Reprint from The Alienist and Neurologist, January, 1883. 
The Therapeutic Value of Cephalic and 
Spinal Electrizations.* 
By C. H. Hughes, M. D., St. Look. 
' I ''HE physiological experiments of MM. Latournian and 
Laborde (Gazette Hebdojninaire, i8jg,) confirmed 
by those of MM. Condorceau and Duval, performed on 
inferior animals, have fully demonstrated the power of 
electrizations to produce in the brain a state of tempo- 
rary anaemia immediately following each application. But 
these demonstrations were only confirmations of a fact 
previously ascertained by clinical methods. M. Latournian 
having, himself, before reported the case of the Abbe C., 
whose brain, chronically congested to such a degree as to 
produce marked and grave psychical aberrations, yielded 
favorably to persistently repeated cephalic electrizations, 
and I had, myself, long before this, employed these 
applications for this purpose, and became convinced from 
repeated [experience, of their power over the brain to 
tranquilize and subdue cerebral excitation, Fand over the 
•This paper was read before the Association of Superintendents of American 
Institutions for the Insane, at Toronto, Canada, June 14th, 1881, some of the 
clinical records being then hriefly.detailed verbally. 2 
C. H. Hughes. 
vasomotor system to promote through them the contrac- 
tion to normal dimensions of the abnormally distended 
cerebral arterioles in hypersemic encephalic conditions. 
Though the precise mode of action of the constant 
current in destructive brain lesions will probably not be 
understood until a number of cases, which have been 
treated in a similar manner, have been investigated post- 
mortem, as Althaus says, is perhaps true, yet we now 
understand its modus operandi in cerebral congestion quite 
well, and in this knowledge we have, in part, doubtless, a 
comprehension of how it may act in arresting, if not in 
diminishing, the growth of morbid products within the 
brain. The diminished calibre of the cerebral vessels may 
be inimical to their development, and the same influence 
that restores normal vasomotor tonicity, may extend itself 
to the trophic and absorbent systems. 
In the beginning of 1878 it had become quite a rou- 
tine practice with me to so employ the constant galvanic 
current, and I have the records of a number of cases of 
induced cerebral hyperaemia, one of them a case of men- 
ingitis verticalli, which occurred in a late general of the 
army, as the result of a saber wound received in battle, in 
which the effects of repeated applications of this valuable 
therapeutic agent were most salutary. Since then I have 
extended the employment of the constant current to all 
well-marked congestive states of the cerebro-spinal nervous 
system, and to parts so involved, and intimately associated 
with the sympathetic system. 
We may say, before passing to the record of our 
cases, that a now somewhat extended observation in 
electro- and neuro-therapy seems to confirm what Lowen- 
feld deduced from experimental galvanization of rabbits, 
viz: that while descending currents contract (the vessels of 
the encephalon including its) meninges, ascending cur- 
rents, from neck to forehead, dilate them; and it is well, 
also, to bear in mind Lowenfeld’s further assertion that 
cross currents dilate on the side of the anode and 
contract on that of the cathode, while induced currents Cephalic and Spinal Electrizations. 
3 
in any direction cause hypercemia cerebri. These facts 
may also be satisfactorily proven by personal experi- 
mentation, and the failure to appreciate them is at 
the foundation of the ill success of so many who have 
attempted to employ cephalic electrization for therapeutic 
purposes and discarded it. It has not, in these instances, 
been the electric current which has been at fault, but 
the operator who has misdirected it. It is as valuable a 
servant when skillfully used as the surgeon’s knife, and 
we should not condemn it because, in unskillful hands, it 
may prove equally unsafe and unsatisfactory. 
In the present note we content ourselves with a few 
clinical confirmations of the value of the constant descend- 
ing current in conditions of the brain associated, primar- 
ily or secondarily, with hyperaemia, reserving for another 
time illustrations of its value in other cerebral states and 
in certain abnormal conditions of the spinal cord. 
Althaus, vide “Brainy April, 1881, has bemployed this 
agent successfully in resolving morbid depositions within 
the brain, and we have seen hemiplegia, dysphagia and 
aphasia from lesions of the brain and pons, dissappear under 
its use, and the conviction has forced itself upon us from 
the more satisfactory results since its regular employment 
in our treatment of our epilepsias, conjoined with internal 
therapy, that it is an auxilliary in this affection which 
ought not to be despised. True, these cases recover 
under treatment without galvanism, but if the majority 
of our cases under the combined treatment stay well, 
whereas formerly the most of them, perhaps three-fifths, 
relapsed, it is not unreasonable to have acquired a little 
faith in its aid. 
