[Reprint from The Alienist and Neukologist, St. Louis, July, 1887.] 
The Scientific Rationale of Electro- 
therapy.* 
A REVISED PAPER ON THE THERAPEUTIC APPLICATIONS 
OF ELECTRICITY. 
By C. H. Hughes, M. D., St. Louis, 
Lecturer on Neurology and Electrotherapy, St. Louis Medical College, etc. 
EVER since Thales of Miletus, six hundred years be- 
fore the Christian era, discovered the power of electron 
(amber) after friction to attract light bodies, electricity 
has been a subject of general wonder, whether displayed 
in the electric eel, in instruments of man's construction, 
or in the batteries of the great Omnipotent, when the 
electric currents of the clouds are seen or heard in light- 
nings and thunder. 
And since Swammerdam, toward the close of the sev- 
enteenth century, saw a frog's leg contract through its 
influence, and Galvani, a century later proved it, this 
wonderful force has presented a peculiar and increasing 
attraction to scientists; and ever since our own Franklin, 
who, with lightning hand, grasped God's hand in nature 
and brought the convulsive force of the clouds to earth, 
it has been a subject of therapeutic study in this country. 
For in 1758 he applied it to disease, and caused a 
Note.-For many years we have endeavored to study electricity with that 
rational and scrutinizing credulity and reasonable confidence in the powers of nature 
which should ever characterize the true physician. We have sought for the facts 
upon which the power of this agent to modify organic conditions and processes are 
based. Such as they have appeared to us, we here record them, in justification of 
the therapeutic faith that is in us. It is hardly necessary to add th«t this paper does 
not claim to be an exhaustive showing of the therapeutic capabilities of electricity, 
but only a cursory exhibit of its principal therapeutic powers as a working basis lor 
the practical physician. It will serve to show why we employ it in the treatment of 
disease though it does not give every valid reason lor its employment, and it is in- 
tended rather for the general practitioner of medicine to read in his office, than 
for the expert electrician in his laboratory. ,- 
* Head before the St. Louis Medical Society, January, 1887. 
1 2 
C. H. Hughes. 
paralytic hand to regain, in great measure, its cunning; and 
before him, in Geneva and the metropolitan centers of all 
Europe and Great Britain, its powers over disease had 
begun to be a subject of investigation. Its promiscuous, 
purely empirical employment by the unprofessional, among 
them the renowned and Reverend John Wesley, and 
the exalted claims put forth for it by its hopeful votaries, 
raised public expectation so high that a reactionary in- 
credulity concerning its powers took the place of pre- 
vious faith, when its many failures became as well 
known as its published miraculous cures. For though 
Watson by it cured a child of chronic congenital muscu- 
lar spasm (something akin to the later discovered Thom- 
sen's disease) and Brydone, Nilson and DeHaen, cases of 
long standing deafness, and it had been successfully used 
by a surgeon of Leeds in amaurosis, and others had re- 
lieved neuralgia, headache, rheumatism and chorea, the 
disappointments and accidents which followed its incau- 
tious and unskillful employment counteracted the good 
impression made by these physicians. 
Quacks and mountebanks seized upon it because of its 
astonishing power, and being reckless and indifferent to 
its dangers, as they are to this day, employed it without 
caution, and promised cures it could not, in their hands 
at least, perform. Out of this ill usage of a truly good 
remedial agent, the false hopes raised, and unfulfilled 
promises made, grew distrust in the professional mind, 
which, to some extent, still abides, but which is destined, 
under the more" certain and definite light now being thrown 
upon this subject, to give way to its confident and satis- 
factory employment in therapeutics. 
Neurotherapy has taken the lead, but general therapy 
must and will invoke its certain aid in all those morbid 
conditions in which its therapeutical utility can be (Rem- 
onstrated. 
It is one of the greatest forces of nature and destined, 
in my judgment, to play as important a part in influencing, 
and controlling morbid conditions in the human organism, The Scientific Rationale of Electrotherapy. 
3 
as it exerts upon inanimate nature, as displayed in 
its employment in physics, the arts and the natural 
sciences. 
To employ it aright in therapeutics we should study 
well its precise powers over the physiological and chem- 
ical actions of the organism, and to an inquiry into these 
powers we first address ourselves. These are its physical 
effects on the system, and to understand them thoroughly 
is to find out a rational basis for its successful thera- 
peutic employment. 
