HIGH FREQUENCY 
PRACTICE 
FOR PRACTITIONERS AND 
STUDENTS 
BY 
BURTON BAKER' GROVER, M.D. 
Author of Handbook of Electrotherapy; President of the Western Elec- 
trotherapeutic Association 1919-1920; Fellow of the American Elec- 
trotherapeutic Association; Fellow of the American Medical 
Association; Member of the Medical Society of 
Missouri Valley; Colorado State 
Medical Society, etc. 
y 
ILLUSTRATED WITH NINETY-FIVE ENGRAVINGS. 
SECOND EDITION / 
KANSAS CITY 
■Sfc; 
THE ELECTRON PRESS 
1923 COPYRIGHT, 1922 
BY 
BURTON BAKER GROVER, M.D. 
COPYRIGHT, 1923 
EY 
BURTON BAKER GROVER,VM.D. DEDICATED 
To my preceptor and lifelong friend, 
FRANK E. BLISS, M.D. FOREWORD. 
With increasing knowledge of the laws governing 
physiological function of many organs of the human 
body, physicians are placing more confidence in the 
methods which conserve these functions. 
The empiric polypharmacy of the last century is 
now being replaced by safe and sound methods in the 
use of certain drugs which have been found to be ef- 
ficient in meeting definite indications. The therapy 
of today is based on more accurate diagnosis and 
greater conceptions of the condition of the human or- 
ganism, its physiology and etiologic pathology, and calls 
for the recognition of other important forms of 
therapy. It is the supreme duty of the physician to 
employ the best agents at hand to meet the existing 
condition, whether they be drugs, surgery, diet, climate, 
serums, vaccines, light, heat, electricity, radium, roent- 
gen rays or other physical measures. 
The indiscriminate use of drugs, overzealous sur- 
gery and discredit of physical therapy have been fruit- 
ful in bringing criticism upon the profession. 
While electricity as an agent in the treatment of 
disease, not unlike drugs, has been and is employed by 
unskilled hands and outrageous claims made for its 
efficacy in this or that condition, it has come into our 
professional life as one of the many important modali- 
ties of our armamentarium, and he who ignores or 
berates its possibilities in many perverted conditions of 
the organism, is, to say the least, derelict in the duty 
V VI 
FOREWORD. 
he owes to himself as a physician and to those who are 
submitted to his charge and keeping. 
The employment of drugs should be based upon 
their physiological indications and no less should be 
every application of electricity. Nothing could be more 
destructive to rational therapeutics than the carrying 
away of the physician by very interesting results 
secured by high-frequency currents. Electrical modal- 
ities assist in rounding out the physician’s armamen- 
tarium, but let us not thru enthusiasm possess our- 
selves with the idea that the entire field of medicine 
revolves about the art of physiotherapy. 
In the application of high-frequency currents to dis- 
eased or perverted conditions of the human organism 
mentioned in these pages, it has been the endeavor of 
the writer to give a physiological reason for their use. 
In a few instances their use has been recommended 
when, without known pathology, they have been proven 
beneficial. 
It is well known that impressions are more easily 
fixed in the mind if made thru several senses and to 
that end many details of technic are visualized by 
means of diagrams, cuts and halftone illustrations. 
The methods of treatment given in this volume, 
while in the main are founded on personal experience 
of the writer, reference has been made to all available 
literature upon the subject. 
No bibliography is appended because it is impos- 
sible to state the source from which emanated many of 
the facts herein enumerated. I am especially indebted FOREWORD. 
VII 
to the members of the American and Western Electro- 
therapeutic Associations, whose writings have been 
consulted and many paragraphs directly quoted. 
It is hoped that the information contained in this 
volume will prove an incentive to the use of less em- 
pirical and more scientific methods in the application 
of high-frequency currents. 
B. B. G. 
Suite 219, Ferguson Building, 
Colorado Springs, Colorado. PREFACE TO SECOND EDITION 
That there is an increasing interest in high fre- 
quency therapy being taken by the profession is proven 
by the exhaustion in a few months of the first edition 
of this work. 
New methods in technic are rapidly being developed 
through the experience of different operators. The 
methods of treatment outlined in these pages are em- 
ployed by the writer. This does not mean that others 
may not obtain as good if not better results from 
some other method. 
The changes made from the first edition of the 
work are few with the exception of Chapter V, which 
has been entirely rewritten and many points in blood 
pressure interpretation added. The treatment of car- 
diovascular diseases has been extended. 
B. B. G. 
Ferguson Building, 
Colorado Springs. CONTENTS. 
CHAPTER I. 
PAGE 
Introduction 1-18 
What is electricity? Atoms and electrons. Radio- 
activity. Energy. Human mechanism. Body Cur- 
rents. Primary cell. Physiology. 
CHAPTER II. 
High-Frequency Currents 21-64 
Definition. Source. Change of frequency. How pro- 
duced. Condensers. Oudin coil. Oscillating currents. 
Types of machines. Meters. Spark gap. Classified 
physiology. Electrodes. Vacuum electrodes. Non- 
vacuum electrodes. Precautions. Preparation of the 
patient. Local auto-condensation. General technic. 
Auto-condensation. Auto-conduction. Effects of auto- 
condensation. Contra-indications and precautions. 
Care of apparatus. 
CHAPTER III. 
Medical Diathermy 65-94 
Definition. Differentiation. Physiology. Physiology 
of the cell. Current density. Technic. Time of treat- 
ment. Contraindications and precautions. 
CHAPTER IV. 
Surgical Diathermy 95-116 
Definition. Desiccation. Advantages of desiccation. 
Disadvantages of desiccation. Effects of desiccation. 
Technic. Fulguration. Electrocoagulation. Advan- 
tages of electrocoagulation. Disadvantages of electro- 
coagulation. Types of electrodes. Points in technic. 
IX X 
CONTENTS. 
CHAPTER V. 
PAGE 
Blood-Pressure 117-144 
Physiology. Etiology. Protein sensitization test. Ef- 
fects of altitude. Blood-pressure reading. The sphyg- 
momanometer. Essential factors. Normal blood-pres- 
sure. Conditions affecting blood-pressure. Hyperten- 
sion. Energy index. Blood-pressure interpretation. 
Hyperpiesia. Therapy. 
CHAPTER VI. 
Pain 145-158 
Definition. Painful stimuli. Classification. Referred 
pain. Reflex pain. Occupational neuroses. Inflam- 
matory pain. Susceptibility to pain. Persistent pain. 
Digestive pain. Muscular spasm. Backache. Pain in 
the limbs. Penile pain. Shoulder pain. Subacromial 
bursitis. Treatment of subacromial bursitis. Headache. 
CHAPTER VII. 
High-Frequency Practice 159-298 
Diseases amenable to high-frequency currents. Defi- 
nition. Etiology. Symptoms and treatment. 
CHAPTER VIII. 
Diseases of the Eye 299-338 
Conjunctivitis. Granular conjunctivitis. Diseases of 
the cornea. Opacities of the vitreous. Chorioiditis. 
Glaucoma. Retinitis. Cataract. Atrophy of the optic 
nerve. Toxic amblyopia. Amblyopia ex anopsia. 
Hemeralopsia. Nervous asthenopia. Hysterical am- 
blyopia. Muscular dysfunction. Ptosis. Diseases of 
the lids. 
Appendix “A”—Questionnaire 339 
Appendix “B”—Presidential Address 347 
Glossary 363 
Index 389 FIG. PAGE 
1 Rotor 22 
2 One cycle two alternations 23 
3 One-half kilowatt high-frequency transformer 25 
4 Leyden jar condenser 27 
5 Oscillating and alternating currents 30 
6 Hot wire meter 31 
7 Multiple spark gap 32 
8 Victor spark gap 33 
8a Multiple spark gap 34 
9 Hogan high-frequency apparatus 35 
10 Thompson-Plaster “FO” cabinet 39 
11 Insulated vacuum electrodes 43 
12 Hand electrode 46 
13 Surface non-vacuum electrode 47 
14 Victor Model Wantz High-Frequency Machine 49 
15 The Excell-Wappler 51 
16 Auto-condensation couch and patient 54 
17 Auto-condensation chair pad 55 
18 Auto-condensation pad and patient 56 
19 Vulcan High-Frequency Apparatus 59 
20 Current density 79 
21 Current density 79 
22 Current density 79 
23 Current density at needle point 81 
24 Current density in electrocoagulation 81 
25 Military Model Diathermy Outfit—Fischer 84 
26 Hand to hand diathermy 88 
27 Foot to foot diathermy 89 
28 Diathermy of liver, kidney and pelvic organs 91 
29 Portable High-Frequency Outfit, Type “K”—Fischer... 92 
30 Desiccation by the indirect method 99 
31 Desiccation of moles, etc 102 
32 Experiment on meat 104 
33 Surgical diathermy electrodes 107 
34 Fischer foot switch 110 
35 The Wappler Telatherm 113 
36 Taking blood-pressure 125 
37 Taking blood-pressure 127 
38 Location of reflex pains...... 148 
39 Location of reflex pains 149 
40 The universal diathermy clamp 155 
41 The Hogan Silent 165 
42 Diathermy of the kidney 166 
43 Diathermy of the femur 171 
44 Vaginal non-vacuum electrode 172 
45 Percussion of the 7th cervical vertebra 174 
46 Double pronged electrode to 6th cervical 176 
47 Cardiac diathermy 177 
ILLUSTRATIONS 
XI XII 
FIG. PAGE 
48 Diathermy to knee joint antero-posteriorly 187 
49 Diathermy to knee joint latterly 189 
50 High-frequency in asthma 191 
51 High-frequency to spine 195 
52 High-frequency in tabes, front view 196 
53 High-frequency in tabes, back view 197 
54 Location of spinal electrode to induce reflex of con- 
traction 199 
55 Location of spinal electrode to induce reflex of dilation 201 
56 Diathermy in bronchitis, direct mtthod 203 
57 Diathermy in bronchitis, indirect method 205 
58 High-frequency in bruises 207 
59 Diathermy of the liver 213 
60 Diathermy to the foot 214 
61 Local auto-condensation in diabetes 218 
62 Hand to foot diathermy 219 
63 High-frequency effluve 222 
64 Bipolar application in endometritis 225 
65 Diathermy in goiter 231 
66 High-frequency and light in lumbago 238 
67 Diathermy in lumbago 239 
68 Trigeminal nerve 244 
69 Diathermy to shoulder, direct method 248 
70 Diathermy to shoulder, indirect method 250 
71 Diathermy in “Tic,” direct method 251 
72 Direct diathermy in “Tic” with clamp 252 
73 Diathermy in “Tic,” indirect method 253 
74 Diathermy in sciatica 254 
75 Diathermy in sciatica with clamp 256 
76 Spinal diathermy. . 264 
77 Normal prostate 270 
78 Prostatic abscess pointing into rectum 273 
79 Prostatic abscess pointing into urethra 274 
80 Chronic prostatitis 275 
81 Willmoth prostatic electrode 276 
82 Monopolar application in prostatitis 277 
83 Bipolar application in prostatitis 278 
84 Unipolar application to enlarged prostate 279 
85 High-frequency in prostatic atrophy 280 
86 Special tonsil electrode 289 
87 Position of cystoscope in desiccation of bladder tumors. 294 
88 Unipolar vaginal application : 295 
89 Urethral growths 297 
90 High-frequency to the eyes 307 
91 Bye, Ear, Nose and Throat Cabinet 331 
92 High Tension ‘Standard” 333 
93 Dynelectron 337 
94 Liebel-Flarsheim portable outfit 338 
ILLUSTRATIONS CHAPTER I. 
What Is Electricity ? CHAPTER I. 
WHAT IS ELECTRICITY? 
Atoms and electrons. Radioactivity. Energy. Human mech- 
anism. Body Currents. Primary cell. Electro-physiology. Light. 
Physiology of light. 
WHAT IS ELECTRICITY? 
Atoms and Electrons.—Centuries ago it was dis- 
covered that the world and the matter of which it con- 
sists were in motion, and until quite recently were we 
content to believe an atom to be the smallest hypothe- 
tical subdivision of matter. Now, however, the exist- 
ence of the atom no longer rests upon a hypothesis. 
According to Hull, “The atom is a real object of defi- 
nite shape and size. We know what it is made of. We 
know its weight in grams. We know its exact speed 
when it flies about a gas, and, lastly, we know its exact 
position when it forms a part of a solid body.” 
The roentgen ray and the ultra-microscope, together 
with other modern scientific instruments, are means 
by which man is enabled to penetrate the mysterious 
composition of the atom and obtain a view of what 
may be life itself. 
Scientists of today tell us that the atom is com- 
posed of minute particles of matter called electrons 
and that an electron consists of an electrical charge. 
3 4 
HIGH-FREQUENCY PRACTICE 
There are two kinds of electrons, positive and nega- 
tive. The nucleus of the atom is composed of positive 
electrons and approximates one-half its atomic weight 
and about 1/100,000 part of the atom in size. The bal- 
ance of the atom is made up of space and negative elec- 
trons which revolve about the nucleus in regular orbits 
not unlike the planets of the celestial system in their 
revolution about the sun—the nucleus representing the 
sun and the negative electrons the planets. 
The electrons of the atoms of any substance are 
sufficiently far apart to enable the electrons of other 
substances to pass thru the atom without coming in 
contact with the electrons of the atom through which 
they pass. 
An atom of hydrogen, the lightest of all gasses, con- 
tains 1000 electrons. The number of electrons con- 
stituting an atom of any substance is in direct propor- 
tion to the atomic weight of the substance. An atom 
of radium, with an atomic weight of 226, contains, 
therefore, 226,000 electrons. 
Some idea of the size of an electron may be had by 
the fact that one gram of radium ejects thirty-seven 
billion atoms of helium per second, which, even at this 
rate of decay, requires over 3000 years to become en- 
tirely consumed. 
According to C. G. Darwin, if we imagine an atom 
magnified 10 million times a million diameters the 
nucleus will appear to have a diameter of about 1 y2 
inches; the innermost electrons will appear to be fol- 
lowing an orbit about ten feet from the nucleus while WHAT IS ELECTRICITY ? 
5 
the outermost ones will appear to be one-half to two- 
thirds of a mile distant. 
The physical features of electrons are their small 
volume and extreme speed. It requires a great dis- 
turbing power to break up atoms of most substances 
and to start the electrons, but when once detached 
little force is required to keep them moving. Mov- 
ing electrons produce visible as well as invisible 
rays. If a target of high atomic weight be placed in 
a vacuum of high degree and in the path of moving 
electrons, the electrons are deflected and x-rays are 
manifest. The production of x-rays depends upon the 
separation of electrons from the atom, giving them high 
rate of speed, concentrating them on a small area and 
stopping them suddenly. Alpha and beta particles may 
be deflected by a magnet, but gamma particles move 
in a straight line and are only deflected by contact 
with a positive nucleus of high atomic weight. At 
the point of deflection or stoppage of electrons great 
heat is produced, sufficient to melt ordinary metal. 
This is the reason for choosing for x-ray targets metals 
of high melting points such as tungsten and platinum. 
However, any known substance may be melted by 
proper concentration of electrons. The atoms of every 
substance, regardless of their position or character- 
istics, are made up of electrons. The number and 
movement of electrons in relation one to another within 
the atom characterize the substance. An atom of gold 
differs from an atom of iron only in the number and 
the manner in which the electrons are grouped. An 
atom of mercury contains but few more electrons than 6 
HIGH-FREQUENCY PRACTICE 
an atom of gold. If it were practical to remove these 
few excess electrons from the mercury atom, gold 
might be produced and the dream of the alchemists 
come true. 
It is possible to count electrons as they emanate 
from radium as helium. It is possible and more or less 
probable that helium was the first existing element 
from which all matter was transmuted, and as all mat- 
ter is more or less radio-active or constantly returning 
to helium, we may dare presume that from helium we 
came and unto helium may return. 
Electricity has been defined in many ways, the one 
most common being that it is a force of nature devel- 
oded or generated by chemism, magnetism or friction, 
but today the theory accepted by most physicists is 
that electricity is a SUBSTANCE composed of moving 
electrons and made manifest to us by its magnetic, 
thermal and chemical effects. 
It is not known whether the electric current coming 
from a primary cell is due to chemical action on the 
elements of the cell or whether the flow of electrons 
causes the chemical changes in the electrolyte. It is 
the belief of the writer that the flow of electrons causes 
the chemical changes in the electrolyte of the primary 
cell. 
Radioactivity.—Radioactivity is the property pos- 
sessed by a substance of emitting rays capable of pene- 
trating opaque substances. When an atom explodes it 
emits alpha particles and becomes another element. WHAT IS ELECTRICITY ? 
7 
An enormous amount of energy must have been 
expended in the formation of radium, as it gives off 
an enormous amount of energy in its disintregation. 
It is said that during the disintegration of one gram of 
radium there is as much heat given off as in the burn- 
ing of 1000 pounds of coal. 
The first radioactive substance was discovered in 
1896 by Henry Becquerel. From that day to this 
thirty-three more radioactive elements have been dis- 
covered. There is probably no substance but what is 
more or less radioactive during its disintegration. Each 
radioactive element has a definite rate of transmuta- 
tion, therefore a definite period of existence. 
The earth and all matter therein are continuously 
being bombarded by the electrons from the sun. There 
is nothing but what undergoes disintegration and con- 
sequent transmutation into atoms of matter entirely 
foreign to those now existing. The marble walls of our 
public buildings will crumble into atoms of dust, and 
the electrons of the dust atoms will be set free to join 
the innumerable caravan whose journey ends in new 
matter. 
For convenience man has divided all material sub- 
stances into two groups, the animate and inanimate. 
In our minds the animate is associated with motion, 
growth and function of reproduction and the inanimate 
with material not possessed by these attributes. This 
division of matter may be entirely wrong and the so- 
called scientific facts of today be discarded theories 
of tomorrow. Those who believe that the electron is 8 
HIGH-FREQUENCY PRACTICE 
the base of all fundamental matter cannot be blamed 
for believing that the electron is life itself. It has 
been proven to be always in motion; it may be capable 
of growth and reproduction and thus fulfill the re- 
quirements of life as we understand it. To say the 
least, it is the prime cause of all life and energy. In 
accordance with our present understanding of the func- 
tion of electrons the existence of inanimate matter is 
impossible. The electron or the possible spark of life 
exists in all matter. 
Energy.—In the movement of electrons energy is 
displayed. Everything in existence is composed of 
electrons, therefore possesses potential energy, and the 
extent of that energy is measured by its capacity to do 
work or transfer its power from one form to another. 
It is impossible for man to create energy, but he has 
discovered methods of transferring it from one form to 
another. All energy tends to return to its original 
form. Heat transfers water into steam, the expansion 
of steam produces power, while it in turn passes back 
into heat; and in all the transfers of which human in- 
genuity is capable not one electron is lost. 
In transferring mechanical energy into electrical 
energy a dynamo is employed. A dynamo creates no 
electricity; it simply separates the electrons of the 
atom by agitation and pushes them apart, when they 
fly to the point of greatest attraction through the 
route of least resistance. 
The water of Lake Erie possesses potential energy, 
and when it falls over Niagara its potential energy is WHAT IS ELECTRICITY ? 
9 
transferred into mechanical energy, and this energy is 
again transferred by the turbine wheel to the dynamo 
which transfers it into electrical energy. The electrons 
composing the mists of Niagara possess the same po- 
tential energy as those which pass the turbine wheel. 
The electrons set free by the dynamos of Niagara 
flow through the copper wires as does water through 
a pipe to the many points of distribution where they 
are again transferred into light, heat and power from 
which they escape to form atoms of new matter. All 
forms of energy can be traced back to an electrical 
source. Light, heat and power are all one and the 
same. 
Human Mechanism.—From an electro-physiologi- 
cal standpoint the human body is the most delicate, in- 
tricate and wonderful apparatus of which we have 
conception. Within its structure are contained elec- 
tric generators, converters, vibrators, rheostats, con- 
densers, resonators, inductances, transformers, con- 
ductors, insulators, collecting and dispersing electrodes. 
It develops electro-motor-force producing volts, am- 
peres, coulombs and watts. The skin presents a resist- 
ance of thousands of ohms. The body is full of pri- 
mary cells connected in series and in multiple and de- 
velops continuous alternating, sinusoidal, static, induc- 
tive and oscillatory currents. Its electrolytes contain 
anions and cathions. Its diathermic apparatus con- 
verts mechanical energy into heat. The body as a 
whole exhibits a polarity which is usually positive but 
may be changed to negative by surrounding objects, 
etc. It receives electrical charges and disperses them. 10 
HIGH-FREQUENCY PRACTICE 
It has electric circuits open and closed. It not only pos- 
sesses every device known to electrical science but 
many details of construction and activity which we do 
not understand. 
Body Currents.—Man’s body currents are direct and 
continuous only to a degree. It is likely that a large 
proportion of them are inductive. Counting the dis- 
tance from origin to destination the rate of flow is 
about 120 feet per second. The reduction of rate of 
flow from that of the ordinary electric current is due 
to the many condensers and rheostats existing in the 
body. While body currents may flow through almost 
any tissue of the body it is well known that the nerves 
are the all-important conductors. In tracing any nerve 
from its origin to its termination many obstacles, such 
as synapses, ganglions and pathological switches, are 
interposed and delay the current flow. 
The human body may lose its electrical charge by 
being grounded, but it will reestablish its charge in a 
very short time, thus demonstrating the presence of 
electrical generators. A portion of the body may lose 
its charge while the remainder retains it, showing that 
the body contains many generators. 
Whether the chemical changes going on within the 
body induce electric currents or the ever-present elec- 
trons produce the chemical changes is not a settled 
matter with physiologists, but the electrical theory is 
fast becoming the accepted one. 
When a normal tissue takes on pathological change 
it becomes an insulator of body currents. The body WHAT IS ELECTRICITY? 
11 
currents being the main factor in nutrition it is logi- 
cal that tissues deprived of these currents will take on 
degeneration. 
The voltage of body currents is very low, something 
like 5 millivolts. It would seem that if we were able 
to detect the obstruction to body currents in time and 
the deficiency be supplied from an outside force patho- 
logical changes might be averted. 
It has been demonstrated that in fatigue of animal 
or vegetable tissues the polarity of the currents was 
reversed. Even metalic substances are subject to re- 
versal of polarity and consequent fatigue. Normal 
nerve will react to the cathodal closing of a direct cur- 
rent, but when the motor nerve supply is cut off by in- 
jury or pathological changes the polarity is changed 
and the nerve reacts only to anodal closing. 
Stimulation of all tissues from any source—vibra- 
tion, light, heat or electricity—increases body currents. 
It is impossible to stimulate any tissue of the body 
without inducing currents in those tissues, and these 
induced currents have their physiological and patholo- 
gical effects. 
A high-frequency curient induces hyperemia with- 
out evident electrolytic action, and at the same time 
changes take place which increase nutrition. Whether 
these marvelous transformations are due to electrical, 
mechanical or chemical effects is not entirely clear, 
but it is the consensus of opinion of the leading physio- 
logists of today that they are electrical. 12 
HIGH-FREQUENCY PRACTICE 
Primary Cell.—Any two dissimilar metals when 
placed in contact with each other cause a flow of elec- 
trons from the metal of higher to that of lower poten- 
tial If the two metals be separated and then connected 
by a conducting medium there will be a flow of elec- 
trons through it. If the medium contains salts in so- 
lution a separation of the basic radical from the acid 
radical will take place. A primary cell consisting of 
copper and zinc elements in an electrolyte of a solution 
of hydrochloric acid and water will illustrate the 
changes which take place due to the movement of elec- 
trons through the solution. The negatively charged 
chlorine seeks the positive pole, and the positively 
charged hydrogen seeks the negative pole. Faraday 
named these charged particles ions. Those carrying 
a positive charge which they give up at the negative 
pole or cathode are called cations and those with a neg- 
ative charge anions, in accordance with the direction 
in which they move. During the passage of the cur- 
rent of electricity the solution or electrolyte is decom- 
posed and the resulting ions take their places at the 
poles in accordance with their charge. It is quite prob- 
able that the chlorin of the hydrogen chloride is dis- 
placed by a positive electron converting it into an atom 
of hydrogen. 
We have been taught that the electrical current is 
the result of the chemical action of the electrolyte upon 
the elements of the cell, but it is far more intelligible 
to assume that the electric current passing from one 
element to the other causes the chemical change in the 
electrolyte. WHAT IS ELECTRICITY ? 
13 
The primary cell in electrical phenomena is analog- 
ous to the animal cell. Baines and Robertson, who 
have spent years in electro-physiological research, have 
arrived at the conclusion that the electrical phenomena 
dominate the entire process of reproduction: “Dur- 
ing the stage of functional activity, and before re- 
productive demands bring this to a halt, we find that the 
nucleus is still the center of life of the cytoplasm, and 
that any portion of that cytoplasm which becomes sep- 
arated from the body of the cell, dies, even though it 
be surrounded by a richly chemical medium from which 
the remaining protoplasm of the cell body continues to 
derive its life. The hyaloplasm apparently, therefore, 
performs two distinct functions. It forms a compound 
barrier through which pass into the cell only those ele- 
ments from the lymph which are essential to its work- 
ing life and specific to its functional activities. But by 
virtue of its lipoid elements it maintains a constant 
equilibrium between the electrical potential within the 
cell and that of the neighboring cells and of the lymph, 
highly charged as it is with electrolytes, by which it is 
environed. So long as massive toxic influences are 
not brought within its area this electrical equilibrium 
is maintained, but this protection from toxic agents 
can be overcome; the hyaloplasm fails in this function 
of barrier, and electrical and chemical diffusion result 
and the cell is doomed.” 
After years of research in Electro-physiology Baines 
has arrived at the following conclusions: 
(1) Everything living, whether animal or vege- 
table, has a well-defined electrical system. 14 
HIGH-FREQUENCY PRACTICE 
(2) Broadly speaking, the edible part of a fruit 
or vegetable is the positive element, or that part which 
yields a positive galvanometric reaction. 
(3) Dry earth is a bad conductor of electricity, 
and therefore water is required as an electrolyte as well 
as being necessary in the formation of protoplasm, etc. 
(4) Every tree, shrub, plant, fruit, vegetable, 
tuber and seed is an electrical cell, differing from cells 
made by human agency in that it cannot be polarized 
or discharged so long as it remains structurally perfect. 
(5) The skin, peel, rind or jacket of fruits and 
vegetables is of the nature of an insulating substance 
primarily designed for the conservation of their elec- 
trical energy. 
(6) The electro-motive force of them all is the 
same, the current varying in accordance with Ohm’s 
law. 
(7) Plants grown in pots or removed from the 
earth and placed in other receptacles differ materially 
in their electrical constitution from those grown in the 
earth. 
(8) If a suitable electrolyte, other than water, is 
mixed with the soil it is possible to grow plants with 
much less moisture. 
(9) Growth may be stimulated by means of a 
continuous current of electricity of low potential and 
proper sign, WHAT IS ELECTRICITY? 
15 
LIGHT. 
Light is usually defined as the propagation of vibra- 
tions or undulations in ether. Newton believed that 
light consisted of particles of material or corpuscles 
sent off in all directions from luminous bodies. His 
theory which held for over a hundred years was dis- 
placed about one hundred years ago by the wave 
theory. The theory of today held by many physicists 
is that light is due to the frequency and undulatory 
movement of electrons. Thus we are gradually return- 
ing to the Newtonian theory. 
We know that particles are deflected from the anode 
of the x-ray tube and that their penetrating qualities 
are due to their extreme speed. This characteristic 
“time-speed” is called by Einstein the “fourth dimen- 
sion.” It is reasonable to assume that the sun’s rays 
are composed of an actual substance. The extreme 
speed of 186,000 miles per second gives to light its pene- 
trating character. The electrons of sunlight possess 
weight and exert a certain amount of pressure upon 
the earth. Particles of light coming from less power- 
ful bodies than the sun are deflected by the powerful 
pressure of the electrons composing the sun’s rays. 
The source of light has been one of the mysteries of 
science for ages. The discoveries of Maxwell and 
Hertz, that light is simply electrical vibration caused 
scientists to look for the electric charges which caused 
the vibration. Bohr says: “Light is given off when 
the electron is suddenly changed from its normal mo- 16 
HIGH-FREQUENCY PRACTICE 
tion, by jumping from one atom to another or from 
one orbit to another about the same atom.” 
The human eye is capable of response only to cer- 
tain limitations of light frequencies (or wave lengths), 
generally supposed to be from 400 to 700 billion per 
second. Lower frequencies which lie beyond the visible 
spectrum are known as infra-red. The lowest known at 
the present time are called Hertzian waves. At the 
opposite end of the visible spectrum the frequencies are 
too rapid and short for the human retina to respond. 
These frequencies are known as ultra-violet; the next 
higher are known as x-rays, while the highest are 
gamma rays of radium. While all frequencies are more 
or less chemical in effects, the most energetic are found 
at the highest frequency end of the spectrum. The vis- 
ible part of the spectrum according to Langley is only 
19 per cent of the total spectrum energy. When we 
consider that 81 per cent of the sun’s rays are invisible 
we must realize how little we know concerning the total 
energy of the sun spectrum. 
Physiology.—Light energy causes contraction of 
protoplasm and increases the oxygenating power of 
the blood. The high-frequencies of ultra-violet of sun- 
light are absorbed by the oxygen and nitrogen as well 
as the particles of material in the air. Sunlight in the 
pure air of the mountain regions is rich in actinic rays, 
which accounts for its health-giving properties. The 
smoke and dust which hover over cities practically shut 
out all ultra-violet rays. Window glass will filter out 
ultraviolet rays, which to a certain extent accounts for WHAT IS ELECTRICITY? 
17 
the poor health of those whose lives are spent in closed 
rooms. 
Robertson says: “Every cell in the plant, every cell 
in the animal body requires light, and it requires light 
frequencies of very definite wave length which will 
determine the resonance of its own molecules and there- 
after activate them in accordance with that specific 
resonance. That is why the plant and the animal tis- 
sues alike are provided with so marvelous a complex 
of light screens, pigments and dyes.” 
The activity of all living matter, animal or vegeta- 
ble, depends upon the frequency of light electrons in 
determining the chemical changes necessary to its ex- 
istence. As chemical changes are due to electrical ac- 
tivity it can be understood that without electricity there 
is no life. 
Every cell being made up of electrons must, there- 
fore, consist of positive and negative charges. When 
the cell is in a normal state a perfect electrical equi- 
librium is maintained. In other words, the potential 
is such that the electrical phenonenon we call life is 
maintained. Whenever the dialectric of the cell is rup- 
tured the integrity of the cellular substance is de- 
stroyed, the process of decomposition sets in. Physio- 
logists no longer look upon a living cell as a mass of 
protoplasm endowed with a particular function due to 
chemical activity. The modern view of the living cell 
is that it contains a highly organized and complex sys- 
tem not unlike that of the atom, and is governed by the 18 
HIGH-FREQUENCY PRACTICE 
same law which controls the universe. Physiologists 
are fast becoming converted to the theory of the body 
being electrically controlled and electrically driven. 
This is the truth of today. Who dares to prophesy 
what the future will bring forth? CHAPTER II. 
High-Frequency Currents CHAPTER II. 
HIGH-FREQUENCY CURRENTS. 
Definition. Source. Change of frequency. How produced. 
Condensers. Oudin coil. Oscillating current. Types of ma- 
chines. Meters. Spark gaps. Classified physiology. Electrodes. 
Vacuum electrodes. Non-vacuum electrodes. Precautions. Prep- 
aration of the patient. General technic. Auto-condensation. 
Auto-conduction. Local auto-condensation. Effects of auto-con- 
densation. Contraindications and precautions. Care of appar- 
atus. 
A high-frequency current is one characterized by 
the high number of cycles completed in one second of 
time. It is a modified alternating and oscillating cur- 
rent. The ordinary alternating current which com- 
pletely reverses itself 120 times per second is known as 
a 60-cycle current. It requires one positive and one 
negative alternation to complete one cycle. The 60 
cycle alternating current is the one usually chosen for 
street lighting. However, some city lighting plants 
employ 125 and 133 cycle currents and a few still use 
the 25 cycle current. Physicians who live in places 
where these currents only are available are seriously 
handicapped as modern electrotherapeutical apparatus 
are designed for the 60 cycle current, and any change 
of frequency from the 60 cycle current supply necessi- 
tates changes in the machine which it operates. 
DEFINITION. 
21 22 
HIGH-FREQUENCY PRACTICE 
Nikola Tesla in 1891, was the first to suggest the 
use of high-frequency currents in medicine. 
D’Arsonval found that a current alternating less 
than 15 times per second produced clonic muscular con- 
tractions ; a frequency of 20 to 30 per second produced 
tonic spasm; increasing the frequency beyond 30 per 
Pig. 1.—Rotor. 
second increases the intensity of the spasm; the maxi- 
mum intensity is reached at about 300 alternations per 
second; beyond 300 alternations per second the inten- 
sity gradually becomes less until a frequency of about 
10,000 per second is reached when all muscular con- 
tractions cease. 
Source.—The alternating current is the usual source 
from which a high-frequency current is obtained. When 23 
HIGH-FREQUENCY CURRENTS 
only D. C. current is available, a motor generator for 
changing it to A. C. is necessary. 
An alternating current leaving the terminals (a) 
of a generator having four poles (1, 2, 3, 4) with the 
rotor driven at 1800 R. P. M., is called a 60 cycle cur- 
rent because the alternator delivers a current with 60 
complete cycles or revolutions and 120 alternations per 
second. 
