Electrolysis by a Current Con- 
troller for the Reduction 
of Spurs of the Nasal 
Sseptum. 
BY 
W. E. CASSELBERRY, M. D., 
CHICAGO, 
Professor of Therapeutics and of Laryngology and Rhinology in 
Northwestern University Medical School (Chicago Medical 
College); Laryngologist to Wesley Hospital, etc. 
REPRINTED FROM THE 
Xeto ¥or!t iUtUlcal journal 
for August 31, 1895. Reprinted from the New York Medical Journal 
for August 31, 1895. 
ELECTROLYSIS BY A CURRENT CONTROLLER 
FOR THE REDUCTION OF 
SPURS OF THE NASAL S2EPTUM * 
By W. E. CASSELBERRY, M.D., 
CHICAGO, 
PROFESSOR OF THERAPEUTICS AND OF LARYNGOLOGY AND RHINOLOGY IN 
NORTHWESTERN UNIVERSITY MEDICAL SCHOOL (CHICAGO MEDICAL COLLEGE) ; 
LARYNGOLOGIST TO WESLEY HOSPITAL, ETC. 
Customarily spurs or excrescences of the nasal sseptum 
are removed by surgical means by the knife, saw, and 
drill, and I wish to disclaim now, as I did in a recent pre- 
liminary report on the same subject, any idea of indorsing 
electrolysis as a universal substitute for the surgical method, 
for the latter, in skillful hands, is more rapid, more pre- 
cise, and in the case of bony spurs certainly more effective 
than is electrolysis. Certain European operators have ad- 
vocated the method by electrolysis; a few have praised it 
with perhaps a degree of extravagance, and yet it would 
seem that a modicum of actual fact must underlie so much 
enthusiasm. 
My own experiments have been undertaken to deter- 
mine the scope or, better stated, the exact limitations of 
* Read before the American Laryngological Association at its seven 
teenth annual congress. For the discussion, see page 246. 
Copyright, 1895, by D. Appleton and Comp, 2 
ELECTROLYSIS FOR SJiPTAL SPURS. 
this method-in what class of cases it is possible by means 
of it to avoid a more or less sanguinary operation, and to 
what extent one can utilize it to reduce spurs and thickened 
areas of minor degree, those which are scarcely deserving 
of surgical treatment with its possibilities of troublesome 
haemorrhage, but which one would like to see resolved for 
the sake of the additional nasal space and better drainage 
which would thereby accrue to the patient. 
A resume of the previous literature of the application of 
electrolysis to the treatment of nasal spurs need be but 
brief. Miot,* of Paris, was the originator in 1888, and 
following him Garel, f of Lyons, reported his results in 
thirty cases; but my attention was first drawn to the 
method by Moure J at the Ninth International Medical 
Congress at Berlin in 1890, where he read an elaborate 
paper on the subject and described minutely the technique. 
Moure and Bergonie * have since embodied their studies 
in a monograph, published in Paris in 1892, and Moure || 
again in 1894, before the Eleventh International Medical 
Congress at Rome, discussed in a paper the Comparison be- 
tween Electrolysis and other Methods of Treatment for the 
Destruction of Deviations and Spurs of the Nasal Sajptum. 
Moritz Schmidt, in his book (Die Krankheiten der oberen 
Luftwege'), published in 1894, confirms the efficacy of the 
method as advanced by the French operators, a significant 
fact which tends to remove the sense of skepticism with 
which the subject was first viewed in America. 
* Revue mensuelle d'otologie et de laryngologie, cited by Garel (loc. 
eit.). 
f Annates des maladies de I'oreille, du larynx, etc., tome xv, 1889, 
pp. 638. 
| Verhandlung des X. intemationalen medicinischen Congresses, 
Band iv. 
* Du traitement par electrolyse des deviations, etc., Paris, 1892. 
|| The Journal of Laryngology, Rhinology, and Otology, May, 1894. ELECTROLYSIS FOR SJSPTAL SPURS. 
3 
Among others may be mentioned Peyrissac, Meyer, and 
Ileryng, all cited by Newcomb. 
