at hand, and properly used, there would never be another death from
_post-partum_ hæmorrhage. The Faradaic current, thoroughly localized
in the uterus, will always produce its contraction, not only while
life persists, but even for a limited time after death, but failure in
localizing electricity in an organ, withdrawn from sight and covered
with thick muscular tissue, is especially liable to occur, unless the
details of application are conducted with extreme care. Assume the case
to be an example of severe _post-partum_ hæmorrhage, that the ordinary
resources of medicine have failed the obstetrician, and that he fears
every moment may be his patient’s last, but he has an induction
instrument at hand. Let him waste no time, but at once introduce his
right hand into the cavity of the uterus and grasp in his left the
moistened sponge attached to one of the conductors of the instrument
in action. Let an attendant, holding by its insulating handle the
conductor from the other pole (which should be a well-moistened sponge)
thoroughly paint with it, as it were, the abdominal parietes, pressing
it with considerable force against the practitioner’s hand, and
afterwards apply it to the lumbar region. _Contraction of the uterus
will invariably result if the current used be of sufficient power._
[SN: Uterine Neuralgia.]
In my own hands an intractable case of uterine neuralgia was perfectly
cured by the Voltaic current; and I have knowledge of a case of
sterility which the localization of the Voltaic and Faradaic currents
alternately would seem to have removed. [SN: Sterility.] One conductor
was applied to the os, and two sponges from the second pole--one to
the position of each ovary. The applications were made thrice a week
for a fortnight before each menstrual period, and for a period of four
months. Conception followed, and the patient, who had been married for
thirteen years, in due course gave birth to her first child.
[SN: Paralysis of Nerves of Special Sense.]
The stimulant effects of electricity are occasionally beneficial
in the treatment of paralysis of the nerves of special sense,
especially of the optic and auditory nerves, while its use has been
advocated in a multitude of diseases to which I shall not further
refer, than by saying that a clear comprehension of the principles of
electro-therapeutics will prevent the occurrence of difficulty in any
special application of them; and let us shortly recapitulate the most
important of these principles. [SN: Résumé of general principles of
Electro-therapeutics.] We have seen that electricity is a stimulant, a
sedative, a restorative, and an absorbent. Its stimulant properties are
chiefly of use in diseases of debility, and notably in paralysis--its
sedative properties in the alleviation and removal of pain and spasm,
and notably in neuralgia--its restorative properties in fatigue
diseases, notably writer’s cramp--and its absorbent properties in
exudation diseases, and notably in gout and rheumatism. The dose of
electricity consists of the addition of two factors--firstly, the
strength of the current, whether Voltaic or Faradaic; secondly, its
duration. It is of essential importance that we do not overdose our
patient, but we are little likely to do this if we adhere to the two
cardinal rules--to use the _minimum_ power which will produce the
results we desire, and not to unduly prolong our application: and
really this question of “dosage” forces us to consider how far it is
advisable for the medical practitioner who prescribes electricity to
sanction its administration by the patients themselves. While there is
no doubt that the most explicit directions will often be misunderstood,
or fail in being correctly carried out, yet it would be practically
impossible (to say nothing of the expense to the patient) for any
medical man to himself apply electricity daily for a lengthened period;
and we are compelled, in certain cases, to do our best in instructing
_some one attendant of the patient_ how to carry out the treatment,
making her do this a few times in our presence, _and looking sharply
after her afterwards_, and in addition explaining everything as fully
as possible to the patient, or the patient’s friends. Moreover, we
must not lose sight of the fact that, with electricity as with other
remedies, the skill of the physician is shown in determining how, when,
and in what dose to administer it, and his judgment in selecting those
cases in which its administration may be wisely committed to others.
In conclusion, Gentlemen, allow me to thank you for the attention with
which you have listened to these imperfect Lectures. I fear that I
have failed in doing full justice to their subject; but I trust that
I have succeeded in indicating the importance of electricity, as a
supplement to, not as a substitute for, the more ordinary resources of
therapeutics: in removing any doubt as to the class of cases calling
for its employment; in supplying any want of information regarding
details of its application; and especially in proving its claim to be
more fully employed in your daily practice. A theoretical belief in its
efficacy is widespread in our profession, its _frequent use_ is yet
in the future, but I hope a not distant future. Gentlemen, with you
rests the decision whether this shall or shall not be. You will decide
it not by the dictum of any specialist, but by the general voice of
the profession, declaring your verdict as founded alone on your own
personal experience.