Fig. 2.—One Cycle, Two Alternations. 
In the above diagrams it is assumed that the cur- 
lent starts from the collector ring (1) of the rotor. 
Following the direction of the arrow, the current as- 
cends in voltage until it reaches its peak at 2. The 
voltage then descends to zero at 3 as the current re- 
turns to another collector ring. At this point (3) the 
rotor of the machine passes to the next set of poles and 
the current reverses and starts anew reaching its peak 
at 4 when it again ascends to zero. 
The rotor revolves 60 times in one second. The 
current completes one cycle and two alternations in 1/60 
second; one-half of each cycle is positive and one-half 
negative in direction. 24 
HIGH-FREQUENCY PRACTICE 
Change of Frequency.—It can be readily understood 
that a change of frequency may obtain from change in 
number of poles or speed of the rotor. If the number 
of poles be doubled the frequency is doubled; the fre- 
quency is also increased in direct proportion to the in- 
creased number of revolutions of the rotor. 
The frequency coming from an alternator may be 
ascertained by multiplying the number of revolutions 
per minute by the number of poles and dividing the 
product by 120. 
How Produced.—The first step in changing a 60 
cycle, 110 volt alternating current of low frequency to 
one of high frequency is to increase the voltage by a 
step-up transformer. This is accomplished by taking a 
rectangular shaped core made of many layers of thin 
sheets of iron, upon one arm of which are wound a few 
turns of heavy copper wire or ribbon and upon the op- 
posite arm are wound many hundred turns of small in- 
sulated wire. 
Fig. 3 illustrates what is known as a closed core 
transformer. This type of transformer is more effi- 
cient than the open core type because a path of metal 
is provided for the passage of lines of force in the place 
of a dialectric of air. This arrangement brings the two 
coils close together but not touching and reduces the 
magnetic leakage to a minimum. A current of elec- 
tricity passing through the first coil, called the pri- 
mary, causes a current to be set up at once in the sec- 
ondary coil. This property of the alternating current 
is called induction, and the current produced in the 
secondary coil is said to be induced. The voltage of the HIGH-FREQUENCY CURRENTS 
25 
induced current in the second coil is in direct propor- 
tion to the ratio between the number of turns of wire 
in the first and second coils. If the first coil contains 
ten turns and the second 100 turns the voltage induced 
in the second coil will be ten times that of the first. In 
Fig. 3.—One-half Kilowatt High-Frequency Transformer. 
P. Primary. S. Secondary. Core 9%x6% inches. 
For a 110-volt, 60 cycle supply current the primary coil con- 
sists of 237 turns of No. 14 wire and the secondary of 16,480 
turns of No. 32 enameled wire. For a 25-cycle current the pri- 
mary consists of 462 turns of No. 14 wire and the secondary of 
32,000 turns of No. 32 enameled wire. 
For a 125-cycle current the primary consists or 125 turns and 
the secondary of 8,240 turns. 
such a transformer with a current supply of 110 volts 
in the primary there will be 1100 volts induced in the 
secondary. If the primary consists of 100 turns and the 
secondary 4000 turns of wire and the voltage impressed 
on the primary be 110, the voltage of the secondary will 
be forty times that of the primary or 4400 volts. 26 
HIGH-FREQUENCY PRACTICE 
The production of high-frequency currents of al- 
most any desired potential may be had by the combi- 
nation of two coils of proper proportions and number 
of turns of wire with a transformer, condenser, and 
spark gap. The principles of transformation may be 
used for stepping up a current to higher voltage as well 
as stepping it down to a lower voltage. With every 
change of voltage there is a corresponding change in 
amperage. When the voltage is stepped up the amper- 
age falls; on the other hand, when the voltage is re- 
duced by means of a step down transformer the am- 
perage is raised. An understanding of this principle 
enables one to construct a transformer of almost any 
voltage or amperage. 
The high voltage of the secondary of all high-fre- 
quency machines calls for the best methods of insula- 
tion. The current from the secondary of a high volt- 
age transformer is dangerous to handle consequently 
something must be done to safeguard the patient. Be- 
fore this high voltage current can be utilized in therapy 
it must be converted into a current of very high fre- 
quency. The frequency of a 60 cycle current must be 
raised to a frequency of 10,000 or more per second to 
be safe to handle. The frequency of the alternations 
in ordinary machines is not 10,000 but several millions 
per second. 
The next step in the process of producing a high- 
frequency current is to pass the current from the sec- 
ondary of the transformer to a device called a con- 
denser. 27 
HIGH-FREQUENCY CURRENTS 
CONDENSERS. 
A condenser may consist of Leyden jars or plates. 
A plate condenser consists of a number of sheets of tin 
foil separated by plates of mica or glass. The sheets 
of tin foil of each alternate layer on either side are 
connected together and to which the wires of the trans- 
former are attached. The condenser acts as a reservoir 
Fig. 4.—Leyden Jar Condenser. 
for the current which stores up as a charge on the plates 
until the tension becomes so great that the current dis- 
charges across the spark gap. The discharge across 
the gap has a to and fro movement of many thousand 
little charges. During the time of discharge across the 
gap the condenser is collecting a new supply from the 
transformer ready to renew the discharge which has 
taken place across the gap. All of this takes place in 28 
HIGH-FREQUENCY PRACTICE 
something like one ten thousandth part of a second. 
The alternating charge and discharge of the current 
from the condenser give it an oscillating character so 
necessary in high-frequency work. 
Theoretically the oscillations from a Leyden jar 
and plate condenser of like capacity are the same, but 
the experience of the writer leads him to favor the 
Leyden jar. It is not clear how the oscillations differ 
in character but it seems that those from the Leyden 
jar are more uniform and have less faradic effect. 
The oscillations across the gap produces a current of 
very high frequency. The current is further modified 
by passing through the primary of another trans- 
former which by the way has no core; it 
consists of a simple coil of wire or solenoid. This coil 
is known as the d'Arsonval solenoid and acts as the 
primary of the second transformer within which is 
placed a secondary of a suitable number of turns of 
wire to obtain a high-frequency current of any de- 
sired potential. The current flows through the primary 
of the second transformer or d’Arsonval solenoid back 
to the condenser thus completing the circuit. There is 
no electrical connection between the primary and sec- 
ondary of the transformer, the secondary receiving its 
charge from the primary by induction. The primary 
of this transformer having no core makes the current 
easy to handle as there is no possibility of the patient 
receiving a shock of low frequency from the terminals 
of the transformer. HIGH-FREQUENCY CURRENTS 
29 
OUDIN COIL. 
Oudin attached to the d’Arsonval solenoid another 
coil of wire which he named Resonator. This coil is in 
reality an auto-transformer. The Oudin coil gives an 
enormous brush discharge from a single terminal and 
is used in unipolar application thru vacuum and non- 
vacuum electrodes. This current is usually employed in 
light desiccation work. The ordinary application of 
this current thru vacuum electrodes causes but a sen- 
sation of slight warmth unless the electrode is lifted 
from the skin in which case the resultant spark is 
quite painful. It is important that the electrode be not 
applied or taken from the patient without first hav- 
ing the current shut off or diverted thru the operator 
by placing his hand on the electrode. 
The effect of vacuum tube application is to increase 
arterial tension and when applied to the thoracic spine 
will increase blood-pressure while in auto-condensation 
application with the d’Arsonval current will reduce 
blood-pressure. A point well worth remembering is, 
never to apply the vacuum tube treatment to cases of 
arteriosclerosis or any other condition accompanied by 
hypertension. 
OSCILLATING CURRENTS. 
An oscillating current while alternating in charac- 
ter differs from the ordinary alternating current in 
the wave length of the alternations. The modification 
is brought about by the introduction of condensers in- 
to the circuit. 30 
HIGH-FREQUENCY PRACTICE 
A high-frequency current possesses qualities un- 
known to other currents. It does not require a conduct- 
ing wire to make a circuit. The resistance offered by 
a conductor of high-frequency currents is directly 
opposite that of other electric currents. The greater the 
diameter of the conductor, the greater the resistence 
to the flow of high-frequency currents. 
Fig. 5.—The Difference Between an Oscillating and 
Alternating Current. 
The original d’Arsonval received its current supply 
from direct current mains. This required the introduc- 
tion of an interrupter in the circuit. The machine of 
today equipped with a d’Arsonval transformer delivers 
a modified form of the d’Arsonval current. Practically 
all high-frequency machines are equipped to deliver the 
modified d’Arsonval, Tesla and Oudin currents. The 
d’Arsonval current is of medium voltage and high am- 
perage. The Tesla current is of extremely high volt- 
age and medium amperage. The Oudin current is one 
of high voltage and low amperage. 
TYPES OF MACHINES. HIGH-FREQUENCY CURRENTS 
31 
METERS 
High-frequency currents cannot be measured by the 
ordinary electric meter. In order to approximate the 
amount of current passing from a high-frequency ap- 
paratus, a thermostat is used and is known as a hot 
wire meter. It simply measures the amount of heat in- 
stead of the electromotive force, coming from the ap- 
Fig. 6.—Hot Wire Meter. 
paratus while an electric meter measures the current 
strength or amperage of the current. 
The construction of a hot wire meter is shown in 
Fig. 6. A is a wire stretched between B and C; A and 
A are connected by a wire spring. When the wires 
A expand the pull of A on the spring D deflects the 
needle. R. Adjuster. 
SPARK GAPS. 
In order to facilitate the charge and discharge of 
the condenser of a high-frequency apparatus, a gap 32 
HIGH-FREQUENCY PRACTICE 
or dialectric of air is introduced between the secondary 
of the step-up transformer and the d’Arsonval solenoid, 
this gap being known as a spark gap. A spark gap not 
only acts as resistance, but multiplies the oscillations of 
the current. There are many forms of spark gaps, 
single and multiple-point, multiple ball, rotary and mul- 
tiple section. The single point, multiple ball and rotary 
gaps make considerable noise in operation and require 
Fig. 7.—Multiple Section Spark Gap. This is a 
modification of the DeKraft Gap. It is arranged to be 
connected to an air pump or tank, allowing free passage 
of air through the entire gap, thus preventing it from 
overheating. 
frequent cleaning and periods of rest to cool. The 
heavy tungsten point spark gap is of excellent con- 
struction and noiseless in operation. It is arranged to 
be connected to an air pump or tank allowing free pass- 
age of air thru the entire gap, thus preventing it from 
over heating. It is also provided with a series of copper 
discs to dissipate the heat generated by the spark. This 
style of spark gap will operate for hours without periods 
of rest to cool. 
Another style of gap is very efficient in high-fre- 
quency work; it is known as the Quenched Gap; it is HIGH-FREQUENCY CURRENTS 
33 
constructed of metal, massive in form and consists of 
large radiation surface. The large surface tends to 
dissipate the heat. This style of spark gap has the 
advantage of multiplying the discharges, that is to 
say, the condenser becomes charged and discharged 
many more times per second. It also increases the 
fatness of the spark. While this gap has its advan- 
tages in auto-condensation work, it has the disad- 
vantage of being noisy. 
Fig. 8.—Victor Multiple Spark Gap. This type of 
Spark Gap is somewhat different from the prevailing 
type. It is self-cooling and designed for hard service. 
PHYSIOLOGY OF HIGH-FREQUENCY CURRENTS 
General.—The physiological action of high-fre- 
quency currents varies with the type of apparatus 
as well as the method of application. Increased meta- 
bolism is one effect common to all methods of appli- 
cation. Applications which induce currents in the hu- 
man body have a general sedative effect upon the 
vasomotor mechanism and reduce blood-pressure. 34 
HIGH-FREQUENCY PRACTICE 
(The open Spark-Gap with slab removed for cleaning tungsten points) 
Fig. 8A.—Multiple Spark Gap. The gap shown in the illustration is of the 
open type being ventilated and cooled by air currents circulating thru it. It is 
easily cleaned. This gap is provided with two controls—a slide-rod to regulats 
the number of gaps and a rotary control to adjust the distance between the tung 
sten points. The two controls admit of fine adjustment. This gap is used on al 
High-frequency machines made by The High Tension Transformer & Equipmem 
Company, Hoboken, New Jersey. HIGH-FREQUENCY CURRENTS 
35 
Sparks from a vacuum tube have a local stimulating 
effect, and when applied to the spine have a tendency 
to raise blood-pressure, especially in cases of hypo- 
tension. 
Fig. 9.—The Hogan High-Frequency Apparatus. 
This apparatus has a number of distinctive features. The 
spark gap consists of six metal discs operating in open 
air inside of the cabinet, having no insulating discs, 
therefore, no insulation to puncture. A number of holes 
drilled in bottom and top of cabinet provide ventilation, 
keeping the spark gap cool. The Condenser is oil-im- 
mersed, sealed in a metal tank, increasing its di-electrjc 
Strength. 36 
HIGH-FREQUENCY PRACTICE 
If a metallic or vacuum electrode be placed in 
good contact with the skin or mucous membrane, a 
current up to 200 milliamperes will produce no sen- 
sation other than that of heat, but a current of over 
250 milliamperes will produce a slight sparking sen- 
sation in addition to that of heat. 
The body temperature is increased by a general 
application of auto-condensation and diathermy. (The 
thermal effects will be more fully discussed in the 
chapter on diathermy.) The increased oxidation 
causes a loss in weight in the obese. Inflammatory 
infiltrations and exudates are absorbed. The roentgen 
ray will break up indurations and exudates and the 
high-frequency current will eliminate the product. 
Infiltrated tissue anywhere is promptly drained. 
Considerable constitutional effects may be produced 
by local application with very little visible local ef- 
fects. 
Skin.—The first effect upon the skin is one of 
vasoconstriction followed by dilatation of the capil- 
laries with little consequent hyperemia. A limited 
superficial anesthesia is produced. Activity of sweat 
glands is visibly increased. Repeated applications will 
tan the skin. Heavy sparks are highly counterirri- 
tant, the effect varying in intensity from a blister to 
necrosis. If the current be condensed upon a needle 
point the effect will be one of dehydration. In pro- 
longed application of heavy sparks the small arter- 
ioles are plugged with gas products thus destroying 
the hair follicles with consequent falling of hair. Skin 
bacteria are destroyed. The effects of the applica- HIGH-FREQUENCY CURRENTS 
37 
tion of a vacuum electrode thru very thin clothing 
are practically the same as when applied to the skin. 
The effects thru heavy clothing are revulsive and 
irritating and should not be employed except when in- 
tense counterirritant effects are desired. 
Tissue Cells.—Local application of high-frequency 
currents produce an increased activity of cellular pro- 
toplasm and increases the resisting power toward 
pathological processes. 
Blood.—High-frequency currents cause chemical 
and physical changes of the protoplasm of the red 
and white cells. The red cells are increased in num- 
ber and the percentage of hemoglobin is also in- 
creased. Phagocytosis increased. Nitrogen content 
i educed. 
Liver.—Activity of liver cells increased and drain- 
age promoted. Relaxed common bile duct. Increased 
defense to bacterial invasion. 
Bone.—Rone offers material resistance to the pass- 
age of high-frequency currents, consequently is last to 
be heated. The heat is retained for hours and is 
slowly given up to the surrounding tissues. Activity 
of bone marrow is increased, resulting in an in- 
crease of hemoglobin content. 
Nerves.—High-frequency currents, depending upon 
the method of application, have profound stimulating 
or inhibitory effects upon the autonomic nervous sys- 
tem. Trophic effects are increased. Pain is relieved 
thru circulatory and reflex effects. Electric excita- 
bility is lessened. Visceral reflexes are incited by ap- 38 
HIGH-FREQUENCY PRACTICE 
plication to certain spinal nerves. A current from a 
multiple-point electrode held away from sparking dis- 
tance from the skin (effluve) produces a sensation 
of a mild breeze and is sedative to tired nerves. 
Glands.—High-frequency currents penetrate more 
deeply than other electric currents and have a more 
profound effect upon lymphatic and other glands. 
Secretory function is increased by local application 
and inhibited thru incitation of reflexes. 
Blood Vessels.—The first effect is one of vasocon- 
striction followed by dilatation of capillaries. There 
is a marked increase in activity of the arterial cir- 
culation which mechanically relieves venous conges- 
tion. Splanchnic stasis is relieved thru a general sta- 
bilization of the circulation. Large blood vessels may 
be dilated or contracted by stimulation of certain 
spinal nerves. Arterial tension is lowered or raised 
in accordance with the method of application. In- 
durated arterial walls are softened. 
Stomach.—Direct application increases gastric se- 
cretion and muscular activity. Pyloric dilatation may 
be secured thru incitation of spinal reflexes. Intes- 
tinal peristalsis is increased by local application and 
may be inhibited thru spinal reflex. 
Heart.—Increase of diastolic pause allowing fresh 
oxygenated blood to enter heart muscle, thus promot- 
ing nutritive effects. Direct application to the heart 
increases cellular activity which proves a factor in HIGH-FREQUENCY CURRENTS 
39 
Fig 10.—The Thompson-Plaster Style “FO” Combination Outfit. 40 
HIGH-FREQUENCY CURRENTS 
the restoration of weakened muscles. Vertebral ap- 
plication influences vagus control which regulates the 
heart rythm. 
Kidney.—General application of the high-fre- 
quency current increases the function of the kidney 
evidenced by increased urinary output. The kidney 
pelvis may be contracted or dilated thru proper ap- 
plication to the vertebral interspaces. 
Pancreas.—The secretion of this gland is in- 
fluenced in some unknown manner which results in 
decreased output of sugar in the urine. 
Eye.—High-frequency currents dilate the blood 
vessels and promote drainage. The reflex of con- 
traction and dilatation may be incited thru applica- 
tion of the current to certain spinal nerves. 
Lungs.—Output of carbon dioxid increased. Drain- 
age promoted thru circulatory effects. 
Brain.—Direct application induces cerebral hy- 
peremia. Cerebral congestion may be dissipated thru 
excitation of spinal reflexes. 
Bronchi.—Effects of contraction and dilatation 
may be obtained by incitation of certain nerve reflexes. 
Spleen.—The reflex of contraction and dilatation 
may be incited thru spinal application, thus in a lim- 
ited manner controlling certain infections. Direct ap- 
plication favors the freeing of specific bacteria which 
enter the circulation causing recurrence of malady. 
Uterus.—Intrauterine application induces vasocon- 
striction. Direct application promotes drainage thru 
thermic and vasomotor effects. HIGH-FREQUENCY CURRENTS 
41 
Rectum and Bladder.—Direct application stimu- 
lates secretion and has a general toning effect upon 
all structures. Sphincters may be dilated thru in- 
citation of spinal reflex. 
Organs of Generation— Increased activity of ov- 
aries and testicles results from direct and vetebral 
stimulation. Power of erection is increased. 
Mucous Surfaces.—The effects upon mucous sur- 
faces are similar to those upon the skin—stimulation 
of secretion, transitory hyperemia and vasomotor vit- 
alizing effects. 
Muscles.—Electric excitability lessened in close 
proximity to electrode. Upon ordinary application 
high-frequency currents do not cause muscles to con- 
tract, but they may be made to contract by the intro- 
duction of an air gap in the circuit. Muscles deprived 
of nervous control may have their nutrition sustained 
by proper application of diathermy. 
The machine illustrated in Fig. 10 is the Thompson- 
Plaster Style “FO” Combination Outfit. This cabinet 
supplies an exceedingly high oscillating current, from 
practically zero potential to all that can be safely ap- 
plied. It embraces all the high-frequency modalities, 
as well as cautery transformer, diagnostic light, com- 
pressed air, nebulizing outfit, electric heater, pneumatic 
vibrator, Bier’s hyperemia, etc. 42 
HIGH-FREQUENCY PRACTICE 
ELECTRODES. 
Almost every conceivable material that absorbs 
moisture has been tried in the manufacture of elec- 
trodes for the application of the different electrical 
modalities. In high-frequency work the solid metal 
and block tin electrodes are to be preferred to wet 
pads. Pure tin electrodes have the following advan- 
tages: 1. A suitable electrode may be fashioned in 
one minute. 2. They are pliable and may be made 
to confoim to almost any contour of surface. 3. They 
are cheap. 4. They are less liable to corrosion. 
In fashioning a block tin electrode care must be 
exercised. The edges must be made smooth and they 
should be circular or oval in form. Disagreeable 
sparks aie liable to occur from sharp corners of 
square and rectangular shaped electrodes, and again 
sharp corners are liable to press too deeply into the 
skin and cause concentration of current at that point. 
Concentration of current is apt to occur at the point 
of attachments, such as snap-button, soldered or 
snapped-on rheophore sockets. Care must also be 
exercised to see that there are no points of the 
electrode which are not in close contact with the skin 
as perspiration may collect, and its vaporization cause 
a burn. In surgical diathermy, solid needle point, but- 
ton and ball-shaped electrodes are used. 
Vacuum Electrodes.—Vacuum electrodes for the 
purpose of delivering charges of high-frequency cur- 
rents are made in almost every conceivable shape to 
conform to the anatomy of the part to be treated. HIGH-FREQUENCY CURRENTS 
43 
Fig. 11—Insulated Vacuum Electrodes. HIGH-FREQUENCY CURRENTS 
45 
The vacuum of these electrodes or tubes varies from a 
very low to a very high degree. The degree of vacuum 
may be estimated by the color which is emitted. One 
of low vacuum emits a reddish glow; one of medium 
vacuum emits a bluish tint and one of high vacuum 
has a whitish appearance. A greenish tint indicates 
the presence of x-rays. In chronic conditions of the 
skin, ulcers or prostatitis, the medium or high vacuum 
is to be preferred. 
The activity of sweat glands of the skin is in- 
creased. The secretion unites with the nitrous acid 
and ozone produced by the current and sticks to the 
electrode, and if the electrode is not kept in motion 
disagreeable sparks will occur. A liberal supply of 
talcum powder will enable the electrode to slide easily 
over the surface, but after a few minutes of applica- 
tion a hardened mass will be found adhering to the 
electrode that will require a strong soap or washing 
powder to remove. The body will retain a peculiar 
odor, perhaps lasting for hours after a general ap- 
plication by the vacuum electrode. 
Some tubes have a leading-in wire, others have a 
single chamber, while others have a vacuum divided 
into two chambers connected by a small tube sur- 
rounded by a chamber which is open to the air. The 
last mentioned are known as insulated vacuum elec- 
trodes and are the only ones which should be used 
in the urethra, vagina and rectum. 
When an electrode is used in mucous-lined cavities, 
some kind of a lubricant is necessary to prevent stick- 46 
HIGH-FREQUENCY PRACTICE 
ing to the membrane. Almost any kind of cerate, 
vaseline or tragacanth jelly may be used. A pro- 
longed application of the high-frequency current to 
any mucous surface is liable to cause a burn. Such 
applications should not exceed seven minutes in dura- 
tion. 
Fig. 12.—Diathermy Hand Electrode. A most con- 
venient method of applying the Diathermic Current by 
the hand, for local treatments. The rubber band holds 
the plate in close contact with the palm of the hand, and 
allows a free movement of the fingers for massage pur- 
poses. 
There is a so-called cataphoric glass electrode made 
and recommended by some for the ionization of drugs, 
but it is practically useless, since a high-frequency 
current is alternating in character and has but little 
if any ionizing power. In order to drive medicaments 
into the skin a direct current is required. 
In local applications, by means of the vacuum elec- 
trode, the effects may be increased by having the pa- 
tient connected to the opposite pole of the machine. 
The popular notion that a vacuum tube emits ultra- 
violet rays is misconceived. While, no doubt, & few HIGH-FREQUENCY CURRENTS 
47 
actinic rays are produced within the tube, the glass 
screens them off and they never reach the patient. In 
order for the patient to receive the few ultra-violet 
rays present, the tube must necessarily be composed 
of quartz. 
Fig. 13.—A Surface Non-vacuum Electrode. 
NON-VACUUM ELECTRODES. 
A non-vacuum electrode in many respects is su- 
perior to the vacuum electrode. There is a direct 
metal connection with the lining of the electrode, and 
as there is no vacuum to overcome, the efficiency of 
the current when it reaches the patient is materially 
increased. The glass is heated quickly and a greater 
degree of heat reaches the patient than is possible 
with a vacuum electrode. They may be employed with 
any electric current. When employed with the static 
current, a direct positive charge may be delivered 
which is impossible with the vacuum electrode. They 
are not easily broken and may be sterilized by boiling. 
They are a distinctive improvement over the vacuum 
electrode in high-frequency work. 48 
HIGH-FREQUENCY PRACTICE 
Precautions.—Inflammable material is liable to be 
set on fire by high-frequency currents whenever a 
spark is produced. 
In treating the scalp, all kind of ornaments should 
be removed. Many ornaments are composed of cellu- 
loid, an exceedingly highly inflammable material. 
Short fuzzy hair should also be avoided. 
The use of glass electrodes within the urethra is 
a hazardous procedure, as a slight movement of the 
patient or side pressure by the operator might break 
the electrode and require an external urethrotomy for 
removal of pieces of glass. 
The machine illustrated in Fig. 14 is the Victor 
Model “Wantz.” This high-frequency outfit is up-to- 
date and well adapted to all kinds of high-frequency 
work. It is equipped with a spark gap which permits 
of long continued service without periods of rest for 
the purpose of cooling off. HIGH-FREQUENCY CURRENTS 
49 
Fig. 14.—The Victor Model “Wantz.” HIGH-FREQUENCY CURRENTS 
51 
Fig. 15.—The Wappler Excell. The Excell High-Fre- 
quency Outfit appeared in 1902, and since that time has 
given evidence of its mechanical durability and ease of 
maintenance and control. It is capable of delivering all 
high-frequency modalities. HIGH-FREQUENCY CURRENTS 
53 
PREPARATION OF THE PATIENT. 
The preparation of the patient all depends upon 
the method of application and effects desired. If no 
sparks are desired all clothing from the part to be 
treated must be removed. 
Metal of all kinds, such as ornamental chains, 
corset steel, hairpins, etc., must be kept out of spark- 
ing distance of the electrode. If a mild spark be de- 
sired, the application may be made thru a sheet of thin 
underwear. A spark thru the clothing will have the 
same effect as if the electrode were held the same dis- 
tance from the skin as represented by the thickness 
of the clothing. 
GENERAL TECHNIC. 
In treating diseases of the skin, such as acne, 
eczema, etc., a reasonably heavy charge is required. 
The electrode should be kept in contact with the skin 
and moving. If itching occurs the electrode should 
be raised sufficiently to allow a few short sparks to 
escape. In skin ulcers, a layer or two of gauze is 
useful in keeping the electrode clean. A short spark 
is not uncomfortable, it produces a hyperemia and 
at the same time bathes the part in ozone, both of 
which are desirable. 
Pain.—For relief from pain the strength of the 
current should be such as will produce a counterirri- 
tant effect. Sparks should be avoided unless a very 
prolonged effect, as obtained from minute blisters, 
be desired. 54 
HIGH-FREQUENCY PRACTICE 
AUTO-CONDENSATION. 
Auto-condensation means that the patient forms a 
part of the condenser in the circuit of the high-fre- 
quency current. An auto-condensation couch con- 
sists of a metal plate attached to one pole of a high- 
Fig. 16.—Auto-condensation Couch and Patient. 
frequency apparatus on the top of which is an insu- 
lating mattress upon which the patient lies. The in- 
sulating material may be of mica, glass, rubber, felt 
or cushion material. The other pole of the machine 
is held in the hands. The plate underneath the mat- 
tress becomes one side of the condenser, similar to HIGH-FREQUENCY CURRENTS 
55 
the lining of a Leyden jar, the patient becomes the 
other plate of the condenser, corresponding to the 
outer coating of the jar. The mattress forms the 
dialectric and corresponds to the glass of the Leyden 
jar. The current enters the plate on one side and 
sets up another current in the patient’s body by in- 
duction, and finds its exit thru the electrode held in 
the hands. This arrangement condenses electricity 
Fig. 17.—Auto-condensation Chair Pad 
in the patient’s body and he undergoes many millions 
of oscillations per second. This produces profound 
effects upon the vasomotor mechanism which causes 
a reduction in blood-pressure, an increased metabol- 
ism as well as an increased elimination of the products 
of combustion and toxins. 
In auto-condensation a chair pad may be substi- 
tuted for the mattress. A chair pad is made in two 
sections hinged together, one part forming the seat 56 
HIGH-FREQUENCY PRACTICE 
and the other the back of the chair. The pad con- 
sists of some indurated fiber covering two sheets of 
metal connected by wire or other metal hinges. 
Fig. 18.—Auto-condensation Pad and Patient. 
This form is very convenient and probably most 
frequently employed. A thick dialectric mattress has 
the advantage of better diffusion of current thruout 
the patient and lessens concentration of current at 
points of poor contact with the pad. If a strong cur- 
rent be employed with a thin dialectric, there is con- 
siderable brush discharge passing to the patient, which HIGH-FREQUENCY CURRENTS 
57 
is more or less disagreeable and lessens the effect upon 
the general circulation. In case it be desired to ad- 
minister more than 800 milliamperes in auto-condensa- 
tion the thick mattress is to be preferred. 
AUTOCONDUCTION. 
Autoconduction is another form of procedure to 
secure the same effects as auto-condensation. In auto- 
conduction there is another solenoid or cage added to 
the d’Arsonval apparatus which is made large enough 
for the patient to be placed therein. The principal 
difference between auto-condensation and autocon- 
duction is that in the latter the patient forms part of 
the coil while in the former he forms part of the 
condenser. Some operators favor autoconduction for 
reducing blood-pressure, but there is not enough dif- 
ference in the effects to compensate one for giving the 
cage space in the office. 
LOCAL AUTO-CONDENSATION. 
If for any reason local auto-condensation be de- 
sired it may be applied by connecting one pole of the 
d’Arsonval current to a couch upon which the patient 
reclines, the other pole being connected with a metal 
or vacuum electrode applied to the patient with rub- 
ber, glass, several layers of gauze which have been 
saturated with salt solution, or any other dialectric 
interposing. 58 
HIGH-FREQUENCY PRACTICE 
EFFECTS OF AUTO-CONDENSATION. 
While under treatment by auto-condensation, there 
is no sensation experienced other than that of warmth 
to the hands and wrists from holding the electrode. 
High-frequency currents become condensed in pass- 
ing thru limited areas, and as the wrists are smaller 
than other parts thru which the current passes in 
auto-condensation, the greatest heat will be felt in 
them. Usually the left is smaller than the right wrist, 
consequently it will experience the greater degree of 
heat. 
Auto-condensation is a great factor in the reduc- 
tion of blood-pressure, the effects being due to an in- 
crease of tissue changes by increasing oxidation, elimi- 
nation of waste products in the urine due to a more 
complete oxidation of nitrogenous matter in the body; 
its special effects upon the protoplasm of tissue cells; 
its elimination of carbon dioxid and its rapid elimina- 
tion of toxins; its increasing oxygen-carrying power 
of the blood, as well as increased amount of hemo- 
globin. These effects are due to an action upon the 
sympathetic nerves controlling vasomotor, secretory 
and peristaltic functions. 
There is a general soothing effect upon all pain- 
ful conditions. Some patients experience a drowsy 
sensation on coming from the auto-condensation couch, 
while others feel exhilarated. In either case it is ad- 
visable to administer laxatives between treatments to 
avoid effects of increased metabolism. HIGH-FREQUENCY CURRENTS 
59 
Fig. 19.—The Vulcan High-Frequency Treatment 
Apparatus, Type “D.” This machine is capable of de- 
livering all forms of high-frequency current, all under 
finely graduated control of the operator. The spark gap 
may be adjusted to suit the volume and frequency of cur- 
rent desired for any purpose. The condenser of this ma- 
chine is composed of India mica. HIGH-FREQUENCY CURRENTS 
61 
The effects upon cases of hypertension are quite 
prompt; one treatment will often reduce the pressure 
from 10 to 30 mm. of mercury. In the course of twen- 
ty-four hours the pressure usually returns to within 
five to ten points of the previous day. The average 
net result is 5 mm. per treatment. While in cases of 
hyperpiesia, the result of treatment by auto-condensa- 
tion is prompt and lasting, in cases where cardiovas- 
cular changes have already taken place the reduction 
is not so marked and has a greater tendency to return, 
but even in these cases the reduction is progressive 
from day to day until the point of fixed tension is 
reached. Fixed tension will be found considerably 
above the normal in every case with cardiovascular 
change. 
Normal blood-pressure is very little, if at all, ef- 
fected by auto-condensation. All the effects of in- 
creased metabolism may be secured without any fall 
in the blood pressure. 
In cases of defective metabolism there is always 
an increased oxidation evidenced by an increased 
amount of urea in the urine and decreased amount of 
nitrogenous products in the blood. Uric acid usually 
disappears from the urine. These effects are not 
transitory, but more or less permanent. The in- 
ci eased output of carbon dioxid and production of 
heat may be easily ascertained by the usual meta- 
bolism test. 
In patients whose glandular system is in a state 
of dysfunction there may be an immediate rise in 
blood-pressure on coming from the auto-condensation 62 
HIGH-FREQUENCY PRACTICE 
couch, but this will be followed by a fall several 
hours later. 
Auto-condensation increases the body as well as 
the surface temperature. During an ordinary treat- 
ment (400 to 600 milliamperes) for a period of 12 
minutes, the rise of body temperature seldom exceeds 
1-5° F.; continuing the treatment for a long time may 
increase the temperature from *4 to 1 degree F. The 
increased heat within the body is probably due to the 
action of the high-frequency current on the vasomotor 
system causing increased cellular activity. The equal- 
ization of the general circulation is also an important 
factor in the reduction of blood-pressure. 
