REPORT ON ELEC^O-TIIERAPEUTICS. 
(Containing some final alterations.) 
By J. J. Putnam, M.D., Boston. 
Electro-physiology. 
Ziemssen.—Die Electricitiit in der Medicin. 4te Aufl.; Physical, 
und Physiol. Erlangen, 1872. 1 ster Theil. 
Cyon.—Principes d’electro-therapie. Paris, 1873. 
Wreden.—Ueber elec. Reizung d. Gehororgans. Pfluger’s Archiv, 
Bd. vi. 
Weber-Liel.—Ueber das Wesen und die Heilbarkeit d. haufigsten 
Formen progress. Schwerhorigkeit. Berlin, 1873. 
Loewenberg.—Ueber d. Einwirk. elec. Strome auf d. sogen Bin- 
nen-muskeln d. Ohres. Monatschrift f. Ohrenheilkunde; Canstatt’s 
Jahresb., 1873. 
Both Cyon and Ziemssen deserve the thanks of the profession for 
having attempted, in the above works, to rescue electro-therapeutics 
from the hands of the purely empirical and to place it upon a scien- 
tific basis. 
The laws of electrotonus, discovered long since by Du Bois-Rey- 
mond, Pfliiger, and others, are stated by Cyon with remarkable clear- 
ness and conciseness. 
For the sake of what follows, a brief review of the most important 
of them may be permitted here. 
When a current of electricity is allowed to flow constantly through 
a (frog’s) nerve, its susceptibility to excitations (mechanical, electrical 
or chemical) suffers certain definite changes. Around the point where 
the current enters the nerve (positive pole, anode), its irritability be- 
comes diminished, so that to produce a given response (a muscular 
contraction of a certain strength), a more intense excitation must be 
used than was previously necessary. Around the point where the 
current leaves the nerve (negative pole, or kathode), the irritability of 
the latter becomes, on the contrary, greater than before, so that an 
irritation previously inefficient now meets with a response. 
These states of altered irritability are called, respectively, anelec- 
trotonus and katelectronus. Several theories for their production 
have been proposed (by Du Bois-Reymond, Hermann and others), but 
it will be sufficient for our purpose to assume, speaking roughly, that, 
where the current enters the nerve, the vibration of its molecules be- 
comes less rapid than before (anelectrotonus, or diminished irritabili- 
ty) ; where the current leaves the nerve, that the rapidity of the mole- 
cular vibration is increased (kalectrotonus, or increased irritability). 
At the moment that the electrical circuit is closed, the state of in- 
creased molecular vibration is induced with great suddenness around 2 
the kathode, and thereby the nerve is sufficiently excited to call out a 
contraction in the muscle which it supplies. 
This excitation, accompanying the closing of the circuit of a constant 
current, takes place, therefore, exclusively at the negative pole (ka- 
thode), and not at all at the positive pole (anode). 
When the circuit is broken, the reverse is true ; the diminished 
molecular vibration around the positive pole (anode) during the pas- 
sage of the current gives place suddenly to a state of normal, or even 
increased vibration, and an excitation, confined to the positive pole, is 
the result. 
Many investigators have attempted to reproduce these phenomena 
upon the human subject, and it has, indeed, been demonstrated satis- 
factorily that with the optic (and perhaps with the auditory) nerve 
the anelectrotonic and katelectrotonic stales may be produced at will. 
Pfliiger’s laws are more difficult of verification ; but by taking great 
precautions, Cyon has obtained very satisfactory.results in experiment- 
ing upon the ulnar nerve. 
It is a matter of common observation in experimenting with the 
human nerve, that a contraction attends the closing of the circuit (if 
the current has a certain strength) when only the positive pole is on 
the nerve, the negative pole, on the contrary, at an indifferent point. 
This is, no doubt, because the human nerve is surrounded by good 
conductors, which give an easy passage to the electrical current, and 
induce it to leave the nerve almost immediately after entering it. 
The muscles constitute for the nerve, in fact, a negative pole (ka- 
thode), and the conditions for the induction of katelectrotonus at the 
moment of circuit-closure are thereby given, although of the metallic 
poles only the positive be in the neighborhood of the nerve. 