FOOTNOTES:
[14] Since writing as above, in 1873, our knowledge of the beneficial
effects of Franklinism has been very largely added to and the improved
apparatus, described at page 10, has enabled the treatment to be
conducted with a degree of precision and success impossible with
the comparatively imperfect instruments in use at that date. [SN:
_Importance of distinguishing between the Positive and Negative Charge
of Franklinism._] Dr. Radcliffe has contended for many years that
the effect of a charge of _positive_ electricity differs altogether
therapeutically from that of a negative charge; and Giacomini (quoted
by Duchenne[15]) attributes a hyposthenic influence to the _negative_
charge. He contends that this charge is derived from the nerves of the
patient instead of from the ground as is the positive charge, and it is
ranked by the Italian School among their most valuable hyposthenisants.
According to Giacomini the “patient is _de-electrized, is consequently
deprived of a greater or less quantity of a stimulant analogous to heat
and undergoes a real hyposthenisant effect_. Erysipelatous tissues
may be seen to become blanched under its influence, and chronic
inflammations undergo an unquestionable improvement. Headaches and
neuralgic pains have been instantly relieved by this kind of electric
flux as by the application of ice, which abstracts heat, and perhaps at
the same time electricity also.”
In reference to the above it has been proved by various physicists that
the natural electrical nerve current is strengthened by the positive
charge, and weakened by the negative--and hence it would seem to be
established that Dr. Radcliffe’s contention is the right one; and that
these two charges are literally “wide as their poles asunder” not
only physically, but _therapeutically_, and this divergence is more
important when we recall to mind that when a patient is insulated, not
only does the electricity accumulate upon the surface of the skin but
that the whole body is saturated with it as a sponge may be with water.
[SN: _Franklinization in Conditions of Debility._]
In my own experience the positive charge has been of great good as
a most potent restorer when the organism from any cause has become
enfeebled. In the general weakness of old age it would seem to have
been beneficial upon several occasions in resuscitating vital action
and in imparting new force and energy. I have also used it with the
best results in conditions of debility following acute diseases, as for
example in convalescence from fevers; in cases of general prostration
from overwork or anxiety--and in some cases of phthisis and other
wasting diseases. In certain varieties of mental disease--notably
melancholia--it is often of service, and in cerebral anæmia, in asthma,
in inveterate insomnia, and in all functional uterine irregularities it
should be employed _before, not after_, all other therapeutic agencies
have been exhausted.
[15] See “Duchenne on Localized Electrization,” English Edition, page
4. Churchill.
[16] In the treatment of _Neuralgia_ by the constant current the
electrodes should be so applied as to include between them the part
or nerve affected--the number of cells the highest number that can
be borne without pain, _i.e._, the current to be distinctly but not
painfully felt, both electrodes being immovable. [SN: Electricity in
Neuralgia.] Time, five to ten minutes. Frequency, as often as the
attacks of pain recur. I am satisfied that in severe cases this rule
of application is essential--that the influence of the current shall
be maintained as much as may be in the irritable nerve during the
intervals of pain. In one case under my care the patient was galvanized
with benefit 27 times in the 24 hours; but in milder cases one or two
applications daily will generally suffice. A weak current from two or
three cells--the electrodes being applied to each temple for one or
two minutes--will sometimes dissipate a severe headache. This soothing
influence of the current is often useful in allaying SPASM, as, for
example, in spasmodic torticollis. The current should be localized in
the irritable muscles: and it is generally advisable to energetically
Faradize their antagonists and to conjoin with the electrical treatment
appropriate gymnastic exercises, alternating with periods of perfect
rest. I may mention that the only recorded case of improvement in that
remarkable condition of spasm first described by Hammond under the name
of _Athetosis_ resulted from the Voltaic current. The case was brought
before the Medico-Chirurgical Society by Dr. Gowers, and is published
in the 49th volume of their Transactions. The reader will find the
subject of neuralgia very exhaustively considered in Dr. Anstie’s
work.[17] He quotes some extremely severe cases in which the effect of
Electrization was to arrest the pain in a few sittings, and to procure
a remission for several days or even weeks; and I have had several
cases which I believe to have been as fairly cured as an ague fit may
be said to be cured by quinine. Dr. Russell Reynolds also quotes the
case of a patient, a lady, who for twenty years had suffered from an
extremely severe neuralgia of the ophthalmic branch of the fifth nerve,
which recurred daily and from which her health had greatly suffered. It
was not only relieved but removed by a single application.