Contraindications and Precautions.—There are 
very few contraindications to the use of auto-con- 
densation. It should not be employed in cases of 
hypotension nor in patients whose temperature is 
100° F., or over. In cases of advanced arterioscler- 
osis, very mild current may be employed; the first 
tieatment must not exceed 300 milliamperes for a 
period of 10 minutes. If for any reason a current of 
300 to 400 milliamperes produces faintness, vertigo, 
dyspena or sleeplessness, the treatment should not be 
repeated until after the alimentary canal has been 
cleared by castor oil; if any of the above-mentioned 
symptoms appear after clearing the food tube, auto- 
condensation should be abandoned. 
Care should be exercised in the employment of any 
electric modality in the aged, as their organs are 
frail and very sensitive to electricity in any form. HIGH-FREQUENCY CURRENTS 
63 
A pricking sensation experienced by the patient 
while under treatment by auto-condensation indicates 
a lack of insulation; a folded sheet or any dialectric 
material placed between the pad and patient will re- 
lieve the situation. 
If the patient be well insulated and experiences 
faradic sparks, the fault lies in the construction of 
the machine. 
A chair or table composed wholly or in part of 
metal should not be used in the administration of any 
form of high-frequency currents. 
While undergoing treatment by auto-condensation, 
if the patient be accidentally grounded by touching 
him, or in any other manner, he will be exposed to 
disagreeable sparks. 
Care of Apparatus.—The spark gap of a high-fre- 
quency apparatus should be kept clean to secure max- 
imum efficiency and avoid unpleasant effects. The 
discharging points of single point and rotary gaps 
should, from time to time, be rubbed smooth with 
emery paper. 
If the condenser consists of Leyden jars it is neces- 
sary to keep them well filled with salt solution to pre- 
vent breaking and to secure best results; a layer of 
paraffin oil on top of the solution will prevent evap- 
oration and lengthen the time for replacing the solu- 
tion. 
If a motor or pump be part of the equipment, it 
should be cleaned and oiled after a six-hour run; it is 
well to have a set time once a week to clean up the 
machine. CHAPTER III. 
Medical Diathermy CHAPTER III. 
MEDICAL DIATHERMY, 
Definition. Differentiation. Physiology. Physiology of the 
cell. Current density. Technic. Time of treatment. Contra- 
indications and precautions. 
DEFINITION. 
The name diathermy has been accepted as the 
proper term to be applied to the method by which an 
elevation of temperature is produced in the tissues 
of the body without destructive effects. 
Other terms, such as “thermopenetration,” “endo- 
thermy” and “transthermia,” are sometimes employed 
instead of the generally accepted one, diathermy. 
Zimmern defined diathermy as “a form of thermo- 
therapy which utilizes electrical energy for the pro- 
duction of thermal effects in the depth of the tissues.” 
D’Arsonval was the first man to show that high- 
frequency currents, if allowed to pass thru the body, 
produce an increase of temperature of the tissues, but 
it remained for other investigators to apply the meth- 
od in the treatment of a variety of diseased con- 
ditions. 
The passage of an electrical current thru the tis- 
sues of the body will always produce heat, but the 
continuous current produces the greatest degree of 
67 68 
HIGH-FREQUENCY PRACTICE 
heat at the points of contact with the electrodes, and 
in order to secure penetration of heat, the application 
becomes too painful. The faradic and the ordinary 
alternating city light currents also produce heat, but 
the violent contraction of muscles precludes their use. 
it has been found that the high-frequency current 
which oscillates millions of times per second is the 
only form which can be passed thru the tissues of 
the human body without pain, muscular contraction 
or any discomforture, other than that of heat. The 
explanation of this lies in the rapid oscillations which 
prevent ionic or chemical effects. 
It was not until 1910 that the therapeutic value 
of diathermy was brought out by Nagleschmidt, thru 
the agency of an apparatus designed by himself. Dur- 
ing the same year Doyen reported his experiments 
with high-frequency currents in the treatment of 
cancer. 
He found that normal cells of the body are able to 
withstand a temperature of 140° F., while cancer cells 
are destroyed by a temperature of between 122- 
131° F. 
DIFFERENTIATION. 
The characteristic difference between the ordi- 
nary high-frequency current and a diathermic current 
lies in the windings of the secondary transformer, 
The ordinary high-frequency machine is one of high 
voltage and low amperage. In order to secure a high 
amperage for diathermy, a secondary solenoid wound MEDICAL DIATHERMY 
69 
on the principle of the stepdown transformer is ne- 
cessary. To illustrate, let us assume that the first 
coil is made of 100 turns of wire charged at 100 
volts and one ampere from the alternating current 
mains, and that the second coil has 10 turns of wire. 
This arrangement will reduce the vo’tage in the sec- 
ond coil ten times or to 10 volts 
and the amperage will be increased to ten times am- 
peres. If the secondary coil consists of but five turns 
of wire the voltage will be reduced twenty times 
and the amperage correspondingly in- 
creased twenty times or 20 amperes. 
PHYSIOLOGY. 
Heat for the aleviation of pain has been employed 
by man since history began. We are familiar with 
the soothing effects of the local application of heat 
in the form of hot bricks, poultices, hot water bottle, 
electrothermic pads, etc. 
The physiological effects of hyperemia and skin 
reflexes were not understood by our grandmothers, 
but they did know that heat applied to the skin would 
relieve pain. 
By means of high-frequency currents, we are now 
able to apply an internal poultice to the organ itself. 
By application of properly sized electrodes, we are 
able to concentrate heat in any part of the body de- 
sired. Diathermy not only soothes pain by its effects 
upon the autonomic nerves, but dilates the veins, al- 
lowing an increased supply of freshly oxygenated 70 
HIGH-FREQUENCY PRACTICE 
blood from the arteries to take the place of the stag- 
nant blood of the affected gland or tissue. 
The passage of high-frequency currents thru the 
tissues of the body sets up a violent agitation of the 
electrons of which the tissues are composed; the re- 
sistance offered to the movement of electrons results 
in heat. As the density of high-frequency currents 
is under our control, we are able to increase the agi- 
tation of electrons and thus raise the temperature of 
any part desired. While every tissue traversed by the 
current will resist its passage and thus produce heat, 
the greatest concentration may be directed to any part 
by properly shaped electrodes. 
There is more or less heat introduced into the tis- 
sues by a high-frequency current, but the greater 
part of the heat is produced by violent agitation of 
the electrons of the tissues. In other words, there is 
an actual generation of heat in the tissues. 
Conductive heat applied to the skin has but little 
penetration and its effects are principally reflex in 
character; no heat of importance reaches the tissues 
underneath the skin. Radiant heat from high power 
electric light lamps is more penetrating than con- 
ductive heat, but it is quite improbable that it pene- 
trates to any material depth of tissues underneath the 
skin. 
The greatest resistance to the passage of direct 
current electricity is offered by the skin, hence the 
heat effects are concentrated therein. The skin offers 
very little resistance to the passage of high-frequency MEDICAL DIATHERMY 
71 
currents, the heat destiny being equal thruout the 
tissues between electrodes of the same area. Bone 
offers the greatest resistance of any of the tissues of 
the body and retains the heat for a longer period of 
time; after becoming thoroughly heated, bone slowly 
gives up heat to the surrounding tissues making this 
feature a useful one in therapeutics. 
PHYSIOLOGY OF THE CELL. 
The cell is the physiological working basis of all 
vegetable and animal organism and without a proper 
electrical balance, ceases to function. 
The human body is the most marvelous laboratory 
of which we have conception. Each cell being a little 
workshop where the mysterious work of metabolism is 
carried on. The animal cell is the true analogue of 
the primary cell of a battery. The contents of the 
cell proper is a colloidal substance which we call pro- 
toplasm and has alkaline reaction; within this 
mass of protoplasm is the nucleus separated there- 
from by a semipermeable membrane, thru which the 
potential of the cell is maintained by osmosis. The 
nucleus is composed mostly of chromatin or nuclein, 
and is of an acid reaction, probably due to nucleinic 
acid. 
The vitality of the cell depends upon the permea- 
bility of its membranes, maintenance of potential and 
oxidation. These dependable qualities may be serious- 
ly impaired by excessive oxidation brought on by ex- 
cessive exercise, infection, worry, fear, anxiety or 72 
HIGH-FREQUENCY PRACTICE 
trauma. Certain drugs and glandular function play 
important roles in cellular vitality. Oxidation, while 
a normal process of cell function, may be overworked 
to such an extent that the protoplasm may be changed 
to an acid reaction, thereby changing its electrical 
potential to such an extent as to destroy its function 
and possibly the cell itself. In that condition, called 
acidosis, all cell function is seriously impaired and 
many cells are destroyed. In order for these billions 
of workshops to keep up their metabolic efficiency, 
there must be a sufficient supply of proper material 
and an escape for its waste products, without which 
work ceases and the shop becomes effete junk and 
has to be removed by other workshops or become a 
nidus of that condition which we are pleased to call 
disease. 
We know that heat applied to the cell increases 
oxidation and may be so concentrated as to destroy it. 
While medical diatheimy properly applied will greatly 
increase the supply of fresh arterial blood, it also has- 
tens, through the channels of dilated capillaries, the 
escape of waste products and thus increases cellular 
efficiency. The mechanical bombardment of the cell 
by any high voltage current increases its potential 
and incites greater activity in the workshop and results 
in an increased metabolic output. On the other hand 
the cell may be overworked by a too prolonged appli- 
cation of the current and result in cellular dysfunction 
as evidenced by sore muscles and fatigue. MEDICAL DIATHERMY 
73 
Clinical observations and many laboratory tests 
show conclusively that a moderate degree of heat in- 
creases cellular activity and that all electric currents 
increase metabolism. 
The end result of all internal glandular and muscu- 
lar activities incidental to the maintenance of life is 
heat and the level of vital activity may be inferred from 
the amount of heat produced. 
Dr. deKraft says: “Venous congestion wherever 
present is relieved because of the marked activity of 
the arterial circulation. Anemia of the splanchnic area 
ensues, visceral congestion is relieved. The liver, the 
intestines and other organs within the abdominal cavity 
are made to disgorge the stagnant pools of blood which 
bathes their structures. When the action of the dia- 
thermic current has subsided and the blood stream re- 
turns again to its normal channels, freshly oxygenated 
arterial blood enters in greater abundance into the pre- 
viously anemic and (before heating) venously congested 
area. The parts are placed in a better state of defense 
against invasion of toxins and bacterial colonies.” 
It will be found that in individuals with subnormal 
temperatures the application of diathermy will raise 
the temperature to normal, improve the appetite, in- 
crease weight, promote sleep and a feeling of comfort. 
The passage of high-frequency currents through 
any portion of the body raises the temperature of the 
part several degrees. The heat, while concentrated be- 
tween the electrodes, if long continued will be distri- 
buted by the general circulation and will heat up the 74 
HIGH-FREQUENCY PRACTICE 
entire body. If it were not for the increased activity 
of the circulation set up in the tissues under the elec- 
trodes by the application of diathermy the parts would 
become very much overheated. 
When general diathermy be given (hand to hand) 
for the purpose of heating the entire body, the wrists 
of the patient become very hot and painful. This may 
be avoided by substituting large block tin sheets (4x7) 
for the hand electrodes. The large electrodes should be 
moulded to fit the flexor surface of the forearms and 
carefully watched to prevent burns. Some operators 
place pads well moistened with salt solution underneath 
the electrodes; this procedure changes the character of 
the current effects as salt acts more or less as an 
insulator. 
In hand to hand diathermy the temperature varies 
in different regions of the body. The highest temper- 
ature will be observed in the wrists and becomes grad- 
ually lower as the current approaches the trunk. The 
temperature in the axilla and in the mouth is about the 
same; in the lower limbs the temperature gradually 
falls from the body to the toes where there is no per- 
ceptible change. 
In foot to foot diathermy the highest temperature 
is found in the ankles and popliteal spaces and gradu- 
ally becomes less as the current approaches the toro; 
the temperature in the rectum and mouth will be found 
to be about equal; in the upper limbs the temperature 
gradually falls from the axilla to the wrists where no 
perceptible change is found. MEDICAL DIATHERMY 
75 
In these applications the rise in temperature is due 
to the general heating of the blood as it passes through 
the heated area. 
When the current is directed through the abdomen 
or chest the temperature in the mouth is little affected, 
the heat being concentrated between the electrodes. Dia- 
thermy applied to the knee joint is more effective in 
raising the body temperature than when applied to 
the body itself; this is probably due to the close prox- 
imity of the electrodes to the circulating blood and to 
the heating of it as it passes. 
When electrodes are placed on the same surface of 
a limb or body there will be little penetration of heat 
as high-frequency currents take the shortest route be- 
tween the electrodes. For example: if one electrode be 
placed on the posterior aspect of the thigh and the 
other on the calf of the leg the heat will only penetrate 
the skin between the electrodes, but if one be placed on 
the anterior aspect of the thigh and the other on the 
calf of the leg the entire limb between the electrodes 
will be heated. 
The elevation of temperatuie caused by diathermy 
has nothing in common with fever from disease. After 
cessation of treatment the temperature soon returns 
to normal. 
The activity of heated blood set up by the rapid 
oscillations of the current causes flushing of inflamed 
tissues which promotes drainage and absorption of in- 
flammatory products and deposits. 76 
HIGH-FREQUENCY PRACTICE 
Heavy diathermy treatments cause, in the obese, a 
liquification of fat and consequent increase of acetone 
in the urine. 
Diathermy produces marked analgesic effects and 
relieves all kinds of pain. Relief from diathermia is 
more lasting than from conductive or radiant heat. 
The long continued relief experienced by heating the 
deep tissues is due to the slow return to normal tem- 
perature; the cooling of tissues takes place by conduc- 
tion through the circulation while skin cooling is rapid 
through radiation. 
Bergonie says: “In cases of defective alimentation, 
diathermy, by supplementing the natural heat-produc- 
tion of the body, relieves the strain on the weak diges- 
tive system, and replaces to a certain extent the calo- 
ries usually derived from food.” 
The diathermic current takes the shortest path be- 
tween the electrodes instead of the one of least resist- 
ance. With the single exception of bone the tissues of 
the body are about equal in conductivity. Longtitudi- 
nal and cross sections of muscular fiber are equally re- 
sistant to diathermic currents. In heating tissues the 
only consideration is the structural mass of the tissues 
between the electrodes; the greater the mass the greater 
amount of heat required. A low milliamperage ap- 
plied for a long period of time will heat the part more 
effectually than a heavy current for a short time. 
It has been found by placing one electrode on the 
back and the other over the epigastrium that the tem- 
perature within the stomach is higher when a current 77 
MEDICAL DIATHERMY 
of 300 milliamperes is employed than when one of 2000 
milliamperes is used. 
The deep effects of heat may be studied through 
the laryngoscope by application of diathermy to the 
larynx or by placing one electrode over the hypogas- 
trium and the other over the sacrum of a female and 
observing through the speculum the changes taking 
place in the cervix. 
All vital energy and activity come from the com- 
bustion of organic material. The more fuel we burn 
the greater our activity and vitality. It is therefore 
apparent that stimulation of metabolism raises the 
energy of the organism and is of first importance in 
the conservation of health. 
The production and elimination of body heat are 
prominent factors in the treatment of diseased condi- 
tions. The abstraction of heat from the body necessi- 
tates oxidation to replace the lost heat. Any condition 
that promotes heat discharge stimulates oxidation and 
metabolism. 
Health and vigor are associated with active meta- 
bolism. Anything that interferes with dissipation of 
body heat lowers metabolism and produces debilitating 
effects, examples of which we have in low diet, indoor 
life and sedentary habits. 
Practically all cases that come to the physician are 
ones of defective anabolism or katabolism many of 
whfeh are amenable to diathermy. 78 
HIGH-FREQUENCY PRACTICE 
There is no means at the command of the physi- 
cian so potent in correcting deranged metabolism as 
high-frequency currents. 
Dr. George W. Crile says: “In what way may heat 
exert its beneficial influence? Grant the premise that 
the natural defense of the organism against infection 
is made through the agency of phagocytosis and the 
chemical antagonism of the blood plasma, it becomes 
evident that in either case the defense is chemical. The 
fact that the defense is chemical gives at once a clue to 
the mechanism by which heat assists the defense against 
bacteria. It is probable because with the rise of each 
degree of temperature in any system, inorganic or bio- 
logic, that chemical activity is increased 10 per cent 
and the electric conductance per cent. The in- 
creased chemical activity increases the chemical de- 
fense. The increased electric conductance increases the 
metabolism. Therefore, we may suppose that heat ac- 
celerates the chemical defense as far as it involves 
chemical defense of the blood plasma, and that the heat 
aids also by increasing the total amount of blood in the 
inflamed part, thereby increasing the number of phago- 
cytes.” 
Cumberbatch says: “The warmth which is felt 
when the high-frequency current traverses the body is 
due to the actual generation of heat in the tissues while 
the current overcomes their resistance. To generate 
perceptible heat the density of the current must be high. 
If it is low, no sensation of any kind will be perceived. 
A high-frequency current is also unable to produce 
any chemical (electrolytic) changes in the tissues. It MEDICAL DIATHERMY 
79 
Fig. 20.—Current Density between two electrodes of 
the same area is equal throughout. 
Fig. 21.—Current Density at A is four times greater 
than at B. 
Fig. 22.—Current Density is four times greater at B than at 
A or C. MEDICAL DIATHERMY 
81 
Fig. 23.—DESICCATION. Current Density at needle point. 
Fig. 24.—ELECTROCOAGULATION 
A—Area of coagulation; B—Area of sterilization; E—Electrodes. MEDICAL DIATHERMY 
83 
flows for such a short time in either direction before 
reversal that it is unable to impart any movement to 
the ions in the tissue fluids. The ions therefore do not 
migrate to the electrodes and so cannot give up their 
electric charges and form new chemical compounds.” 
CURRENT DENSITY. 
There are a few basic principles in the application of 
diathermy which should be memorized: The density 
of a current varies in accordance with the area of the 
electrode. The density increases in inverse proportion 
to the square of the surface of the electrodes. For ex- 
ample : An electrode 8 inches square contains 64 square 
inches and another 4 inches square contains 16 square 
inches. If the 8-inch electrode be placed on one side of 
the body and the 4-inch electrode on the opposite side, 
each square inch under the 4-inch electrode will receive 
four times the heat of that under the 8-inch electrode. 
This knowledge of the density of current enables us 
to concentrate heat at any point desired. For example: 
in pneumonia we find the affected area to be near the 
anterior portion of the lung, and desiring to concen- 
trate the heat at the point of greatest activity of the 
disease we place a large electrode on the back and a 
small one in front. If the disease is one affecting an 
entire lobe we use electrodes of equal area. 
Theoretically the effects of heat currents vary as 
the square of the amperage. If a milliamperage of 200 
is being given and a change is made to 400 milliamperes, 84 
HIGH-FREQUENCY PRACTICE 
the meter reading has been doubled but the heat ef- 
fects have been quadrupled; if the milliamperage be in- 
creased from 200 to 800 the heat effects have been in- 
creased sixteen times. 
Fig. 25.—Fischer Military Model Diathermy Outfit. 
This apparatus is capable of delivering upward of 2,500 
milliamperes in diathermy and an average of 1,450 milli- 
amperes in auto-condensation. It is dependable and well 
adapted for surgical diathermy. 
In practice upon the living subject this principle 
does not hold, because when strong currents are em- 
ployed the body reflexes are stimulated to such an ex- 
tent that all the functions which regulate heat in the 85 
MEDICAL DIATHERMY 
body are stimulated to combat the heat from the out- 
side, but when the smaller current strength is employed 
the reflexes are not stimulated, allowing the current 
to get by. 
TECHNIC. 
Electrodes.—The choice of electrodes is of first im- 
portance in diathermy. Heavy metal electrodes are 
furnished with all high-frequency machines which, for 
many applications are satisfactory, but over bony prom- 
inences are useless. In selecting an electrode the con- 
tour of the surface to which it is to be applied must be 
taken into consideration; the object being perfect con- 
tact at all points. The experience of the writer leads 
him to select a metal electrode composed of block tin 
as they possess the following advantages: 1. They are 
pliable and can be made to conform to almost any con- 
tour of surface; 2. They are easily fashioned for the 
individual case in hand; 3. They are not easy to cor- 
lode and are easily kept bright and clean. 
In fashioning tin electrodes the edges must be made 
smooth in order to prevent sparking; this is easily ac- 
complished by turning the edge backward; they should 
be oval or circular in form and of proper size for the 
administration of the dose desired. As a general rule 
15 square inches of surface for each 1000 milliamperes 
of current should be employed. Wherever possible the 
electrodes should be securely fastened by means of a 
roller bandage. When employed on the back of a pa- 
tient the weight of the body may secure proper con- 
tact. On the front of the body they may be weighted 86 
HIGH-FREQUENCY PRACTICE 
down with sand bags or held firmly in place with the 
hands. 
Even contact must be secured to prevent concen- 
tration of current and consequent burns. Usually the 
sensation of the patient will be a proper guide, but in 
cases of skin anesthesia it proves no guide at all. Again, 
sometimes the first contact of the current with the 
skin anesthetizes it to such an extent that a burn may 
occur regardless of precautions; at any rate the pa- 
tient’s toleration should not be exceeded; if a greater 
effect be desired than the patient seems to tolerate the 
amperage should be reduced and time of application 
lengthened. Better results are obtained by a low am- 
perage and long time than by high amperage for a 
short time. Naturally the more tissue between the elec- 
trodes the greater the resistance, and this must be 
taken into consideration in choosing the size of the 
electrodes to be employed. In medical diathermy the 
metal is placed in direct contact with the skin, but 
some operators interpose 10 to 20 layers of gauze 
thoroughly soaked in salt solution. 
Sodium chlorid solution is an excellent electrolyte 
and being easily ionized by direct continuous currents 
increases their conductivity. High-frequency currents 
being alternating in character their conductivity is 
more or less impeded by electrolytes hence the use of 
pads wet with salt solution is illogical. The effects of 
high-frequency currents upon the body tissues are de- 
cidedly modified by salt pads. The pads being insula- 
tors the tissues receive the current by induction, the MEDICAL DIATHERMY 
87 
diathermic effects being transformed into those of mod- 
ified auto-condensation. However, in surgical dia- 
thermy where the effects are to be concentrated at or 
near the surface, their use may be justified. 
In case the patient experiences a faradic sensation 
from bare metal electrodes the skin may be moistened 
with water or soap suds which will obviate the trouble. 
Where wet pads are used they should be at least two 
inches greater in diameter than the electrode. In lo- 
cations such as prominent ribs and sternum, prominent 
spine and knee joints, bare metal electrodes are im- 
practical. 
Perfect technic is important in all treatments by 
diathermy. The apparatus must be of proper construc- 
tion and in perfect order; all connections must be se- 
cure and perfect coaptation of electrodes be secured be- 
fore the current is turned on. The current must be un- 
der perfect control of the operator and turned on grad- 
ually until warmth be felt by the patient and continued 
at that point for at least five minutes after which the 
current strength is increased gradually to the point 
desired and when treatment is completed the current 
must be gradually reduced to zero. 
Time of Treatment.—The resistance of the skin, the 
thickness of fat underneath the skin or anywhere be- 
tween the electrodes, the moisture of the tissues, the 
density of all the tissues, the reflexes of the patient, 
the distance between the electrodes, the size of the elec- 
trodes and degree of temperature desired, all enter into 
the consideration of time for each treatment. The 
greater the skill of the operator the better the results. 88 
HIGH-FREQUENCY PRACTICE 
CONTRAINDICATIONS AND PRECAUTIONS. 
Diathermy is positively contraindicated where there 
is a recent history of hemorrhage; no matter where the 
hemorrhage be from that part must be avoided. While 
Fig. 26.—Hand-to-Hand Diathermy. Useful in brachial 
neuritis and insomnia without known pathology. 
papillomata of the bladder are easily destroyed by dia- 
thermy, a most disagreeable hemorrhage might occur 
therefrom through an application of high-frequency 
current to the prostate. It should not be applied to the 
pelvis if there be a recent history of bleeding. It should MEDICAL DIATHERMY 
89 
Fig. 27.—Foot-to-Foot Diathermy. Useful in cold 
limbs of the aged, sciatica, etc. MEDICAL DIATHERMY 
91 
not be employed within 24 hours of the menstrual pe- 
riod. Pregnancy is a positive contraindication to its 
use below the waistline. 
Fig. 28.—Diagram showing location of posterior elec- 
trode in Diathermy of Liver, Kidney and Pelvic Organs 
Diathermy powerfully stimulates the secretion of 
glandular organs consequently it should not be applied 
to the thyroid gland in hyperthyrodism. It should not 
be applied to any place where there is a collection of 
pus. The strepto and staphlococci are increased by 92 
HIGH-FREQUENCY PRACTICE 
the stimulation and there might be sufficient absorption 
to produce pyemia. However, diathermy is often of 
great service in pus accumulations where there is good 
Fig. 29.—Portable Combination Type “K”—Fischer 
drainage. It should not be applied to an acutely in- 
fected joint; it is therefore contraindicated in acute 
rheumatism. 
It is best to avoid its application to sinuses of the 
head unless there be good drainage. It should not be MEDICAL DIATHERMY 
93 
employed in gall-bladder infection unless there be drain- 
age through the common duct. Gastric, duodenal and 
other internal ulcers are positive contraindications to 
diathermy. 
In giving treatments by diathermy it is important 
to see that no part of the body is constricted by tight 
clothing as the heat will concentrate wherever the cir- 
culation is impeded. When bandages are used to hold 
electrodes in place, care should be exercised to see that 
they are not too tightly applied. Through stimulation 
of the circulation the tissues swell to such an extent 
that bandages may unduly constrict the part. CHAPTER IV. 
Surgical Diathermy CHAPTER IV. 
SURGICAL DIATHERMY. 
Definition. Desiccation. Advantages of desiccation. Disad- 
vantages of desiccation. Effects of desiccation. Technic. Fi- 
guration. Electrocoagulation. Advantages of electrocoagulation. 
Disadvantages of electrocoagulation. Types of electrodes. Points 
in technic. 
Definition.—Surgical diathermy is rapidly becom- 
ing the method of choice in dealing with malignant dis- 
ease about the face, mouth and throat. It differs from 
medical diathermy simply in the density of the current 
applied. In medical diathermy the object to be attained 
is to raise the temperature of the tissues without de- 
structive effects while in surgical diathermy the ob- 
ject is the destruction of the tissues by heat. When the 
current is concentrated by means of special electrodes 
the current density may be increased to a degree suf- 
ficient to destroy not only soft tissues but bone as well. 
Before attempting to employ surgical diathermy on 
living tissue the operator should become familiar with 
its effects on dead tissue. The destruction of living 
tissue requires a greater degree of density of current 
than dead tissue on account of the circulating fluids of 
the body which rapidly carry away the heat. 
Considerable skill and practice are required to be 
able to judge the amount of heat required to completely 
97 98 
HIGH-FREQUENCY PRACTICE 
destroy malign tissue without unnecessary destruction 
of normal tissue. 
Surgical diathermy contemplates two distinct meth- 
ods of destruction of tissues, and are known as desic- 
cation and electrocoagulation. 
DESICCATION. 
Desiccation is a dehydrating process, rupturing the 
cell capsule and transforming it into a dry mass. For 
this purpose a needle point instrument known as a fi- 
guration electrode is employed. The electrode may or 
may not be brought into contact with the tissues. Usu- 
ally an air space of from one-eighth to three-fourths 
of an inch is interposed. Due credit should be given 
Dr. William L. Clark of Philadelphia for the name 
“desiccation” as well as the technic of application. 
Another method known as the “disruptive arc” may 
be employed, the technic of which is as follows: Place 
the patient on the auto-condensation couch or pad and 
connect it as in the unipolar method. Connect the elec- 
trode to a water pipe or other ground; place point of 
electrode upon the spot to be treated; switch on the 
current of sufficient strength to do the work desired. 
For mucous surfaces this method has some advan- 
tages. 
Advantages.—The advantages of desiccation as 
given by Dr. Clark are: (1) The rapid and effective 
destruction of abnormal growths without the loss of 
blood; (2) Precision, considerable area may be de- 
stroyed without infringement upon normal tissues; (3) SURGICAL DIATHERMY 
99 
Fig. 30.—Desiccation by the Indirect Method. SURGICAL DIATHERMY 
101 
no instrument of any kind enters the growth; (4) nor- 
mal cells are left intact; (5) sterilized wounds result; 
(6) the blood and lymph channels are sealed which les- 
sens the likelihood of metastasis in malignant cases; 
(7) the cosmetic result is good, leaving no contracted 
cicatricial tissue. 
Desiccation Effects.—The area and depth that may 
be desiccated with one application are controlled by 
the operator and depend not only upon the current 
strength but on the distance of the electrode from the 
part, time of application, density of tissue and whether 
the unipolar or bipolar method be employed. 
Desiccation is usually but not always contraindi- 
cated in neoplasms that are covered with healthy skin, 
as in order to reach the diseased tissue the skin must 
be removed or destroyed. After desiccation a dry crust 
forms and the time required for separation depends 
upon the character of the tissue. In case of mucous 
membranes the desiccated tissue soon becomes macer- 
ated by the secretions and may separate in a few hours 
while on the skin surface 10 to 21 days are required. 
Regeneration of skin takes place underneath the crust. 
The crust should remain until the healing has taken 
place underneath. No application to the crust is nec- 
essary ; let it dry and fall. 
Indications.—Desiccation is applicable to the treat- 
ment of warts, moles, nevi, tatoo, powder and coal 
marks, keloid, papillomata of the urethra and bladder, 
urethral caruncle, unrethral granulations, closed crypts 
of Morgagni, tumors in the nose, throat, mouth and 102 
HIGH-FREQUENCY PRACTICE 
larynx, diseased tonsils and hemorrhoids. It is specific 
in tuberculous ulcers of the throat, rectum and bladder. 
Fissures that can be reached by the electrode require 
but one application. 
Fig. 31.—Desiccation of Warts, Moles, etc. 
Technic.—There is little to be said regarding tech- 
nic. When the electrode is brought within 1/8 of an 
inch from the part, with current of sufficient strength 
the electrons are thrown from the electrode into the 
tissues, the sparks following one another with such SURGICAL DIATHERMY 
103 
rapidity that to the eye the appearance is that of a 
luminous glow. 
A few long sparks applied at first will usually an- 
esthetize sufficiently the point to be destroyed, except 
in supersensitive persons. A local anesthetic of pro- 
cain may be used where the growth is non-malignant. 
In rare cases a general anesthetic is required. Where 
the field of operation is in the mouth and throat a topi- 
cal application of cocain and adrenalin is usually suf- 
ficient. See Diseased Tonsils. 
Fulguration.—The term fulguration is commonly 
used when desiccation, electrocoagulation or genuine 
fulguration by the deKeating-Hart method is employed. 
Fulguration as practiced by deKeating-Hart does not 
destroy tissue. The method consists of applying long 
sparks of 6 to 10 inches to the field in malignant dis- 
ease after radical operation, changing the nutrition of 
the part to such an extent as to prevent the formation 
of cancer cells. 
ELECTROCOAGULATION. 
Doyen employed the high-frequency current for the 
destruction of cancer cells by heat. The cell destruc- 
tion in this method is the result of tissue coagulation. 
The electrode is applied 'directly to the part with the 
opposite pole placed on some indifferent part of the 
body. The tissues are coagulated to almost any desired 
depth by simply prolonging the time of application. 
This method is diathermy carried to the point of de- 
struction of tissue. Electrocoagulation has been em- 
ployed for the treatment of benign as well as malign 104 
HIGH-FREQUENCY PRACTICE 
tumors by Doyen and Luys in France, Berndt in Aus- 
tria, Nagleschmidt of Germany, Clark and many others 
in America. Dr. Georges Luys of Paris employs a 
combination of galvanocautery and electrocoagulation 
in tunneling the prostate for the purpose of restoring 
the urethra to normal in cases of prostatic hypertrophy. 
Fig. 32.—Experiment on Meat. Electrode % inch in 
diameter applied 10 seconds. Current strength, 700 milli- 
amperes. Area of coagulation, y2 inch wide and % inch 
deep. 
Advantages.—1. The operation is bloodless; 2. 
There is no shock; 3. The parts are thoroughly steri- 
lized; 4. Dangers of metastasis are practically nil; 5. 
Tumors otherwise inoperable may be safely removed; 
6. The operation is easily and quickly done; 7. Post- 
operative adhesions are rare; 8. Rapid convalescence. 
Disadvantages.—1. Destruction of important blood 
vessels and nerves. 2. Secondary hemorrhage from im- 
portant blood vessels which have been overheated. 3. SURGICAL DIATHERMY 
105 
Formation of keloid in operations on skin surfaces. 4. 
Destruction of periosteum when operating on tissues 
close to bone. 
The difference between effects of electrocautery and 
diathermy lies in the fact that in the former the tis- 
sues are heated from without while in the latter the 
heat comes from the tissues themselves. In electro- 
cautery a hot electrode is plunged into the tissues and 
is rapidly cooled resulting in a superficial carbonization. 
In electrocoagulation the tissues are gradually cooked 
for some distance about the electrode. 
Dose.—It is impossible to state the amperage re- 
quired in any particular case. Much depends upon the 
size of the electrode. Generally speaking the depth of 
coagulation is the same as the diameter of the elec- 
trode, but this depends upon the strength of current 
and time of application. 
An amperage of 300 is sufficient in small operations 
while in large operations a current strength of 2000 
milliamperes may be required. 