Althaus (vide supra) has successfully treated diabetes 
insipidus by galvanizing the medulla, and melancholia by 
applying the current to the occipital lobes, and has caused 
auditory delusion to disappear by applying the current 
to Ferrier’s auditory centres in the superior tempero-sphe- 
noidal convolutions. 
We have seen similar results follow the use of the 4 
C. H. Hughes. 
galvanic current applied to the head and spine, though 
always from using a descending current except in tinnitus 
aurium and other auditory hallucinations. Bright’s and 
Addison’s diseases, which, in all probability, are intimately 
associated with renal ganglia disease in their origin, are 
greatly benefited by spinal electrizations, and the former 
has disappeared under its use, if albumen and tube casts 
are to be taken as indubitable evidence of its existence. 
Diabetes mellitus, associated with profound melancholia 
and sexual apathy (loss of sexual desire without sperma- 
torrhoea for six months), we have seen cured by it, 
conjoined with codia, cannabis indica and neurotic tonics 
and reconstructives. The miracles of medicine already 
wrought and still capable of being performed by the aid 
of galvanism wisely employed as auxiliary to a judici- 
ously prescribed internal therapy, can not yet be 
exactly estimated, but if we judge even from the known 
curative verifications of the medicinal power of this agent, 
our prophetic record must be a liberal and exalted one. 
It will avoid lengthening this paper, which is intended to 
be but a brief note on one part of this interesting subject, 
if we refer the reader to Dr. Althaus’ two interesting 
papers, in Nos. XII. and XIII. of “Brain,” “On Some 
Points in the Diognosis and Treatment of Brain Disease.” 
The cases of cerebral trouble which we now detail 
may serve to illustrate the one aspect of our subject, 
which we started out to show: 
N. J. W. is a young unmarried man, of dif- 
fident mien, florid complexion; moderately good flesh ; 
sleepless; pulse full and 84 per minute. He is troubled 
with morbid fears of various kinds, timid, forgetful and 
unable to attend to business. His appetite is ravenous 
and he is suspicious of the good intentions of his best 
friends, irritable and cross with them. He is of a san- 
guine, nervous temperament; some of his family have 
died of consumption; a sister is excessively nervous and 
his father died of cancer. Insanity is with him an 
impending possibility. Cephalic electrization through Cephalic and Spinal Electrizations. 
5 
February and March (1879) and some general treatment 
in April restored him. He now (1882) attends regularly 
to business, having only occasional slight recurrences of 
the head symptons, which a few days’ treatment promptly 
dissipates. 
A young clerk, F. G. W., jet. twenty-three, of full 
habit, red in the face, with bounding accelerated pulse 
and constipated; complains of a severe pressure in the 
head. Filling a position beneath his aspirations and es- 
teemed by him a menial one, he has become sleepless and 
melancholy, brooding over what he considers the tyranny 
of his employer, and lamenting his inexorable adverse 
fate; he proposes to end his troubles by jumping off the 
river bridge. A consciousness, however, that something 
is wrong with his head, leads him to consult his physician, 
the distinguished Prof. H., who refers him to me. Coming 
directly to our office and receiving a five minutes’ elec- 
trization, he feels more comfortable, and for the present 
gives up his purpose of suicide. Given a drachm dose of 
bromide of potassium in a glass of water and retained in 
the office half an hour, he is then allowed to go home, 
with another drachm dose combined with half as much 
chloral, to be taken as he retires. In the morning he 
takes a citrate of magnesia and mercurial cathartic, and 
comes to the office for another seance, which, repeated 
morning and evening for a fortnight, with bromide and 
chloral for a few nights, .0 prolong the tranquilizing 
effect of the electricity, and later, if he should awaken 
between midnight and morning, an uncombined dose of 
chloral, to sufficiently prolong his sleep, and this patient’s 
cure is practically complete. An injunction to take a 
dose of the bromide mixture at night when inclined to 
be sleepless, or during the day, if head feels full, and a 
laxative pill for use when bowels are not free, are all 
of the precautionary measures prescribed. The patient 
has had no return of former symptoms at this time (Jan- 
uary 1st, 1883). 
Mrs. G., set. thirty-three, married, has borne one child; has 6 
C. H. Hughes. 
intra-cranial vascular tension, auditory and visual hallucin- 
ations, highly vascular sclerotics and protruding eyeballs. 