[17] “Neuralgia and the Diseases that resemble it.” By Francis E.
Anstie, M.D., &c. London: Macmillan and Co. 1871.
[18] Electrolysis is, of course, chiefly applicable to tumours which,
from their nature or situation, are difficult or impossible to be
removed by the knife; and, perhaps, also to malignant tumours; for
whether or not the Voltaic current exerts a special destructive
influence upon diseased germs, it seems certainly proved that there is
a less frequent return of cancerous growths removed by its agency than
by ordinary operative procedures or by caustics.
[SN: Electrolysis of Tumours.]
This treatment of malignant tumours by electrolysis is yet _sub
judice_, but the evidence in its favour has recently much accumulated,
and its full and exhaustive trial by competent observers possessing the
opportunities of large hospital practice ought not to be much longer
delayed. [SN: Electrolysis of Malignant Tumours.] Neftel, of New York,
who is its chief advocate, contends that malignant tumours are at first
entirely local, and he explains their recurrence, after removal by the
knife, from the fact of the impossibility of the whole of the diseased
mass being excised, as apparently healthy parts when microscopically
examined show that they have already become infected. Electrolysis
he considers acts not only on the tumour but also on the surrounding
tissues, the current being diffused to some distance in all directions.
After electrolysis he applies a mild and not painful current for from
a quarter to half an hour daily to the _locus morbi_, and continues
this for some months. In one of his cases a mammary tumour existed of
the size of a small orange. Three needles, from the negative pole of
thirty-five cells, were inserted for half an hour under chloroform,
and the operation was repeated thrice at intervals of a week, daily
external galvanization being also used. The tumour gradually became
smaller, and at last disappeared, but external treatment was continued
for several months. At the end of a year there had been no relapse. In
another case, in which the tumour had been excised by Marion Sims, it
reappeared, and was again removed by the same surgeon, and pronounced
cancerous. It again reappeared and was then electrolyzed, upon three
occasions, by two, three, and four needles respectively, and with a
current gradually increased from ten to thirty cells. The tumour by
degrees grew less, and in three months was entirely dispersed; while,
when the patient died from another disease three years afterwards,
there had been no recurrence.
[SN: Aneurismal Electro-puncture.]
Electrolysis has been successfully employed in several cases of
aneurism. Where pressure and ligature admit of application, it is
hardly necessary to say that the preference should be given to them;
but many internal aneurisms, and especially aortic aneurisms, cannot
be thus treated, and in such cases the question of electro-puncture
should be carefully considered, and, when called for, it should not be
too long delayed. Two fine, sharp, and carefully insulated needles, one
connected with each pole, should be introduced into the aneurismal sac,
and the current allowed to pass for from half an hour to an hour, the
needles carefully withdrawn, and their punctures covered with a bit of
lint soaked in collodion or styptic colloid. Authorities are divided
as to the kinds of aneurism calculated for electro-puncture, but there
is no doubt than an aneurism pressing on the parietes, but not having
actually perforated them, is the best adapted for this treatment, and
that it is contra-indicated where the sac is of large size, or where
large trunks issue from it.