Only two papers by American authors have come under 
my observation; one by Newcomb,* of New York, with a 
report of two cases and an excellent review of the bibliog- 
raphy and technique, and the other by Ballenger,f of Chi- 
cago, with a report of three cases. 
All of these operators have employed as the source of 
the electricity a primary galvanic battery of about thirty 
cells. The inconveniences of this apparatus, and especially 
its unreliability when called into use only at irregular and 
prolonged intervals, has deterred many from trying the 
electrolytic method. I have sought to avoid these annoy- 
ances by adapting the Edison electric-light circuit to the 
purpose by means of lamp resistance and the McIntosh cur- 
rent controller. The controller, together with a milliam- 
peremeter, cords, and needles, is contained in a small 
drawer within easy reach as one sits in position for the 
treatment of patients, and is always ready for immediate 
use without waste or corrosion. It is as easily and readily 
applied as the galvano-cautery, except for the few minutes' 
additional time that its energy needs to accomplish the 
work. When used it is necessary only to pull out the 
drawer, adjust the milliamperemeter, and insert the needles. 
The current strength necessary for electrolysis of nasal 
spurs is from fifteen to forty milliamperes, measured with 
the resistance of the spur in the circuit, and, to supply this 
current, from fifteen to thirty cells of a galvanic battery 
would ordinarily be used with a corresponding electro- 
motive force of from twelve to twenty volts or more. A 
current suitable for electrolysis should be characterized by 
* Medical Record, August 5, 1893. 
+ The Journal of the American Medical Association, November 10, 
1894. 4 
ELECTROLYSIS FOR SjEPTAL SPURS. 
moderately high tension or voltage and comparatively low 
current strength or amperage. 
The Chicago Edison current has an electro-motive force 
of one hundred and ten volts, which must be reduced by the 
current controller. The amperage, of course, depends on 
the amount of resistance in the circuit, but it also can be 
correspondingly reduced by the resistance of lamps and the 
controller so that with the spur in the circuit it measures 
the requisite number of milliamperes. 
The McIntosh current controller was described at length 
in my preliminary report. It will suffice now to say that 
it is composed of a number of resistance coils of varying 
size, arranged in two rows, with sliding contacts to each, 
so that the patient may be placed in a shunt circuit to one 
or more coils. The coils on the left divide the electro- 
motive force into tenths, and its contacts I have named the 
decimal slide, while the coils on the right divide the elec- 
tro-motive force into hundredths, named in consequence 
the centesimal slide. Thus, if placed in direct connection 
with the one-hundred-and-ten-volt Edison circuit, and the 
decimal slide be advanced to 1, enough coil resistance is re- 
moved to secure a current intensity of one tenth of a hun- 
dred and ten volts, equal to eleven volts. In like manner, 
if advanced to 2, two tenths of a hundred and ten volts is 
secured, equal to twenty-two volts. If now the centesimal 
slide be advanced to any given contact, say 4, there will be 
added four hundredths of a hundred and ten volts, or four 
volts, equal now to twenty-six volts. 
But the decimal division of an initial one-hundred- 
and-ten-volt circuit is still too painful to the patient on ad- 
vancing the contacts, so I have resorted to the expedient 
of placing a sixteen-candle-power lamp in the circuit (in 
series), the resistance of which reduces the original electro- 
motive force aside from the action of the controller to an ELECTROLYSIS FOR S.EPTAL SPURS. 
5 
initial current of fifty-five volts. The result is, that on 
advancing the decimal slide of the controller to 1, 
enough coil resistance is removed to secure a current of 
one tenth of fifty-five volts, or, on advancing to 2, two 
tenths of fifty-five volts, equal to eleven volts ; and on ad- 
vancing the centesimal slide there will be added at each 
successive coil contact one one-hundredth, two one-hun- 
dredths, three one-hundredths, or four one-hundredths of 
the initial fifty-five volts, or, if stopping at 4, equal to 
two volts, which, added to the eleven volts of the decimal 
slide, makes in all thirteen volts. This is about the 
arrangement of the mechanism with which I have treated 
most of my cases. The controller has been constructed 
and has been thoroughly tested with a view to absolute 
safety, the details of which have previously been de- 
scribed. 