It is claimed on many sides (especially by Brenner and his follow- 
ers with regard to the auditory nerve), that a state of more or less 
permanent anelectrotonus may be induced in a nerve by bringing it 
under the influence of the positive pole for a time, and then gradually 
reducing the strength of the current to zero, so as to avoid the circuit 
opening reaction. In this way, it is said that irritative conditions in 
nerves, and, indeed, in other tissues, may be removed. 
The facts may be true, but physiology does not justify this expla- 
nation ; for, with the frog’s nerve at least, the anelectrotonic state dis- 
appears immediately, or almost immediately, after the opening of the 
circuit. A more probable explanation would seem to be that better 
conditions of nutrition are induced in the irritated nerve by the pas- 
sage of the current. Furthermore, much doubt has been thrown on 
the propriety of Brenner’s diagnosis of irritation, and, indeed, on the 
whole theory of the reaction to electricity of the auditory nerve, by 
Wreden, of St. Petersburg, who has made a long series of experi- 
ments to show that the subjective sounds which attend the so-called 
galvanization of the auditory nerve, are, in fact, due to the contraction 
of the intrinsic ear-muscles. 
That many cases of ringing in the ears and partial deafness are, in 
fact, dependent upon abnormal conditions of these muscles, and are 
often curable by galvanizing them (by passing a metallic probe into 3 
the tympanic cavity through the Eustachian tube), has been conclu- 
sively shown by (among others) Weber, of Berlin. Loewenberg sug- 
gests that, by the use of a manometer connected with a water-tight 
ear-speculum, the supposed action of these muscles might be studied. 
Both Cyon and Ziemssen criticize severely the loose and unscientific 
manner in which marvellous results are set down on all sides as due to 
the so-called galvanization of the cervical sympathetic. The cervical 
sympathetic (apart from its connection with the pupil and the salivary 
glands) contains the vaso-motor nerves for the ear, face, and some 
parts of the brain, but not for the rest of the body, and the nutrition 
of the legs, for instance, can in no wise be dependent upon its influence. 
Moreover, as the sympathetic is usually galvanized, not it alone, 
but also the depressor nerve and the vagus, must be brought under 
the influence of the current, and, perhaps, through their agency, the 
circulation of the distant parts of the body may, indeed, be affected. 
Cyon points out that the spinal centre for the vaso-motor nerves of 
the arms lies in the upper dorsal, that for those of the legs in the lower 
dorsal, region. 
Ziemssen has measui’ed carefully the rise in temperature which nor- 
mal muscles exhibit when made to contract by faradic currents, and 
found it to amount to several degrees in a few minutes (4°-8° F.). 
The therapeutical importance of such a rise must, of course, be great. 
No elevation of temperature, on the other hand, attended the passage 
of a pretty strong galvanic (constant) current through the skin and 
muscles for five minutes, except at the point of application of the 
electrodes. At the same time, there can be little doubt that the nutri- 
tion of the various tissues of the body, especially when 1*hey are for 
the moment in a pathological, but tending to return to the normal, 
state, may be improved by the simple passage of a constant (galvanic) 
current. Physiological evidence therefor is given by the increased 
weight which Orimus and Legros found a number of puppies, selected 
at random from a large litter, to attain under daily galvanization. 
Electro-therapeutics. 
Neftel.—Galvano-therapeutics. New York, 1871; also, New York 
Medical Record, December, 1872. 
Clarence J. Blake.—Annual Report of the Massachusetts Charita- 
ble Eye and Ear Infirmary. 
J. Russell Reynolds.—Clinical Uses of Electricity. London. 1873. 
Herbert Tibbits.—A Handbook of Medical Electricity. London. 
1873. 
IIolst.—Die elect. Behandlung von Migraine. Dorpater. Med. Zeit- 
schrift, II., 4 Schmidt’s Jahrb., No. 6, 1872. 
Bouchut.—Paralysie Infantile. Bull. gen. de Therapie. 1872, Aout. 
Centralblatt, No. 45, 1872. 
