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THE
ELECTRIC BATH
ITS MEDICAL USES, EFFECTS
AND APPLIANCE
BY
GEORGE M. SCHWEIG, M.D.
MEMBER OF THE NEW YORK COUNTY MEDICAL SOCIETY AND OF THE MEDICAL
JOURNAL ASSOCIATION OF THE CITY OF NEW YORK; ONE OF THE
PHYSICIANS TO THE NEW YORK LYING-IN ASYLUM, ETC.
NEW YORK
G. P. PUTNAM'S SONS
182 FIFTH AVENUE
1877
COPYRIGHT,
G. P. PUTNAM'S SONS,
1876.
PREFACE.
In No 216 of "The Medical Record" (Dec. 15th, 1874) was published an
article written by me, entitled "On some of the Uses of Galvanic and
Faradic Baths."
The interest manifested in the subject, as evidenced by numerous letters
of inquiry since received from physicians in almost all parts of the
United States, and some in Europe, has induced me to write the present
treatise, in which I have endeavored to present to the profession, as
far as lies in my power, all that is necessary to a full comprehension
of the electro-balneological treatment.
When it is considered that in the employment of electric baths I have
been to a great extent groping in the dark, that I have been deprived of
the advantage of having the experience of others to guide me, it will
not appear surprising that I should have met with many disappointments.
My failures have been illustrative of the fact that the electric bath is
no more a panacea for all ills than any other remedial agent.
Applicable as it is to a great variety of pathological conditions, it
meets with many where it is destined to have negative or at best
imperfect results. Far from discouraging me, however, failures have
served to inspire me with fresh ardor to seek for light, and to
persevere in my efforts to establish on the basis of statistical truth,
the therapeutic merits of the agent which I employed.
In view of the imperfectness of the results thus far obtained, I should
consider the present work premature, did I not find a justification for
it in my desire to induce other and abler observers to investigate the
subject, and place it on whatever footing it may merit.
To say that I am fully conscious of the shortcomings of my work, would
be but feebly to express my convictions in this respect. I beg the
reader however to consider that the subject is not a hackneyed one, that
mine has not been the work of the compiler who remodels the brain-work
of others. It may be crude and rough, it may lack the gloss and polish
that is the result of much handling, but I have at least the
consciousness that it has the merits of originality and candor.
NEW YORK.
160 Second Avenue. November, 1876.
CONTENTS.
CHAPTER I.
THE APPARATUS.
PAGE
_a_)--The tub. _b_)--The electrodes and connections.
_c_)--The water. _d_)--Chemicals. _e_)--The batteries. 7
CHAPTER II.
MODE OF ADMINISTRATION 19
CHAPTER III.
PHYSIOLOGICAL EFFECTS.
Characteristic differences between the electric bath and
other methods of electrization--Effects on sleep; on general
sensation; on the change of matter; on the pulse and
temperature; as a stimulant and tonic; on general nutrition;
on the digestive apparatus; on the sexual apparatus--Sedative
influence--Affects cranial nerves--Cutaneous sensation--Its
freedom from pain--Muscular contractions--Effects on the mind 31
CHAPTER IV.
GENERAL THERAPEUTIC EFFECTS AND USES.
The electric bath as a diagnostic; as an equalizer of the
circulation; as a general counter-irritant; as a general
invigorant and tonic--Its hypnotic and sedative influence--Its
improvement of nutrition--As a prophylactic 52
CHAPTER V.
SPECIAL THERAPEUTICS AND CLINICAL RECORD.
General directions--Special diseases--Acute rheumatism--Subacute
rheumatism--Chronic rheumatism--Cases of rheumatism--Chorea,
with cases--Hysterical affections, with cases--Neurasthenia,
with cases--Agrypnia, with cases--Anaemia, with case--Paralyses
and Pareses, with cases--Neuralgiae, with cases--Articular
effusions, with case--Impotency, with cases--Constipation, with
cases--Hydrargyrosis, with case--Locomotor ataxia, with
case--Cachexia, with case--Dyspepsia--Melancholia, with
case--Inequalities of the circulation--Affections of the
Sympathetic, with case--Miscellaneous conditions--Concluding
remarks 61
THE ELECTRIC BATH.
CHAPTER I.
THE APPARATUS.
To a proper comprehension of the succeeding chapters, it is necessary
first of all to be familiar with the apparatus employed in carrying out
electro-balneological treatment, and I therefore proceed to give a
description of this.[1] It may conveniently be divided as follows, viz.
_a._ The tub;
_b._ The electrodes and connections;
_c._ The water;
_d._ Chemicals;
_e._ The batteries.
(_a_) _The Tub._ This must be made of a non-conducting material. Of
substances that will answer, I will mention: wood, porcelain, soapstone,
vulcanized rubber, or glass. In choosing one of these materials, regard
should be had to the facility of attaching the electrodes. In this
respect wood deserves the preference over all the others mentioned.
Where economy is to be studied, it has a further item in its favor.
The tubs, which I have now in use for nearly three years are made of
wood, and I find them to answer very well. It must not be forgotten,
however, that a wooden tub requires to be well painted on the inside, in
order to prevent its becoming water-soaked, because in that event it
would become a conductor of electricity, and interfere to some extent,
with the administration of the electric current in the bath.