TYPES OF ELECTRODES. 
The indifferent electrode should be 8 to 10 inches in 
diameter and must fit perfectly to avoid a burn. All 
connections must be perfect. Choice of active elec- 
trode depends upon the character and situation of the 
part to be treated. It must be well insulated. 
Many active electrodes are fashioned to suit the 
fancy of the operator among which the following list 
will be found useful: 1. Circular or oval plates varying 106 
HIGH-FREQUENCY PRACTICE 
in diameter from 1/8 to 1 inch. 2. Properly constructed 
needles for the treatment of nevi and papillomata. 3. 
Button shaped electrodes for coagulating base of tumors 
after removal and for cavities. 4. Scalpel shaped elec- 
trodes 1/8-inch in width and 1 inch in length for the 
ablation of tumors. 
Technic.—After the electrodes are properly placed 
switch on the current at zero and gradually increase its 
strength until the effect desired is produced. The cur- 
rent should be switched off as soon as sparks are seen 
to jump from the edge of the electrode to the surround- 
ing tissues. If for any reason sufficient coagulation 
has not taken place when the sparking appears, the tis- 
sues may be saved from carbonization by the applica- 
tion of a few drops of normal salt solution which acts as 
an insulator. Always switch off the current before 
removing the electrodes. In small operations the coag- 
ulated mass should be left in situ to slough later on. 
Anatomy of the part to be treated must be understood 
in order to avoid coagulating the walls of important 
blood vessels and destruction of nerves. If the part to 
be removed be pierced by large arteries they must be 
ligated before the operation. Care must be exercised 
when coagulating tissues over bone as destruction of 
periosteum means slow convalescence. Considerable 
edema follows operations in the mouth and throat, so 
much so that the operator should prepare for tracheo- 
tomy. However, this extreme measure is seldom called 
for. 
It is important that the operator become familiar 
with the action of currents of various densities upon SURGICAL DIATHERMY 
107 
Fig. 33.—Surgical Diathermy Electrodes. SURGICAL DIATHERMY 
109 
dead tissue before he attempts operative diathermy on 
living tissue. Many experiments on beef steak will be 
required to enable the operator to closely approximate 
the depth of the coagulation process on living tissues. 
As a general rule the requirements are: More current 
and longer time on living than dead tissue. The acti- 
vity of the circulation in the part to be destroyed is an 
important factor in arriving at the probable time and 
amperage required in each individual case. The greater 
the circulatory activity, the stronger the current or 
longer the time required. The greater the diameter of 
the electrode the greater the time required. In operat- 
ing on living tissue the depth of coagulation may be 
roughly estimated by the width the tissue is dehydrated 
around the electrode; the depth being approximately 
twice the distance of the coagulated tissue at side of 
the electrode. Again, this may be no guide at all, much 
depending upon the rapidity of the operation. When 
the current is applied slowly giving the circulation time 
to adjust itself, the coagulation will be more uniform 
and charring of tissues obviated. 
As the tissue about the electrode becomes dried out 
as evidenced by its pale color, there is a tendency for 
the current to spark across to moist tissue beyond, the 
result of this sparking is carbonization or charring of 
the normal tissue, which should be avoided. As soon 
as the tissue is coagulated there will be an escape of 
particles of steam. Considerable experience is required 
to know the exact distance from the electrode the steam- 
ing should extend before sparking takes place. How- 
ever, in any ease if sp&rks appear the current should be 110 
HIGH-FREQUENCY PRACTICE 
turned off or salt solution applied. The smaller the 
diameter of the electrode the sooner coagulation takes 
place. As an average proposition with an electrode of 
1/4 inch in diameter the tissue will coagulate and steam 
escape in 8 to 10 seconds. If a disc electrode to which 
spikes are attached be employed, the depth of the coag- 
ulation will be in direct ratio with the length of the 
spikes and area of tissue covered by the disc. For ex- 
ample: When spikes one-half inch in length and set 
one-half inch apart are plunged into the tissues, the 
Pig. 34.—Fischer Foot Switch. A convenient device 
in urological work. 
depth of coagulation will be one-half inch below the 
points of the spikes. Disc electrodes of a larger diame- 
ter than one inch are impracticable because the current 
density is not sufficient to coagulate the tissue in a rea- 
sonable time. When the area to be coagulated cannot be 
covered by a disc of one-half inch in diameter, it is bet- 
ter to move the electrode than use a larger one. When 
the depth of the tissue to be coagulated exceeds one-half 
inch it is advisable to employ the spike electrode. 
Another factor in depth of coagulation is the degree 
of moisture in the tissues. The drier the tissue the SURGICAL DIATHERMY 
111 
less the penetration before sparking takes place. Perio- 
steum dries quickly and sparking occurs very soon after 
application. 
The most important matter in technic is the rapi- 
dity with which the current is increased after being 
turned on; the amount turned on should be just suffi- 
cient to warm up the tissues and gradually increased 
so that the coagulation point be reached in 40 seconds; 
if the maximum of current be employed at the start, 
the heat will suddenly dry the tissues close to the elec- 
trode and the area and depth of coagulation be limited 
at least one-half. An experiment on dead tissue will 
easily demonstrate this fact, and when applied to liv- 
ing tissue the reaction of the body tissues further limits 
the area of coagulation. 
When the disc or needle electrode remains after the 
tissues have become dry, it will adhere to them and 
when removed will bring particles of tissue with it. 
This unpleasant feature may be avoided by removal of 
the electrode while the tissues are still moist. In case a 
disc electrode does adhere a few drops of hot salt solu- 
tion on the electrode will facilitate its removal. When 
coagulated tissue adheres to the needle electrode it must 
be cleaned before using again by boiling in salt solu- 
tion. ' 
Coagulated tissue mass should not be removed but 
allowed to slough unless it is impossible to reach the re- 
quired depth without, in which case a portion of the. 
growth may be removed with the diathermy, knife and 
the base coagulated by the disc electrode. 112 
HIGH-FREQUENCY PRACTICE 
The tissues about blood vessels will become coagu- 
lated with less heat than the vessels themselves because 
the moving blood cools the vessel walls but the forcible 
removal of coagulated tissue near blood vessels is liable 
to cause a hemorrhage. When bleeding does occur the 
vascular wall has been destroyed but no thrombus has 
formed. Under such circumstances the bleeding is best 
controlled by a disc electrode pressed firmly against the 
bleeding surface with sufficient current to coagulate the 
entire vessels. Electrocoagulation should not be per- 
formed close to important blood vessels without pre- 
vious ligation. When small vessels have been coagu- 
lated the bleeding is prevented by thrombi which may 
come away with the sloughing mass and cause a sec- 
ondary hemorrhage. However, this accident rarely oc- 
curs. 
When operating close to bone care should be exer- 
cised not to destroy the periosteum or a slow healing 
will follow and a favorable nidus of infection be formed. 
Operations about the face, mouth and throat are 
quickly followed by edema of the surrounding tissues 
which lasts for two or three days. This calls for no 
special treatment unless it involves the larynx when a 
tracheotomy may become necessary. Operations on the 
larynx require tracheotomy before the operation. 
Most operations by electrocoagulation require a 
general anesthetic; ether on account of its inflammibil- 
ity should not be employed in operations in the mouth, 
throat or larynx. 
In prolonged operations where very heavy currents 
are used, the indifferent electrode should be of large SURGICAL DIATHERMY 
113 
Fig. 35.—The Wappler Telatherm. This apparatus 
has sufficient capacity for all kinds of high-frequency 
work. SURGICAL DIATHERMY 
115 
area and well padded with gauze previously saturated 
with salt solution. The pad must be kept wet or a burn 
will result. Such pads act more or less as insulators 
and their use demands a great increase of current. The 
electrode should be placed on the back or abdomen and 
be firmly secured in place by bandage or sand bags. 
Some growths are so situated as to make the oper- 
ation a greater success when no indifferent electrode 
is used. In such cases two active electrodes are em- 
ployed; one small disc electrode is placed on one side 
of the growth and the other, a spike or needle electrode 
is plunged into the tissues near the disc electrode or 
possibly on the opposite side of the growth. This pro- 
cedure is entirely with the option of the operator. CHAPTER V. 
Blood Pressure CHAPTER V. 
BLOOD-PRESSURE. 
Physiology. Etiology. Protein sensitization test. Effects of 
altitude. Blood-pressure reading. The sphygmomanometer. Es- 
sential factors. Normal blood-pressure. Conditions affecting 
blood-pressure. Hypertension. Energy index. Hyperpiesia. 
Blood-pressure interpretation. Blood-pressure therapy. 
Physiology.—The general conditions governing the 
blood-flow through the circulatory system are the same 
as those governing the flow of fluid through any system 
of tubes. The rate of flow from any such system de- 
pends upon two essential factors: (1) The head and 
end pressure of the system; (2) the caliber of the tube 
at the outlet. Raising the head pressure will increase 
the flow if the caliber of the outlet remain the same. 
The flow may be increased by enlarging the caliber of 
the outlet. 
The circulation of the blood is maintained by pres- 
sure given by the heart and the resistance offered by 
the blood vessels. Blood-pressure depends upon five 
principal factors: 
1. Heart force. 
2. End resistance. 
3. Elasticity of vessel walls. 
4. Amount of blood. 
5. Viscosity of the blood. 
119 120 
HIGH-FREQUENCY PRACTICE 
These factors vary somewhat in the norm and very 
much in disease. 
Etiology.—The exact etiology of high blood pres- 
sure has not yet been discovered, but considerable evi- 
dence has been obtained from which we are tentatively 
assured that the cause lies in certain substances cir- 
culating in the blood. These substances are called 
pressor and depressor substances because of their 
effect upon the pressor and depressor nerve fibers. 
The pressor substances are probably parts of protein 
molecules which have been split in an improper man- 
ner during the process of digestion. In cases of defec- 
tive elimination they enter the circulation, and, coming 
in contact with the pressor nerve fibers, stimulate them 
to increased activity, causing a spasm of the minute 
blood vessels with which they are abundantly supplied. 
The lumen of these small vessels is narrowed, under 
which condition the systolic pressure rises to over- 
come the resistance. This condition when prolonged 
leads to cardiac hypertrophy. 
It is also true that influences other than pressor 
substances circulating in the blood cause elevation of 
blood pressure, among which may be mentioned pain, 
worry, mental overwork, anger, etc. The last men- 
tioned causes being usually of brief duration, the hyper- 
tension consequently is not continuous. If the pressor 
substances are continually formed the hypertension 
necessarily is continuous. 
Hypertension is not a disease, but a condition 
which, if not corrected, leads to pathological changes 
in the arterial tree. BLOOD-PRESSURE 
121 
The chronological data of high blood pressure runs 
something as follows: 1. Defective metabolism result- 
ing in the formation of pressor substances which enter 
the circulation and stimulate the pressor nerve fibers 
to overactivity. 2. Hypertension due to spasm of the 
arterioles (at which time there is no evidence of arte- 
rial degeneration). Later on there are changes in the 
larger vessels. 3. Cardiac hypertrophy. 4. Kidney 
dysfunction, intracranial tension, retinal changes, 
hemorrhages, etc. 5. Chronic myocarditis and ne- 
phritis. 
Following recent discussions upon the subject of 
blood pressure it is said that depressor substances may 
be formed through another form of improper splitting 
up of the protein molecule. When a depressor sub- 
stance circulates with the blood stream it excites the 
depressor nerve fibers, causing relaxation of the walls 
of the smaller blood vessels producing another effect 
known as hypotension. 
It is well known that neurasthenia is usually accom- 
panied by hypotension, but there is not sufficient evi- 
dence at hand upon which to form a conclusion that 
depressor substances circulating in the blood is a prom- 
inent factor in the etiology of this condition. A high 
venous pressure naturally increases capillary pressure 
and this phenomenon, in a way, may account for the 
low systolic pressure in neurasthenia. 
There is a type of hypertension which results from 
spastic contraction of the external layer of the larger 
blood vessels. This phenomenon may be due to exci- 122 
HIGH-FREQUENCY PRACTICE 
tation of the sympathetic nerves with which this mus- 
cular layer is richly supplied. 
A purely local hypertension is sometimes encoun- 
tered in the hands, feet and portions of the face. To 
this form of capillary hypertension Cordier has ap- 
plied the neonym, acrocyanosis. Cordier says, “the 
primary cause seems to be some toxic action on the vas- 
omotor centers. The nervous intoxication being the 
successor to some latent infection.” 
All evidence at our command seems to prove that 
arterial disease when accompanied by hypertension is 
the result rather than the cause of the hypertension. 
Chronic nephritis associated with hypertension is pri- 
marily a vascular disease caused by hypertension. The 
glomerular lesions which are always present in nephri- 
tis are of an arteriosclerotic nature: in other words, 
nephritis is an “arterio-capillary fibrosis”—a neonym 
given to this condition by Sutton & Gull. The cause of 
the vascular changes in albuminuric retinitis is also 
found in hypertension. 
It has been suggested by workers in the field of 
endrocrinology that hypertension is sometimes due to 
hyperthyroidism and dysfunction of the sex glands 
and that hypotension is often due to adrenal insuffi- 
ciency. 
Hypertension may be due to venous stasis in the 
liver or altered viscosity of the blood. Focal infections 
may give rise to hypertension but more often they 
cause a lowering of blood-pressure. Fever, pain and 
worry generally increase the systolic pressure but have 
little effect upon the diastolic. BLOOD-PRESSURE 
123 
Heredity is a dominant predisposing factor in the 
etiology of diseases of the vascular system. Entire 
families are often found with poor vascular systems. 
Some individuals have a poor vascular system from 
birth and are destined to cardiovascular lesions in 
early and middle life. Human arteries are not unlike 
in efficiency the garden hose sold by the merchant; 
one grade will last one season, another two seasons 
while the best grade will last for years. 
To differentiate the true etiological factor in any 
particular case of hyper or hypotension requires the 
most painstaking investigation. To place one’s finger 
upon any one factor and exclaim “Eureka” is extremely 
hazardous to a correct diagnosis. Too much signifi- 
cance must not be given to any one particular symptom. 
The experience of the writer leads him to beleive that 
in a large percentage of cases of hypertension the cause 
will be found in faulty metabolism due to absorption of 
the products of incomplete alimentation. It is not usual 
for metabolism to fail to care for all proteins, but rather 
particular proteins which must be ferreted out. Many 
people acquire an anaphylaxis to certain articles of diet 
such as meat, eggs, beans or certain fruits. It is not 
the quantity of proteins consumed that produces an ana- 
phylaxis as a small amount will react as promptly as a 
larger one. 
The protein sensitization test will often assist in the 
discovery of some particular protein as the etiological 
factor. While the test does not prove absolutely that a 
particular protein is the cause it suggests that such may 
be a factor. 124 
HIGH-FREQUENCY PRACTICE 
Sensitization Test.—A slight scarification of the 
skin of the flexor surface of the forearm is made, not 
deep enough to draw blood but sufficient to penetrate 
the skin. On the scarified surface is placed the sus- 
pected protein to which is added a drop of 1/10 normal 
sodium hydroxid solution to dissolve the protein and 
permit its absorption. At the end of one-half hour the 
portein is washed off and the reaction noted. Always 
compare with normal control. A positive reaction con- 
sists of a white elevation or urticarial wheel. Positive 
reaction to any protein suggests its removal from the 
diet. The effect upon the blood-pressure should be 
carefully observed. 
Another method is the removal of all proteins from 
the diet for one week. If the blood-pressure is mate- 
rially reduced in that time it is reasonable to conclude 
that the patient is sensitive to some particular protein. 
One protein at a time is added to the diet and blood- 
pressure carefully noted until the offending one or ones 
be found, when it should be removed from the diet 
forever. 
Effects of Altitude.—In a normal individual there is 
little or no effect upon the blood-pressure until an alti- 
tude of 8000 feet is reached. Individuals with high 
pressures who have arterial changes in the form of 
sclerosis and those with poor vasmotor control do badly 
in altitudes over 8,000 feet. 
Blood-pressure Reading.—Nearly every physician 
possesses an instrument for the estimation of blood- BLOOD-PRESSURE 
125 
pressure. This instrument, the sphygmomanometer, 
consists of two types—one, a column of mercury, the 
other built upon the principle of the aneroid—both of 
which record the pressures in millimeters of mercury. 
Fig 36—Taking Blood-pressure with Mercury Sphyg- 
momanometer (Baumanometer). 
The technic in the use of both types of instrument is 
the same. The brachial artery of either arm may be 
chosen. All constricting clothing should be removed 
from the arm which rests on a table with all muscles 126 
HIGH-FREQUENCY PRACTICE 
relaxed. The manometer sleeve is applied over the bi- 
ceps, making sure that it does not impinge upon the el- 
bow joint. Do not wind too tight nor too loose. Place 
the stethoscope over the radial artery close to bend of 
the elbow; inflate the sleeve until the instrument re- 
cords ten points above where all sound ceases then al- 
low the air to escape slowly until the first distinct 
sound (a distinct click) is audible. The point regis- 
tered will be the systolic pressure. Open valve slightly 
and carefully record the point when all sound ceases, 
which point will be the diastolic pressure. The pulse 
pressure is the difference between the systolic and dia- 
stolic pressures. 
Essential Factors.—The essential factors in blood- 
pressure reading are: Systolic pressure, which repre- 
sents the energy of the heart during systoli; diastolic 
pressure, the energy exerted in overcoming resistance; 
pulse pressure, the energy exerted on the arterial walls 
and recognized as the pulse. These factors in the norm 
bear a practically fixed ratio to one another. According 
to Faught the ratio is 1, 2, 3, viz: pulse pressure 1, dia- 
stolic 2, systolic 3. Any substantial deviation from this 
ratio has its significance. 
Normal Blood-Pressure.—Many tests have been 
made to establish a table of normal blood-pressures. 
There is no hard-and-fast rule and we can but approxi- 
mate the normal pressures because a variation of ten 
points up or down may and usually does occur in the 
norm during any 24-hour period. The normal limits 
vary under the following conditions, viz: BLOOD-PRESSURE 
127 
1. Position of the Body.—About 4 mm. higher 
when standing than sitting. About 4 mm. lower in the 
recumbent than in the sitting position. 2. Muscular Ex- 
Fig. 37.—Taking Blood-pressure with Aneroid Sphyg- 
momanometer (Tycos). 
ertion.—Higher immediately after exercise, amounting 
to an average of 20 per cent, but should return to nor- 
mal within five minutes. In exertion followed by fa- 
tigue the pressure is lower than normal but should re- 
turn within an hour. 3. Excitement, Anger, Passion, etc. 
—A sudden rise which may continue for 24 hours. 4. 128 
HIGH-FREQUENCY ' PRACTICE 
Time of Day.—Lower in forenoon than in afternoon. 
5. Digestion.—A fall immediately after a meal followed 
by a gradual rise, reaching the maximum about one hour 
after the meal. 
In conducting a series of experiments on hyperpie- 
tics observations were made of the effects of food upon 
blood-pressures: A cup of coffee invariably raised the 
systolic pressure 10 to 15 mm., the pulse pressure also 
being invariably raised. A bowl of hot cereal and 
cream lowered the pressure, but when taken cold there 
was either a slight rise or no effect. A cup of tea was 
followed by the same effect as coffee. A square meal 
of meat, potatoes, bread, butter and dessert was fol- 
lowed by lower systolic and pulse pressures, but after 
two hours the systolic pressure was raised by 20 to 30 
mm., and did not return for 24 hours. Raw oysters 
were followed by a rise of 10 to 15 mm. which remained 
for 24 hours. Toast, bacon and eggs, followed in one 
hour by a rise of 10 mm., returning in 4 hours. In one 
case of hyperpesia buttermilk was followed by a rise of 
10 mm. which remained for 24 hours. However, but- 
termilk usually has the effect of lowering the pressure 
after a few days’ consumption of one to two pints per 
day. 
6. Locality.—Usually a difference of about 4 mm. 
between the right and left side arteries, also between 
the femoral and brachial arteries. A difference will be 
found between a fat and a lean arm. 
7. Sleep.—During sleep the systolic pressure in 
men is about 94 mm. and in women 88 mm. in normal BLOOD-PRESSURE 
129 
conditions. The drop during sleep is due to general re- 
laxation of the arterial musculature. Blood pressure 
elevation due to functional disturbances while awake 
is wiped out during sleep. Systolic blood pressure ele- 
vation due to pathological changes while reduced will 
be found to be 100 or over during sleep. 
8. Pain.—Intense pain will always increase blood- 
pressure—the greater the intensity the greater the ele- 
vation. Taking the blood-pressure of patients com- 
plaining of pains will aid materially in diagnosis. Gas- 
tric crises of tabes dorsalis will often raise the blood- 
pressure 70 to 80 mm. Hysterical and neurasthenic 
pains have no effect upon blood-pressure. 
9. Age.—It is quite probable that age in itself has 
no effect upon blood-pressure, the moderately elevated 
pressures found in elderly persons being due to abnor- 
mal vascular conditions. 
While different observers make tables of their own 
and all vary somewhat, the following will be found prac- 
tical and safe: 
TABLE OF BLOOD-PRESSURE AT DIFFERENT AGES. 
Age 
Systolic 
Diastolic 
10 to 17 
80 to 110 
50 to 
70 
20 to 30 
120 to 125 
70 to 
85 
30 to 40 
120 to 130 
75 to 
90 
40 to 50 
125 to 135 
80 to 
90 
50 to 60 
130 to 140 
80 to 
90 
60 to 70 
135 to 145 
85 to 100 
70 to 80 
140 to 150 
,90 to 105 
Females 10 mm. lower for same’ages. 130 
HIGH-FREQUENCY PRACTICE 
A sustained systolic pressure of over 150 or diastolic 
of 105 or over, at any age, is always pathological. 
Hypertension means a sustained blood-pressure 
above normal; hypotension means a constant pressure 
below normal; hyperpiesia means hypertension without 
cardiovascular changes. 
Hypertension does not always depend upon the 
work of the heart, since it has been noted often that in 
cases of weakness of the heart muscle the pressure may 
be high. 
The systolic pressure alone cannot be depended upon 
unless supported by the diastolic and pulse pressures to- 
gether with the pulse rate. 
It is also important to know the total amount of 
energy spent by the circulatory system in a minute or 
an hour. This information is of value in cases where 
we suspect the giving-way of the vessels—such as ap- 
oplexy and other hemorrhages. 
Barach has applied the neonyrn “Energy Index” to 
the method of obtaining the above information. He 
says: “From the pulse rate we know how many sys- 
toles and how many diastoles to each minute there are 
in the arterial tree.” For example, if the systolic pres- 
sure is 120 mm., the diastolic pressure 70 mm. and the 
pulse rate 72 per minute, the energy exerted in one 
minute would be: 
In systole 120x72 or 8,640 mm. of Hg. 
In diastole 72x72 or 5,040 mm. of Hg. 
In both 190x72 or 13,650 mm. of Hg. 
ENERGY INDEX. BLOOD-PRESSURE 
131 
The energy index is obtained by multiplying the 
sum of the systolic and diastolic pressures by the pulse 
rate. Repeated experiments show that the maximum 
energy index consistent with safety to the vascular sys- 
tem is 21,000 mm. of mercury. The normal index range 
is from 13,000 to 20,000. When less than 13,000 it sug- 
gests general weakness; when above 20,000 an exces- 
sive circulatory load which will sooner or later, if not 
corrected, lead to disastrous consequences. 
A careful consideration of blood pressures, pulse 
rate and energy index will yield an abundance of in- 
formation of inestimable value in arriving at a diagno- 
sis of many pathological conditions. 
In taking readings on the same patient over a pe- 
riod of time it is important that they be taken as near 
the same hour of the day, the same time from a meal 
and under conditions as nearly alike as possible. 
BLOOD PRESSURE INTERPRETATION 
The interpretation of signs elicited through the aid 
of mechanical diagnostic devices is liable to be faulty. 
Eased upon the readings of the sphygmomanometer, 
many conditions are erroneously assumed to be pres- 
ent, nevertheless, it is one of the most useful diagnostic 
aids in our armamantarium. 
My acquaintance with physicians who use the 
sphygmomanometer leads me to believe that a very 
large proportion of them are satisfied with systolic 
readings; a greatly reduced number take both the sys- 
tolic and diastolic pressures and but few compare these 
readings with the pulse rkte. 132 
HIGH-FREQUENCY PRACTICE 
While the systolic pressure taken alone may give 
some idea of vascular tension it is of little value in 
diagnosis. The diastolic pressure is a better guide to 
diagnosis than the systolic. Systolic pressure repre- 
sents the force of the heart to drive the blood through 
the arteries. The diastolic pressure represents the 
tension which the arterial walls exert upon the blood; 
it is the pressure that the left ventricle must overcome 
before the aortic valve opens. The systolic and pulse 
pressures show heart values and the diastolic pressure 
shows resistance to be overcome. The systolic pres- 
sure is easily influenced by psychic phenomena. It 
has been suggested that the courts take cognizance of 
this fact by submitting witnesses on the stand to blood 
pressure tests to test their veracity. If the witness 
bears false testimony his systolic pressure will sud- 
denly rise; if he is telling the truth there is no effect 
upon the blood pressure. Anger will raise the systolic 
pressure from 10 to 80 mm of mercury with little or 
no effect upon the diastolic. The elevation of the sys- 
tolic pressure is more or less a physiological process; 
the elevation of the diastolic pressure depends largely 
upon pathological changes. 
Pulse pressure, the difference between the systolic 
and diastolic pressures, when taken by itself repre- 
sents the force applied to the arteries by the heart dur- 
ing systole or the heart’s energy which produces a dis- 
tension of the arteries known as the pulse. The pulse 
pressure represents the heart load or overload and is 
of great importance in prognosis. The pulse pressure 
should bo fifty percent of the diastolic and an increase BLOOD-PRESSURE 
133 
of 40 mm in load would indicate that danger is lurk- 
ing near. 
The importance of the pulse rate in connection with 
the systolic and diastolic pressures may be appreciated 
by reference to the following examples: A normal 
systolic, high diastolic and high pulse rate suggest 
myocardial weakness—a normal systolic and diastolic 
with a low pulse rate suggest the opposite, cardiac 
hypertrophy. 
A low systolic, normal diastolic and normal pulse 
rate suggest neurasthenia while the same systolic and 
diastolic pressures with a high pulse rate suggest tu- 
berculosis or other infection. 
A high systolic, high diastolic and high pulse rate 
suggest failing heart while the same pressures with a 
low pulse rate suggest arterial changes and a competent 
heart. 
A high systolic, low diastolic with a normal pulse 
rate suggest a weak myocardium, while the same pres- 
sure with a high pulse rate points to thyroid intoxica- 
tion. 
Many other examples could be cited but these will 
illustrate the importance of considering the pulse rate 
with blood pressures in differentiating cardiovascular 
conditions. 
In typhoid as the disease progresses the systolic 
pressure gradually falls and the diastolic gradually 
rises with a corresponding lowering of the pulse pres- 
sure; the lowering of the systolic is not of much im- 
portance provided the diastolic remains normal, but 
with a descending systolic and ascending diastolic a 134 
HIGH-FREQUENCY PRACTICE 
weakening of the heart is imminent. About the third 
or fourth week of the disease, a gradual rise of the 
systolic and decline of diastolic is an indication of re- 
covery. A sudden fall followed by a rapid rise of the 
systolic points to perforation. The blood pressures and 
pulse rate are of more importance than the tempera- 
ture in prognosis of this disease. 
Blood pressures are of signal importance in tuber- 
culosis. A condition of hypotension exists for a long 
time prior to any manifestations of physical signs. 
When tuberculosis is suspected and hypotension is not 
present we may be almost assured that our suspicions 
are groundless. The differentiation between pleurisy 
and tuberculosis is often difficult; if the systolic and 
diastolic pressures are normal the evidence is in favor 
of pleurisy; if the systolic is low, diastolic normal and 
pulse rate high, the evidence is strongly in favor of 
tuberculosis. However, it is possible in cases of nephri- 
tis combined with tuberculosis that the effects of the 
nephritis on the vasomotor mechanism may offset the 
hypotension of tuberculosis, but low pressures in ne- 
phritis suggest tuberculous kidney. A gradual rise 
of systolic and gradual decline in pulse rate point to 
an arrest of the disease. In tuberculosis the pulse rate 
per minute is frequently higher than the systolic pres- 
sure in mm of mercury, but when this occurs in an 
acute disease like pneumonia an unfavorable prognosis 
is suggested. 
Hypotension always means lowered vitality and 
occurs in acute infections, chronic wasting diseases, BLOOD-PRESSURE 
135 
most nervous diseases, some cardio-vascular condi- 
tions, blood dyscrasias, intoxications, etc. 
Another factor in blood pressure interpretation 
which is often underestimated is the position of the 
patient. 
All readings especially the first should be taken in 
the horizontal (supine) sitting and standing positions. 
If these readings are reversed they indicate vasomotor 
insufficiency, myocardial weakness or an accumulation 
of blood in the splanchnic area. 
With a normal heart the pulse pressure will fall 
upon changing from the supine to erect position. 
NORMAL RELATION OF COMPONENT ELEMENTS 
OF BLOOD-PRESSURE 
Position 
S. 
D. 
P. P. 
P. R. 
E.I. 
Standing 
124 
90 
34 
84 
179 
Sitting 
120 
80 
40 
80 
160 
Supine 
116 
78 
38 
75 
145 
If there be a rise in pulse pressure on changing 
from the supine to standing position it points to car- 
diac hypertrophy. Example: 
Position 
S. 
D. 
P. P. 
P.R. 
E. I. 
Supine 
135 
70 
65 
60 
123 
Standing 
150 
70 
80 
68 
150 
The diastolic pressure in changing position from 
horizontal to erect rises in the norm. If it lowers look 
for valvular disease of the heart. Example: 
Position 
S. 
D. 
P. P. 
P. R. 
E. I. 
Supine 
135 
60 
75 
90 
175 
Standing 
135 
50 
85 
90 
166 136 
HIGH-FREQUENCY PRACTICE 
Should there be a fall in all pressures in changing 
from supine to standing position it points to cardiac 
dilatation which an examination of the heart will con- 
firm. Example: 
Position 
S. 
D. 
P. P. 
P.R. 
E. I. 
Supine 
110 
70 
40 
90 
162 
Standing 
90 
55 
35 
110 
159 
A continued pulse pressure higher than the diasto- 
lic points to failing heart, although such a condition 
may prevail for a short time in hyperpiesia. A high 
diastolic pressure always means great vascular tension 
and when constant points to cardiovascular changes. 
A normal systolic, high diastolic with high pulse 
rate suggests a poor myocardium. The deficient heart 
muscles require an increased rate of contraction to 
overcome the peripheral resistance or diatolic pressure. 
This condition leads to cardiac dilatation. Example: 
s. 
D. 
P.P. 
P.R. 
E.I. 
135 
110 
25 
100 
245 
A normal systolic, low diastolic with a low pulse 
rate suggests that the diastolic pressure is making an 
effort to compensate for an over-worked heart. This 
condition leads to cardiac hypertrophy. Example: 
s. 
D. 
P.P. 
P.R. 
E.I. 
135 
70 
65 
60 
123 
A normal systolic and pulse rate with an extremely 
low diastolic suggests aortic insufficiency. The dia- 
stolic is failing in its effort to compensate for the in- 
creased cardiac effort. Example: BLOOD PRESSURE 
137 
s. 
D. 
P.P. 
P.R. 
E.I. 
135 
40 
95 
76 
126 
A high diastolic, high systolic with but slightly in- 
creased pulse pressure and a normal pulse rate suggests 
vascular changes met with in arteriosclerosis. Ex- 
ample: 
s. 
D. 
P.P. 
P.R. 
E.I. 
210 
150 
60 
70 
252 
A high systolic, high diastolic with low pulse pres- 
sure and high pulse rate suggests failing myocardium. 
Example: 
s. 
D. 
P.P. 
P.R. 
E.I. 
180 
160 
20 
110 
. 374 
A low systolic, normal diastolic, pulse pressure and 
pulse rate suggests neurasthenia. Example: 
s. 
D. 
P.P. 
P.R. 
E.I. 
100 
70 
30 
80 
136 
A low systolic, normal diastolic and pulse pressure 
with increased pulse rate suggests cardiac insufficiency. 
Example: 
s. 
D. 
P.P. 
P.R. 
E.I. 
110 
70 
40 
100 
180 
A low systolic normal diastolic and low pulse pres- 
sure with increased pulse rate suggests infection. This 
condition is met with in tuberculosis. Example: 
s. 
D. 
P.P. 
P.R. 
E.I. 
90 
70 
20 
100 
160 138 
HIGH-FREQUENCY PRACTICE 
A low systolic and diastolic with increased pulse 
pressure suggests abnormal relation of the components 
of the blood as met with in anemia. Example: 
s. 
D. 
P.P. 
P.R. 
E.I. 
100 
30 
70 
100 
130 
The normal range of diastolic pressure is from 70 
to 90 mm. of mercury. A persistent diastolic pressure 
of 130 which cannot be reduced suggests a fatal termin- 
ation within a period of from two to five years. 
When all pressures are low general infection is sug- 
gested. In cases of hemorrhage a progressive decline in 
pulse pressure indicates a continuance of the hemor- 
rhage. 
Systolic pressure is easily influenced by physiolo- 
gical factors, while the diastolic is not so easily influ- 
enced. Systolic and pulse pressure show heart values; 
diastolic shows end resistance. 