With this enlightenment the stone which the earlier 
therapeutic builders rejected, is destined to become the 
head of the corner in the new remedial foundations in 
the temple of therapy. 
Chemical and Physical Changes in the System, Induced 
by Dynamic Electricity. 
Absorption and Endosmosis.-While strong galvanic 
currents can arrest endosmosis, mild induction currents 
have a contrary effect. Remak promoted this physiolog- 
ical phenomenon by placing the positive pole on edema- 
tous parts, and the negative pole between the swelling 
and the cerobro-spinal axis. 
If two small blisters are made upon the skin, and the 
positive pole be placed on one and the negative pole on 
the other, and a strong current be passed between them, 
the blister under the positive pole will become dry within 
a quarter of an hour after the electricity has passed, and 
under the negative pole a new blister will be found. 
This law of electrical promotion of endosmosis can 
be proven out of the body: 
If two platinum electrodes should be connected with 
a constant galvanic current from ten or twelve cells, and 
then be immersed in pure water, the negative or zinc 
terminal within a porous vessel, and the positive or car- 
bon terminal outside of this porous medium, the water in 
the inner vessel will accumulate in two hours to a level 
about one-sixth higher than that in the outside (Amory, 4 
C. H. Hughes. 
p. 291). There is a flow of the fluid through a porous 
septum from the positive towards the negative pole. 
Likewise in pure electro-cautery the eschar under 
positive pole is paler, dryer and harder than that under 
the negative pole which is soft and moist. 
Remak was the first to observe this, and Legros and 
Onimus first explained the phenomenon upon the hypothe- 
sis of vascular contractions, a physiological fact, since 
abundantly confirmed, but the power of electricity over 
endosmosis was known to Detrouchet. 
Effects on Nerves and Fluids.-The nerves and 
fluids of the body are good conductors, and it is through 
nerves and channels of moisture that with galvanism or 
Faradism we can get into the interior of the body in 
certain direct lines from pole to pole, in certain parts. 
Schiff asserted that the passage of an induction current 
through a nerve produced appreciable elevation of tem- 
perature, and very strong currents must, undoubtedly, heat 
and destroy nerves, as the galvano-causty current heats the 
wire, but heat is mostly developed in a part by increase of 
vascular supply through muscular contraction and reaction- 
ary influx of blood after brief vasomotor stimulation and 
arteriole contraction. The opposite state of heat-depression 
through electrically-induced anaemia, would likewise occur 
if applications were not too prolonged. 
Nerves may be damaged by crossed currents, but they 
cannot be excited to physiological action by electricity 
applied in this way. 
Galvanic, Faradic and static currents may be made to 
penetrate the cavities of the body, the two former only 
through connecting the body with both poles,-the latter in 
this way and also by electrical discharge. Faradic electricity 
is, however, more a surface current than galvanic. The 
Faradic and static forms of electricity exert greater power 
over the voluntary muscular contractions than the galvanic. 
The galvanic exerts its most beneficial influence on the non- 
striated muscular fibers through the vasomotor mechanism. The Scientific Rationale of Electrotherapy. 
5 
It may be sent to remote interior parts with more cer- 
tainty and accuracy and less harm than other currents. It 
can be passed through the brain, and is the only current 
which, as a rule, in the present state of our knowledge, can 
be safely employed, to any considerable extent, upon the 
interior of the head. 
A Faradic current, from center to periphery, causes 
stronger muscular contractions than from periphery to 
center. 
Chemical Effects-Electrolysis.-Electrolytic de- 
composition is the chief chemical effect of electricity, acids 
being formed and liberated at the positive electrode, and 
alkalies at the negative. When muscles, severed from the 
living organism, are subjected long enough to electric cur- 
rents, the mineral acids, sulphuric, nitric, muriatic and 
phosphoric, are formed at the positive pole, and potassa, 
soda and ammonia at the negative electrode. 
This decomposition at the poles is due to the acids 
and alkalies formed at the respective poles; for if alkalies 
be placed at the positive pole to neutralize the acids, and 
acids at the negative pole to neutralize the liberated alka- 
lies, no blister results. 
It can be shown that any internal decompositions take 
place in electrolysis when the ordinary currents are used. 
The decomposed elements of the organism appear only at 
the electrodes. 
This is an important point with reference to constitu- 
tional electrization, and also shows the probable fallacious- 
ness of the claims of certain quacks that they have been 
able to extract the mercury and other poisonous min- 
erals put into the system by the regular profession. 