The shape and size of the tub may be the same as those of an ordinary
bath tub. To suit individual cases however, its length may be made to
vary. The only peculiarity in its construction is at the head. Here,
instead of slanting, it is made square, and the slightly concave (from
side to side) board against which the back of the bather is to rest, is
fitted in afterwards. This is necessary, because it is very difficult to
make a wooden tub with a slanting back water-tight. If the length of
the tub from outside to outside is made to measure about five feet ten
inches, the back-rest fitted in at a proper slant will bring the inside
of the tub to about the right length for an average male adult. All
around the upper edge of the tub runs a wooden coping, which must not be
fastened down however until all the attachments for conducting the
current are _in situ_. Along that portion of the top of the tub where
required--and this will depend on the situation of the binding posts
presently to be mentioned--and underneath the coping, runs a groove for
the reception of the wires that are to connect the carbon electrodes on
the inside of the tub with the binding posts on the outside. This groove
is continued vertically along the inside of the back-rest and foot of
the tub respectively, to communicate at either end with the bed for the
reception of the carbon plates. These vertical grooves should at their
lower end be a little over 1/4 inch deep, in order to admit of the wires
being introduced beneath the carbons.
The face of the foot of the tub and that of the back-rest, should have
in their centres (from side to side) and commencing at about five inches
from the bottom of the tub, a bed for the reception of the carbons. The
dimensions of these receptacles must of course correspond to those of
the carbon plates to be employed as electrodes. Those which I use
measure 12x8" at the head, 8x6" at the foot of the tub. They are 1/4"
thick. They are placed so as to have their long diameter correspond to
the height of the tub. The bed which is to receive the carbon at the
head of the tub must be deeper than 1/4" on account of the concavity of
the back-rest.
In order to adapt a tub to individuals of different lengths, it will be
found advantageous to have two small vertical cleats on each side of the
tub, near the foot and bottom, for the reception of a foot-board, which
will practically shorten the tub and adapt it to persons of different
lengths. This board may conveniently be six inches wide, and should have
a number of perforations about an inch in diameter, for the transmission
of the current to the feet. 1 1/4" pine plank is the most suitable wood
to use in the construction of the tub. This is preferable to any of the
hard woods, because of the greater facility of fitting in the electrodes
etc. It is also the most economical.
(_b_) _The electrodes and connections._ These consist of two carbon
plates, two brass binding posts, and insulated wires to connect the
carbons with the binding posts, and these with the battery. The carbons
are such as are ordinarily employed in the construction of galvanic
batteries, and can, as well as the wire and binding posts, be procured
from any house that deals in telegraph material. Their size is to some
extent optional; the dimensions I have given above however answer very
well.
The inside of the tub having received one or preferably two coats of
paint, the carbons are now fitted in the receptacles provided for them.
The next step is the attaching of the binding posts. These should be of
the kind known as "single" binding posts with "wood screws." The most
convenient location for them will be found on the coping covering the
horizontal portion at the head of the tub. Here the coping, as it has to
cover not only the upper edge of the head of the tub, but that of the
back-rest also, is of necessity much wider than at any other portion,
and thus affords most room for the binding posts.
Having marked out then a site for the binding posts, say in the centre
of the coping at the head of the tub--which should now be placed in
position--and about two inches apart, the posts are laid aside to be put
in place when the wires are all _in situ_, and the coping fastened down.
In order to facilitate the description of the placing of the wires by
means of which communication is to be established between the electrodes
and the binding posts, I shall term the end of the wire that is to be
attached to the electrodes the distal, that which is attached to the
binding posts the proximal end. A gimlet hole sufficiently large to
admit of the passage of one wire should be made half an inch outwards
from the centre of the site of each binding post. The best wire to use
is about No. 16 copper wire, coated with gutta percha or rubber. The
site of the posts being as above suggested, it will be found that the
wire which is to connect the head electrode with one post requires to be
about 18 inches long, that which runs from the other post to the
foot-electrode, between eight and nine feet. The distal ends of the
wires should be stripped of their coating for a length of about three
inches, the proximal ends for about two inches. The denuded portion of
the distal ends should be rolled up in the form of a spiral coil; this
will insure their constant impinging on the carbons more certainly than
could be expected from a simple straight end of wire.
The carbons having now been fitted in their beds, the distal end (coil)
of the head wire is placed beneath the carbon, and the wire itself
continued up along the vertical groove to either one of the gimlet
holes. Through this, from within outward, the proximal end of the wire
is now drawn and left for the present. The distal end of the second wire
having now been placed beneath the carbon at the foot of the tub, this
wire is continued up through the vertical groove, along the upper edge
of the foot of the tub to the side nearest the binding post to which the
wire is to be attached, along the groove on the upper edge of this side
to the head of the tub, and thence to the respective gimlet hole, and
through this, from within outward. The wires being now all in position,
all the coping is next screwed or nailed down firmly, care being taken
that the screws or nails used for this purpose do not injure any of the
wires. The coping fastened down, the binding posts are now screwed down
in the sites previously marked out for them. Before they are screwed
_entirely_ down, the denuded portion of the proximal end of each wire is
securely wound around the screw of the respective binding post, and the
posts are then _firmly_ screwed down, holding the proximal ends of the
wires in place. Connection is now established between the binding posts
and the head and foot electrodes respectively. The vertical grooves are
now to be filled in with putty and painted over, care being taken to
keep the carbon free from paint. The last step towards completing the
apparatus is to fasten the carbons in their beds. The simplest way of
doing this is by stretching over each carbon a piece of muslin, folded
double, and tacking this down around the edges. Zinc or galvanized iron
tacks are best. Copper tacks should be avoided on account of their
superior conductivity.