In myocardial degeneration with or without arrhy- 
thmia there may be high blood-pressure, but sooner or 
later the pressure falls. In such cases if the pulse pres- 
sure be much over 50 per cent of the diastolic, look out 
for heart failure. In myocardial disease mild exercise 
will be followed by a fall in the systolic pressure. If 
the heart be competent there will be a slight rise in 
pressure. In cases of nerve exhaustion the systolic 
pressure may be lower in the standing than in the sit- 
ting position. Systolic pressure may be high in cases 
of weak heart due to the action of the vasoconstrictors 
in an effort to compensate for cardiac insufficiency. BLOOD PRESSURE 
139 
In organic heart affections the pulse pressure may 
be normal, but should it suddenly increase decompen- 
sation is indicated. Normally the pulse rate is 8 to 10 
beats faster in the standing than in the recumbent po- 
sition. In cases of failing heart the rate may be as 
fast in the recumbent as in the standing position. In 
aortic incompetency there is a high systolic and low 
diastolic pressure, hence a high pulse pressure. 
In mitral stenosis the systolic pressure is low on 
account of the small amount of blood passing from the 
auricle to ventricle. It is possible, however, to find 
normal pressures in valvular diseases of the heart. 
HYPERPIESIA. 
Hyperpiesia is a word coined by Dr. Clifford 
Allbut descriptive of cases of hypertension without 
marked cardiovascular changes. 
Hyperpiesia is a premonitory indication of patho- 
logical changes yet to come and is not, as has oftimes 
been supposed, the result of arterial changes. In other 
words, hypertension is now considered to be the pri- 
mary cause of structural changes in the arteries. Per- 
sistent hypertension naturally causes cardiac hyper- 
trophy which develops to overcome the resistance. This 
is a physiological and not a pathological process. When- 
ever hyperpiesia exists it may be known that in the 
course of time hypertrophy will follow unless the cause 
be removed. Heart murmurs are ear-marks of pre- 
vious hyperpiesia. 
The argument that hypertension is compensatory 
and should not be interfered with will not hold good, 140 
HIGH-FREQUENCY PRACTICE 
as the condition antedates by months and even years 
the cardiac hypertrophy and kidney lesions. 
TREATMENT OF CARDIOVASCULAR CONDITIONS. 
Much has been said and written for and against 
the use of high frequency currents in cardiovascular 
conditions, but after many years experience the writer 
is willing to go on record in saying that hyperpiesia or 
that stage of hypertension which exists for years prior 
to pathological changes in the arteries, in a large ma- 
jority of cases, can be cured by a combination of high 
frequency currents and common sense hygienic meas- 
ures. 
After a hyperthrophic condition of the smaller blood 
vessels and a mild degree of cardiac hypertrophy has 
developed as evidenced by a systolic pressure of 170 
or less, a normal or slightly elevated diastolic accom- 
panied with a normal pulse rate, the effects of treat- 
ment, while not so prompt, are satisfactory and a 
favorable outcome may be expected. 
Even after the urinary and blood findings justify 
a diagnosis of nephritis, the systolic pressure very 
high and diastolic under 120, with a slightly decreased 
or increased pulse rate, while the cardiovascular con- 
dition cannot be restored to normal, much may be done 
toward prevention of further changes in the arterial 
tree. 
The systolic pressure alone, regardless of its height, 
is no guide at all in the consideration of prognosis, but 
when the diastolic persists at 120 or above for a period 
of two years a fatal termination within one or two BLOOD PRESSURE 
141 
years more may be expected. Yet under these condi- 
tions much can be done to modify the symptoms and 
make the patient comfortable. 
High frequency currents in the form of autocon- 
densation, diathermy and the unipolar application, each 
under indications of its own, are employed in the man- 
agement of cardiovascular conditions. 
Hyperpiesia or hypertension prior to cardio- 
vascular changes is easily controlled by auto-con- 
densation. The patient should be treated daily until 
the systolic pressure reaches the same point after each 
treatment for three days in succession. This point is 
known as fixed tension and it will be impossible further 
to reduce the pressure. When the point of fixed tension 
is reached the frequency of the treatments is so regu- 
lated that this point may be approximately maintained. 
The patient for a time should report at least once a 
week for blood pressure reading. If there be no im- 
portant rise in pressure for a month the periods be- 
tween reports may be extended to 30 days. Every per- 
son in supposed good health should have his blood pres- 
sure taken at least twice a year that faulty conditions 
may be detected and corrected. 
The blood pressure in hyperpiesia can always be 
reduced to normal and be maintained if it has not ex- 
ceeded 170 systolic. In cases of nephritis with hyper- 
tension, while the pressure may be lowered it cannot 
be maintained without increased elimination by the 
kidneys. 
A normal or slightly elevated systolic, high dias- 
tolic and high pulse rate suggest a poor myocardium. 142 
HIGH-FREQUENCY PRACTICE 
This condition is best treated by autocondensation, 350 
to 450 milliamperes for a period of 10 to 12 minutes; 
the milliamperage and time may be varied to suit the 
case, but strong currents must be avoided. After the 
pressures have been reduced nearly or quite to normal 
a static breeze over the precordial region is of value 
in restoring efficiency to the heart muscle. In case 
a static breeze is not available a high frequency effluve 
may be substituted. Cardiodiathermy is also of value 
in this condition. 
A normal or slightly elevated systolic, a very low 
diastolic and high pulse rate point to aortic insuf- 
ficiency. Autocondensation in this condition will 
probably do more harm than good. The diastolic may 
be raised and the systolic lowered at the same time by 
application of the static wave current over the third 
to sixth cervical vertebrae. The unipolar application 
of the high frequency current to the same locality, 
while inferior to the static wave, is of value in the 
reduction of high pulse pressure in these cases. 
A very high systolic, very high diastolic with a nor- 
mal or low pulse rate suggest arterial changes. While 
autocondensation is indicated in this condition, it is 
advisable to begin the treatment with a low amperage, 
not over 300 milliamperes, for a period of 10 minutes 
and gradually increase the dosage from time to time, 
but it is not advisable to exceed 600 milliamperes at 
any time. Now and then a case will be met with in 
which the pressures will be higher immediately after 
the treatment, but will be found to be much lower the 
following day. While a gradual decline in pressures BLOOD PRESSURE 
143 
may be anticipated, a return to normal can only oc- 
casionally be experienced. Unipolar high frequency 
currents are contraindicated in this condition. 
In connection with autocondensation a careful 
hygienic management is required in order to hold the 
pressure near to normal limits and prevent cerebral 
accidents. See Arteriosclerosis. 
High blood pressures may be reduced through ex- 
citation of the depressor nerve fibers by concussion or 
vibration of the second to fifth dorsal interspaces. In 
some cases the same results may be achieved by uni- 
polar application of the high frequency current through 
a double pronged spinal electrode to the same area, but 
a strong current is required. However, the unipolar 
current is liable to have the opposite effect and raise 
the blood pressure. 
The writer has never seen a high systolic pressure 
that could not be reduced by high frequency currents. 
However, he has seen a few patients who require daily 
treatments to keep the pressure below 200. These 
usually are cases of interstitial nephritis associated 
with marked cardiovascular changes. While such cases 
do not yield to autocondensation, much can be done for 
them by diathermy to the liver and kidneys. As a 
general rule valvular diseases of the heart with decom- 
pensation are benefited by high frequency effluve to 
the cervical region and static breeze to the precordial 
region. 
In cases of hypotension of nervous origin the blood 
pressure may be raised through excitation of the pressor 
nerve fibers by concussion or vibration of the sixth and 144 
HIGH-FREQUENCY PRACTICE 
seventh cervical vertebrae or by application of the 
slow sinusoidal or high frequency current. Another 
method of raising blood pressure is: apply a metal 
electrode to the epigastrium with a vacuum or non- 
vacuum electrode over the sixth and seventh dorsal 
vertebrae, emitting a succession of sparks within tol- 
eration of the patient. 
For treatment of hypotension due to loss of nerve 
tone, see Neurasthenia. CHAPTER VI. 
Pain CHAPTER VI. 
PAIN. 
Definition. Painful stimuli. Classification. Referred pain. 
Reflex pain. Occupational neuroses. Inflammatory pain Sus- 
ceptibility to pain. Persistency of pain. Digestive pain. Mus- 
cular spasm. Backache. Pain in the limbs. Penile pain. Shoul- 
der pain. Subacromial bursitis. Treatment of subacromial bur- 
sitis. Headache. 
Definition.—Nearly all diseases either commence 
with or have pain as a symptom at some time during 
their course. Pain is a mental interpretation of a harm- 
ful process occurring in the organism and is due usu- 
ally, if not always, to pressure from within or without 
the nerve sheath. 
The mind interprets three kinds of sensations: Pain- 
ful, pleasurable and neutral. 
Painful Stimuli.—The intellect is able to produce 
sensations of pain without any objective means, the re- 
sult being known as subjective pain. The production of 
pain depends upon a proper stimulus. The stimuli 
which produce pain may be divided into those due to 
pressure, toxemia, chemical, electrical and thermic re- 
actions, all of which in their finality may be reduced to 
pressure. The mind being capable of interpreting but 
a single sensation at a time, pains of equal intensity 
cannot be felt in two places at the same time. 
147 148 
HIGH-FREQUENCY PRACTICE 
Classification.—There are many types of pain, such 
as emotional, subjective, associated, referred, reflected, 
occupational, objective, organic, functional, sympa- 
thetic, habit, etc. While all types of pain are important 
Fig. 38.—Location of Reflex Pains. A, anemia; C, 
constipation; D, dental infection; U, uterus; A-P, angina 
pectoris; O and P, ovaries and prostate. 
and interesting to the physician, for obvious reasons 
only the most important in high-frequency practice 
will be discussed. 
Referred Pain. — When irritation occurs in the 
course of nerve fibers, and pain is experienced in the PAIN 
149 
peripheral distribution of those fibers, it is called re- 
ferred pain. 
Examples of referred pain: Pain in the knee from 
hip-joint disease; leg ache from prostatitis; penile pain 
Figure 39.—Location of Reflex Pains. D, dental in- 
fection; L, liver; N, neurasthenia; O, ovary; P, prostate; 
S, spleen; St, stomach; U, uterus. 
from calculus in the bladder; pain in the fingers from 
brachial neuritis. 
Reflex Pain.—Painful stimuli carried to the cord 
and from there deflected to some secondary neuron is 
known as reflex pain. It differs from referred pain in 150 
HIGH-FREQUENCY PRACTICE 
that it is deflected from one set of neurons to those of 
another system. 
The most common examples of reflex pains are 
those due to diseased viscera. 
The Behan method of localizing the viscus causing 
the reflected pain is as follows: 
1. Determine if in connection with it, there is an 
associated area of hyperalgesia. 
2. Delimit the area of hyperalgesia as nearly as 
possible and orient it with a cord segment. 
3. Find out what organs are supplied by this seg- 
ment. 
4. Examine the organ or organs for disease. 
5. See if the pain can be reproduced by manipula- 
tion of the organ. 
Occupational Neuroses.—In this class the pain is in- 
duced only thru making the occupation movements, and 
every repetition of the same movement will cause pain. 
This condition occurs most frequently with piano play- 
ers, typists and penmen. Many cases are benefited but 
few cured by high-frequency currents. The only cure 
lies in change of occupation. 
Inflammatory Pain.—The principal cause of pain 
in inflammatory conditions is pressure from stasis. The 
throbbing character of the pain is due to the alternate 
contraction and dilatation of the vascular walls. While 
stasis exists in all inflammatory conditions, many im- 
portant viscera are not supplied by sensory nerves to 
convey the stimulus to the brain, therefore are painless. PAIN 
151 
Practically all non-infectious inflammations are 
amenable to high-frequency currents. 
Susceptibility to Pain.—Susceptibility to pain varies 
with the individual, light skins being more susceptible 
than dark ones. Unsusceptibility to pain may be due 
to lack of mental development. Will-power may be suf- 
ficiently intense to produce an immunity to pain. There 
are many degrees of intensity of will-power to with- 
stand pain. Emotional influence may be sufficient to 
overcome interpretation of the stimuli which produce 
painful sensations, or the emotions may be carried to 
such a high pitch as to transform pleasure into pain sen- 
sations. Sensations may be both pleasant and painful. 
Pain and pleasure are but attributes of sensation. Heat, 
cold, taste, smell, sight and hearing may all be painfully 
as well as pleasurably perceived. 
Persistency of Pain.—Pain may be constant, remit- 
tent or intermittent. When constant it calls for inves- 
tigation into conditions which act constantly, such as 
new growths which press upon the nerve fibers some- 
where in their course. When the pressure is constant 
the pain also is constant, but it is usually referred to 
peripheral distribution of the nerve fibers. 
If an inflamed mass has periods of less congestion 
these periods will be accompanied by pain of a remit- 
tent character. A remission of pain may be complete 
for a time again to reappear. This form is known as 
intermittent pain. 
Pains of intense paroxysmal character are known 
as crises. They come suddenly and suddenly disappear. 
This form of pain is usually caused by muscular spasm, 152 
HIGH-FREQUENCY PRACTICE 
and the cause of the muscular spasm may be far re- 
moved from the site of the pain. 
Digestive Pain.—Pain experienced during digestion 
occurs only when there is some disease of the food tube 
or organs closely related thereto. Pain during inges- 
tion of food points to disease of the esophagus or car- 
diac end of the stomach; immediately following the in- 
gestion of food, gastric ulcer is suggested; two or three 
hours after taking food, duodenal ulcer is suspected; 
four to five hours after food is taken, gall-bladder dis- 
ease is thought of; six to seven hours after a meal, pain 
suggests trouble in the appendix or colon. If ingestion 
of food relieves pain, duodenal ulcer is suspected. 
Muscular Spasm.—Muscular spasm is a frequent 
cause of pain. Spasm of certain muscles producing 
pain leads to an investigation of all joints, periosteum, 
bone and all tissues and organs liable to inflammation 
in the neighborhood as well as the corresponding spinal 
segment area. Spasm of muscles lying over an in- 
flamed viscus is nature’s method of protection. 
Backache.—Among the diseases associated with pain 
in the back may be enumerated lumbago, trauma, in- 
flammation, debility, fatigue and neuralgia of muscles; 
inflammation of joints; caries, eroding growths and 
trauma of bones; tumors and inflammation of the men- 
inges and cord; referred from diseased viscera; infec- 
tious diseases, herpes and tuberculosis. (See Neuras- 
thenia) . 
Pain in the Limbs.—Generally pains in the limbs re- 
sult from systemic disease; however, in a few instances PAIN 
153 
the pains are associated with local lesions. Soreness, 
stiffness and local tenderness may result from over- 
strain. Legache and general muscular pains are quite 
common at the onset of acute infectious diseases such 
as coryza, tonsilitis, influenza, etc. 
Chronic pains in the limbs occur in diseases such 
as peripheral neuritis, all forms of arthritis, liver and 
kidney disease, blood dyscrasias, arteriosclerosis, loco- 
motor ataxia, disease of the spine, disease of sacroiliac 
and hip joints and many disorders of the pelvic viscera. 
Hysterical and neurasthenic patients often complain 
of pain in the limbs. 
Penile Pain.—Pains in the penis are nearly all re- 
ferred from disease of the uretha, prostate, bladder or 
kidney. Pain experienced during micturition points to 
disease of the urethra or prostate; pain immediately 
following urination points to some lesion of the bladder. 
Penile pain not associated with micturition is usually 
due to some local lesion or referred from the ureter or 
kidney. Ejaculatory pain suggests verumontanitis. 
Shoulder Pain.—Pain in the shoulder may be due to 
local conditions of the shoulder or causes more or less 
remote. Among the local causes may be enumerated: 
Trauma, arthritis, bursitis, neuritis, occupational neu- 
roses and local palsies. Among the remote causes may 
be mentioned cardiovascular, pulmonary and mediasti- 
nal lesions; gastric and duodenal ulcers; diseases of 
the liver; diseases of the spine; nerve lesions affecting 
the brachial plexus and focal infections. 154 
HIGH-FREQUENCY PRACTICE 
Shoulder is rather an indefinite term and may mean 
any place from the posterio-inferior angle of the scap- 
ula to the elbow. The most painstaking examination 
is necessary to a correct diagnosis of the cause of shoul- 
der pain. The first important thing to do is to locate 
the pain. If definitely localized in the region of the 
shoulder it points to a lesion of the joint, bursse, liga- 
ments, muscles or nerves about the joint. Pain about 
the scapula usually suggests remote causes; if under the 
left scapula, digestive causes; if under the right scap- 
ula, hepatic causes; if of a constructive nature about 
the entire shoulder and deltoid it suggests cardiovascu- 
lar disturbance. 
The shoulder is supplied by the suprascapular and 
circumflex branches of the brachial plexus, and irrita- 
tion of these nerves is likely to be reflected and cause 
pain in any part of the plexus. 
Tenderness and pain about the claviculo-acromial 
juncture, following trauma accompanied with painful 
abduction of the arm, without x-ray findings, are most 
surely caused by infiltrations. 
Teniosynovitis of the biceps tendon may cause shoul- 
der pain. Irregularities in the bursse are common 
causes of shoulder pain, the symptoms of which are 
retarded movement accompanied by crepitus and pe- 
riods of exacerbation and apparent recovery. 
In brachial neuritis the pain and tenderness are to 
be found under the spine of the scapula or about the 
deltoid, the joint being unaffected. PAIN 
155 
Subacromial bursitis is often the result of indirect 
or direct violence, overstrain, sudden jerking of the 
arm common with ball players and in certain occupa- 
tions. The symptoms of subacromial bursitis are ten- 
Fig. 40.—The Universal Diathermy Clamp. A prac- 
tical electrode for application of diathermy in difficult 
places. The two round electrode discs are made of block 
tin. The set screws hold the electrodes in place during 
treatment. It is especially useful in the application of 
diathermy to the shoulder, hip, knee, kidney and to face 
in “tic.” 
derness just below the acromial process and which 
disappears with adduction of the arm; pain over the 
deltoid and upon adduction of the arm. The familiar 
catch-pain upon adduction is significant. 
To diagnose between bursitis and tuberculosis is 
often difficult. The history of the patient and the 
roentgen ray will assist in the differentiation. Arth- 
ritis may be differentiated from bursitis by observing 
the degree of abduction. In bursitis this is limited to 
a few degrees without pain, while in arthritis there 
is no abduction without pain. 156 
HIGH-FREQUENCY PRACTICE 
There are three stages of subacromial bursitis: Con- 
gestion, following trauma or infection; adhesion and 
contraction; deposit of lime salts in or underneath the 
bursae and atrophy of the shoulder muscles. 
Treatment of Subacromial Bursitis.—Daily applica- 
tion of diathermy during the congestive stage of bursi- 
tis will be followed by recovery in from one to four 
weeks, success depending upon the thorough heating 
of the entire shoulder joint for at least 45 minutes every 
day. The second stage is treated in the same manner 
but the results are not so flattering—a fifty-fifty result 
may be anticipated in from six to eight weeks. The 
third stage may be treated by diathermy, radiant-light- 
heat for temporary relief, but surgery followed by phy- 
siotherapeutic measures for restoration of muscular 
function is the best treatment for this stage of the dis- 
ease. 
Headache.—The most common pain complained of 
by man; a concomitant symptom of many diseases and 
pathognomonic of none. It is the leading symptom of 
many functional and pathological conditions. Were 
we to consider one thousand cases of headache taken as 
they naturally come, we would find 350 due to psycho- 
neuioses; about 200 from nephritis; about 200 due to 
hypertension, eyestrain and infectious diseases; 100 to 
meningitis, sinusitis, neuralgia and migraine; about 50 
to brain tumor and syphilis and about 100 from un- 
known causes. 
Two causes, toxic and functional, may be mentioned 
among those of headache outside of organic diseases PAIN 
157 
within the skull. The toxic cause may be divided into 
two groups: 1. Due to toxic causes outside the body; 
2. Due to toxemia produced within the body. Included 
in the first group are alcohol, tobacco, mineral poisons, 
certain drugs, poisonous gases and foul air; in the sec- 
ond group uremia, gout, diabetes, constipation and 
other gastro-intestinal disturbances, specific fevers and 
local infections. Functional causes—Hypertension, 
hypotension, anemias, mental strain, menstruation, mi- 
graine, epilepsy, eye-strain, fatigue, hunger, hysteria, 
neurasthenia and persistent noise. 
Headache from reflected causes is common and in 
many instances suggests the causative factor but often 
is no guide at all. A pain in the top of the head suggests 
uterine disease, but many men suffer from pain in this 
locality. Pain in the occipital region suggests eye- 
strain, but it may be caused by a diseased prostate. 
Frontal headache suggests gastro-intestinal disturb- 
ance : it may be caused from sinusitis. The pain from 
an infected tooth may simulate trigeminal neuralgia. 
Earache, while suggesting aural disease may be caused 
by infection in the nose or throat. Headaches of a 
throbbing, boring and burning character suggest brain 
tumor but may be due to extrinsic causes. The charac- 
ter of the headache is of little importance in diagnosis. 
Syphilitic headache is worse at night, but not all noc- 
turnal headaches are due to syphilis. The passing of a 
headache at about the noon hour and returning at 
some definite time suggests malaria but may be due to 
infection, especially that of influenza. 158 
HIGH-FREQUENCY PRACTICE 
One of the causes of headache especially in women 
and children is pituitary hunger which may be termed 
carbohydrate dipsomania or craving for sweets. A 
candy spree is often followed by pituitary headache; 
the pain is deeply seated behind the eyes and persists 
from one to forty-eight hours. The spree terminates, 
not unlike alcoholic intoxication, in nausea and vomit- 
ing. 
In locating the cause of headache do not minimize 
the patient’s story: it will often lead to a diagnosis of 
psychoneurosis or disturbance of the vasomotor me- 
chanism. While the majority of causes of headache 
are extrinsic it is best to thoroughly examine the eyes, 
the nose and its accessory sinuses; take the blood-pres- 
sure and temperature and look for foci of infection; ex- 
amine the blood and urine. A Wassermann test will 
often clear up a difficult diagnosis. 
The treatment of headache depends entirely upon 
the cause. Many cases are amenable to treatment by 
high-frequency currents especially when due to vaso- 
motor disturbances. Above all things, the route which 
leads to the acetanilid shelf should be avoided. 
Note.—Much of the information contained in this 
chapter is gleaned from the writings of Richard J. Be- 
han and Richard C. Cabot. CHAPTER VII. 
High-Frequency Therapy CHAPTER VII. 
HIGH-FREQUENCY THERAPY 
ABSCESS. 
Essential Features.—Acute when due to staphy- 
lococci, streptococci and other microorganisms; chronic 
when due to a specific microbe such as the bacillus of 
tuberculosis. 
Therapy.—High-frequency currents are contraindi- 
cated in all closed cavities containing pus, however, ab- 
scesses such as boils, carbuncles, etc., may be aborted by 
early application of the high-frequency current from a 
vacuum or non-vacuum electrode carrying a current 
capacity of spark. The electrode should be in 
contact with the part for a period of 5 to 8 minutes. 
Physiology.—The current raises the temperature of 
the part and produces an intense hyperemia; the capil- 
laries are dilated; the arterial blood supply is increased 
flooding the part with fresh blood which clears the con- 
gested area of microorganisms. In cases of accumula- 
tion of pus, it can be readily understood that this pro- 
cedure would carry a large amount of purulent matter 
into the general circulation which might result in met- 
astatic abscesses or general pyemia. The borderline 
cases require skill in differentiation. There can be no 
objection to the use of high-frequency currents after 
the abscess is opened and drainage established and are 
161 162 
HIGH-FREQUENCY PRACTICE 
often of great service in cleaning the field of micro-or- 
ganisms. 
Zinc ionization is to be preferred in all closed ab- 
scesses. See Ulcers. 
Essential Features.—Acne may or may not be a bac- 
terial infection. In acne vulgaris the mouth of the se- 
baceous gland duct is obstructed, the plug appearing on 
the surface as a small black point—the comedo or black 
head. The lesion may remain in this stage, but it usu- 
ally grows into a reddish papule when the lesion is 
known as acne papulosa, the papules having no disposi- 
tion to form pus and disappear by absorption or exfolia- 
tion. 
In acne pustulosa the papules are usually of large 
size and pass rapidly into the pustular stage. The in- 
fection is usually of the streptococcus family. It is quite 
common for black heads, papules and pustules to be 
present at the same time. When the papules are 
crowded together and form an indurated mass the lesion 
is called acne indurata. 
The diagnosis is usually easy but should be differ- 
entiated from syphilis sycosis, variola and varicella. 
Therapy.—The first indication to be met is the re- 
moval of the plug to the gland duct; the following lotion 
is very efficacious in cleaning the duct. Green soap 
and alcohol equal parts—apply freely and wash out 
with clear water. After removal of comedones the high- 
frequency current from a vacuum or non-vacuum elec- 
ACNE. HIGH-FREQUENCY THERAPY 
163 
trode will stimulate the sebaceous glands by increasing 
the activity of the circulation, carrying away effete 
products and restoring normal function. In acne pustu- 
losa all pustules should be opened and the pus expressed 
with the side of a needle. The electrode should be kept 
on the skin and moving to avoid sparks which are irri- 
tating and should be avoided. Hyperemia is the effect 
desired. 
The time consumed in each treatment cannot be 
stated definitely on account of the variation of the sen- 
sibility of different patients’ skin. 
Treat every second day until results are obtained. 
While the treatment of acne by high-frequency cur- 
rents is quite satisfactory, it is less efficacious than 
fractional doses of X-ray which require from one to 
four exposures. Actinic rays from a standard appara- 
tus is said to be beneficial in this disease. 
ACNE ROSACEA. 
The local application of high-frequency currents 
thru a vacuum tube is of little if any benefit in this dis- 
ease. The effects being to further dilate the already 
over dilated vessels. 
Dr. William L. Clark treats cases of moderate hy- 
pertrophy of the nose by desiccation. His technic is 
as follows: After local anesthetization with a solution 
of novocaine and adrenalin (2%), a small needle is in- 
serted at right angles directly into the hypertrophied 
tissue as deeply as is necessary, and the current al- 
lowed to pass for a few seconds until slight blanching 164 
HIGH-FREQUENCY PRACTICE 
takes place. The needle is again inserted about six 
millimeters away from the original puncture, and so on 
until the whole involved area is systematically treated. 
Clark says: “The heat from the current sterilizes the 
infected glands, obliterates the sebaceous orifices and 
dilated capillaries, and restores the nose approximately 
to its normal color. The scar tissue produced by the 
heat from the current causes the hypertrophic connec- 
tive tissue to contract in the course of several weeks 
with subsequent reduction in size of the nose. A second 
treatment after an interval of about three months will 
cause still further improvement.” 
ADENITIS. 
High-frequency currents in the form of diathermy 
may be used with benefit in glandular infections before 
suppuration has taken place, but are less effective than 
one intense dose of X-ray. After suppuration has 
taken place the gland should be treated as an abscess. 
ALBUMINURIA. 
Albuminuria is a term employed to denote the pres- 
ence of one or more albumins in the urine. It may or 
may not be a symptom of disease. It often occurs in 
febrile diseases, diseases of the nervous system,- violent 
exertion, cystitis, enlarged prostate, exopthalmic goiter, 
etc. When accompanied with a pathological amount of 
renal casts are justified in making a diagnosis of 
nephritic HIGH-FREQUENCY THERAPY 
165 
Fig. 41.—The Hogan 2 K. W. Combination of X-Ray 
Unit and High-Frequency. This apparatus is somewhat 
unique, as it affords all of the advantages of a modern 
Bedside Unit, capable of operating a 30 M. A. Radiator 
Type Coolidge Tube to full capacity, or a Self-Rectifying 
Gas Tube, with built-in Coolidge Control with filament 
transformer in the same tank with the high-tension wind- 
ing, together with a complete high-frequency resonator 
operable from the same high-tension transformer which 
is employed for X-Ray work. 166 
HIGH-FREQUENCY PRACTICE 
Therapy.—The treatment of albuminuria depends 
entirely upon its origin and cause. When due to nerv- 
ous disturbances, pregnancy, toxemia and early circu- 
latory changes much may be accomplished by auto-con- 
densation and diathermy, the physiological action of 
Fig. 42.—Diathermy of Kidney. 
which is explained under auto-condensation and dia- 
thermy. 
Albuminuria when due to nephritis is preceded by 
as well as accompanied with hypertension. The sphy- 
gmomanometer will advise us of approaching albumi- 
nuria weeks, months and even years before albumins 
can be detected in the urine. If the early hypertension 
be corrected cardio-renal disease may be prevented. HIGH-FREQUENCY THERAPY 
167 
Albuminuria due to nervous disturbances is benefited 
by the unipolar application of the high-frequency cur- 
rent from a vacuum or non-vacuum electrode to the 
fourth and fifth dorsal vertebrae. 
Cardio-renal conditions associated with edema 
should be treated by diathermy to the liver and kidneys. 
See Figs. 42 and 59. However, only amelioration of 
symptoms is to be expected. 
The high-frequency current from a multiple-point 
electrode to the 10th dorsal spine is very gratefully re- 
ceived by the patient. See Fig. 63. 
ALOPECIA (BALDNESS). 
Alopecia, a term applied to baldness, may vary in 
degree from slight thinning to complete loss of the hair. 
There are three distinct varieties, viz: Congenital, se- 
nile and premature. 
Congenital Alopecia.—This form of alopecia is ac- 
companied by defects in development. It may be par- 
tial or complete. When complete there is no hair on 
any part of the body. 
Senile Alopecia.—This form needs no description, 
it may be seen in the parquet of the theater at almost 
any performance. 
Premature Alopecia.—This form may be temporary 
or permanent, gradual or rapid and is dependent upon 
local and constitutional causes. Among the local causes 
may be mentioned seborrhea, psoriasis, eczema, erysip- 
elas, favus and ringworm. Among the constitutional 168 
HIGH-FREQUENCY PRACTICE 
causes we find prolonged debilitating influences, ex- 
cessive mental labor, excesses, struma, typhoid fever 
and exanthemata, mercury poisoning, diabetes, syphi- 
lis, etc. The most common form of falling hair is due to 
seborrhea of the scalp. 
Alopecia Areata.—In this form of alopecia the 
hair falls out in more or less circular patches leaving 
the skin smooth and white. In rare cases the whole 
scalp and possibly the entire body may be denuded. 
Prognosis.—In the congenital and senile forms the 
prognosis is unfavorable. The prognosis in the prema- 
ture form depends largely upon the cause. When due 
to local causes the prognosis is favorable. When due to 
constitutional causes the result depends upon the cor- 
rection of the cause. Alopecia areata under proper 
treatment usually recovers. 
Therapy.—When baldness is due to seborrhea of the 
scalp, eczema, psoriasis or ringworm, the first indica- 
tion is to kill the germ which is most effectually ac- 
complished by x-rays. If the treatment be too intense 
the hair follicles may be destroyed. The dose applied 
should be just enough to act as a germicide. A dose of 
54 to H. at intervals of one week is usually sufficient. 
The rays not only kill the bacillus or other germ, but 
act as a stimulant to the hair follicle, if there be any 
to stimulate. 
The stimulating and germicidal effects of actinic 
rays are also known to be of service in this affection. 
Alopecia areata usually yields to high-frequency 
sparks from a vacuum electrode. The application HIGH-FREQUENCY THERAPY 
169 
should be of sufficient strength to produce a very active 
hyperemia and be repeated three times a week. Small 
blisters may be produced and a crust formed; when the 
crust separates there will often appear a growth of very 
fine hair. 
Physiology.—Elimination of effete matter from the 
skin ducts thru hyperemia; stimulation of hair folli- 
cles to renewed activity. 
AMENORRHEA. 
Amenorrhea is defined as an absence of menstrual 
flow in women of suitable age who are not pregnant. 
Classification.—Complete when all menstrual flow 
has ceased; comparative when*it appears occasionally; 
primary when menstruation has never appeared; sec- 
ondary when, having appeared, the flow ceases. 
Etiology.—Among the causes of apparent amen- 
orrhea may be enumerated imperforate vagina, imper- 
fect cervix, imperforate hymen, absence of any of the 
genital organs, retention in hematometria and hema- 
tosalpinx. 
The causes of real amenorrhea are physiological, 
pathological and toxic. Physiological causes are, be- 
fore and after the menopause, pregnancy and lacta- 
tion. Pathological causes are absence of essential or- 
gans, pelvic inflammation, superinvolution, anemia, 
chlorosis, leucocythemia, Hodgkin’s disease, malignan- 
cy, tuberculosis, pyemia, diabetes, late stage of cardio- 
renal disease, cretinism, insanity, exposure to cold at 170 
HIGH-FREQUENCY PRACTICE 
the time of menstruation, fear of pregnancy, myxe- 
dema, exopthalmic goiter and obesity. Toxic causes 
are chronic poisoning from lead, mercury, morphine 
or alcohol; specific fevers. 
Essential Features.—Among the essential features 
of amenorrhea may be stated: Alterations in the 
blood itself; changes in blood-pressure; altered nerve 
impulses; altered relations between the ductless glands 
such as ovary and thyroid and opposed action of the 
suprarenal and pituitary. 
Therapy.—The etiology of this disease demands a 
painstaking examination of the pelvic contents in every 
case. Laboratory confirmation of diagnosis is often 
of extreme importance. 
Secondary amenorrhea is often relieved by drugs. 
When due to some chronic disease outside the local con- 
dition, general medicinal and hygienic management is 
required. 
Treatment by properly selected currents constitutes 
the most efficacious method known for amenorrhea 
not dependent upon organic irremedial causes. 