Its Power to Coagulate the Blood.-Electrical cur- 
rents passed through the blood in sufficient strength cause 
it to coagulate at both poles, but chiefly at the positive 
pole. 
Heidenriech found the coagula at the positive pole to 6 
C. H. Hughes. 
be composed mainly of albumin, fibrin, fat and acids; 
chlorine also appeared at this pole. The coagula at the 
negative pole were made up mainly of iron and the alkaline 
and earthy bases. The watery and alcoholic extracts and 
coloring matter also appeared at the negative pole. 
The contractile power of electricity over surrounding 
muscles and its influence over the ganglionic system 
added to the coagulating power, contribute to the cure of 
aneurism, by toning and contracting arterial walls, es- 
pecially of the small arterioles in miliary aneurisms, and 
strengthening the vessels by artificial walls of fibrin, etc., 
when electrodes can be inserted. 
In 1869, Cliniselli reported out of twenty-one aneurisms 
treated by voltaic electricity, fourteen successes and seven 
failures. Inflammation and gangrene set in in five of the 
failures, probably because too strong a current was used. 
He used a current of sixty to eighty piles of large surface 
elements. The current emitted bright sparks and its ten- 
sion was greater than necessary for mere coagulation of 
blood. Out of nineteen aneurisms treated by the batteries 
of Wollaston, Daniel, Bunsen and Senee, there were eight 
cures and eleven failures. Of the eleven failures four failed 
because the operation failed, five died and two were made 
worse. Grave accidents followed in all the eleven. This 
was in the earlier days of galvano-puncture for aneurism. 
Since then numerous successes have been reported by 
different surgeons, and likewise many failures. 
I do not think the coagulation should be so much aimed 
at, especially in the aorta, as tonicity to the weakened 
arterial walls; and I believe it would be better to apply the 
current along the arterial walls and to affect the vasomotor 
ganglion supplying the affected artery, where practicable, 
by a number of preliminary mild treatments, say fifteen or 
twenty daily seances, if that much delay were admissible 
before resorting to the puncture. 
Hamilton has reported one hundred and twenty-six 
cases, out of which there were forty-six recoveries. 
He might have had more recoveries had he treated his The Scientific Rationale of Electrotherapy. 
7 
cases earlier and endeavored to affect the tonicity and im- 
prove the strength of the arterial walls by electrization, 
preliminary to galvano-puncture. In all such cases I would 
insulate the patient daily and give him a quiet charge of 
positive static electricity. 
Some put the positive pole in the sac. This pole makes 
the firm clot, the negative makes the soft one. Althaus 
and Pepper employ both. I believe it is best to put in only 
the positive pole. It is said that clots formed by electro- 
lysis have not been known to dislodge and cause embolic 
closure of distant vessels. This statement is not proven. 
This coagulable power of electricity suggests its value 
in purpura hemorrhagia, varicose veins and hemophilia. 
I have employed it to some extent in these states, but 
not alone because of its power of coagulating the blood, 
and not without the aid of static electricity. 
Static currents of a certain strength not only produce 
decomposition of blood, but they exert a physiological 
action over the vessels, as already intimated, which will 
claim our attention later. 
We are now considering the locally disintegrating 
power of electricity. The blood is here disorganized, and 
its component elements are separated by chemical action. 
In it the scientific therapeutist has the control of a 
great power for good or ill, just as the machinist and the 
engineer have in steam a great power evolved from the 
disintegration of inanimate matter, and either, according 
as they are used, may benefit or destroy. The judicious 
physician will not ignore this power because of its strength 
for evil any more than he rejects a potent drug because 
in improper hands it may do harm. 
Galvano-Cautery.-Next to the electrolytic power of 
this agent is the galvano-cautery which is direct disinte- 
gration by heat destruction. The heat is developed by 
the quantity of electricity and the degree of resistance in 
the conductor. It is the most perfect form of actual cau- 
tery because it is a fire without blaze or smoke, which 8 
C. H. Hughes. 
may be lit and extinguished at pleasure, and definitely 
circumscribed. It stops hemorrhages as the ancients did 
(with boiling oil) but in a more refined, less formidable 
and less painful manner. Ends of nerves may be instanta- 
neously destroyed by it in a part, and after that there 
need be no pain. It may be made to cut with the pre- 
cision of the knife in certain otherwise inaccessible parts, 
and it leaves an eschar that protects against hemorrhage 
and infection. (There are obstacles in the way of suc- 
cessful galvano-cautery in certain regions and tissues, 
which it is not germane to our present purpose to dis- 
cuss.) It requires a skilled hand in its use, just as the 
surgeon's knife does, and may kill or cure; but the 
surgeon does not hesitate to resort to a daring amputa- 
tion, because, perchance, the only knife at hand may be 
an assassin's dirk. 