I have used exclusively the bipolar method, as it is 
conceded by all to be equally if not more effective than the 
monopolar, and it is more convenient to the operator and 
less disagreeable to the patient. Not more than two nee- 
dles, one representing the positive and the other the nega- 
tive pole, should be employed, as there is no advantage in 
the use of multiple points, and it is thought to be more 
difficult to estimate the exact amount of destruction when 
more than two points have been inserted. 
The parts of the needles intended for insertion into the 
spur should be from fifteen to twenty millimetres in length, 
about half a millimetre in thickness, and they should 
lie parallel and distant from each other about three milli- 
metres. 
The material which I have found best adapted to the 
purpose, all things considered, is irido-platinum, in which 
enough iridium is placed to make the composition very 
hard and stiff. A very sharp point can be given this sub- 6 
ELECTROLYSIS FOR SJEPTAL SPURS. 
stance, and its penetrating power is almost equal to steel. 
Not being oxidizable, irido-platinum needles can be used 
repeatedly, and hence can be permanently soldered to 
metallic conductors running through a light handle, which 
then constitutes the needle-holder. I have devised and 
had constructed by the McIntosh Company such an instru- 
ment, which meets all requirements, and it has the advan- 
tage of being always ready for immediate use, without loss 
of time in screwing and unscrewing steel or gold-plated 
needles into an adjustable needle-holder (Fig. 1). Moure 
and others recommend steel needles, especially such as are 
Fig. 1. 
used by sailmakers. That connected with the positive 
pole will oxidize, which does not harm the patient, but 
necessitates replacing the needle by a new one at each 
treatment, and I have been unable to obtain a neat, light 
adjustable needle-holder which would firmly fix and carry 
two needles, and to use separate needle-holders is awk- 
ward. Even steel will not penetrate bone, and irido-plat- 
inum will easily penetrate cartilage. 
I have treated by the electrolytic method ten cases, and 
for the sake of brevity, and to enable us the better to draw 
definite conclusions therefrom, these may be classed in three 
types according to the composition and location of the spur 
and the degree of success attained. Three of these cases 
have already been reported in detail, so that others will 
be selected for elaboration as representatives of the various 
types. 
Type I. Strictly Cartilaginous Spurs. 
Case I.-Mr. R., a medical student, has witnessed in my 
clinic at the Northwestern University Medical School opera- ELECTROLYSIS FOR S/EPT AL SPURS. 
7 
tions for the removal of seeptal spurs by both the surgical and 
electrolytic methods, and he willingly submits his spur to 
treatment by the latter process. It happens to be of the 
strictly cartilaginous class, the sort of spur best adapted for 
reduction by electrolysis. 
It is an ovoid excrescence, truncated or flat at the base, 
projecting from the right side of the saeptum, a distance at its 
point of greatest thickness of about five or six millimetres, 
sufficient to occlude almost entirely the right nostril. It is 
confined to the quadrangular cartilage and is implanted upon 
the convexity of a slight but, in itself, not material deviation 
of this part of the saeptum. 
Electrolysis by means of the Edison current and McIntosh 
current controller, one sixteen-candle lamp in the circuit; 
bipolar method, with the author's needles of irido-platinum, 
which were inserted into the body of the spur well toward 
the bottom, the thickest part, one needle above the other and 
extending almost through the spur, a distance from the front 
to the back of about eighteen millimetres. A ten-per-cent, 
cocaine solution on cotton had previously been applied to 
both sides of the saeptum for fifteen minutes. The deci- 
mal slide of the current controller was pushed to 1; the 
needles then being inserted, the milliamp&remeter registered 
twenty milliamperes; the slide was then advanced to 2, 
which equals a current of eleven volts, the meter registering 
forty milliamperes. On making contact 2, a slight shock 
was felt. No further increase was made in the current in 
this case, as forty milliamperes is adequate. This was main- 
tained for eight minutes, during the last five of which the pa- 
tient complained of feeling faint, but it was not necessary to 
change position or suspend the treatment. The pain was 
slight, the patient not regarding it as of any moment. There 
was evolution of gas with crackling sounds, and at the end of 
eight minutes the larger part of the spur had assumed a mot- 
tled bluish and whitish aspect. 