Physiological Indications. — The indications in 
faulty metabolism are met by auto-condensation; an- 
emic conditions by diathermy of the bones of the thigh; 
hypertension by auto-condensation; altered nerve im- 
pulses by stimulation of the spinal roots of affected 
nerves by high-frequency current thru a double 
pronged vacuum electrode applied for five minutes 
daily; in faulty ovarian function the gland may be 
stimulated by diathermy, one electrode over the hypo- HIGH-FREQUENCY THERAPY 
171 
gastrium, the other over the sacrum, in the rectum or 
vagina; the last named position being the one of 
choice in married women; pass a current of tolerance 
for seven minutes every second day. (See Fig. 64). 
Fig. 43.—Diathermy of the Femur. 
In hypothyroidism, diathermy of the thyroid may cor- 
rect the glandular dysfunction. (See Fig. 65). The 
technic of which is as follows: Seat the patient on the 
auto-condensation pad, place a well fitting metal elec- 
trode to the thyroid, turn on a current of 500 milli- 
amperes for five minutes. This may be repeated every 172 
HIGH-FREQUENCY PRACTICE 
third day. Care should be exercised not to over stimu- 
late the gland. 
infantile uteri usually require electrolysis and sinu- 
soidal currents, but much good may be accomplished by 
flooding the parts with new arterial blood thru dia- 
thermy. Apply one electrode over the hypogastrium 
and insert within the vagina a well insulated electrode 
that will be best adapted to the case, turn on a current 
of toleration for seven minutes and repeat daily. (See 
Fig. 64). While uterine flexions, adhesions and exu- 
dates are best treated by electrolysis, much good may 
be done by diathermy with same technic as above men- 
tioned. 
Fig. 44.—Vaginal Non-Vacuum Electrode. 
ANEMIA. 
Anemia is a term employed to denote many dif- 
ferent changes in the blood. It is a symptomatic dis- 
order characterized by a deficiency of some of the im- 
portant constituents of the blood; clinically, a diminu- 
tion in the amount of hemoglobin, usually, but not al- 
ways, associated with a decrease in the number of red 
<>ells. 
Diagnosis.—The simple form should be differen- 
tiated from the severe forms, chlorosis, pernicious ane- 
mia and leucocythemia. 
Etiology.—The principal causes of simple anemia 
are hemorrhages, deficient metabolism and abnormal HIGH-FREQUENCY THERAPY 
173 
expenditure of blood constituents as in pregnancy and 
lactation. 
Prolonged use of mercury, arsenic or salicylates 
will produce a blood picture of anemia. The causes are 
so numerous and varied that each case becomes an in- 
dividual one and the underlying etiological factor must 
be sought and found before any therapeutic measure 
be applied. 
Therapy.—The treatment of anemia may be summed 
up as follows: Removal of cause; hygienic measures 
and proper medication. In benign anemia the admin- 
istration of iron and arsenic is of prime importance. 
Physiological Indications. — Auto-condensation for 
faulty metabolism; diathermy of long bones, especially 
the femur, to increase the hemoglobin; high-frequency 
from a body electrode (vacuum or non- vacuum) to cor- 
rect nervous dysfunction. 
General radiation of actinic rays over the entire 
body improves the general vitality and may be em- 
ployed with benefit in anemic conditions. 
ANEURYSM. 
Dr. Albert Abrams has made exhaustive studies of 
aneurysmal conditions and his conclusions demand re- 
spect. In his book “Spondylotherapy” he says: “It 
occurred to the writer when he first employed the aortic 
reflexes in diagnosis that if concussion of the seventh 
cervical vertebra would cause contraction of the aneu- 
rysmal sac, this fact would prove advantageous in the 174 
HIGH-FREQUENCY PRACTICE 
treatment of thoracic aneurysm. The results achieved 
have exceeded his expectations.” 
The treatment may be administered by any suit- 
able apparatus that will give a hammer stroke. In 
Pig. 45.—Percussion of Seventh Cervical Vertebra. 
the absence of an apparatus a plexor and pleximeter 
may be employed. The percussion stroke may be de- 
livered directly to the spine of the seventh cervical ver- 
tebra or indirectly thru a strip of rubber or linoleum. 
The rapidity of the stroke employed by Abrams is about HIGH-FREQUENCY THERAPY 
175 
150 per minute for a period of from 5 to 15 minutes 
with several interruptions to avoid irritation of the 
skin. 
Physiological Indication.—The treatment is not em- 
pirical but founded on scientific principles. By per- 
cussion of the seventh cervical vertebra the vagus is 
stimulated and thru the effects of the stimulation the 
heart beat is lowered in frequency and at the same time 
the aorta is contracted. 
The sinusoidal current will accomplish the same re- 
sults when applied to the space between the seventh 
cervical and first dorsal with opposite electrode over 
the sacrum. 
The high-frequency current thru a non-vacuum 
electrode applied to the seventh cervical vertebra, or 
thru a double-pronged vacuum electrode applied be- 
tween the sixth and seventh cervical in some cases will 
be efficient, but a strong current must be employed. 
As a rule the high-frequency current is inferior in effi- 
ciency to percussion or the sinusoidal current. 
ANGINA PECTORIS. 
The term “angina pectoris” is employed to denote 
an intense paroxysmal pain and constricting oppression 
about the heart. The symptoms are characteristic, but 
the condition should be differentiated from false angina 
which includes intercostal neuralgia, gastralgia, car- 
diac asthma, hysteria and tobacco heart. True angina 
is always associated with cardiac lesions, especially of 
the coronary arteries. 176 
HIGH-FREQUENCY PRACTICE 
Fig. 46.—Double-Pronged Electrode to Sixth Cervical Space. HIGH-FREQUENCY THERAPY 
177 
Therapy.—The underlying condition may prove 
fatal at any time but careful management may prolong 
life. The space of time between the attacks is when 
high-frequency currents are of value. If there be hy- 
Fig. 47.—Cardio-diathermy. 
pertension it should be treated by auto-condensation 
(the only vaso-dilator that may be employed with im- 
punity) . Arterial dilatation within the heart muscle 
will increase capillary efficiency and thereby improve 
the nutrition of the heart muscle, allowing the coronary 
arteries to resume their function. 178 
HIGH-FREQUENCY PRACTICE 
Technic of Cardio-diathermy.—Two electrodes not 
less than five inches in diameter are employed, one di- 
rectly over the heart and the other directly opposite on 
the back. The current should be turned on gradually, 
consuming three minutes in attaining a comfortable 
tolerance, at which point the dose is maintained for 8 
to 10 minutes when the current should be slowly re- 
turned to zero. After two or three treatments the time 
and amperage may be increased, always depending 
upon effects. 
ANGIOMATA. 
Angiomata usually spoken of as “strawberry 
marks” consists of dilatation and reproduction of new 
blood vessels, the process giving rise to a reddish and 
slightly elevated tumor. 
Therapy.—The objects to be attained are the coag- 
ulation of the blood in the tumor, the destruction of the 
dilated vascular walls and preservation of the over- 
lying skin. 
Electrocoagulation by the bipolar, or desiccation 
by the unipolar method may be employed but has 
the disadvantage of producing scars. In desiccation or 
electrocoagulation the needle electrode should be in- 
sulated in that portion which passes thru the skin, 
the needle point only entering the part to be coagu- 
lated. 
Small superficial angiomata of the lips and mouth 
may be easily destroyed by desiccation, HIGH-FREQUENCY THERAPY 
179 
APPENDICITIS. 
Many cases of catarrhal appendicitis recover under 
medicinal treatment. The same class of cases are bene- 
fited by diathermy but it is usually an unsafe procedure. 
If diathermy fails to abort the disease a simple appendi- 
citis is transformed into a fulminating one. The best 
procedure in all cases of appendicitis is to turn them 
over to the surgeon. 
Arteriosclerosis is a condition in which the walls 
of the arteries are thickened, due to morbid changes 
in the intima which result in narrowing of their lu- 
men. There are three varieties: the nodular, in which 
the changes are localized; the senile, due to physical 
degeneration attending old age; the general form, 
which occurs in middle life as a result of various etiolo- 
gical factors. 
The disease is one of insidious character. The 
changes in the arterial walls take place very slowly. 
It is probable that the first change is one of arterio- 
capillary fibrosis; this change takes place early in the 
kidney. Although an increase in blood-pressure pre- 
cedes recognized kidney lesion for a long period of 
time, probably years. 
Essential Features.—After changes have taken 
place in the intima of arterial walls the general line of 
symptoms is more or less characteristic. Hyperten- 
sion is constant until the last stages of the disease when 
a condition of hypotension may supervene; there is a 
ARTERIOSCLEROSIS. 180 
HIGH-FREQUENCY PRACTICE 
tendency to shortness of breath; dizziness on sudden 
change of posture; inability to recall names and recent 
events; noises in the ears; consciousness of heart beat; 
increased area of cardiac dullness with apex beat more 
or less to the left of normal; albuminuria may or may 
not be present. Subacute inflammation of serous mem- 
branes such as the peritoneum, pericardium and pleura 
may be the first recognized symptom. Individuals sup- 
posed to be in robust health are often unaware of their 
condition until the nature of the case is revealed in an 
apoplectic seizure due to cerebral hemorrhage. 
Arteriosclerosis when well advanced is sometimes 
attended by severe headaches accompanied with vomit- 
ing which closely resembles the symptoms of cerebral 
tumor. 
Physiological Therapy.—It is the belief of the writer 
that all cases of arteriosclerosis not caused by specific 
infection are primarily due to faulty alimentation. In- 
complete digestion results in more or less toxemia which 
is an important etiological factor in hypertension. A 
long continued hypertension results in arterio-capillary 
fibrosis, after which the cardio-vascular changes take 
on a more or less rapid course, resulting in cardio-renal 
disease with all its disastrous consequences. 
Before arterial changes have taken place, that is, 
the hyperpietic stage, the changes may be prevented by 
auto-condensation and proper hygienic management. 
After the disease is well developed and cardiovascular 
changes have taken place there is no cure, but much may 
be done to prevent further changes by keeping the arte- 
rial tension within the safety zone, and this is accom- HIGH-FREQUENCY THERAPY 
181 
plished by close observation, the occasional application 
of auto-condensation, together with good hygienic 
measures that common sense will suggest. Teach the 
patient how to live to avoid further changes in his vas- 
cular system that comfort be enjoyed and life prolonged. 
While the physiological action of certain drugs is to 
reduce blood-pressure, the effects are evanescent and 
have a tendency to increase kidney dysfunction. 
The inroads of this disease can only be estimated 
by the symptoms present and they are not always a safe 
guide, therefore, it is advisable to commence auto-con- 
densation treatments with a low amperage. The first 
treatment should not exceed 300 miliamperes for a pe- 
riod of 10 minutes and it is not advisable to exceed 600 
milliamperes at any time. There is no advantage to be 
gained by heavy doses. Small doses for a long period 
of time are more effectual than large doses for any pe- 
riod of time. Crampy muscles may be the only sub- 
jective symptom present. This condition calls for local 
diathermy; for the first treatment it is advisable to 
place both electrodes on the same aspect of the limb, 
the object being simply to heat the superficial parts; 
the subsequent treatments should include the affected 
muscles with electrodes on opposite sides of the limb 
with one electrode somewhat nearer the body. The 
heat flushes the muscles with new arterial blood and 
relaxes spasm. The local application of diathermy will 
often yield constitutional as well as local effects. 182 
HIGH-FREQUENCY PRACTICE 
ARTHRITIS. 
Classification.—The differential diagnosis of the 
many forms of arthritis is most important that we may 
know when and when not to employ high-frequency 
currents in their therapeutic management. 
Acute Rheumatic Arthritis.—The essential features 
are sudden onset without previous trauma; swelling 
moderate; pain very severe but relieved by salicylates; 
a red blush over the joint nearly always present; after 
48 hours from its onset one after another joint affected. 
One swallow does not spell spring, neither does 
aithritis of one joint spell rheumatism, it flits from 
joint to joint as the honey bee from flower to flower, 
suppuration never occurs, destruction of joint seldom 
results, the inflammation subsides and normal function 
usually returns in from 2 to 6 weeks. The disease is 
often followed by endocarditis which permanently dis- 
ables the heart. 
Septic Arthritis.—This form does not affect one 
joint after another as in rheumatism. The trouble re- 
mains in the joint until the source of infection is cleared 
up; the tissues around the joint are thickened; the hue 
of the skin is more dusky than red as in rheumatism; 
suppuration is common. Septic arthritis follows ac- 
cumulations of pus in other parts of the body. 
Arthritis may accompany or follow such diseases as 
pneumonia, typhoid, scarlet fever, measles, diphtheria, 
small pox and influenza. In all these cases the pres- 
ence of the causative disease determines the diagnosis. HIGH-FREQUENCY THERAPY 
183 
Gonorrheal Arthritis.—Usually large joints like the 
knee are affected, but many joints may be affected sim- 
ulating rheumatism; the tendons and fascia about the 
joint are usually involved; the pain is severe and not 
relieved by salicylates; fibrous ankylosis may follow; 
this form accompanies or follows gonococcus infection. 
Rheumatoid Arthritis.—While the first attack of 
this disease resembles rheumatism it runs an entirely 
different clinical course; the joints first attacked are 
the phalanges; there is spindle shaped swelling; fever 
continues longer and is less severe; the pulse when com- 
pared with the temperature is faster than in acute rheu- 
matism ; the joints do not suppurate but become rapidly 
enlarged with inflammatory products; recurrent at- 
tacks are the rule and follow each other with a few 
weeks or months intervening until nearly all the joints 
of the body become affected; deformities always fol- 
low unless the treatment has been such as to prevent. 
Gouty Arthritis.—The diagnosis of gout is not usu- 
ally difficult. Its first appearance is usually in the ball 
of the right great toe; pain is often excruciating during 
the night; during the day the patient goes about his 
business, the next night it returns; the night exacerba- 
tions usually grow less and less until the disease abates; 
after a longer or shorter period of time the patient suf- 
fers another attack unless the etiological factor be re- 
moved. 
Osteo-arthmtis. — Simulates rheumatoid arthritis 
but is a distinct disease. Rheumatoid arthritis is a dis- 
ease of the soft parts and osteo-arthritis is a disease of 184 
HIGH-FREQUENCY PRACTICE 
the bone and usually confined to one large joint. Rheu- 
matoid arthritis is accompanied by an elevation of tem- 
perature (there is no fever in osteo-arthritis). When 
it attacks the hip joint of the aged the condition is 
sometimes called morbus coxae senilis. 
Tuberculous arthritis is most common in children. 
The favorite location is the spine and hip joint; other 
joint affection represents about 15 % of the number of 
cases. The onset is insidious and often overlooked dur- 
ing the first month of the disease. Pain is a prominent 
symptom and always worse at night. Swelling of the 
joint is always present but may be so slight as to be 
overlooked. Tuberculosis of the sacro-iliac joint is often 
difficult of diagnosis. The pain of a tuberculous hip 
joint is often referred to the knee. 
Congenital syphilis often causes arthritis and may 
be mistaken for tuberculosis, but other symptoms of 
syphilis should make the differentiation easy. 
Charcot’s disease.—This condition is an arthritis 
met with in locomotor ataxia. It affects large joints 
and results in rapid destruction of bone. Considerable 
swelling about the joint takes place but is devoid of 
pain. 
Traumatic arthritis.—Joints are very prone to in- 
jury. The essential features are ecchymoses; rapid 
swelling due to infiltration of the soft tissues; the syno- 
vial membrane becomes inflamed followed by a pouring 
into the joint of synovial fluid; muscular spasm (na- 
ture’s splint) is always present. HIGH-FREQUENCY THERAPY 
185 
Many acute conditions herein mentioned may be- 
come chronic and some of them are chronic from the 
first. 
Therapy.—The physiotherapist has a right to be en- 
thusiastic because the results obtained by his methods 
are monuments that mark the progress made in the 
management of this disease. 
The cure of any condition consists of the removal 
of the cause and the restoration of normal function. 
There are few cases of chronic arthritis cured, but 
thousands are arrested by removal of cause and restor- 
ation of function to the degree permissible by the de- 
struction of the anatomical structures. 
Acute rheumatic arthritis is caused by infection. 
The particular germ has not been isolated but is sup- 
posed to be of the streptococcus family and may attack 
fibrous tissue. During the acute stage of this form of 
arthritis about the worst treatment that can be applied 
is electricity. Any electrical current will aggravate the 
disease. After the temperature has returned to normal 
the resulting exudates and adhesions may be dissipated 
by the Morton wave and blue pencil discharge from a 
static machine. If static electricity is not available the 
next in order of usefulness is the high-frequency ef- 
fluve from a multiple-point electrode held just outside of 
sparking distance from the affected joint, which appli- 
cation will be found to be very soothing. The judicious 
application of diathermy to the joint is followed by ex- 
cellent results. 
Septic arthritis.—Electricity should never be ap- 
plied to any septic joint unless there be free drainage. 186 
HIGH-FREQUENCY PRACTICE 
Arthritides which accompany infectious diseases 
should not be treated by high-frequency currents until 
the causative factor of the disease is removed. 
Gonorrheal arthritis.—This condition seldom occurs 
during the acute stage of gonococcus infection. A very 
large proportion of cases is due to relapses of the dis- 
ease from some local focus in either the deep urethra, 
prostate or seminal vesicles from which the coccus 
enters the blood and is carried to some remote joint. 
The treatment of the disease demands first of all 
the removal of the focus of infection. The writer knows 
of no procedure that equals the static wave current to 
drain the prostate and seminal vesicles. The high-fre- 
quency current thru a properly insulated electrode for 
a period of 7 minutes daily will also drain the prostate 
by flooding the gland with new blood, thereby increas- 
ing phagocytosis and hastening return of normal func- 
tion. 
Rheumatoid arthritis.—In the early stage of this 
disease much damage to the joints may be averted 
by auto-condensation with sufficient time and dosage 
to thoroughly heat the entire body as evidenced by a 
rise of one degree with thermometer under the tongue. 
The subacute and chronic stages of the disease are 
best treated by static wave currents and diathermy. 
The katabolism of the patient is always below par; this 
condition is greatly benefited by application of dia- 
thermy to the liver, as well as auto-condensation. The 
joints may also be diathermatized. Static sparks are 
very efficient in hastening absorption of the inflamma- 
tory products. Common sense hygienic measures are HIGH-FREQUENCY THERAPY 
187 
very important in this disease. The patient should not 
be starved by a withdrawal of all proteins. A liberal 
Fig. 48.—Diathermy to knee joint anterio-posteriorly. 
diet with a limited amount of proteins should be ad- 
vised. 
Gouty arthritis.—This form of arthritis is always 
one of faulty metabolism. Auto-condensation suffici- 
ent to raise the body temperature at least one degree 
is indicated. However, a patient here and there will be 
found who cannot tolerate this treatment. High-fre- 
quency currents to the affected parts often aggravate 188 
HIGH-FREQUENCY PRACTICE 
the condition, under which circumstances heat from a 
high power lamp should replace diathermy. 
The liver should be diathermatized (See Fig. 59) at 
least twice a week. Physicians who are familiar with 
static currents prefer the static wave to diathermy to 
1 estore liver function. 
Osteo-arthritis in the early stage may be favorably 
influenced by diathermy, but after bony changes have 
taken place little can be done with high-frequency cur- 
rents. 
Tuberculous arthritis should not be treated by high- 
frequency currents. Exposure of the affected joints to 
radiant light, X-rays and actinic rays increases phago- 
cytosis and is often followed by excellent results. 
Tabetic arthritis or Charcot’s disease is benefited 
only by measures which favorably influence tabes dor- 
salis. 
Traumatic arthritis.—This is the form of arthritis 
where physiotherapy has proven its superiority to all 
methods of treatment. To those familiar with the ad- 
ministration of static currents the management of this 
condition is one of the easiest in practice. The treat- 
ment is not empirical but physiological. Radiant light 
and heat will dilate the capillaries of the skin and has- 
ten the removal of ecchymoses. The deeper conges- 
tion and stasis are easily removed by the Morton wave 
or static sparks. 
While this volume is not intended to be a treatise on 
static electricity, the writer who employs this modality HIGH-FREQUENCY THERAPY 
189 
in his daily practice cannot refrain from mentioning 
the most efficient means in the management of sprains 
to ligaments and joints. Outside of static currents the 
most efficient treatment of this condition is diathermy. 
Fig. 49.—Diathermy to knee joint laterally. 
The affected joint should be heated thru and thru not 
only anterio-posteriorly but laterally (See Figs. 48 and 
49). While the unipolar application of the high-fre- 
quency current will hasten absorption of infiltrations 
about superficial tendons, its action in arthritis is too 
superficial to be of much service. 190 
HIGH-FREQUENCY PRACTICE 
If proper treatment be instituted soon after the in- 
jury there will be no call for strapping the joint, a sim- 
ple bandage being sufficient and often not necessary. 
Chronic arthritis.—The treatment of non-infective 
chronic arthritis with or without ankylosis is essen- 
tially the same as in the traumatic form. The static 
wave and sparks will relieve the muscular spasm and 
liven up the joint to renewed activity, so much so that 
it may simulate the acute form of the disease, after 
which diathermy and passive motion will complete the 
rejuvenation. Stimulation of the liver to the removal 
of toxins by static wave or diathermy is an important 
part of the treatment of every form of anthritis whether 
it be acute, chronic or infectious. 
It is not to be expected that every case of chronic 
arthritis with ankylosis will be restored to normal func- 
tion by the treatment mentioned, but a fairly good per- 
centage will recover sufficiently to make useful joints. 
The rule of one, two, three cannot be applied to every 
case, but patience, perseverance and a fair degree of 
skill will work out the reconstruction of joints which 
heretofore have been considered incurable. 
ASTHMA. 
Asthma is a neurosis characterized by paroxysmal 
dyspnea due to spasmodic narrowing of the bronchial 
lumen, alternating with spasm of the muscles of the 
thorax. The term asthma is applied to symptoms just 
mentioned when no organic lesions can be recognized 
in its causation, HIGH-FREQUENCY THERAPY 
191 
The essential feature of asthma is dyspnea with a. 
history of typical recurrent attacks which were relieved 
Pig. 50.—High-Frequency in Asthma. 
by cocaine, sprays in the nose, inhalations of stramo- 
nium or injections of adrenalin. 
Dyspnea is a symptom of many diseases such as 
cardio-renal disease, syphilis of the bronchus, goiter, 
thoracic aneurysm, bronchitis, mediastinal and laryn- 
geal growths and tuberculosis. 
Irritation of the vagus nerve from any point of its 
distribution may precipitate an asthmatic attack. Fre- 192 
HIGH-FREQUENCY PRACTICE 
quently the irritation comes from the nasal passages. 
Treatment.—The prime object of treatment is the 
removal of the cause of irritation. When found in the 
nose it may be removed by surgery or desiccation. 
Polypi of the nasal cavities are easily removed by desic- 
cation. 
Technic: The entire field of operation as well as the 
mucous surfaces of the nares is anesthetized with a so- 
lution of cocaine. Seat the patient in a chair with a 
good head rest, the nasal cavity well illuminated. A 
suitable electrode for this purpose may be easily con- 
structed from a small knitting needle insulated (ex- 
cept the operating point) with rubber or adhesive, set 
in an ordinary fulguration handle; place the point of 
the electrode in the base of the polyp and turn on suffi- 
cient current to dehydrate it. In a few days the mass 
will separate and come away. After operation the 
nose should daily be cleansed with normal salt solution 
until separation takes place. This treatment has the 
advantages of no hemorrhage and no post-operative dis- 
comfort. Care should be exercised not to touch any 
part of the nose with any part of the electrode other 
than the operating point, as high-frequency currents 
are difficult to insulate and sparks will pass thru the 
insulation; if allowed to touch the patient they are not 
only disagreeable to the patient but lessen the current 
strength at point of operation. 
In the treatment of asthma where there is no dis- 
coverable cause, the provocation of the lung reflex of 
contraction may be brought about by concussion of the HIGH-FREQUENCY THERAPY 
193 
spines of the 4th and 5th cervical vertebrae as directed 
by Abrams. The unipolar high-frequency current thru 
a double pronged non-vacuum spinal electrode applied 
to the 4th and 5th cervical interspace for a period of 
from two to five minutes will often relieve the paroxysm. 
The current must be a strong one. 
The sinusoidal current with one electrode over the 
cervical region and the other over the sacrum with a 
strong wave for 15 to 30 minutes every other day will 
also relieve the paroxysms. When the spasm is due to 
bronchitis there is no treatment so satisfactory as dia- 
thermy with the same technic as in bronchitis. (Fig. 
56). 194 
HIGH-FREQUENCY PRACTICE 
ATAXIA (LOCOMOTOR). 
Tabes dorsalis. 
Ataxia (ataxy) is a term employed to express in- 
coordination of muscular action and is a symptom of 
several nervous lesions. In this article it will be con- 
sidered only as a symptom of tabes dorsalis, a disease 
dependent upon degeneration and sclerosis of the pos- 
terior columns of the spinal cord. 
Essential features.—The essential features of this 
disease consist of degeneration and atrophy of nerve 
fibers with hypertrophy of connective tissue. The symp- 
toms which may be present are numerous. The chief 
ones characterizing the disease are muscular incoordi- 
nation of locomotor and other voluntary muscles; light- 
ning pains and disturbance of vision. The Argyll- 
Robertson pupil, abolition of patellar reflex and mus- 
cular incoordination when combined are pathognomo- 
nic of tabes. 
The disease is essentially chronic but may not be 
progressive. There is practically no muscular atrophy 
as in multiple neuritis. The most common cause of the 
disease is syphilis. 
Therapy.—Tabes dorsalis is an incurable disease, but 
much relief of symptoms may obtain from electrical 
modalities, the chief one being the static wave current 
and sparks applied to the dorsal spine. Auto-conden- 
sation is indicated for its effects upon the general me- 
tabolism, this being best accomplished with light doses 
(under 500 milliamperes). HIGH-FREQUENCY THERAPY 
195 
Lightning pains and gastric crises may be relieved 
by high-frequency sparks from a vacuum or non-vac- 
uum electrode applied over the dorsal spine. The loca- 
tion of the pain or paraesthesia will be a guide to the 
proper point of spinal application. 
Fig. 51.—Double electrode to spine. 
Diathermy is of special value in pains of this dis- 
ease. The electrodes should be placed on either side 
of the spinal column corresponding to painful skin 
areas. If pain is below the knees the electrodes should 
be applied to the 11th and 12th dorsal vertebrae. 196 
HIGH-FREQUENCY PRACTICE 
Fig. 52.—High-frequency application in tabes, front view. HIGH-FREQUENCY THERAPY 
197 
Fig. 53.—High-frequency application in tabes, back view. 198 
HIGH-FREQUENCY PRACTICE 
ATROPHY, MUSCULAR. 
Muscular atrophy is due to dysfunction of the mo- 
tor nerve which supplies the affected muscle. The 
causes of atrophy are: Trauma, diseases of the spinal 
cord, diseases of the peripheral nerves due to neuritis, 
chemical or organic poisons; anemias, microbial and 
other toxins and constitutional diseases. 
Diagnosis.—The responses to electrical tests will 
show whether the atrophy is neuro-thropic or other- 
wise. When, atrophy is due merely to wasting disease 
there will be no reaction of degeneration (R. D.) ; when 
due to disease of the spinal cord the R. D. is present; 
when due to peripheral neuritis the R. D. is but partial. 
(See Fractures, Neuritis, etc.). 
Therapy.—The general management of muscular 
atrophy depends entirely upon the causative factor. 
When there is a prospect of final regeneration of nerve 
supply the retention of nutrition of the muscle is of 
prime importance, in order that the muscle will be able 
to resume its function immediately following regener- 
ation. This may be accomplished in many ways among 
which may be mentioned faradic, galvanic and high- 
frequency currents, massage, etc. The high-frequency 
current in the form of diathermy is of first importance 
in retaining cellular activity. 
After atrophy has taken place the muscles should 
be thoroughly heated by diathermy and mildly exer- 
cised by the faradic, sinusoidal or galvanic current. If 
there be but partial R. D. the faradic current as modified 
by the Bristow coil or the sinusoidal current is to be HIGH-FREQUENCY THERAPY 
199 
Fig. 54.—Location of electrode to induce reflex of 
contraction. L, lungs; H, heart; G, gall-bladder; S-V, 
splanchnic vessels; K-P, kidney and prostate; S, stomach, 
spleen and genitals. 200 
HIGH-FREQUENCY PRACTICE 
preferred. However, the interrupted galvanic current 
is sometimes required. 
The writer believes that we have in the galvanic 
current a means of muscle feeding secondary only to 
diathermy. 
BRONCHIECTASIS. 
Bronchiectasis is a term used to denote a condition 
of a more or less uniform dilatation of the bronchial 
tubes of one or both lungs. It is accompanied by a 
copious expectoration of a fetid character. When a 
considerable time intervenes the copious expectoration 
attacks may simulate tuberculous cavitation, a rup- 
tured empyema or gangrene of the lung. 
Therapy.—The excitation of lung reflex of contrac- 
tion so useful in this condition may be induced by per- 
cussion of or the application of a strong high-frequency 
current to the 4th and 5th cervical vertebrae. 
Diathermy as employed in pneumonia will be found 
to be of signal service. (See Fig. 56). Semi-intensive 
treatment with the roentgen ray alternated with dia- 
thermy will clear up some cases apparently almost mori- 
bund. 
In the following case history pictures very well 
what may be accomplished by roentgen radiations: 
A boy aged six. Both parents well. No family his- 
tory of tuberculosis, lues or other dyscrasia. The boy 
was always in good health until five years of age after 
which he suffered several attacks of tonsilitis. In July, HIGH-FREQUENCY THERAPY 
201 
Fig. 55.—Location of electrode to induce reflex of 
dilatation. H, heart and esophagus; L, lungs; K, kid- 
ney; G, gall-bladder; P-V, pulmonary vessels and uterus; 
C, cervix and vagina; P, penile muscles. 202 
HIGH-FREQUENCY PRACTICE 
1920, he was operated upon for adenoids and at the 
same time his tonsils were removed. About one month 
later he suffered an attack of appendicitis and an ap- 
pendectomy was performed. Before he fully recov- 
ered from this operation symptoms of pneumonia su- 
pervened. The orthodox symptoms of lobar pneumonia 
prevailed for ten days but there was no resolution. The 
high temperature, cough and emaciation continued. The 
expectoration was profuse and purulent. A tenta- 
tive diagnosis of lung abscess was made. On Febru- 
ary 1, 1921, an X-ray examination was made with find- 
ings of bronchial dilatation, parencymatous and peri- 
bronchial infiltration over the entire area of right lung. 
Blood examination showed extreme anemia, low red 
count and high leucocytosis. 
He was referred to the writer for treatment. His 
general appearance was found to be waxy, emaciated 
and with hectic flush. He was able to stand but could 
not walk. His temperature was 102F. The chart 
showed great variations in temperature. It ranged 
from 100 in the morning to 102-105 in the evening. 
Pulse 150. Respiration 40. Percussion dull over en- 
tire right chest. Auscultation—a few coarse rales and 
bronchial breathing. Cough almost incessant. A post- 
operative hernia was present over the region of the 
appendix. 
This case was diagnosed as “bronchiectasis” and 
treated solely with roentgen rays. The rays were di- 
rected over the affected side every third day; the dose 
varied from |H to £H. After the fourth exposure his HIGH-FREQUENCY THERAPY 
203 
temperature became normal and remained so; expec- 
toration reduced very much in quantity and lost much 
of its purulent character. His improvement was steady; 
his weight and strength and blood conditions improved 
Fig. 56.—Diathermy in Bronchitis, direct method. 
In a period of 30 days his weight had increased 25 per 
cent. In 60 days while he had a slight dry cough he had 
regained his normal weight and was able to take his 
place with other boys. 204 
HIGH-FREQUENCY PRACTICE 
BRONCHITIS. 
Many cases of acute bronchitis may be jugulated by 
early use of diathermy. If treated during the first 24 
hours after the onset, one treatment is usually suffici- 
ent. After the first day more treatments will be re- 
quired. 
Technic.—Place a large electrode (6x8) over the 
upper dorsal spines and another of the same or smaller 
area over the sternum. Gradually turn the current on 
to 500 milliamperes for 5 minutes, then gradually in- 
crease to comfortable toleration and continue for 20 
minutes, then gradually reduce current to zero. Put 
the patient in bed to remain for 24 hours. If he is not 
well repeat the treatment. 
The same technic applies to chronic bronchitis but 
will require several treatments to subdue the disease. 
Some cases of chronic bronchitis will not recover under 
any treatment. 
BRUISES. 
Bruises vary in severity according to the degree of 
traumatism. First degree includes light bruises of 
the skin; second degree, more severe cases when the 
skin and soft tissues are injured; third degree, bruises 
of the periosteum and bone. 
From a medical standpoint every bruise should be 
regarded as serious and every effort be made to restore 
normal circulation of the parts at the earliest possible 
moment. Treat all bruises as though serious conse- 
quences were to be expected. Radiant light and heat HIGH-FREQUENCY THERAPY 
205 
Fig. 57.—Diathermy in Bronchitis, indirect method. 206 
HIGH-FREQUENCY PRACTICE 
should be applied as soon as possible after the trauma. 
Success lies in prolonged exposure. One hour twice a 
day is the least time to be considered and more is better. 
Between the exposures to light, high-frequency vacuum 
or non-vacuum application should be made. 
First and second degree bruises will yield promptly 
to the above treatment. Third degree bruises may re- 
quire in addition the static wave current to dissipate 
the infiltration. If applied sufficiently early the static 
wave will prevent disintegration. 