[19] The following is an illustrative case:--
A lady, forty-one years of age, had suffered from right hemiplegia for
eighteen months, and described her condition as having remained without
improvement for the past six months. She had recovered sufficiently to
walk with the aid of a stick, but the movements of the arm were very
weak, especially those of the deltoid, extensors of the fingers, and
individual muscles of the hand. Faradic contractility was somewhat
lowered, but there was no rigidity. The muscles were carefully
Faradized with a current just sufficiently strong to produce their
contraction. The entire application occupied about fifteen minutes,
and was made once daily. After a fortnight’s electrization she was
able to raise the arm to a right angle with the body, and _to use the
hand to feed herself_, neither of which had she been able to do before
treatment.
[20] The following is an extract from Dr. Sturge’s Report of the
results of treatment at the National Hospital for the Paralyzed and
Epileptic:--
“In the division of Muscular Atrophies some striking cases have
occurred, and in all of these the improvement is mainly due to the
electrical treatment prescribed.
“A patient, with atrophy of some of the muscles of both arms of six
months’ standing, which incapacitated her from dressing herself or
cutting her food, or doing much household work, was discharged at the
end of three and a half months, able to feed and dress herself, sew,
and perform almost any domestic duty.
“Another woman, with atrophy of the muscles of the forearm of several
years’ standing, and who was similarly incapacitated from almost
all use of the hands, went out, after a month’s treatment, able to
dress and feed herself, and to perform many actions that were before
impossible for her.
“A man came to the hospital with atrophy of many muscles in various
parts of the body, more especially in the left arm, which he was unable
to move from the side. He went out able to lift his arm well over his
head, and with much increased strength in the limb.
“Another man, in a very similar condition, was also greatly benefited;
and whereas on admission he could barely bend the right arm at the
elbow, after three months’ treatment he was able to use a hammer with
the arm.”
INDEX.
Bath, Electric, 42
Battery, Accessories of, 35
Faradaic, 29
Hospital Combined, 33
Portable, 18
Voltaic, 20
Voltaic, Essentials of, 27
Cautions in Electrizing Facial Muscles, 85
Cells, Voltaic, 18
Conducting Cords, 35
“Constant Current,” importance of exactitude in administering, 52
Cords, Conducting, 35
Current, Constant, Radcliffe’s Variety of, 41
Degenerative Nerve Reaction, 66
Diagnosis between Real and Feigned Disease, 67
of Central Paralysis, 66
Electro, 62
of Peripheral from Central Disease, 65
of Hysterical Paralysis, 67
of Spinal Paralysis, 66
Dischargers, Improved, 16
Electricity as Proof Positive of Death, 67
Electricity in Diagnosis, 62
Varieties of, 5
Methods of applying, 37
the Galvanometer as an aid to the Dosage of, 22
Electrization, 71
as a Constant Current, 72
as a Stimulant, 72
Central, 44
Cutaneous, 53
Direct, 49
in Diseases of Women, 90
Effects of upon Nutrition, 72
in Fatigue Diseases, 74
in General Debility, 80
General effects of, 79
in Hemiplegia, 85
Indirect, 50
in Locomotor Ataxy, 88
Muscular Rule for, 83
in Mental Diseases, 89
in Neuralgia, 73
in Paralysis, Atrophic, 81
in Paralysis, 80
in Paraplegic Constipation, 88
in Paralysis, Emotional, 88
in Paralysis, Infantile, 81
in Paraplegia, 88
in Paralysis of Nerves of Special Sense, 92
in Post-partum Hæmorrhage, 91
in Paralysis, Traumatic, 84
Localized, 44
in Wasting Palsy, 85
of Auditory Nerve, 57
of Bladder, 55
of Brain, 56
of Central Organs, 57
of Internal Organs, 54
of Larynx, 55
of Male Genital Organs, 55
of Ocular Muscles, 57
possesses an influence _sui generis_, 74
precautions in, 59
of Rectum, 54
Restorative Power of, 74
of Retina, 57
of Spinal Cord, 57
of Sympathetic, 56
of Uterus, 55
Electrical Static Machine, 7, 10
Static Machine with Fly-wheel, 12
Winter’s Machine, 8
Electrolysis of Tumours, 76
in Aneurisms, 77
Needles for, 58
Electrotonus, 75
Engine, Gas, Bischoff’s, 9
Faradism, 28
Faradization, General, 43
Franklinism, 6
Franklinization, 68
by Sparks, 16
Distinction between Positive and Negative Charge of, 70
in Conditions of Debility, 71
in Emotional Aphonia, 69
in Facial Neuralgia, 68
in Facial Spasm, 68
in Sciatica, 68
in Localized Excessive Sensitiveness, 70
in Tremor, 70
Modes of Generating, 7, 15
Galvanism, _see_ Voltaism
Galvanization, Central, 44
Galvanometer as an aid to the Dosage of Electricity, 22
Irritability, Electro, 62
Farado, 63
Voltao, 63
Electro, Diminished, 64
Electro, Increased, 65
Voltao, Increased, 65
Paralysis, Importance of Early Electrical Treatment in, 82
Rigid Forms of, 84
Rheophores, Different Kinds of, 47
Voltaic Cells, 18
Current, Resolvent Effects of, 76
Voltaism, 17
and Faradism, Points of Distinction between, 18
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A MANUAL OF DISEASES OF THE NERVOUS SYSTEM.