At the end of one week the slough had not yet separated, 
although some shrinkage in size was apparent. Annoyance 
occasioned by incrustation was at once relieved by the use of 8 
ELECTROLYSIS FOR S Ji PT AL SPURS. 
an ointment of yellow oxide of mercury in vaseline, two grains 
to the ounce. 
At the end of two weeks the slough had disappeared, leav- 
ing a granulating, grooved surface through the lower part of 
the spur. The loss of substance is pronounced; had it been 
more so, perforation must have resulted. 
At the end of three weeks the treatment was repeated, 
but for a shorter period of five minutes, to the upper part of 
the spur, which is not so thick. This followed much the same 
course, and the result is satisfactory, abundance of space and 
a fairly even surface having been obtained. 
The chief difficulty in the reduction of cartilaginous 
spurs is to determine exactly when sufficient destruction 
has been effected. One does not wish to produce a perfo- 
ration, and a close watch should be maintained in the op- 
posite nostril and the electrolytic action discontinued on 
the slightest mottling in hue or escape of gas from that 
side of the smpturn. But there is reason to think that too 
great destruction can be effected even short of the produc- 
tion of these danger signals, and other safeguards, such as 
not inserting the needles too deeply, nor permitting the 
treatment to endure too long, should be kept in mind. The 
duration necessary depends somewhat, of course, upon the 
current strength ; but with the meter registering from fif- 
teen to forty milliampbres I have not found it necessary to 
exceed from six to eight minutes for the devitalization of 
cartilage. The continental authors cited mention fifteen 
to twenty-five minutes as the duration of their seances, 
which would seem unnecessarily long. 
To Type I may be assigned four other cases of the 
entire number treated. 
Case II of this type.-Mr. A. G. M. complained of inability 
to breathe through the right side; the cartilaginous saeptum 
was deflected to the right and, in addition, situated toward 
the base of the convexity was an excrescence which pro- ELECTROLYSIS FOR S/EPT AL SPURS. 
9 
jected sufficiently forward to approach the partially collapsed 
ala and so close the nostril. Electrolysis was selected because 
of the nervous disposition of the patient, he having so little 
self-control that the surgical method might have involved 
unusual difficulties. The reduction of the excrescence was 
effected in three treatments at intervals of about three weeks, 
the process being unusually tedious for the size of the spur 
because only six-minute applications, with from ten to twenty- 
five milliamperes, were employed, unusual care being neces- 
sary, on account of the adjoining deviation of the sseptum, not 
to produce a perforation. It has been wisely alleged as a 
disadvantage that perforation is especially liable to result 
from electrolysis; but this case satisfied me that it could be 
avoided by proper care in any case in which it would be 
avoidable by the surgical method. 
The result was satisfactory; by the removal of the excres- 
cence without interference with the deflection, enough space 
was gained for comfortable respiration. 
Case III of Type I was quite an elderly gentleman, who 
was under treatment for nasal polypi. A cartilaginous ex- 
crescence, which prevented the ready transmission of light 
and the passage of instruments to the seat of polyp growth, 
was effectively reduced by electrolysis. His age and some- 
what feeble condition led to the adoption of this substitute 
for the surgical method in his case. His was the only one of 
the ten cases in which there was any noticeable reaction after 
the treatment. His temperature rose slightly, he complained 
of heat, pain, and tenderness of the nose, and of a sense of 
malaise and headache for a day or so. 