One of the cornae is scarred from former ulceration. Has 
had iritis and been under the care of different oculists for 
inflammatory and exudative conditions of the cornea and 
anterior chambers of the eye, and it has been pronounced 
amaurotic and glaucomatous. At the time she came under 
my care, March 13, 1881, she could neither see objects in 
her room, or discern light from darkness, though the 
pupils were dilated with atropine. Her homeopathic oculist 
informed her that only Providence could save her. An 
ophthalmoscopic examination revealed no retinal trouble, 
so that the inference was justifiable that the failure of vision 
was due to encephalic trouble beyond the ocular fundus, 
(vascular pressure and exudation about the chiasma, the 
tubercula quadrigemina and augular gyri probably.) The 
latter condition being especially inferrable from the flashes 
of light which she has sometimes seen with closed eyes, 
and the visions of angels which came to her recently 
during a period of cerebral excitation. Her heart’s action 
was increased in frequency and force, the pulse being 120 
when she came under treatment. She had treatment from 
an irregular electrician and from most of the pathists of 
this city, without avail. The electrician employed the 
interrupted current through the head, a procedure not 
commendable. The patient had marked insomania, an 
impaired appetite and sluggish bowels. 
Under Gelsemium and the bromides and proto-iodide 
of mercury, with daily cephalic electrization, eight to 
twelve elements of a constant current battery—descending 
current—she so greatly improved in the course of a fort- 
night that she could distinguish all objects in her room, 
the lineaments of her physician’s and husband’s faces, the 
color of her friends’ hair and eyes, etc., in short, to see 
anything but fine print. Her appetite and general con- 
dition every way improved, the sclerotis became normally 
free from blood, and the sanguineous effusion in the 
anterior chamber began rapidly to disappear. Our visits Cephalic and Spinal Electrizations. 
7 
became less frequent after this—every fourth or fifth day. 
A minimum dose of hyoscyamia had a very unsatisfactory 
effect, causing much cerebral excitement, and some kalium 
iodidum likewise discovered in her an idiosyncrasy, causing, 
in ten grain doses, an intense diarrhoea. These abortive 
effects greatly prejudiced the patient against our treat- 
ment, notwithstanding we had come in as a dernier ressor 
and greatly benefited her, and during our absence at 
Richmond, she returned to the infinitesimals. 
This patient had formerly suffered from malarial con- 
gestions, and some years ago fell down unconscious in an 
apoplectic fit from which, in a few weeks, she slowly 
recovered. 
The therapeutic lesson of this case confirms what I 
have so often before clinically proven, that it has become 
a fixed article of therapeutic faith with me, that for hyper- 
aemic cerebral states, passive effusions and intra-cranial exu- 
dations, constant galvanism is the remedy par excellence 
The current seemingly acts equally well when applied from 
above downwards, following the direction of the normal 
nerve influence, from one hemisphere of the cortex down 
through the basal ganglia and out at the opposite side 
of the medulla, as when the electrodes are placed so as 
to impress the cervical sympathetic, namely, behind carotid 
at the ramus and angle of the jaw, and at the back of the 
neck above the seventh cervical vertebra. 
Dr. Edward C. Mann, of New York, in Vol. VII., part 
2, of the London Journal of Psychological Medicine and 
Mental Pathology, reports an interesting case of blindness 
and deafness, resulting from cerebro-spinal meningitis, 
successfully treated by him with a constant current, in 
which he details an experience with the electricity quite 
in accord with our own. We have never, however, cured 
a case of post meningitic blindness or deafness from this 
agent, though we have employed it with a view (and we 
think successfully) of averting this and other horrible 
sequelae of this formidable affection. 
The following case, however, is much like the preceding. 8 
C. H. Hughes. 
The details of the case appear more at length in a late 
number of the Louisville Medical News. The case was 
also verbally reported by us along with a number of 
others, to the Southern Illinois Medical Society, which 
lately met at Anna, Ills. The patient is quite well-known 
in that section of the country : 
Rev. L. is a Presbyterian divine residing in Illinois, 
of intensely studious habits, preparing his weekly sermons 
with much research and solicitude. The time habitually 
devoted to this labor is from the middle of the week 
until the following Sabbath; his hours of most intense 
labor being the night time, rarely terminating before mid- 
night on Saturdays, and later, on other nights. 
His congregation is influential, critical and appreciative 
of his work, which he realizes, and while he has labored 
with solicitude to fill their expectations of him, he has had 
none of those feelings of depression which come from a con- 
sciousness of unappreciated effort, and is not melancholic. 
He has, however, realized of late the failure of his mental 
powers for prolonged studious effort, and has become 
conscious that he must get relief or abandon his calling. 
His symptoms, when he first came under observation, 
were protrusion of the right eye and inability to distin- 
guish light from darkness with it; cephalagia with inabil- 
ity to labor mentally without intensifying it; full pulse, 
84 per minute, and increased temperature, 99.5 F. on 
side of blindness; sluggish bowels; an ill-at-ease sort of 
feeling in the day-time, and incapacity for sufficiently pro- 
longed, dreamless and refreshing sleep, to daily recuperate 
him. He had no catarrh, and there were subjective noises 
in his left ear. Otoscopic and ophthalmoscopic examina- 
tion gave negative results. yEsthesiometric examination 
gave abnormal and lessened tactile sensibility in the ter- 
minal branches of the tri-facial. Giddy sensations were 
complained of, and his appetite was somewhat impaired. 