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the Nervous System; and to direct especial attention to the importance
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[Illustration: A MAP OF Ziemssen’s Motor Points of the Human Body
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* * * * *
TRANSLATED AND EDITED BY DR. TIBBITS.
_Part I. 8vo, pp. 322, price 7s. 6d., with 92 Illustrations, and Notes
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A TREATISE ON LOCALIZED ELECTRIZATION,
AND ITS APPLICATIONS TO PATHOLOGY AND THERAPEUTICS.
By Dr. G. B. DUCHENNE (DE BOULOGNE).
CONTENTS.
CHAP. I.--Medical Electricity. The Physiological and Therapeutic
Properties of Static, Galvanic, and Induced Electricity.
CHAP. II.--Localized Electrization. The Principles and Methods
of Procedure in the Local Application of Electricity; (_a_) of
Galvanic Electricity (Galvanization); (_b_) of Induced Electricity
(Faradization).
CHAP. III.--Historical and Critical Observations upon the Principal
Methods of Electrization: (_a_) Electro-puncture; (_b_) Electrization
by Reflex Action; (_c_) Therapeutic Value of Localized Faradization;
and (_d_) of Galvanization.
CHAP. IV.--Electro-Medical Instruments, with regard to their
Application in Pathology, Physiology, and Therapeutics.
The First Part of Duchenne’s work is devoted to METHODOLOGY, AND IS
COMPLETE IN ITSELF.
The admirable selection by Dr. Poore from Duchenne’s Clinical Works
(published by the New Sydenham Society) renders unnecessary any further
publication _in extenso_ of Duchenne’s most voluminous treatise.
“Duchenne’s great work has for years held its place as the most
complete on the subject of which it treats, and Dr. Tibbits, by
presenting us with an English version of the forthcoming Third Edition,
has earned the gratitude of the profession in this country.
“... The reader will find himself so thoroughly instructed in the
principles underlying the medical employment of electricity, as well
as in all the methods of applying it, that the work can hardly fail
largely to increase the use of this powerful and often valuable
agent.... The translation itself is very creditable, and reads with
almost as much smoothness as original English composition, while the
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utility.”--_The Lancet._
“We have to congratulate Dr. Tibbits upon his successful labours
thus far. This instalment promises that the results of the best
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standard.... The tentative and accurate spirit of the master has
found its kin in the spirit of his follower, and we see little in the
work of either open to cavil or correction.”--_British and Foreign
Medico-Chirurgical Review._
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_Second Edition, Revised and Enlarged, with 95 Illustrations, 9s._
A HANDBOOK OF MEDICAL & SURGICAL ELECTRICITY
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CONTENTS.
CHAP.
I.--Electricity and Electro-Medical Instruments.
II.--The Application of Electricity.
III.--Electricity as an aid to Diagnosis.
IV.--Electricity in Medicine.
V.--Electricity in Surgery.
VI.--Electricity in Midwifery and the Diseases of Women.
_Opinions of the Medical Press._