Case IV of Type I was a small cartilaginous excrescence 
with which I might not have deemed it necessary to interfere 
by the surgical method, yet the patient is much improved by 
its reduction. The only noteworthy feature is that the 
slough did not separate as a whole, but seemed to liquefy and 
be in part discharged and in part absorbed, without complete 
destruction of the mucous membrane, which has therefore 
been reproduced more perfectly than is usual after the cut- 
ting operation. This is an advantage, as the tendency to in- 10 
ELECTROLYSIS FOR S.EPT AL "SPURS. 
crustation so frequently observed after the surgical method 
due to the poor quality of reproduced mucosa will be avoided. 
It is an advantage, however, which does not invariably fol- 
low electrolysis, since if the slough produced be large it will 
separate as a whole, with corresponding complete destruction 
of the surface mucosa. 
Case V of Type I presented no features not already noted 
in connection with the others. 
Type II. Mixed Cartilaginous and Bony Spurs. 
Case VI.-Mr. M. J. EL, aged twenty-five years, has lived 
in Colorado for two years on account of suspected incipient 
pulmonary tuberculosis, but has now resided in Chicago again 
for a year and a half. Maternal grandfather, mother, and 
sister died of tuberculosis. The physical signs and general 
condition indicate tuberculosis in a comparatively quiescent 
or arrested state. He now complains especially of nasal ob- 
struction and consequent irritation of the throat, which is due 
to hypertrophic rhinitis aggravated by a sfeptal spur. This 
excrescence is of the kind which commences anteriorly and 
runs upward and backward, following the sutural line of the 
vomer and cartilaginous plate of the saeptum, gathering vol- 
ume and thickness and terminating opposite the middle tur- 
binal, into which body its point presses, reaching at this plane 
quite across the nasal space. 
March 1st.-The same needles as were used in Case I were 
inserted into the projecting point of this excrescence. They 
met bone and could not be inserted as deeply as desired. The 
controller was adjusted gradually as in Case I to a maximum 
electro-motive force of thirteen volts, at which time the cur- 
rent registered from twenty to thirty-five milliamperes, the 
action being maintained for seven minutes. The patient is 
uncomplaining, and he regarded the pain as trivial. No 
haemorrhage. 
6th.-He suffered no discomfort after the treatment. The 
excrescence point is soft and smaller. 
19th.-The spearlike point of the excrescence having been ELECTROLYSIS FOR SJEPTAL SPURS. 
11 
destroyed, a second application was made in like manner to 
the part of the ridge next adjoining anteriorly. 
April 30th.-The final result is fairly satisfactory, the spur 
being very much reduced in prominence, but not wholly re- 
moved. Both cartilage and bone entered into its composi- 
tion, and the reduction in volume was probably commensurate 
with the proportion of cartilage contained in it. 
Doubtless a flatter surface might have been made by 
the surgical method, but on account of the latent tubercu- 
lous state of this patient one would not have wished to 
risk either the shock or possible haemorrhage of the surgi- 
cal method. 
Case VII.-Mr. II. had a spur similar in location and com- 
position to the last described; only the anterior lower part of 
it, however, yielded to electrolysis. The larger part of it 
proved to be of bone, which was unaffected by the treatment. 
Slight improvement only. 
In one other case of this type the treatment is not yet 
completed, but the indications point toward a partial re- 
duction only. 
Type III. Bony Spurs. 
Case IX.-Mr. E. R., aged nineteen years, has been under 
treatment for hypertrophic rhinitis, adenoid vegetations, and 
hypertrophy of the tonsils, which are now remedied. He has 
also a sseptal spur of the kind which commences anteriorly 
and runs upward and backward, terminating opposite and 
projecting into the middle meatus of the right side. 
March 20th.-Electrolysis applied to the spur-eleven volts, 
twenty milliamperes, for four minutes-when the patient so 
nearly fainted that it was necessary to discontinue the treat- 
ment. The needles would not penetrate thoroughly into the 
spur, the bone seemingly being of ivorylike hardness. 
April 27th.-The spur is practically unchanged, and elec- 
trolysis again attempted, the method with two lamps in the 
circuit for the more gradual application of the current being 
selected. This treatment was also a failure, for the needles 12 
ELECTROLYSIS FOR StEPTAL SPURS. 
could not be made to penetrate adequately, and besides the 
patient nearly fainted after three minutes of a current of only 
eight volts and ten milliamperes. A subsequent effort to in- 
sert steel needles into this spur resulted in failure. 