Action on the Nervous System.-Electricity has the 
power to contract muscular fiber, both striated and non- 
striated, and in non-striated muscles the temperature rises 
very sensibly, often as high sometimes as four or five 
degrees Fahrenheit. The temperature change is due 
mainly to the muscular contractions and circulatory 
changes. In the beginning of electro-muscular contrac- 
tions there is, according to Ziemssen and others, a slight 
lowering of temperature, but Ziemssen found, after Faradic 
contraction had been continued for a few minutes, the 
temperature began to rise, and continued rising till it 
reached an increase above normal of one to two degrees 
centigrade. The maximum temperature was reached after 
cessation of contractions. Here are two other therapeutic 
powers-muscle-contraction and heat-production in a part. 
Faradic or induced currents contract the voluntary 
muscles more powerfully than galvanic or voltaic. 
The real cause of this difference is not certainly known. 
Ziemssen thought it was due to the difference in rapidity 
of the two currents, but this is not known. 
The contractile effect of galvanic currents, even when The Scientific Rationale of Electrotherapy. 
9 
interrupted, is markedly less on voluntary muscle than 
those of Faradic electricity. 
When nerves or muscles undergo alteration, their im- 
pressibility to electric stimuli generally diminishes, and a 
longer and stronger current is necessary to promote con- 
traction, but there is an exception to this law in certain 
states of muscular degeneration. 
When from any cause striated muscles undergo a cer- 
tain kind of generation through central nerve conditions, 
and they lose their striated character, they contract more 
readily to the constant current-this is the reaction of 
degeneration. 
Electrical currents have the following effects on the 
muscular system in disease : 
1. There are cases of peripheral paralysis, when the 
muscles do not contract either under influence of the 
will or of voltaic or Faradic currents, and I have found 
some cases will not respond to static shock. 
2. In some cases motility is in part preserved, but 
neither the affected muscles nor their motor nerves are 
excitable by induced or voltaic currents. Eulenberg found 
this the case in rheumatic and facial paralysis. 
3. Motility may be entirely extinct, while muscular excit- 
ability for both kinds of currents is equal and weakened. 
4. The muscles and their motor nerves have lost 
all contractility under influence of the will and of in- 
duced currents, while it is increased for voltaic currents. 
Observations give the following phenomena in such cases : 
A-during absence of motility.- 1. The contractility of 
voltaic currents is increased; a very feeble current, which 
would cause no sign of contraction in healthy muscles, 
produces energetic contractions in the paralyzed muscles. 
2. Voltaic excitability increases during the course of 
treatment, rapidly reaches its maximum, and then diminishes. 
3. Voltaic excitability is not always increased at the same 
time in all the branches of the paralyzed nerve. In the 
least excitable muscles and nerve branches it increases and 
diminishes more slowly than in those which are more so. 10 
C. H. Hughes. 
4- The contractility produced by voltaic current is less 
rapid for the paralyzed muscles than for the healthy ones. 
5. The contraction often occurs only by direct irrita- 
tion of the muscles, and not by irritation of the corre- 
sponding motor nerve. 
6. The voltaic excitability is gradually lost with the 
return of voluntary movements, whilst the Faradic excit- 
ability gradually returns (Schulz and Ziemssen). 
7. The voltaic excitability is gradually lost with the 
return of motility, but Faradic excitability remains extinct 
despite restoration of motility. The excitability for all 
kinds of currents becomes normal slowly, and in like 
proportion, after several months or years. 
8. Faradic excitability, although reappearing, remains 
more feeble than for corresponding muscles of healthy 
side. 
9. Voltaic excitability remains the same, and Faradic 
excitability never returns. 
These conclusions are true for rheumatic and trau- 
matic paralysis, and also for diphtheritic and cerebro-spinal 
fever and some other post-febrile paralytic states. 
