GENERAL THERAPEUTIC EFFECTS AND USES.
The therapeutic uses of a remedy are based on what we know of its
physiological effects. Many--or rather most--of the therapeutic effects
of this as well as of most other remedies, correspond to certain
physiological effects. Those therapeutic effects whereto we find none
analogous among the physiological effects, are yet the results of the
physiological tendencies of the remedy, and where these tendencies do
not manifest themselves as results, it is because they find no field for
action in the healthy organism. When they meet with the requisite
pathological conditions, these tendencies make themselves manifest in
the shape of definite results, commonly known as therapeutic effects.
NOTHNAGEL, in his classical work,[9] recognizes this theory by excluding
from his book the term "therapeutic effects" altogether. Where he finds
it necessary to say anything of the physiological effects of a remedy,
in addition to those "on man in health," he speaks--still under the head
of "physiological effects"--of those "on man when sick." When, setting
aside its empirical employment, we come then to inquire what it is that
furnishes us with the true indications for the use of a remedy, analysis
of the question leads us invariably back to its physiological effects.
If I have failed nevertheless to include the few effects which I am
about to touch on, under the head of "physiological effects," I have
done so simply in compliance with universal usage, and as a matter of
convenience for reference.
I will now, without further digression, proceed to the consideration of
those effects of electric baths not yet enumerated.
As a fitting precursor to the enumeration of the therapeutic properties
of the remedy under consideration, it may be well to dwell for a moment
on what is among its most prominent characteristics; I have reference to
its great value as a
DIAGNOSTIC.
In explanation of this, I will state that in a very large number of
cases of disease of an obscure nature, and where, to be candid, the
electric bath was employed empirically, or, if you please, tentatively,
it has served to point out the _locus morbi_. The number of cases in
which I have made this observation, has been sufficiently large to
establish beyond a doubt the fact, that as a rule the electric current
makes itself more decidedly and often even painfully felt in any part
where a morbid condition exists; whether this be of an inflammatory,
neuralgic, rheumatic, traumatic, congestive or other nature, the result
is the same. It appears to be somewhat analogous to the "tenderness on
pressure" that we find present in many of these conditions. In
_anaesthesiae_ even the current makes itself conspicuous by the _absence_
of its normal effects. The value of this will at once be recognized in
connection with a method of electric application which at one and the
same time acts on every portion of the body. Local electrization is
accompanied by like phenomena, _when we happen to strike the right
spot_. The superiority of the bath as a means of diagnosis is found in
the circumstance that here we _must_ touch it.
The great importance of this feature of the electric bath will at once
be realized by every physician of much experience, for there can be none
such who has not frequently met with subacute or chronic conditions the
etiology of which was more or less obscure.
One of the most important effects in its therapeutic application of the
electric bath, is its superior excellency as an
EQUALIZER OF THE CIRCULATION;
so far as I know, it is more potent, constant and comprehensive in this
respect than any other agent. Where an imperfect circulation of the
blood is due to irremovable organic causes, the results obtained will of
course be transient only. In all other cases, however, favorable
results, more or less perfect according to the nature of the case, may
be reliably looked for. Both currents act very well in this respect,
though on the whole I look upon the galvanic as superior to the faradic
current.
As a theory of this effect of the currents I would offer the following,
viz: That the galvanic current acts by stimulating the vasomotor centres
and peripheral nerves, by giving tone to the mucular coats of blood
vessels, and by counter-irritation. That the _faradic_ current
stimulates the vasomotor centres little, if at all, does not influence
the coats of vessels, except such as are close to the skin, but
tonicizes these latter more effectually than the galvanic current; that
it stimulates the peripheral nerves to some extent, though far inferior
in this respect to the galvanic current; but that when employed of
sufficient intensity it superadds to those mentioned a strictly
mechanical action, which consists in forcing static blood from the
capillary into the general circulation through the medium of muscular
contractions.