Cinselli.—Sullc correnti galvaniche continue. Gaz. Med. Ital. 
Lomb., No. 37. Canstatt’s Jahresb., 1873. 
N. Mayer.—Philadelphia Medical Times, May 15, 1873. 
Gerhardt.—neilung d. Icterus catarrhalis durch Farad, d. Gallen- 
blase. Berl. Klin. Wochenschr., No. 27, 1873. 4 
George M. Beard.—Cases illustrating the Treatment of Skin Diseases 
by Central Galvanism. N. Y. Medical Record, Aug. 15, 1873. 
Neftel and Blake report cases where electricity was of service in the 
diagnosis and treatment of various aural diseases. Neftel found “ hy- 
peresthesia ” of the auditory nerve in some cases of chlorosis, and a 
torpid condition in case of Bright’s disease. (Compare above.) 
Reynolds and Tibbits, both connected with the Queen’s Square Hos- 
pital, London, recommend the use of static (frictional) electricity for 
its tonic effect upon the nervous centres, the treatment consisting in 
charging the patient, placed on an insulated stool, with free electricity. 
Tumors of various kinds are reported as having been relieved, at 
least temporarily, in this way. 
The free electricity obtained from one pole of a large galvanic bat- 
tery (the other being connected, by way of the gas tubing, with the 
earth) was found by them to have a similar tonic effect in cases of 
general nervous debility. 
Dr. William R. Fisher (New York Medical Journal, May. 1873) 
speaks of the importance of placing weak or palsied muscles in a re- 
laxed condition while faradizing them. Under these circumstances, 
they become able to contract, although previously unable. The re- 
viewer believes the point to be an important one. 
Holst has been more fortunate than most physicians in his treatment 
of hemicrania by electricity. He distinguishes sharply between two 
opposite forms of the disease, one due to an irritated condition of the 
cervical sympathetic, and consequent spasm of the vessels controlled 
by it (observed and studied upon himself, by Du Bois-Reymond), the 
other to paralysis of nerve and vessels (first described by Moellen- 
dorflf). 
The excessive irritability of the nerve he treats by bringing it (vide 
above) under the influence of the anode of a galvanic battery, a long 
and narrow electrode being pressed inwards and backwards from just 
in front of the sterno-mastoid muscle, while the other pole is grasped 
by the patient’s hand. 
The neuro-paralytic form he treats, on the contrary, by exciting the 
nerve strongly through the agency of the negative pole (kathode). 
Not being able to tell, in most cases, which form of the disease is 
present, he lets the results of treatment decide the diagnosis. 
Dr. Anstie believes, as is well known, that migraine is dependent 
upon degenerative changes affecting the root of the trigeminus. In 
this, as in all true neuralgias, he finds that the vaso-motor nerves are 
generally affected, but secondarily causing, in most cases, first vascu- 
lar spasm, then vascular paralysis. 
The use of weak, long-continued galvanic currents is increasing in 
favor. Bouchut found good results in infantile paralysis from letting 
the current from four elements run from six to twelve hours at a time 
through the paralyzed muscles, and considers the resulting improve- 
ment an argument for the myopathic origin of the disease. Ciniselli 
and Mayer recommend the wearing for a long time of batteries, such 
as have been long in use in the treatment of ulcers, either on opposite 
sides of the head or on other parts, for neuralgia, paralysis and a long 
list of nervous disorders. 5 
These batteries differ from Dr. Garratt’s disks principally in the fur- 
ther separation from each other of the metallic plates, whereby the 
tendency of the current to penetrate deeper into the tissues is in- 
creased. 
T. Clifford Allbutt (West Riding Hosp. Rep. for 1872 ; Practitioner, 
Dec., 1872) gives a number of cases of dementia and. melancholia treat- 
ed successfully by the use of galvanism directed to the head and the 
cervical sympathetic. Arndt (Zeitschr.f. Psych., Bd. 28) has met 
with similar results. 
Arndt’s observations, however, have by no means been confirmed in 
all the large hospitals in Europe, and the cases and observers are too 
few as yet to justify a decided opinion in the matter. 