In order to be able when required to localize the current in special
portions of the body, it is well to be provided with what I have termed
a "surface board." This is a piece of black walnut, say 14 in. long by 5
in. wide, 3/4 thick, having in the centre a bed to accommodate a carbon
plate, say 5 in. long by 2 in. wide, 1/4 thick. From the centre of this
bed a gimlet hole pierces the board. The denuded end of an insulated
wire is drawn through this gimlet hole from without inward (toward the
bed) and twisted in the form of a spiral to prevent its slipping back,
as well as to insure its more certain connection with the carbon. The
carbon is now placed in the bed, and kept there by a piece of muslin
drawn over it and tacked down. The wire should be of sufficient length
to reach the battery. I shall speak further on of the use to be made of
the surface board.
_c_) _The Water._ The quantity of water may be the same as that in an
ordinary bath. In those cases alone where it is intended to localize the
current by means of the surface board, and to concentrate it _very
strongly_ in one spot, the water in the tub should be left low enough to
leave the particular spot to be treated uncovered by this; the surface
board can then be applied to this spot without the loss to the current
of strength, through derived currents, inevitable in its application
under water.
The temperature of the water may range from 85 deg. to 105 deg.
Fahrenheit. As a rule the comfort of the patient may be consulted in
this respect. There are certain cases, however, where an especially high
or low temperature is indicated, and where the extremes mentioned have
to be touched.
_d_) _Chemicals._ Where these are added to the water of the bath, it is
for one of three purposes: viz. 1)--To exercise a direct therapeutic
influence on the patient, either internally by being absorbed, or
externally by their action on the skin; 2)--Through chemical affinity to
aid in eliminating certain metallic substances from the body; or 3)--To
further the absorption of morbid deposits. The various indications in
these respects will be treated of in their proper places.
_e_) _The Batteries._ In the choice of this, the most important part of
the electro-balneological apparatus, the greatest circumspection is
necessary. Inferior instruments and such as are liable to get out of
order frequently, have time and again been the means of discouraging the
beginner in electro-therapeutics, and causing him to abandon the study
of an art, the pursuit of which would have well repaid him for all his
labor. Fortunately our manufacturers here in New York turn out very good
instruments, and if a physician purchases an inferior one, the fault is
his own.
Two different currents are required for the baths, viz. 1)--The
galvanic, which may be employed either in the constant or interrupted
(by means of a rheotome) form; and 2)--the faradic or induced current.
Several manufacturers of this city turn out good and serviceable faradic
instruments. Those which I have been in the habit of using for some
years past are manufactured by the Galvano-Faradic Manufacturing
Company, and they have given me unvarying satisfaction. By means of a
recently introduced attachment to their batteries, termed the "fine
adjustment," a current of exquisite "fineness" (rapidity of
interruption) is obtained, thus removing the only inferiority that has
heretofore distinguished American from the best imported instruments.
The instrument is very easy of management, and its liability to get out
of order very small.
As however the galvanic current is of vastly greater importance in a
therapeutic respect, than the faradic, so also much greater care is
required in the choice of a galvanic than a faradic battery. In making
choice of a galvanic battery, we have to consider its relative quantity,
intensity, constancy, permanency, economy of running expenses, and
facility of management. We cannot be guided here by the same
considerations that guide us in the choice of a battery for office use,
where the _seances_ are usually brief and the elements taxed not nearly
so much as in the administration of baths. It is not within the scope of
this work to enter into a description of the various galvanic batteries
that are in use. Neither do I believe that, in a therapeutic sense,
there is much difference between the various batteries ordinarily found
described in text-books on electro-therapeutics.
Where the battery is to be stationary, a zinc-copper battery, such as
the Hill battery for example, is preferable both on account of its
constancy and the economy of running it. Of this there should be fully
sixty cells, communicating with the bath through a current selector, by
means of which the current from any desired number of cells can be
obtained. The electro-susceptibility of different individuals varies to
such an extent that this is absolutely necessary. Where a portable
battery is desired, the Stoehrer zinc-carbon battery will be found the
most useful.
I have mentioned these two batteries simply because I have them in use,
and they give me satisfaction. There are many others, however, that will
answer equally well. On the whole, any battery possessing quantity and
intensity in a medium degree will answer.
Footnotes:
[Footnote 1: A written description can never convey so true an
idea of anything, as an ocular inspection. I will therefore say
that it will afford me much pleasure to show any member of the
profession the apparatus I am about to describe, at my
residence.]