As a
GENERAL COUNTER-IRRITANT
the _galvanic_ bath has few if any superiors. The degree of
counter-irritation can be very nicely determined by regulating the
intensity of the current. The characteristic tingling sensation of the
galvanic current is felt over the entire surface, corresponding in
degree of course to the intensity of the current; while the redness of
the skin, bearing a like relation to the intensity of the current, is
observable more especially near the electrodes, being particularly
conspicuous over the entire back. Concentrated local counter-irritation
can be obtained by the use of the surface board.
The counter-irritant effects of the galvanic bath, differ from those of
ordinary counter-irritants in their freedom from pain, even the slight
burning sensation accompanying strong currents ceasing with the
application. The redness remains quite a while and the stimulus to the
peripheral circulation causes the persistence for some time of a
"glowing" sensation all over the body.
In the chapter on physiological effects enough has been stated to make
it apparent that as a
GENERAL INVIGORANT AND TONIC
the electric bath can have few if any superiors. In the healthy
organism, however, the stimulant and tonic effects of the baths are much
less marked than they are where the general condition is "below par." In
health there is little or no margin for improvement. The results
obtained are _temporary_ stimulation, and a permanent invigoration which
partakes more of artificial development than anything else. It is
analogous to the development by gymnastic or other exercise of a
previously healthy set of muscles. Where we meet with atonic conditions
however, with debility, malnutrition, want of energy or general asthenia
of an obscure nature, and amenable to electric influence, the tonic
effects of the baths become striking and brilliant. I have observed
cases where patients fairly bloomed up under their influence and
acquired actually more physical strength and weighed more than before
they became sick. When we consider how in such conditions as those
mentioned, patients are made to swallow pills and mixtures for months or
years, or, more appropriately, and if they can afford it, are sent
abroad, we can realize the importance of an agent by means of which the
desired end can be obtained more conveniently, certainly, economically
and in a shorter time than by any other means. There is no rule without
its exceptions, and I freely admit that in many instances where persons
are, as the saying is, "run down," a sojourn in some mountainous region
or a course of sea-bathing, etc., would do them more good than anything
else, electric baths included. The results obtained from these last are
however sufficiently uniform to justify us in looking for very favorable
results in every case.
In the preceding chapter I have already dwelt on the
HYPNOTIC AND SEDATIVE INFLUENCE
of the baths. It is only necessary to state here that this influence
manifests itself still more decidedly in corresponding morbid conditions
than in health. The greater the degree of restlessness, irritability or
wakefulness, the more strikingly does the soothing and hypnotic
influence of the baths--appropriately administered, of course--become
apparent.
IMPROVEMENT OF NUTRITION,
as manifested by rapid increase of weight, and which I have likewise
touched upon in the preceding chapter, is a reliable, constant effect of
electric baths. Where previous loss of weight is due to an incurable
organic disease, it is, if at all obtained, of course much less in
degree, as well as transient. When due, however, as is frequently the
case, to causes that are amenable to electrical influence, the increase
in weight is marked, and has a tendency to be permanent.
It will be seen that the few therapeutic effects which I have here
enumerated, are in reality nothing more than intensified physiological
effects, there being about them nothing that might be termed specific.
It may be asked in reply: why then did I devote any space to them at
all? I will answer that I thought best to point out some general
therapeutic USES for which electric baths may be made available, and the
indications for which are furnished by so great a number of pathological
conditions, that omitting special reference to them would have led to a
great deal of tautology in the chapter on "special therapeutics."
Before leaving the subject of "general uses" of the baths, I will dwell
for a moment on their admirable adaptability as a
PROPHYLACTIC.
Every physician is fully aware of the fact that disturbances of the
circulation constitute one of the most frequent causes of disease. There
are, indeed, comparatively few pathological conditions that do not bring
with them congestion of some more or less important organ. A remedy then
which more than any other has a tendency to equalize the circulation,
and thus counteract a condition which as cause or effect, or both, is an
almost universal concomitant of disease, and which in addition to this
is so admirable and physiological a stimulant and tonic, can hardly be
surpassed as a prophylactic by any other uncombined remedy.
Footnotes:
[Footnote 9: Dr. Hermann Nothnagel: Handbuch der
Arzneimittellehre. Berlin, 1870.]