Case X of Type III was a similar bony spur in which, fail- 
ing to get a proper insertion of the needles, the process by 
electrolysis was abandoned and the surgical method substi- 
tuted. 
Conclusions.-1. As demonstrated by the cases reported 
under Type I, strictly cartilaginous spurs can be thoroughly 
removed by electrolysis-one, two, or at most three opera- 
tive sittings being required. It is more tedious and less 
brilliant than the surgical method, but is not accompanied 
by any liability to immediate haemorrhage and by only 
a remote possibility of secondary haemorrhage. It is not 
to be indorsed as a universal substitute for the surgical 
method in even this limited class; but the number of indi- 
vidual cases, both in this type and in Type II, for which it 
is applicable is large, and with the efficiency, convenience, 
and compactness of the McIntosh current controller which 
adapts the Edison electric circuit to its use, together with 
properly constructed irido-platinum needles, I consider it a 
valuable addition to our resources. 
2. As demonstrated by the cases reported under Type 
II, it will not thoroughly remove spurs which belong to 
that large class of mixed cartilaginous and bony substance ; 
but it will reduce them in size, the amount of reduction 
being commensurate with the proportion of cartilage of 
which they are composed. The majority of such cases 
would therefore better be treated surgically, as being the 
more thorough method ; but instances will arise in which 
the surgical method being declined or being for some rea- 
son inexpedient, benefit may accrue from the use of elec- 
trolysis. ELECTROLYSIS FOR SEPTAL SPURS. 
13 
3. As demonstrated by the cases reported under Type 
HI, spurs composed wholly or largely of hard bone can not 
be successfully treated by electrolysis, for the reason that 
needles can not be caused to penetrate properly, and fur- 
ther, it is doubtful if the process is adequate, even if the 
needles should penetrate, to the resolution of hard and 
dense bone. 
4. Spur or excrescence, and not deviation of the saep- 
tum, is the subject of this paper. Electrolysis is powerless 
to correct deviated saepta of any form. 
34 Washington Street. The New York Medical Journal. 
A WEEKLY REVIEW OF MEDICINE. 
EDITED BY 
FRANK P. FOSTER, M.D. 
THE PHYSICIAN who would keep abreast with the advances in 
medical science must read a live weekly medical journal, in which 
scientific facts are presented in a clear manner; one for which the 
articles are written by men of learning, and by those who are good and 
accurate observers ; a journal that is stripped of every feature irrelevant 
to medical science, and gives evidence of being carefully and conscien- 
tiously edited ; one that bears upon every page the stamp of desire to 
elevate the standard of the profession of medicine. Such a journal 
fulfills its mission-that of educator-to the highest degree, for not 
only does it inform its readers of all that is new in theory and practice, 
but, by means of its correct editing, instructs them in the very important 
yet much-neglected art of expressing their thoughts and ideas in a clear 
and correct manner. Too much stress can not be laid upon this feature, 
so utterly ignored by the " average " medical periodical. 
Without making invidious comparisons, it can be truthfully stated 
that no medical journal in this country occupies the place, in these par- 
ticulars, that is held by The New York Medical Journal. No 
other journal is edited with the care that is bestowed on this ; none 
contains articles of such high scientific value, coming as they do from 
the pens of the brightest and most learned medical men of America. A 
glance at the list of contributors to any volume, or an examination of 
any issue of the JOURNAL, will attest the truth of these statements. It 
is a journal for the masses of the profession, for the country as well as 
for the city practitioner; it covers the entire range of medicine and 
surgery. A very important feature of the Journal is the number and 
character of its illustrations, which are unequaled by those of any other 
journal in the world. They appear in frequent issues, whenever called 
for by the article which they accompany, and no expense is spared to 
make them of superior excellence. 
Subscription price, $5.00 per annum, Volumes begin in 
January and July. 
PUBLISHED BY 
D. APPLETON & CO., 72 Fifth Avenue, New York.