The same differences between voltaic and Faradic 
currents has been observed by innumerable observers 
since Ziemssen, Eulenberg, Legros and Onimus first noted 
them in cases of muscular degeneration, and in lead palsy, 
where the voltaic current (fifteen elements) caused no con- 
traction of the healthy muscles, but only of the common 
extensors of the fingers, extensor proprius of index finger 
and the extensors of the throat, that is to say, those 
muscles in which Faradic currents caused no contraction. 
After even this incomplete review of what we know 
to be the power of electric currents ought not pessimism 
to stand aside and skepticism to be abashed. For one, we 
confess ourselves to belong to that class of " happy thera- 
peutists " at which Mobius sneers and other German phy- 
sicians smile. Despite all incredulity and the opposition 
of the faithless this great and wondrous force is destined 
to become as indispensable and powerful in the cure of The Scientific Rationale of Electrotherapy. 
11 
■disease as it is indispensable and powerful in the arts and in 
the economy of nature. But this is only a part of what 
we positively know of its powers. In the next number 
this review of its powers will be extended into a domain 
still more interesting to the neurotherapeutist. 
Note -The reader will perceive how rational the basis for the employment of 
electricity on the foregoing facts and those to follow in the next paper as compared 
with such reasoning as appears in the following, -which may be found in two works 
by Irregular practitioners, whose authors it is needless here to mention. These 
writers substitute an unproved and improbable theory for proven fact, and like the 
blind leading the blind, they go into the ditch together. The theory fixes the nature of 
the supposed disease and the disease confirms the theory, and thus the vicious circle 
of their reasoning is complete. The electricity of these fellows is generally of a most 
positive and shocking kind, and their ignorance and assurance are as positive as 
their electricity. Muller's idea of weak currents, with which he has done so much, 
finds noplace in such positive and sensational minds. Indeed they have evidently 
not carefully studied any scientific treatise on the real powers and uses of the electric 
currents: 
"The reader will bear in mind that all acutely inflammatory or hypersthenic 
affections are electrically positive in excess-having too much vital action-being 
overcharged with the electro-vital fluid; and that all paralytic diseases, or those 
of sluggish, azoodynamic character, or electrically negative, having too little 
electro-vital fluid, too little vital action. It is a universal law of electricity that pos- 
itives repel each other, and that negatives repel each other; but that positives and 
negatives attract each other. This is a principle of electric action everywhere known 
where anything is known on the subject. We appropriate it practically to thera- 
peutic purposes. Therefore, when I wish to repress or repel inflammation, which is 
electrically positive in excess, I put the positive pole to it; or, at least, I bring it 
under that half of the circuit with which the positive pole is connected, and as near 
to the pole or electrode as possible. And because two positives repel each other, 
and also because the direction of the current is always from the positive to the nega- 
tive pole, carrying the electro-vital fluid with it, either I must withdraw my positive 
•electrode, or that excess of electro-vitality in the diseased part which makes it mor- 
bidly positive, and thus produces inflammation, must give way. I will not withdraw 
my positive pole, and therefore the positive inflammation must retreat and be dis- 
persed. In treating this case, I will place my negative electrode either on some 
healthy part, or, if there be perceptible anywhere in the system a morbidly negative 
part, as is often the case, I will place my negative pole there. For example: if I 
am treating for nephritis-inflammation of the kidneys-when I do not perceive any 
part to be abnormally negative, I manipulate with my positive electrode over the in- 
flamed kidney, having the negative electrode placed at the coccyx, the lowest part 
of the spine. My positive pole repels the positive inflammation from the kidney; or, 
rather, repels from it that excess of electro-vital fluid which makes it morbidly 
positive and induces the inflammation, while the' negative pole attracts the same 
towards the coccyx. On its way it becomes more orless diverted to adjacent nerves; 
or, if gathered in the healthy part, under the negative pole, it is immediately dis- 
persed by the normal circulation as soon as the electrode is removed. But if I find 
a spinal irritation, say in one or more of the cervical cr dorsal vertebrae, and, at the 
same time, a stomach affected with chronic dyspepsia, accompanied with constipation 
of the bowels, I will work over the inflamed or irritated spine with my positive pole, 
because I know from the irritation that there is an excess of electro-vital fluid in the 
part, making it improperly positive; and, with my negative electrode, I will at the 
same time, treat over the stomach, bowels and liver; because I know, from the in- 
action of these organs, that there is a lack of vital force, a deficiency of the electro- 
vital fluid, there, and that, consequently, they are too negative.''