BURNS. 
Healing of burns may be accelerated by high-fre- 
quency application thru a vacuum or non-vacuum elec- 
trode. The application should be made thru a few 
layers of gauze. 
BURSITIS. 
Bursitis mucosae, an inflammation of subcutaneous 
bursae; bursitis synovial, an inflammation of bursae 
found between tendons; bursitis vaginalis, an inflamma- 
tion of the synovial sheath, are all conditions occurring 
frequently about the tendons of the wrist. 
Treatment.—The patient seated on auto-condensa- 
tion pad connected to one pole of d’Arsonval machine, 
opposite pole connected to small metal electrode which 
is placed on the inflamed bursa. Diathermatize for 15 
minutes with a current of about 400 milliamperes daily 
until cured, which will require from 3 to 12 treatments. HIGH-FREQUENCY THERAPY 
207 
CANCER. 
The real etiological factor of cancer is still in doubt. 
The belief held by many members of the medical profes- 
sion is that cancer is caused by local irritation and re- 
curring chronic inflammation; that it is primarily a 
local disease with post constitutional effects. Others 
Fig. 58.—High-frequency in Bruises—black eye. 
believe it to be a constitutional disease with local mani- 
festations, among whom may be mentioned Dr. Dun- 
can Bulkley, Member of American Association for Can- 
cer Research, who states in his book (Cancer and its 
Non-Surgical Treatment) : “Laboratory research has 
proved an utter failure in solving the Cancer Problem. 
The theory of its purely local nature and treatment 208 
HIGH-FREQUENCY PRACTICE 
has resulted only in a steady increasing morbidity and 
mortality. The mortality is less under medical than 
surgical treatment. Cancer is a constitutional and not 
a local disease, the cancer itself being a manifestation 
of that constitutional condition, carcinosis.” 
Therapy.—The treatment of cancer by diathermy is 
so eminently stated by Dr. Albert C. Geyser in the 
American Physician and reprinted in the Medical Her- 
ald and Electrotherapist, May, 1921, that the entire 
article is quoted: 
“Cancer is both a local and a constitutional disease, 
therefore, both a local and a constitutional treatment is 
indicated. 
“If the tumor has not yet broken down, diather- 
mia is the only local treatment required. After such a 
mass has been consistently treated with diathermia the 
entire physiology of the tumor is changed and to all 
intents and purposes we have converted a malignant 
growth into a benign one. If it is desirable for cos- 
metic or other reasons to remove the growth this may 
be accomplished with the assurance of no recurrence. 
If the tumor has broken down the only dressing required 
is a ten to twenty per cent bicarbonate of soda solution. 
This dressing should not be changed oftener than three 
times in twenty-four hours. 
Two conditions must be created to their fullest ex- 
tent—the dialyzing and the oxydizing power of the 
blood. Of all drugs known, iodine or its compounds 
supply the former while iron induces the latter. There- 
fore, the cancer patient should receive an intravenous HIGH-FREQUENCY THERAPY 
209 
injection of sodium iodide 16 grains (1 gram) to 20 
mils, of a sterile solution on alternate days for two 
weeks. During the third week on alternate days a so- 
lution of iron and arsenic 5 mils, containing of iron 
cacodylate one grain (64 milligrams) should be injected 
in the usual intravenous manner. The fourth week no 
internal medication will be given. The entire process 
may then be repeated as often as necessary. The weekly 
divisions are entirely arbitrary and can be changed to 
suit the individual case. 
“As to diet, I am a firm believer in the vegetable diet 
in all patients suffering from malignancy. Animal pro- 
teins of all kinds should be reduced to the smallest 
amount, if not entirely interdicted. 
“In selecting cases for the diathermic method of 
treatment, it is only necessary to use ordinary common 
sense. A moribund patient is no more a fit subject for 
diathermia than he is for operative procedure. 
“Reference has been previously made to the thermic 
effects upon cancer cells. In all of those tests the cells 
had been removed from the patient for the purpose of 
transplantation. It was then shown that these cells, 
after the application of certain degrees of heat to them 
were no longer viable, therefore, did not produce cancer 
upon the experimented animal. It is not our desire to 
remove cancer cells and then destroy them. We intend 
to leave the cells in situ, but by the application of an 
electric current cause them to become heated to exactly 
the same degree of temperature as the experimented 210 
HIGH-FREQUENCY PRACTICE 
cells. It is not our object to interfere with their ana- 
tomy, but we do want to change their physiology. To 
do this it is necessary to include the entire tumor be- 
tween the two electrodes of a high-frequency current. 
With breast or superficially situated skin cancers this is 
quite simple. With uterine and rectal cancers, while a 
little more complicated and uncertain, nevertheless, 
practical results may be achieved in eighty per cent of 
the cases. 
“In cases of breast cancer, a suitable electrode is ap- 
plied directly over the lesion, the other electrode con- 
taining at least four times the surface area is placed 
directly opposite upon the dorsum of the patient. The 
current is turned on to the point of tolerance, which is 
usually about fifty milliamperes to each square inch of 
the anterior electrode. If the skin overlying the growth 
is as yet intact, the reading may go as high as one hun- 
dred milliamperes per square inch. From forty-five to 
sixty minutes should be consumed for each treatment, 
repeated daily or at least on alternate days. When the 
growth is situated in the cervix uteri or rectum, a suit- 
ably shaped electrode is placed in position, then a larger 
posterior electrode is placed in the skin of the abdomen 
and back of the patient; these two larger electrodes are 
short circuited and led to one binding post of the high- 
frequency machine. The uterine as well as the rectal 
cavity will bear temperatures considerably higher than 
the external skin. It is not uncommon to use 200-300 
milliamperes per square inch of area in these mucous 
membrane applications. The treatments should be HIGH-FREQUENCY THERAPY 
211 
given daily or at least on alternate days for at least two 
months, then once per week for an indefinite time. 
“Let it be thoroughly understood that the applica- 
tion of diathermia does not necessarily remove the 
growth, but it does interfere with the physiology of 
the cancer cells in such a manner that the previously 
present cachexia disappears, there is complete cessa- 
tion of pain, all lymphatic enlargements subside, the 
patient gains weight and appears to all intents and pur- 
poses normal. 
“After diathermia has been used for a sufficient 
length of time, and these constitutional changes have 
been brought about, there is no reason why the growth 
should not be removed surgically, because practically 
all chances of recurrence have been removed. The 
growth which was previously malignant may now be 
looked upon as a benign tumor and dealt with corres- 
pondingly/’ 
For the electro-surgical treatment of cancer see 
“Surgical Diathermy.” The treatment of cancer by 
radium and X-rays is not apropos in a treatise on high- 
frequency practice. 
CARUNCLE, URETHRAL. 
Caruncles yield rapidly to desiccation. Technic.— 
Bring the growth well into view and anesthetize with 
procaine injection into its base. Desiccate with a needle 
point electrode for sufficient time to dehydrate the tu- 
mor ; apply a wet boric acid dressing. Owing to the con- 
stant moisture of the part the dehydrated mass will 212 
HIGH-FREQUENCY PRACTICE 
soon separate and leave a clean base. There will be no 
postoperative cicatrix. 
CERVICAL EROSIONS. 
Therapy.—One thorough treatment by surgical dia- 
thermy will usually clear up cervical erosions. 
Technic. — (Unipolar) The vagina should be 
cleansed with a hot solution of sodium chlorid. Place 
the patient upon a wood table with feet in stirrups; 
introduce a glass speculum, bringing the cervix well 
into view; wipe away every vestige of the salt solution ; 
connect a long needle electrode with the Oudin post and 
thoroughly desiccate every portion of the erosion. 
The bipolar method is some times desirable. The 
same technic as that in the unipolar method is followed 
with the exception that the d’Arsonval current is em- 
ployed. The indifferent electrode should be not less 
than 36 square inches in area and placed underneath 
the buttocks or some other convenient locality and con- 
nected to one post of the d’Arsonal apparatus, the long 
needle electrode is connected with the opposite post and 
sufficient current employed to thoroughly destroy 
every vestige of the eroded surface. No after treat- 
ment is needed. 
CHANCROID. 
Chancroid is usually rebellious to ordinary germici- 
dal or antiseptic treatment. The disease may be cut 
short by a thorough dehydration of the ulcerating sur- 
face by desiccation. 
Technic.—The part to be treated should be anes- 
thetized by cocain and every part of the ulcer surface HIGH-FREQUENCY THERAPY 
213 
thoroughly destroyed. If the operation is thorough one 
treatment is sufficient, the destroyed mass will sepa- 
rate in a few days leaving a clean base. If any part of 
the ulcer escape dehydration there will be an exacerba- 
tion of the disease and another treatment will be re- 
quired. 
Fig. 59.—Diathermy of Liver. 
CIRRHOSIS OF LIVER. 
Treatment.—During the early stage of cirrhosis the 
liver is engorged with excess of blood and being the 
“clearing house” of the body toxins and unable to elim- 
inate them, the host suffers more or less from toxemia. 
As auto-condensation physiology is to eliminate 
toxic material from the blood it is indicated in this dis- 
ease unless there be hypotension. 214 
HIGH-FREQUENCY PRACTICE 
Fig. 60.—Diathermy to the Foot. HIGH-FREQUENCY THERAPY 
215 
Diathermy may be employed in any stage and is of 
special service during the stage of atrophy when as- 
cites and more or less edema have occurred; it floods 
the liver with new arterial blood and assists the liver 
in the performance of its function. While it does not 
cure the disease it is a source of relief to the patient. 
Technic.—Place an electrode at least five inches in 
diameter over the 4th, 5th and 6th dorsal vertebrae. 
The other electrode should be smaller in area and placed 
over the anterior hepatic region. The current strength 
should be gradually increased from zero to the point 
of tolerance regardless of the meter reading. Time of 
treatment 20 to 60 minutes and repeated daily until re- 
sults are obtained. 
CHILBLAINS. 
This aggravating condition may be promptly re- 
lieved by diathermy. Practically all cases yield to from 
one to three treatments. 
Technic.—Heavy pads consisting of many layers of 
gauze saturated with a solution of common salt are 
placed on the dorsal and plantar surfaces of the foot 
over which small flexible metal electrodes are firmly 
secured. The diathermic current is turned on to point 
of toleration and continued for 15 to 25 minutes and 
slowly returned to zero. 
This technic is also useful in ischemia, muscular 
spasms, Raynaud’s disease, metatarsalgia and trench 
foot. 216 
HIGH-FREQUENCY PRACTICE 
CHLOROSIS. 
(See Anemia; 
CHOLELITHIASIS (Gall Stones;. 
Gall stones may cause obstructive jaundice, cirrhosis 
and intenstinal obstruction. 
Gall stone disease should be differentiated from 
pleurisy, neuralgia, gastric and intenstinal colic, duode- 
nal ulcer and appendicitis. 
Therapy.—While a well developed case of gall stone 
is essentially a surgical one, the condition known as 
gall-stone disease may in its early stages be relieved 
by applications of radiant light and diathermy. For 
technic of liver diathermy see “Cirrhosis of Liver.” 
Relief is also often obtained thru excitation of the 
liver reflex by unipolar application of the high-fre- 
quency current to the 4th, 5th and 6th dorsal spines. 
Acute chorea commonly called “St.Vitus’ dance” is 
usually a disease of childhood during adolescence. It 
is more common in girls than boys. It may occur in 
adults. The disease is often associated with diseased 
tonsils. An attack may be precipitated by removal of 
the tonsils. The cause is probably of a bacterial nature. 
Choreiform contractions occur in many hysterical 
as well as pathological conditions. 
Therapy.—The successful management of chorea 
depends upon removal of the cause. The tonsils are first 
to be thought of as the possible home of focal infection. 
CHOREA. HIGH-FREQUENCY THERAPY 
217 
If there be tonsillar infection associated with chorei- 
form contractions the tonsils should be treated in ac- 
cordance with the technic suggested under the head of 
Diseased Tonsils. It is quite absurd to expect favorable 
results from the general application of electricity in 
any form, when the condition is due to a focus of in- 
fection. In the hysterical form unipolar application of 
the high-frequency current to the upper dorsal spines 
is often beneficial. 
It is well known that autocondensation quiets mus- 
cular unrest and its application in chorea is often fol- 
lowed by restful sleep. 
COCCYX (Painful) 
Painful coccyx, when due to injury, is promptly 
relieved by the application of diathermy. The technic 
is simple: Place a metal electrode within the rectum 
and the other over the painful area and employ a mild 
current—from 100 to 250 milliamperes being suf- 
ficient. 
DIABETES MELLITUS. 
True diabetes is characterized by a permanent con- 
dition of glycosuria. The urine is largely increased in 
amount, there is muscular weakness and marked thirst. 
As the disease advances acetone and diacetic acids ap- 
pear in the urine. In the acute form any form of diet 
seldom influences the amount of sugar in the urine. 
The patient usually succumbs to the disease within two 
or three years. 218 
HIGH-FREQUENCY PRACTICE 
Sugar in the urine may accompany many conditions 
such as hemorrhage, tumors, pancreatic disease, goiter, 
alcoholism, etc. 
Chronic glycosuria.—This occurs in elderly subjects 
who have gouty tendencies. The urine is increased in 
amount but does not contain acetone. There is no 
wasting, little or no thirst and appetite not altered. A 
strict diet always benefits these cases. 
Fig. 61—Local auto-condensation in Diabetes. 
Therapy.—To the dietetic management of chronic 
glycosuria we may add diathermy with profit. HIGH-FREQUENCY THERAPY 
219 
Fig. 62.—Hands-to-feet Diathermy. HIGH-FREQUENCY THERAPY 
221 
Technic.—Place the patient on an auto-condensation 
couch or pad, place a large non-vacuum electrode over 
the epigastrium and gradually turn the current on to 
toleration, allow the current to flow for ten minutes 
then gradually reduce the current to zero, then move 
the electrode to another abdominal location and repeat 
the maneuver until the entire abdomen has received 
treatment. Repeat every other day. 
Hand to foot diathermy is an alternative which is 
often useful. The percentage of sugar in the urine is 
always decreased by diathermy. High-frequency ef- 
fluve from a multiple-point electrode to the back and 
lower limbs is gratefully received by the patient and re- 
lieves the nervous symptoms which are present in many 
cases of diabetes. 
Physiology.—The explanation of the modus oper- 
anda of this treatment is not clear. The benefits de- 
rived are probably due to the effects upon metabolism. 
DYSMENORRHEA. 
Dysmenorrhea is a term applied to difficult or pain- 
ful menstruation. Several forms of this condition are 
recognized: (1) Congestive due to an intense conges- 
tion of the pelvic viscera: (2) Intermediate, pain occur- 
ring between the menstrual periods; (3) Membranous, 
a painful discharge of the menstrual decidua; (4) Neu- 
ralgic applied to neurotic dysmenorrhea; (5) Obstruc- 
tive due to mechanical obstruction; (6) Ovarian the 
form in which the pain is confined to the ovaries and 
lumbar region; (7) Spasmodic due to uterine spasm. 222 
HIGH-FREQUENCY PRACTICE 
Therapy.—The congestive and spasmodic forms of 
dysmenorrhea are promptly relieved by diathermy. 
Technic.—One electrode should be placed over the 
sacrum, the other over the lower abdomen and the 
d’Arsonval current turned on gradually to comfortable 
Pig. 63.—High-Frequency Bffluve. 
toleration of the patient, allowed to remain for 15 to 
20 minutes then gradually reduced to zero. One treat- 
ment is usually sufficient to relieve the symptoms. 
Another method is to apply one electrode to sacrum, 
one over the hypogastrium and both electrodes attached HIGH-FREQUENCY THERAPY 
223 
to one post of machine by means of bifurcated conduct- 
ing cord. The third or active electrode being an insu- 
lated vacuum vaginal electrode attached to opposite 
post of the machine is placed in the vaginal fornix and 
a current of toleration allowed to pass for 7 minutes. 
Physiology.—The heat induces rapid circulatory 
changes and relaxes spasm. 
Membranous Dysmenorrhea is best treated by the 
softening effects of the negative pole of the constant 
current applied within the uterus. 
Intermediate Dysmenorrhea is successfully treated 
by galvanism. The management of other forms depends 
entirely upon the causative factors. 
The intrauterine application of the high frequency 
current in dysmenorrhea is an excellent one in cases 
where the cervical canal will admit an electrode cov- 
ered with cotton which has been previously saturated 
with hot saline solution. A bare metal or glass elec- 
trode within the uterus with even a mild current may 
damage the uterine mucosa, but when wrapped as 
above described the salt acts more or less as an insu- 
lator and protects the mucosa. This technic admits 
the use of stronger currents which may be applied for 
a longer period of time, thus more effectually heating 
the entire pelvic contents. When an intra-uterine ap- 
plication is made the effects may be enhanced by the 
use of two indifferent electrodes, one over the sacrum, 
the other over the hypo-gastrium, both being connected 
by means of a bifurcated cord to one pole of the d’Ar- 224 
HIGH-FREQUENCY PRACTICE 
sonal apparatus. This method is known as modified 
diathermy. 
ECLAMPSIA. 
Eclampsia is a term denoting a sudden convulsive 
seizure in a woman prior to or during labor, or during 
puerpium. 
Therapy.—The treatment of eclampsia is prophy- 
lactic, medical and surgical. 
One of the earliest and most constant signs of a 
toxic condition is a gradual increase in the systolic 
blood pressure and will be noted for a month or more 
before albumin can be detected in the urine. When the 
systolic blood-pressure reaches 145 in a pregnant wom- 
an, otherwise normal, eclampsia is to be expected. The 
blood-pressure of every pregnant woman should be 
taken at least once in two weeks during the period of 
gestation. If the pressure is found to be gradually 
rising do not wait for albumin to appear in the urine, 
but give the patient the benefit of all doubts by insti- 
tuting treatment by auto-condensation 300 to 400 milli- 
amperes for 12 minutes at such intervals necessary to 
keep the systolic pressure near to normal. The saying, 
“An ounce of prevention is worth a pound of cure,” was 
never more pertinent than in eclampsia. 
ECZEMA. 
Eczema is a term applied to acute, subacute or 
chronic inflammation of the skin, characterized by 
erythema, vesicles, papules, pustules or a combination 
of two or more of these lesions. The varieties are too 
numerous to be mentioned here. HIGH-FREQUENCY THERAPY 
225 
Therapy.—While the unipolar application of the 
high-frequency current will often relieve the itching 
and the hyperemic effects prove useful, a cure of the 
disease should not be looked for. 
The ideal treatment of all eczemas is found in the 
roentgen ray. Often one intensive treatment will clear 
up the lesion. However, the writer prefers fractional 
doses of 1/3H daily for 3 days, repeating the dose in 
three weeks if found necessary. 
ENDOMETRITIS. 
Endometritis is an inflammation or hyperplasia of 
the uterine mucous membrane, involving to a greater 
or less extent the uterine parenchyma. There are two 
forms, the acute and chronic. The acute form may be 
so mild as to be overlooked. The chronic form super- 
venes the acute form in a gradual manner. 
A differential diagnosis between endometritis, car- 
cinoma, sarcoma and fibroid should be made before 
treatment is instituted. 
Therapy.—The acute form resulting from sup- 
pressed menstruation, over exertion, etc., is promptly 
relieved by diathermy, with one electrode over the hypo- 
gastrium, the other over the 1st to 4th lumbar verte- 
brae. A current of toleration should be passed for 20 
to 30 minutes every other day. 
A more pronounced effect may be induced with a 
well insulated vaginal or prostatic electrode in the va- 
ginal fornix, the other electrode of metal over the hypo- 
gastrium, current strength of toleration for 7 minutes 226 
HIGH-FREQUENCY PRACTICE 
daily. Modified diathermy is also useful. See dys- 
menorrhea. 
The uterus may be reached also with active prostatic 
electrode in the rectum with opposite electrode over the 
Fig. 64.—Bipolar Application in Endometritis 
electrodes; U, uterus; B, bladder; R, rectum. 
hypogastrium as in diathermy of the prostate (Fig. 
83). 
Uterine reflex of contraction may be induced by a 
strong unipolar current over the 1st, 2nd and 3rd lum- 
bar vertebrae for a period of 5 minutes. This is of spe- 
cial value if there be uterine bleeding. 
Physiology.—Dissipation of inflammatory products 
thru circulatory effects. See physiology of diathermy. 
EPIDIDYMITIS AND ORCHITIS. 
Therapy.—The early treatment of epididymitis by 
diathermy will limit the deposition of inflammatory HIGH-FREQUENCY THERAPY 
227 
products and will also hasten their elimination after 
they are formed. 
Technic.—Owing to the peculiar anatomical contour 
of the parts it is advisable to employ several layers of 
gauze saturated with hot salt solution underneath the 
flexible metal electrode which is shaped to cover the 
inflamed area. The other electrode may be held in the 
hands of the patient and the d’Arsonval current turned 
on gradually to point of tolerance; the amperage should 
then be reduced slightly and continued for 30 minutes 
to one hour and repeated daily until satisfactory re- 
sults are obtained. Acute cases should be aborted with- 
in four days. 
Physiology.—Circulation of blood and lymph is has- 
tened and tissues drained. 
EPILEPSY. 
Epileptiform attacks are probably due to spasm of 
the cerebral vessels producing a sudden anemia of the 
brain. If this theory be true, at least a temporary ame- 
lioration may be secured by inciting the reflex of dila- 
tation by strong high-frequency application to the 
lower dorsal vertebrae. 
Many reports have been made of favorable action 
of high-frequency currents in this disease, but as a rule 
the effects have been transient. However, Tracy has 
reported tentative cures of from 12 per cent in grand 
mal to 25 per cent in 'petit mal. 
The writer’s experience with high-frequency cur- 
rents in this disease leads him to believe that with the 228 
HIGH-FREQUENCY PRACTICE 
exception of auto-condensation to relieve the existing 
toxemia, there is little to be gained by their use. 
EPITHELIOMA. 
Before metastasis takes place practically all basal 
cell epitheliomata envolving the skin may be removed 
by surgical diathermy with little or no fear of recur- 
rence. 
For technic, see Surgical Diathermy. 
FISTULAS AND FISSURES. 
Any fissure of the tissues that can be brought into 
view with or without the employment of a speculum 
is easily and successfully treated by desiccation. 
Technic.—Bring the fissure well into view and with 
a needle electrode desiccate the entire tract, destroying 
all adventitious tissue. Fistulous tracts that can be 
reached with any shaped electrode are easily cured by 
desiccation. The difficulty encountered by tortuous 
tracts is more or less a barrier to successful manage- 
ment. Every portion of the pyogenic membrane must 
be destroyed in order to bring about the closing of the 
tract. The good judgment of the operator must be in- 
voked to render a decision in regard to the indications 
present in each individual case. 
The technic is essentially the same as in desiccation 
of fissures. 
The time required for healing fractures may be 
shortened one-third to one-half, better results obtained 
and many deformities obviated by timely employment 
FRACTURES. HIGH-FREQUENCY THERAPY 
229 
of electrotherapeutic measures. Atrophied muscles, 
adherent tendon sheaths and ankylosed joints result 
from improper after-treatment of fractures and dislo- 
cations. 
The too common practice of allowing splints to re- 
main from one to four weeks without removal is to be 
condemned. In nearly all cases the splint should be 
removed not later than the third day and at least twice 
a week thereafter, and diathermy applied for the pur- 
pose of maintaining nutrition. 
Diathermy will reduce edema and promote absorp- 
tion of exudates and consequently relieve pain. 
Diathermy will hasten the formation of callus by 
increasing the metabolism of the part, thus shortening 
the time of disability. If muscular activity be main- 
tained the muscles will be able to do their part as soon 
as sufficient union of bone has taken place. In cases 
where it is inadvisable to remove the splint (Pott’s 
fracture) a little ingenuity on the part of the surgeon 
will enable him to apply the electrodes, above and be- 
low the splint in such a manner as to flood the parts 
with new blood. 
GANGRENE. 
A vascular disease of the extremities known as 
Raynaud’s Disease is frequently arrested by physical 
measures such as radiant light from incandescent lamps 
and heat by diathermy. Radiant light should be applied 
every second day alternating with diathermy. The 
treatment must be continued for a long time—6 or 8 
months. 
Technic.—Same as for Chilblains. See Fig. 60. 230 
HIGH-FREQUENCY PRACTICE 
GOITER. 
The term goiter simply means an enlargement of the 
thyroid gland. There are several varieties of goiter, 
named in accordance with the pathology: Parenchy- 
matous, cystic, fibrous, exophthalmic and malignant. 
Therapy.—The writer desires to issue a warning 
against the indiscriminate use of high-frequency cur- 
rents in this disease. While physical measures have 
been proven to be of great value in the treatment of 
the parenchymatous and exopthalmic varieties there 
are but few cases benefited by high-frequency currents. 
The parenchymatous or simple adolescent form may be 
treated by diathermy with hope for success in a few 
cases. 
Technic.—Seat the patient on the auto-condensation 
pad, place a well-fitting metal electrode to the thyroid, 
turn on a current of 500 milliamperes for 5 minutes. 
This application may be repeated every third day. Care 
should be exercised not to overstimulate the gland. 
While treatment of the exophthalmic goiter by the 
roentgen ray is successful in many cases it should not 
be undertaken by unskilled hands. 
With proper technic the treatment of gonorrhea in 
the female by diathermy is very successful. The tem- 
perature of the infected area must be raised to 108 F. 
and maintained for a period of three hours in order to 
kill the gonococci; this is easily accomplished with one 
electrode in the vagina, the other over the hypogas- 
GONORRHEA. HIGH-FREQUENCY THERAPY 
231 
trium. Two or three hour applications with an inter- 
mission of three hours should be employed daily until 
no gonococci can be found. Three to ten days are 
usually required. The temperature is recorded by a 
thermometer in the rectum. 
Fig. 65.—Diathermy in Goiter. 
Hysterical hemiplegia may be differentiated from 
the organic form by one symptom, that of unconscious- 
ness. Hysterical hemiplegia is not preceded by un- 
HEMIPLEGIA. 232 
HIGH-FREQUENCY PRACTICE 
consciousness, while true organic hemiplegia is always 
preceded by a period, sometimes of only a few seconds 
of time, of unconsciousness. 
Treatment.—Hysterical hemiplegia is readily cured 
by the application of almost any electric modality, the 
more spectacular the application, the more prompt the 
results. This form is often cured by suggestion. 
In organic hemiplegia due to morbid processes such 
as embolism, thrombosis and atheroma which lead to 
local destruction there is little hope of restoration of 
function, but in some cases of small emboli much may 
be accomplished by the vascular dilatation and absorb- 
ent effects of autocondensation, 300 to 600 milliam- 
peres for 15 minutes, applied three times a week for a 
period of 3 to 6 weeks. 
HEMORRHOIDS. 
A hemorrhoid is defined as a vascular tumor of the 
mucous membrane of the rectum, skin or both. There 
are two varieties, the external and internal. The symp- 
toms are characteristic but should be differentiated 
from polypi, villous tumors, malignant growths and 
prolapsus. 
Therapy.—The general condition of the patient 
should first elicit our attention. Patients with hemor- 
rhoids are usually overfed, constipated and toxic. 
Nearly all cases have hypertension. Toxins must be 
removed and this is best accomplished by auto-conden- 
sation and diathermy. The liver should be diatherma- 
tized for 20 minutes three times a week with a current HIGH-FREQUENCY THERAPY 
233 
strength of 1000 to 2000 milliamperes. (See Fig. 59.) 
The food tube should be cleared and kept as clean as 
possible. 
This line of treatment will relieve practically all 
cases of recent development. However, if there be 
chronic thickening or dilatation of the venous walls, I 
know of no surgical procedure that equals the desicca- 
tion method first brought to our notice by Dr. W. L. 
Clark. The advantages of the method are: No gen- 
eral anesthetic required; complete destruction in one 
treatment; little post-operative discomfort; no pri- 
mary or secondary hemorrhages; less inflammatory 
reaction than when cautery is employed; no resulting 
cicatrices, hence no rectal strictures; external piles may 
be removed in the office and patient allowed to go about 
his business. 
Technic.—For internal hemorrhoids a preliminary 
purgative and enema are given. The area about the 
anus is anesthetized with a 2 per cent solution of pro- 
cain, the injections being made at points about one inch 
from the anus. The skin being anesthetized will allow 
of deeper injections to thoroughly block the nerves of 
the sphincter sufficiently to dilate the sphincter. After 
dilatation of the sphincter the hemorrhoid is pulled 
down, clamped and desiccated down to the clamp. The 
mass is then removed with scissors. The clamp is then 
removed without fear of hemorrhage. A soothing sup- 
pository is inserted into the rectum and may be re- 
peated as circumstances dictate. 
If the pile be external no clamp is used. The base of 
the pile is anesthetized with a 2 per cent solution of 234 
HIGH-FREQUENCY PRACTICE 
procain to which epinephrin may be added. If the pile 
be small the entire mass is desiccated until it changes in 
color to chamois or light yellow. 
There is no rule for dosage. Apply the current until 
the color mentioned appears. This will require from 
3 to 10 seconds according to the size of the pile. Piles 
with small pedicales need only to have the base desic- 
cated and the mass cut away with scissors. No post- 
operative treatment required; complete healing takes 
place in a few days. 
HERPES ZOSTER. 
(Shingles.). 
Herpes Zoster is an acute inflammatory disease of 
the skin, appearing along the course of certain cuta- 
neous nerves and is characterized by groups of papules. 
The eruption is preceded by intense? pain in the neigh- 
borhood of the area attacked. The eruption may occur 
on almost any part of the body, its favorite site being 
along the course of intercostal nerves. The skin lesion 
is secondary to neuritis. 
Therapy.—The unpleasant symptoms caused by the 
eruption are often relieved by high-frequency applica- 
tion thru a vacuum electrode. High-frequency effluve 
from a multiple-point electrode is soothing to the pain- 
ful areas. Auto-condensation for its general effect 
upon metabolism is indicated. (See Neuralgia and Neu- 
ritis.) 235 
HIGH-FREQUENCY THERAPY 
The effects of high-frequency currents in this dis- 
ease are principally psychic in character. 
HYSTERIA. 
IMPOTENCE (Sexual) 
Patients suffering with sexual impotence require 
careful examination to ascertain the causative factor 
in each particular case and when found it should be 
treated with due regard for the indications present. 
Most of the conditions which produce sexual incom- 
petency are amenable to some form of physiotherapy. 
In many cases diathermic applications are followed 
by relief of the incompetency. With a metal electrode 
within the rectum and another over the hypogastrium 
with a small amperage of current the arterial flow 
of blood will be increased in the parts affected and re- 
lieve the coldness in the parts and at the same time in- 
crease the glandular activity. A strong Oudin current 
applied over the lower lumbar region increases the 
activity of the nerves supplying the organs of gener- 
ation. 
Superficial types of infection are best treated by 
radiant light and heat from a high wattage carbon 
filiment lamp. The heat produces an increased resist- 
ance to infection to a degree capable of overcoming 
the germ process. To be successful with this agent 
long exposures of one hour each must be made; at least 
three such exposures should be made during each 
twenty-four hours. 
Where there is no closed accumulation of pus, dia- 
thermy will do excellent service. 
INFECTIONS. 236 
HIGH-FREQUENCY PRACTICE 
INSOMNIA. 
Insomnia is not a disease but a symptom common 
to many diseases and dysfunctions. The amount of 
sleep required varies greatly in individuals, some re- 
quiring but five hours’ sleep while others require nine 
to ten to be able to perform the same amount of work. 
The normal average for men is seven and for women- 
eight hours out of each twenty-four. 
Classification.—Etiologically insomnia is divided in- 
to three groups: (1) Insomnia due to faulty habits 
and hygiene; (2) insomnia due to acute diseases; (3) 
insomnia due to chronic diseases. 
Therapy.—The “hit and miss” application of high- 
frequency curr ents for insomnia cannot be too strongly 
condemned. When insomnia is a symptom of a condi- 
tion in which high-frequency currents are indicated, 
it yields readily to such application. In chronic disord- 
ers due largely to toxemia the auto-condensation treat- 
ment is indicated to facilitate elimination. If there be 
no physiological indications for the high-frequency 
current it is illogical to apply it. 
The unipolar high frequency current with an auto- 
condensation or glass vacuum electrode held in the 
patient’s hands has a soothing effect upon the nervous 
system and is often followed by quiet sleep. 
LEUKEMIA. 
Leukemia is a disease characterized by an increase 
of lymphatic tissue in the body and an excess of white 
corpuscles in the blood. HIGH-FREQUENCY THERAPY 
237 
Therapy.—High-frequency currents in the forms of 
auto-condensation and hand to hand diathermy in- 
crease metabolism and have a tendency to increase the 
proportion of red cells, consequently are indicated in 
this disease. 
LICHEN PLANUS. 
This disease is characterized by an inflammation of 
the skin with an eruption of papules that are broad and 
angular at the base, flat and glazed on top and slightly 
umbilicated. The lesion favors the flexor surfaces of 
the forearm, the flanks, around the waist and knees. 
Pruritus is quite severe. 
Therapy.—High-frequency currents are of little 
service in this disease except for relief of the pruritus. 
The best treatment for this condition is roentgen radi- 
ations in semi-intensive doses and continued over a 
long period of time. 
LUMBAGO. 
Pain in the lumbar region may be due to any one of 
several pathological conditions. True lumbago is char- 
acterized by spasm of the lumbar muscles. 
Therapy.—Apply radiant light and heat from a high 
power lamp for one hour and follow up with high-fre- 
quency sparks from a non-vacuum electrode. 