Gerhardt has succeeded, in several cases of icterus catarrhalis, in 
causing the gall-bladder to contract strongly by energetic and wrell- 
directed faradization, whereby the plug of mucus was expelled from 
the gall-duct. In most of these cases, careful percussion had revealed 
an area of dulness, which disappeared after treatment. 
In the treatment of skin diseases of the most chronic and obstinate 
character, Dr. Beard has met with marvellous success, both when 
using local and central galvanism (galvanism of nervous centres). We 
shall look with interest to see if his observations are confirmed by 
others. 
It has long been known that the health of the skin may be influenced 
by the state of the central nervous system, and that eczematous, her- 
petic and other inflammations may be caused by lesions of peripheral 
nerves, but that so close and so general a connection exists between 
the state of the central nervous system and that of the skin as the re- 
sults claimed to follow the galvanization of the former would indicate, 
would certainly surprise all but the most neuropathic of dermatologists. 
Dr. D. P. Lincoln reports the results of the use of electricity, dur- 
ing the past year, at the Boston Dispensary for Diseases of the Ner- 
vous System, in a great variety of diseases, mostly of nervous origin. 
Among those “ relieved ” are 5 cases of epilepsy out of 8, 18 of my- 
algia out of 19, 22 of asthenia out of 47, 6 of neuralgia out of 9. 
J. Byrne.—Notes on Uterine Surgery. New York Medical Record, 
December, 1872, and January, 1873. 
Neftel.—Die elect. Behandl. d. bosartigen Geschwiilste. Yirch. 
Arch., 1873, I., VII. ; Centralblatt, 5 July, 1873. 
Carl Michel.—Pharyngitis u. deren Heilung durch Galvanocaustik. 
Allg. Med. Centr. Zeit., 26th and 27th March, 1873. 
Kodolfi.—Della elettr. nella congiuntivite gran. Gazz. Med. 
Ital. Lomb., Nov. 2, 4, 7, 14, 1872. Canstatt’s Jahresb., 1871. Schi- 
vardi. 1871. 
Trueheart.—Granular Conjunctivitis. New York Medical Record, 
No. 168, 1872. 
Girard.—Amputations-neuroma. Deutsches Arch. f. Chirurgie, B. 
I., II. 1. 
Electro-surgery. 6 
Dr. Byrne appears as an advocate for the use of the electro-cautery 
in uterine surgery, in a series of very sensible papers, in which he also 
describes some new and apparently excellent forms of instruments and 
batteries. (All fluid batteries for this purpose will, probably, be su- 
perseded some day by magneto-electric machines, such as Mr. M. G. 
Farmer makes for exploding torpedoes.) 
Michel has used the galvano-cautery to advantage in chronic pha- 
ryngitis, touching lightly the thickened prominences of the mucous 
membrane with the red hot wire, which may be easily introduced, even 
through the nostril. The operation is not attended with any great 
pain, and in ten or twelve days every trace of it has disappeared. 
In granular conjunctivitis good results are claimed to follow the use 
of the constant current, one (either) pole armed with a soft sponge 
being applied directly to the conjunctiva, while the other is placed on 
the eyebrow or molar process. (Vide Journal, Vol. x. 1872, page 
305.) 
The duration of each application is ten to thirty minutes. 
Three to five applications are generally enough ; if not, then one 
should begin again after an intermission of three to eight days. Mean- 
time, solution of nitrate of silver, gr. ij.—§ i., may be used. 
Neftel claims to have destroyed a number of cancerous growths, 
with better results than usual in the way of recurrence, by means of 
electrolysis. He believes that the cancer cells, being of low vitality, 
are killed by the current, even when they are not in a position to be 
directly decomposed. 
His papers on the subject would repay careful perusal. 
Girard gives a carefully reported case in which three amputation- 
neuromata, which had recurred twice after removal by the knife, were 
destroyed by electro-puncture, needles connected with a battery of 
thirty-six small Bunsen elements having been thrust into them. Eight 
weeks after the operation (the longest time that they had remained 
away before), there was no sign of recurrence. 
[Reprinted from the Boston Medical and Surgical Journal, Oct. 30.]