The renal, hepatic, enteric and cardiac functions, save the 
ganglionic excitation in the latter, were not appreciably 
abnormal. Cephalic and Spinal Electrizations. 
9 
The condition of this patient was one of partial paral- 
ysis of the vaso-constrictor nervous system, due probably 
to malarial influences as the pre-determining cause, and 
to psychical overstrain as the immediate exciting cause. I 
regard the cerebral pathological condition as one of 
psychically induced cerebral hyperaemia with meningeal 
hyperaesthesia and cortex irritability. 
The treatment consisted mainly in cerebral galvaniza- 
tion with the constant descending current, daily, of vary- 
ing strength, enforced brain rest, and chemical restraint 
imposed by the sodium and potassic bromides in after- 
part of day and night, together with all rational efforts 
to restore trophic and waste cerebral equilibration. The 
following further history of this case is given by the 
patient himself: 
“I came into Southern Illinois in the spring of 1876. 
After being here about a month or two, 1 took chills and 
fever. I was troubled with them for about one year. 
After getting clear of them 1 began to be troubled with 
what my physician here called nervous headache. As 
time passed this grew more troublesome until I had it 
half or more, probably of my time. In September, 1881, 
I went north to spend a few days, and while there had 
severe pains in my head, and was under the necessity of 
remaining in a dark room for about forty-eight hours. 
During that time I lost the sight of my right eye entirely. 
Came back home and staid until last of November, when 
my left eye became somewhat affected. When I placed 
my case in your hands, or under your treatment, my 
sight was perfectly restored before 1 left the city, and 
since I have had no trouble whatever, so far as they are 
concerned. I have been able to work ever since I returned 
home. Have done harder work and more of it than for 
three or four years before. My head does not trouble 
me much now. 1 think I have had headache but once 
during the last month. 1 eat well, sleep well, I feel well 
generally, but I am exceedingly nervous.” 
The patient has lost thirty-seven pounds in weight, and 
complains that he can hardly hold a paper still enough 
to read it. He will require further treatment for the 
general nervous symptoms, but the cerebral hyperaemia, 10 
C. H. Hughes. 
meningeal hyperaesthesia and cortex irritability were 
subdued by the treatment and the concomitant blindness 
due to the cerebral condition, disappeared simultaneously. 
In our view, while the effect of cephalic electrization 
is to produce diminished circulation within the brain, this 
effect is often undoubtedly contributed to by a concomi- 
tant or precedent tranquilization of the cerebral cells, 
whose state of excitation induces hyperaemia. The effect 
on the brain and its meninges may be primary, on the 
circulation secondary to, and as a consequence of, the 
tranquilization of the excited cell movements, in some 
cases. An essential property of the constant descending 
galvanic current in induced cerebral hypercemia is that of 
a tranquilizer of irritable nerve tissue, secondarily contri- 
buting to the contraction of over-distended vessels. It 
acts on the irritable brain like bromides, hyoscyamin and 
chloral, vasomotor results being secondarily induced when 
there is over vascular distension as well as primarily 
accomplished. 
Certain effects of cephalic electrization are too im- 
mediate to be the result solely of the circulatory changes 
made by it. For example: the prompt relief of migrain 
and other hyperaesthetic neuroses of the meninges, as well 
as in all forms of anaemic and congestive cephalalgias; 
though it is undoubtedly more effective in the latter. 
It is a well-known fact, in regard to certain hypnotics, 
that they first accelerate and augment in force the ce- 
rebral circulation, even while the obtunding of conscious- 
ness and the gradual quiescence of the brain is being 
accomplished, so that to attribute their sleep-inducing 
power to their influence over the vasomotor system is 
not logical. They induce sleep under varying states of 
the circulation, as in opium, alcohol, chloral and bromide 
slumber, the state of the circulation being different in 
all. We may fall into error if we attribute the effects 
of electricity solely to its vasomotor influence. 
Note.—Further detail of cases would be needlessly 
cumulative testimony in regard to congestive states of Cephalic and Spinal Electrization. 
11 
the head at least, but it will not be amiss to record a 
few confirmations of the value of electrization of the spine 
in congestive states, of which we have on our case book 
the notes of some remarkable illustrations. We promise 
them for a subsequent number, contenting ourself now 
with the assurance, that rightly used, these electrizations 
will be found the best of auxiliaries and often our chief 
reliance in purely congestive states of the brain and cord. 
(To be continued.)