current, is characterized by a high
electromotive force and a low amperage or quantity. It is an
interrupted current, and from the secondary coil it is an
alternating current. It cannot be used like the galvanic for
electrolytic-cataphoric purposes. Its effect upon the body is almost
entirely mechanical; also unlike the galvanic, there is practically no
polarity. It cannot be used to affect the deep-lying structures, such
as the brain, spinal cord, etc. The current-strength is not measured by
a milliampere meter. It will produce muscular contraction only through
the motor nerve supplying the muscle. This is a point to be remembered.
Its use is confined largely to exercising muscles and stimulating
peripheral circulation, and is useful in such conditions as paralysis
where the cause of the paralysis is in the brain (because where the
lesion producing the paralysis is in the spinal cord or peripheral
nerves the muscle will not contract when faradism is applied), and
in convalescence and all conditions requiring exercise which cannot
be obtained actively. In applying this form of electricity (if the
object be to stimulate circulation), the strength of the current should
be regulated to suit the feelings of the patient. The technic is
practically the same as described above for general galvanization. If
we wish to exercise the muscle, then that current should be used which
is just strong enough to produce muscular contraction and no stronger,
care being necessary not to over-stimulate and exhaust the muscle.
As a means of muscular exercise only this current is preferable to
galvanism, being easier of application and less likely to produce harm.
Franklinic, or static electricity, is seldom administered by a nurse
unless in a hospital or in a physician’s office. The current is
produced by machines of various makes, such as glass and mica. The
plates vary in diameter from twenty inches to three feet or more, and
in number from two to sixteen or more. Its current then generated is
characterized by an enormously high electromotive force, but a very
minute quantity or amperage. Unlike the other two forms of current
described, its use does not necessitate the removal of clothing. It may
be used by placing the patient on an insulated platform and charging
him with this current of high electromotive force, which very markedly
stimulates circulation; or it may be used by applying or drawing
sparks directly from the patient’s body, in this manner producing
counterirritation, stimulating circulation, relieving localized
pains, etc. It has been found useful in such conditions as chorea,
neurasthenia, muscular rheumatism, lumbago, chronic inflammation of
nerves, etc.
Nurses probably will never be called upon to use the _x_-ray, but this
most wonderful manifestation of electro-force has recently taken a
prominent position as a diagnostic and therapeutic agent. Parts of the
human body heretofore only revealed by the use of the knife or post
mortem are now plainly discernible during life through the use of this
force. The field of its therapeutic application is a large one, and
disorders which have been considered incurable or difficult of cure by
other means now yield readily to the _x_-ray.