Diathermy will also relieve the spasm. 
Technic.—-With patient reclining an electrode (6x6) 
is placed over the affected muscles; the opposite elec- 
trode (8x8) js placed upon the abdomen and held in 238 
HIGH-FREQUENCY PRACTICE 
place by sand bags. The d’Arsonval current is turned 
on to comfortable toleration of the patient and continued 
from 20 to 30 minutes then gradually reduced to zero. 
Fig. 66.—High-Frequency and Light in Lumbago. 
High-frequency effluve from a multiple point elec- 
trode held just outside of sparking distance is grate- 
fully received by the patient. 
LUPUS. 
Lupus Vulgaris is a chronic disease of the skin 
characterized by nodules of connective tissue which HIGH-FREQUENCY THERAPY 
239 
terminate in ulceration or atrophy. The causative fac- 
tor is the tubercle bacillus. 
Therapy.—In the early stages the nodules are easily 
destroyed by desiccation. Later in the disease, when 
the nodules take on ulceration, the lesions may be re- 
moved by electro-coagulation with same technic as in 
epithelioma. 
Fig. 67.—Diathermy in Lumbago. 
High-frequency currents are more liable to aggra- 
vate than benefit uterine bleeding. However, when ap- 
plied by the unipolar method to the 1st, 2nd and 3rd 
MENORRHAGIA AND METRORRHAGIA. 240 
HIGH-FREQUENCY PRACTICE 
lumbar vertebrae to induce the reflex of contraction, 
amelioration of symptoms may result. See Endome- 
tritis. 
MIGRAINE. 
Cases of migraine are born, not made. The pain is 
usually confined to one fronto-temporal region. There 
is nausea and vomiting. These patients are always 
toxic. A course of auto-condensation consisting of 5 
daily treatments and one treatment every two weeks 
thereafter will be of great service to these patients in 
warding off attacks. 
MENOPAUSE. 
The nervous phenomena from which many women 
suffer at the period of menopause are often relieved by 
auto-condensation. 
MASTOIDITIS. 
Mastoiditis is an essential infection of the mastoid 
cells and often occurs following an otitis media. Ra- 
diant light and heat applied early will often prevent sup- 
puration. 
High-frequency currents are contra-indicated in this 
disease. 
MOLES. 
It is the duty of the physician to recommend to their 
patients the early removal of all warts, moles and skin 
growths. Every mole does not take on cancer prolif- 
eration, but the tendency is to do so and an early de- 
struction of all moles is advisable. HIGH-FREQUENCY THERAPY 
241 
Therapy.—The ideal method of removal of all skin 
blemishes is desiccation. 
Technic.—A local anesthetic may or may not be nec- 
essary, much depending upon the sensitiveness of the 
patient. A needle-point electrode is placed in a suitable 
handle and held about one-fourth inch distant from the 
growth. A mild high-frequency current is then turned 
on. Allow the short sparks to play until the color of the 
growth indicates dehydration. No application of a 
medicinal nature should be made. A crust should be al- 
lowed to form which will fall in 10 to 20 days leaving a 
clean pink surface. The pinkish color will disappear in 
a few weeks leaving no scar. If a scar results it is 
the fault of the operator. (See Fig. 31). 
Another method may be employed known as the in- 
direct or disruptive arc method, the technic of which is 
as follows: Seat the patient on an auto-condensation 
pad which is connected to one pole of the d’Arsonval 
machine and connect opposite pole to the ground. (See 
Fig. 30.) 
Still another method is employed by seating the pa- 
tient on the auto-condensation pad which is connected 
to the Oudin post of the machine, the operating elec- 
trode being grounded to a water or gas pipe: otherwise 
the technic is the same as in the direct method. For 
obvious reasons the direct method is to be preferred. 
NEURALGIA AND NEURITIS. 
Neuralgia is a term employed to designate nerve 
pain. It is often difficult to differentiate the former 
from the latter, the essential difference between them 242 
HIGH-FREQUENCY PRACTICE 
lying in the fact that neuralgia has no pathology and 
therefore is a symptom, while neuritis has a distinct 
pathology and, therefore, is a disease. 
It is more or less common in practice to apply the 
term neuralgia to pains of an intermittent character, 
and neuritis to those of a more severe and constant 
character. The causative factors in neuralgia and neu- 
ritis are essentially the same. Exposure to cold may 
irritate peripheral nerves and cause neuralgia. If the 
patient’s resistance be lowered thru constitutional con- 
ditions the same exposure to cold may set up a neuritis. 
Neuritis is always due to pressure either from with- 
in or without the nerve sheath. When from within it is 
due to infection or poison, and when from without it is 
due to mechanical pressure from tumors, dislocations 
and the like or chemical activities. 
Neuralgias are always unilateral. Neuritides are 
often bilateral. Superficial or deep pressure on an in- 
flamed nerve always causes pain, while in neuralgia 
deep pressure often relieves the pain. The pain in 
neuritis is always associated with the nerve; neuralgic 
pains are often experienced some distance from the 
lesion. 
Brachial Neuralgia.—This, like neuralgias else- 
where, is characterized by pain in the distribution of 
one or more nerves of the plexus. The pain may be 
referred to all or few of the branches of the brachial 
plexus, such as the musculospiral, ulnar or cutaneous 
branches. There is nearly always a tenderness upon 
pressure where the nerve lies near the surface and close 
to bone. 243 
HIGH-FREQUENCY THERAPY 
In cases of pain in any of the branches of the brach- 
ial plexus and not associated with vasomotor changes 
in the skin, sensory loss or muscular atrophy, the diag- 
nosis is neuralgia. Brachial neuralgia is usually asso- 
ciated with some constitutional diathesis or specific 
toxic conditions such as malaria, influenza, etc. 
Brachial Neuritis.—Pain in the distribution of the 
nerves of the brachial plexus when associated with vas- 
omotor changes in the skin, sensory loss or muscular 
atrophy must be considered of neuritis. 
In all cases of pain in the brachial plexus careful 
search for the cause must be made. Among the causes 
of neuritis may be mentioned servical rib, tumors in 
neck or axilla, malignant disease, cervical caries, spinal 
tumors. Many cases of neuritis follow slight trauma 
when the patient harbors foci of infection especially 
about the nasal sinuses, throat and mediastinum. 
Neuralgia and neuritis must be differentiated from 
occupational neurosis. The diagnosis is usually easy 
because in a particular occupation certain muscles are 
overworked and the pain is associated with spasm of 
these muscles. The pains associated with bursitis, arth- 
ritis and tuberculous joint are of a neuralgic character. 
Trigeminal Neuralgia (tic douloureux).—This is an 
essential disease the pathology of which is obscure. It 
is characterized by paroxysms of acute pain in one or 
more of the branches of the trigeminal nerve. 
It is usually unilateral. There are all grades of se- 
verity from an occasional pain to one which is almost 
constant. In severe cases the pain is incited by the least 244 
HIGH-FREQUENCY PRACTICE 
movement of the facial muscle and often a slight breeze 
will excite an attack. The pain is probably the most 
excrutiating that mortal has to bear. 
The diagnosis depends chiefly upon the following 
points: (1) age, usually after 35; (2) absence of re- 
lief after removal of possible causes; (3) presence of 
definite starting points; (4) the intense severity of the 
pain; (5) precipitation of attacks by slight peripheral 
stimuli; (6) the various trophic phenomena; (7) ab- 
sence of definite lesions. 
Trigeminal neuralgia simulating tic douloureux 
may be due to tumors at the base of the brain, tumors 
Fig. 68.—Trigeminal Nerve. 
in the skull and in the cranial nerves, optic neuritis, 
gummas, etc. The neuralgic pain prior to the eruption HIGH-FREQUENCY THERAPY 
245 
of herpes zoster affecting the Gasserian ganglion sim- 
ulates genuine tic. 
Mild facial neuralgias are frequently associated with 
various diseases of the local structures of the face, such 
as decayed teeth and sinusitis. Facial neuralgia may be 
due to errors of refraction. The pseudo-neuralgias of 
neurasthenia are usually bilateral and the pain com- 
plained of is not of definite character like true neural- 
gia. 
Sciatica.—Pain referred to the sciatic nerve may be 
either a neuralgia or a neuritis. In true neuritis if the 
inflammation is not soon subdued there are vasomotor 
skin changes somewhere along the course of the nerve. 
Sooner or later depending upon the severity of the dis- 
ease, there will be evidence of muscular atrophy and 
sensory loss. Numbness on the dorsum of the foot fre- 
quently occurs in neuritis but not in neuralgia. 
When a patient complains of pain along the distri- 
bution of the sciatic nerve the physician should make a 
painstaking examination of the hip, sacroiliac and lum- 
bar joints, and if at all in doubt should make a thor- 
ough roentgen ray examination. Pain in the sciatic 
nerve is common in cases of prostatic disease, hemor- 
rhoids and rectal tumors in men, and uterine disease 
and growths about the uterus and rectum in women. 
Every case of persistent sciatica demands a thorough 
examination of the pelvic contents. Tuberculosis and 
syphilitic meningitis of the lower portion of the spinal 
cord may give rise to sciatica. Lightning pains of tabes 
dorsalis may simulate sciatica. They may be differen- 246 
HIGH-FREQUENCY PRACTICE 
tiated by knee-jerk which is present in neuralgia and 
absent in tabes. The pains of tabes are bilateral and 
not referred to any particular nerve. 
Anterior cruritis is sometimes associated with scia- 
tic neuritis but seldom if ever accompanies sciatic neu- 
ralgia. Pains in the legs due to inte't'mittent claudica- 
tion which depends upon an insufficient blood supply are 
felt principally in the calves and do not simulate scia- 
tica. 
Metatarsel Neuralgia.—The pain in this type is of a 
paroxysmal character and has its inception at the base 
of one or more of the toes, extends upward thru the 
foot and may even be experienced as far as the body. 
Pain in the tarsal region of the foot when not due to 
trauma or acute rheumatism suggests gonorrheal bur- 
sitis. 
Intercostal Neuralgia.—The pain in this condition 
is felt along the course of one or more intercostal nerves. 
There is marked tenderness over the branches of the 
cutaneous nerves. The pain is increased by breathing 
or movement of affected muscles. If it be unilateral 
it points to neuritis of herpes zoster. The pain may be 
due to spinal caries or tumors of the mediastinum. In 
influenza the pain may simulate that of pneumonia or 
pleurisy, but these conditions are usually easily differ- 
entiated. 
Multiple Neuritis.—The pain associated with this 
condition is variable—great in some cases, little in oth- 
ers. Vasomotor and motor symptoms are always pres- 
ent. The reaction of degeneration may be complete or HIGH-FREQUENCY THERAPY 
247 
only partial; knee-jerk usually lost. The disease is 
usually caused by alcoholism but may be due to other 
poisons such as arsenic and lead. The writer has seen 
a few cases of multiple neuritis following intense treat- 
ments of salvarsan. It is not uncommon to see multiple 
neuritis accompany diabetes. It is often an heir to in- 
fluenza. The chief symptoms of peripheral neuritis are 
tingling in the extremities, numbness of fingers or toes, 
crampy muscles and severe aching of limbs. 
Therapy.—The success in treatment of neuralgia 
and neuritis depends upon an accurate diagnosis, re- 
moval of cause and application of proper remedy. The 
etiology and symptomology of these conditions have 
been concisely stated for the purpose of drawing the 
reader’s attention to the diversified conditions which 
have their sequel in pain. 
The ordinary medicinal treatment for these condi- 
tions in most cases is worse than useless. Such reme- 
dies as aspirin, acetanilid and opium simply cover up 
the symptoms. It must be admitted that the patient is 
not as keenly interested in the diagnosis as in the treat- 
ment of his affliction. He demands relief from pain, 
and when very severe the physician is impelled to ad- 
minister some drug of analgesic properties. The anal- 
gesic route from neuritis to drug addiction is short, and, 
to change such routing to one less agreeable to the pa- 
tient often taxes the physician’s resources. In some 
cases the pain is of such severity as to require a seda- 
tive such as phenacetine, but this drug should be avoided 
if possible. Acute neuritis may be of a type that will 248 
HIGH-FREQUENCY PRACTICE 
require rest in bed, but absolute rest should be limited 
to a few days at most. 
Fig. 69.—Diathermy to shoulder, direct method. 
The physiology of neuritis demands the application 
of heat. The ordinary hot water bottle, electric pad or 
similar modes of convective heat is often soothing to 
peripheral nerves but falls short in penetration. Ra- 
diant light and heat from high voltage lamps pene- 
trates sufficiently for superficial nerves, but the treat- 
ment pa?- excellence is heat by diathermy. HIGH-FREQUENCY THERAPY 
249 
Pain due to lesions and dysfunction of the brachial 
plexus is very common and most pronounced about the 
shoulder. The technic of diathermy to the shoulder 
will be best understood by reference to Figs. 69 and 70. 
The anatomical contour of the shoulder is such as to 
make close adaptation of metal pads to all points more 
or less difficult; and to facilitate contact pads of gauze 
wet with hot saline solution are employed. It must not 
be forgotten that salt pads modify the diathermic cur- 
rent. The electrodes should not be so large as to make 
the distance between their edges shorter than the dis- 
tance thru the joint. High-frequency currents travel 
in a direct line between the electrodes, but the heat will 
be greatest where the tissue is smallest in diameter. If 
the edges of the electrodes come closer together than 
the distance thru the part desired to be heated, the heat 
will concentrate at that point and nullify the object to 
be attained. Electrodes with a diameter of from 2 to 
3| inches are best. The dose here as elsewhere should 
be one of toleration. The time should not be less than 
30 minutes and one hour is better. 
Fig. 70 illustrates an indirect method of applying 
diathermy and which is employed when the pain ra- 
diates from shoulder to forearm. In this case the pads 
may be greater in diameter. The forearm pad should 
cover the flexor side of the forearm for a space of at 
least 6 inches. There is no objection to the electrode 
entirely encircling the forearm. 
Some operators treat brachial neuritis by seating 
the patient on auto-condensation pad and moving a 250 
HIGH-FREQUENCY PRACTICE 
small disc electrode along the course of the nerve. This 
method will do very well for superficial nerves but is 
inferior to heating the entire limb. 
Trigeminal Neuralgia (tic douloureux).—This, for- 
tunately, is not a common disease, and as its pathology 
is unknown the treatment must be empirical. Prior to 
the discovery of high-frequency currents the treatment 
Fig. 70.—Diathermy to shoulder, indirect method. 
of this condition was resection of the nerve or injections 
of alcohol to produce degeneration of the nerve. Neither 
of these treatments was successful for more than a short HIGH-FREQUENCY THERAPY 
251 
period of time when the pain would recur with all its 
severity. Intracranial neurectomy has recently come 
into vogue. The operation is said to be not a dangerous 
one and the results more or less gratifying. In the 
high-frequency current in the form of diathermy we 
have found a means of at least alleviating the excruci- 
ating pain, in many instances the relief lasting for 
months and even years. 
Fig. 71.—Diathermy in “Tic,” direct method. 
Technic (direct method).—Fashion a soft metal 
(block tin) electrode to fit the entire side of the face 252 
HIGH-FREQUENCY PRACTICE 
from lower jaw to temple, and from front of ear to 
side of the nose. This electrode being the indifferent 
one is placed on the face opposite the affected side. A 
small metal electrode 11 inch in diameter as the active 
one is placed over the Gasserian ganglion of the af- 
fected side. If the contour of the face be such as to 
preclude perfect contact several layers of gauze satur- 
Fig. 72.—Direct diathermy with clamp. 
ated with hot salt solution may be placed between the 
electrode and the skin. However, the effects are better 
with bare electrodes. HIGH-FREQUENCY THERAPY 
253 
The patient should recline on the large electrode, 
the smaller or active one being held firmly in place with 
a sand bag or held in hand of operator. The current 
should be turned on very slowly, reaching about 700 
milliamperes in a period of ten minutes then the cur- 
Fig. 73.—Diathermy in “Tic/’ indirect method. 
rent is increased to a point just short of toleration 
which will be found to be from 900 to 1200 milliam- 
peres. Continue this dose for 20 to 30 minutes longer. 
This treatment relieves the pain for several hours. In 
severe cases it may be best to repeat the treatment the 254 
HIGH-FREQUENCY PRACTICE 
same day, but one treatment a day is usually sufficient 
to assuage the pain. Cases of mild neuralgia will be 
relieved in 3 or 4 days while severe ones require a daily 
treatment for 4 to 6 weeks. 
Another method in technic, known as the indirect 
method, is sometimes employed: A large (8xl0-inch) 
electrode as the indifferent one is placed on the chest 
Fig. 74.—Diathermy in Sciatica. 
near the shoulder of the affected side and held in place 
with sand bags. Otherwise, the technic is the same as 
in the direct method. 
Sciatica.—Sciatic neuritis, like neuritis elsewhere, 
is treated by diathermy. Fig. 74 illustrates the proper 
position of the electrodes. A small electrode (2-inch HIGH-FREQUENCY THERAPY 
255 
diameter) is placed over the sciatic notch and held 
firmly in place by the patient’s body. The other elec- 
trode (6x8-inch) is placed over the groin of the af- 
fected side and held in place with sand bags. Other- 
wise the technic is the same as in trigeminal neuralgia. 
Vacuum electrode applications over the course of 
the nerve sometimes relieve the intense pain but the ef- 
fects are not lasting. Cases of sciatica which do not 
yield to high-frequency currents should be exposed to 
X-rays. Technic.—Radiate over the sciatic notch every 
second day for three treatments. Each treatment should 
consist of one-third of an erythema dose. If a second 
seance is required it may be given after a period of 10 
days. If the first radiation increases the pain it is a 
favorable omen. 
Sciatic Neuralgia.—This condition points to lesions 
outside the nerve. While the same technic as in sciatic 
neuritis is often followed by relief of pain, the lesion 
itself must receive proper treatment in order perma- 
nently to relieve the neuralgia. If the cause of the neu- 
ralgia be tuberculous or rheumatic any electric mod- 
ality will aggravate the condition. 
Cruritis Anterior.—Diathermy is the proper treat- 
ment for this condition. Technic.—Place a 6x8-inch 
electrode over the anterior aspect of the thigh and 
weight down with sand bags; the opposing electrode 
(8x10) over the lumbar region and held in place by the 
patient’s weight. Time and dose same as in sciatica. 
Metatarsal Neuralgia.—The treatment in this con- 
dition is illustrated in Fig. 60. A current of toleration 
for 30 minutes should be employed. 256 
HIGH-FREQUENCY PRACTICE 
Intercostal Neuralgia and Neuritis.—These condi- 
tions should be treated by auto-condensation, 500 mill- 
iamperes for 15 minutes, unless there are contraindica- 
tions. A vigorous application of the unipolar current 
Fig. 75.—Diathermy in Sciatica with clamp. 
thru a non-vacuum electrode over the dorsal spines 
should be made daily until relief is obtained. 
Diathermy with electrodes of equal area, one over 
the dorsal region and the other over the sternum, with 
a current of toleration for 20 minutes is often followed 
by excellent results. 257 
HIGH-FREQUENCY THERAPY 
Multiple Neuritis.—The management of these cases 
taxes the resources of the physician to limitation. Owing 
to the multiplicity of the symptoms it is impossible to 
outline a treatment which will yield results in all cases. 
The first consideration is the removal of the cause; 
next in order, the preservation of affected muscles the 
nutrition of which may be preserved by efficient appli- 
cation of diathermy. 
Auto-condensation is important in many cases. Dia- 
thermy directly to the affected portion of the spinal 
cord will limit the degeneration, and the favorable re- 
sults obtained will be in inverse proportion to the de- 
struction of nerve cells. These cases require the best 
hygienic management. 
Other physiotherapeutic measures which will sug- 
gest themselves in each individual case may be em- 
ployed with benefit: among these static electricity takes 
first place. 
NEURASTHENIA, NEUROSTHENIA AND SPINAL 
TENDERNESS. 
The term neurasthenia serves to designate many 
forms of neuroses as well as psycho-neuroses. Neuros- 
thenia is a term applied to neurasthenia accompanied 
with “hypertension.” Spinal tenderness is grouped 
with neurasthenia by reason of its persistence in that 
condition. 
There is probably no disease or condition which 
presents such a symptom complex as the one we are 258 
HIGH-FREQUENCY PRACTICE 
pleased to call neurasthenia. There is no definite symp- 
tomatology of the condition unless it be a combination 
of all the unpleasant sensations derived from all the 
varied pathological states to which man is heir. The 
nearer the symptoms approach definiteness the greater 
the indefiniteness becomes. 
In comparing the symptoms with symptoms of defi- 
nite lesions there are always a few missing links in the 
chain of evidence. Each case must be investigated on 
its merits, and when all testimony is in, the physician 
becomes judge and jury and must decide the case in 
accordance with the facts presented, always making 
allowance for deceptive and perjured testimony, be- 
cause a neurasthenic will always exaggerate and in 
many instances deliberately perjure himelf. While he 
often bears false testimony, to him the suffering is a 
reality. His nervous system is bankrupt, he loves sym- 
pathy and will lead his physician a merry chase to se- 
cure it. 
There is always a cause, but being so covered with 
multiplicity of symptoms its discovery is one of the dif- 
ficult problems in medicine. The patient’s confidence 
can never be won by mirroring his false statements. He 
must be handled with the greatest finesse, and when 
his confidence has been won the physician is in a posi- 
tion to ferret out the etiological factor in the case, and 
it will be found under one of the following heads: 
1. Toxemia. 
2. Syphilis. 
3. Hereditary psychoneurosis. HIGH-FREQUENCY THERAPY 
259 
4. Perverted sexual function. 
5. Americanitis. 
The prognosis depends entirely upon discovery of 
the causative factor and skill of the physician to elimi- 
nate it. Often after the cause is removed some of the 
symptoms remain due to habit. These cases fuss and 
fidget thru life and die of old age. 
Spinal Tenderness occurs in three different condi- 
tions: (1) trauma and disease of the fascia, muscles, 
nerves or bone in the immediate neighborhood of the 
spine; (2) disease of distant parts of the body; (3) ob- 
scure nervous disorders such as neurasthenia. 
Tenderness when due to Local Disease is always ac- 
companied with rigidity of the muscles (nature’s 
splint). When the disease or injury involves the spinal 
cord additional symptoms are present, such as sensory 
loss, muscular atrophy, paralysis, etc. 
Spinal Tenderness when due to Disease in Dis- 
tant Viscera is found in many diseases, especially 
those of the heart, stomach, liver and genito-urinary or- 
gans. In diseases of the heart, especially those affect- 
ing the myocardium, the area of spinal tenderness will 
be found between the 6th cervical and 4th dorsal; in 
disease of the stomach, between the 3rd and 7th dorsal. 
In the female tenderness over the 4th lumbar spine sug- 
gests uterine disease; over the 3rd lumbar, ovarian dis- 
ease; over the 10th, 11th and 12th dorsal, kidney dis- 
ease ; on the right side of the 2nd lumbar, appendicitis. 
Reflex pains from diseased viscera are often experi- 
enced in other parts of the body. (See Figs. 38 and 39). 260 
HIGH-FREQUENCY PRACTICE 
Spinal Pain and Tenderness Due to Neurasthenia.— 
Traumatic neurasthenia may follow slight injuries to 
the head, spine or testicle, or more or less severe trau- 
mas and strains of fibrous and muscular tissues of the 
back. The so-called “railway spine” is a familiar ex- 
ample of traumatic neurasthenia. The ruling out of 
actual lesions in these cases is often difficult. When the 
symptoms continue for a long period of time and symp- 
toms of definite lesions are absent we are quite safe in 
making a diagnosis of neurasthenia. The knee-jerk 
in neurasthenia is usually exaggerated, and in spinal 
lesions it is usually impaired or lost. 
As a general proposition the spinal pain and tender- 
ness of neurasthenia is more widely disseminated than 
when due to trauma or visceral disease: that is, it may 
be found on pressure at any point from the cervical to 
the sacral region. 
In splanchic neurasthenia the point of tenderness 
is usually found between the 2nd and 8th dorsal verte- 
bra. 
Spinal pain due to diseased viscera will be increased 
by handling the affected viscus. The pain of local 
spinal lesions is increased by pressure. When due to 
diseased viscera or neurasthenia pressure usually re- 
lieves the pain. 
Neurasthenics, as a rule, have a blood-pressure be- 
low normal (hypotension). However, a small per cent 
will be met who have a blood-pressure above normal 
(hypertension), to which condition the neonym, Neu- 
rosthenia, has been applied. HIGH-FREQUENCY THERAPY 
261 
The term neurosthenia may be unfortunate as hy- 
pertension in these cases usually indicates some defi- 
nite lesion of the vascular system. These cases usually 
have cardiac hypertrophy and albumin in the urine. 
Defective alimentation and intestinal stasis play an im- 
portant role in nearly all cases of neurasthenia. All 
toxic cases are not neurasthenics, but practically all 
neurasthenics are toxic. 
Dysfunction of the endocrine glands is very com- 
mon in neurasthenia, supra-renal deficiency being the 
most common. 
Therapy.—The treatment of neurasthenia always 
has been, and probably always will be more or less em- 
pirical, but as we progress in scientific attainment, to- 
gether with the aid of modern methods of diagnosis, 
we hope to become more and more proficient in diagno- 
sis of the etiological factors in this condition and be 
able to classify them and to relegate the term “neuras- 
thenia” to the junk-heap of oblivion. In the present 
state of knowledge, however, we are compelled by 
force of circumstances to recognize and classify certain 
cases as neurasthenics. 
In outlining a definite treatment of neurasthenia 
one meets with a proposition as difficult as the killing 
of a flock of blackbirds with one shot of a rifle. How- 
ever, the management of this condition is rapidly be- 
ing facilitated as we advance in knowledge of the ap- 
plication of physical measures in therapeutics. 
It is to be assumed that all definite lesions have 
been eliminated; that the mode of living, diet, habits, 262 
HIGH-FREQUENCY PRACTICE 
etc., have been investigated and proper advice given, 
after which the most important thing to do is to clear 
the intestinal tract. The Abbott advice, “clean up and 
keep clean” is most apropos. If there be foci of infec- 
tion they should be eradicated. 
In a very large percent of cases in the male the 
focus of infection will be found in the prostate, semi- 
nal vesicles or deep urethra. In many cases in the 
female the focus of infection will be found within the 
pelvis. Posture and dress greatly influence the splan- 
chnic circulation and must be corrected. Vicious hab- 
its must be overcome. Relaxation of abdominal mus- 
cles and ptosed abdominal viscera are common. The 
liver suffers from blood stasis and is unable to prepare 
existing toxins for removal. Whether splanchnic stasis 
be the cause or the result of the nervous insolvency it 
should be corrected. Diathermy to the liver will favor- 
ably influence the splanchnic circulation, as will also 
vibration of the 2nd to 8th dorsal vertebrae. High- 
frequency current from a double pronged electrode ap- 
plied to the tender spinal area will also relieve splan- 
chnic stasis and tone up the intestinal musculature. 
(Fig. 51). The high-frequency current is beneficial 
but less efficient than percussion or vibration in these 
cases. High-frequency from a vacuum electrode ap- 
plied over the various intestinal nodes is of service but 
inferior to the static wave or sinusoidal current. The 
Morse wave current is of great service in these cases, 
not only in securing deep muscular contraction, but, 
when applied to the spine with one electrode over the 
cervical vertebrae and the other over the sacrum with HIGH-FREQUENCY THERAPY 
263 
a strong slow wave, by greatly assisting in draining the 
splanchnic vessels as well as toning up the peripheral 
nerves. 
Neurasthenic symptoms accompanied with hyper- 
tension (neurosthenia) are best combated with auto- 
condensation. Some cases are benefited with patient 
seated on auto-condensation pad with a metal electrode 
over the epigastrium and passing a current of 800 mill- 
iamperes for 15 minutes. 
A study of the physiology of high-frequency cur- 
rents will enable the operator to choose from the dif- 
ferent methods of application the one most suitable for 
the case in hand. Practically all physiotherapeutic 
measures in one way or another are beneficial in the 
neurasthenic condition, their success depending largely 
upon the proper selection and skillful application on 
the part of the operator. 
OTITIS MEDIA. 
Otitis Media is an inflammation of the middle ear 
and caused by infection. It may or may not be accom- 
panied with elevation of temperature or earache. 
Therapy.—Radiant-light-heat applied for one hour 
at a time four times a day will often prevent extension 
to the mastoid. If the infection has reached the mastoid 
cells electricity in any form is worse than useless. The 
writer’s experience justifies the statement: Keep away 
from otitis media with high-frequency currents. 264 
HIGH-FREQUENCY PRACTICE 
PARALYSIS 
(Local Palsies,). 
Facial.—Facial paralysis or Bell’s palsy is a term 
applied to partial or complete paralysis of the muscles 
supplied by the cranial nerve. This condition is usu- 
Fig. 76.—Spinal Diathermy. Useful in circulatory 
disorders of the brain. 
ally unilateral. The signs are usually characteristic: 
diffculty in closing the eye; cannot wrinkle the fore- 
head ; angle of mouth cannot be raised; cannot whistle; 
mastication more or less difficult, etc. 
The causes of facial paralysis are: A lesion any- 
where in the course of the pyramidal fibers from the HIGH-FREQUENCY THERAPY 
265 
cerebral hemisphere to facial nucleus; lesion of the 
facial nucleus; lesion anywhere in course of the nerve 
between the nucleus and its peripheral distribution. 
When the lesion is within the skull the paralysis extends 
to the tongue, and in protruding it moves to the healthy 
side and sense of taste is impaired. A lesion between 
the pons and auditory meatus will give rise to vertigo 
and impairment of hearing. A neuritis outside the 
skull may give rise to a herpetic eruption about the 
ear. Many cases of facial paralysis occurring in per- 
sons with lowered metabolism are excited by cold air 
blowing for some time on the neck and face. 
Therapy.—While electrotherapeutic modalities oth- 
er than high-frequency are indicated, the congestion 
about the nerve when outside the skull is best dissip- 
ated by diathermy with same technic as in “Trigeminal 
neuralgia.” 
Regular application of diathermy will often prevent 
muscular atrophy. After atrophy has commenced the 
muscles should be treated by electric currents capable 
of producing muscular contraction. Roentgen radia- 
tion over the mastoid region often abbreviates the at- 
tack. 
When the lesion causing facial paralysis is intra- 
cranial spinal diathermy is indicated: one electrode 
over the cervical and the other over the dorsal region. 
After placing the well fitted electrodes the current 
should be turned on gradually reaching a maximum of 
700 milliaperes in five minutes, the current strength 266 
HIGH-FREQUENCY PRACTICE 
remaining for 5 minutes, then gradually reduced to zero 
in five minutes—total time 15 minutes. 
The treatment of palsies of the upper and lower ex- 
tremities is virtually the same as of neuritis of these 
parts. Nearly all local palsies are accompanied by low 
blood-pressure. Common sense hygienic measures 
should be adopted in these cases. The general treat- 
ment of palsies is not within the scope of this volume. 
For electrotherapeutic management of these cases ref- 
erence to standard works is suggested. 
PARALYSIS INFANTILE. 
(Poliomyelitis). 
The essential feature of this disease is an inflamma- 
tion in the anterior horns of the gray matter of the 
spinal cord. Not unlike inflammation elsewhere it is 
accompanied by edema and consequent pressure. 
Often the use of certain muscles is impossible due 
to pressure on certain nerve fibers. If the edema sub- 
sides early in the course of the disease there will be a 
spontaneous recovery, but if stasis in the cord continues 
for a prolonged period of time the nerve fibers will de- 
generate and cause a permanent paralysis. The muscles 
deprived of nutrition soon atrophy and the patient be- 
comes a helpless cripple. 
The regeneration of nerve fiber takes place slowly 
during which time the muscle being inactive fades away 
into a mere band. HIGH-FREQUENCY THERAPY 
267 
Therapy.—The orthodox treatment of this disease is 
directed to the prevention of deformity. The patient is 
placed at rest and splints and casts are applied to 
maintain normal position, but nothing is done for the 
relief of the causative factor, pressure. The writer be- 
lieves this method of treatment to be entirely wrong. 
It is well known that a normal muscle when placed at 
complete rest will soon atrophy from inactivity. The 
treatment by fixation simply causes atrophy of not only 
the affected but opposing normal muscles and results 
in complete loss of function. This form of expectant 
treatment seems irrational and should be displaced by 
measures directed to the restoration of physiological 
function. 
In some cases, the intensity of the infectious pro- 
cess is so great as to preclude all hope of recovery, but 
this knowledge should not prevent the employment of 
measures which at least will give the patient a chance 
to recover. 
All medical men agree that in this disease there is 
a stasis in the circulation of the anterior horns of the 
cord and that the stasis is soon followed by inflamma- 
tory exudates which by pressure causes the dysfunc- 
tion of the nerve fibers. 
It is well known by workers in the field of physical 
therapy that the physiological action of diathermy is 
to relieve stasis and assist the dissipation of inflamma- 
tory products. Therefore, it would appear that the 
early application of diathermy to the affected area of 
the cord be a rational procedure. The earlier the in- 268 
HIGH-FREQUENCY PRACTICE 
stitution of this treatment to prevent organized exu- 
dates the greater the hope of success. 
Instead of muscle fixation and consequent atrophy 
the function of the muscles should be maintained by 
early application of diathermy directly thereto. Volun- 
tary effort to move the affected muscle should be ob- 
tained thru the tact of the attending physician and 
nurse. Later on, if these measures seem to fail to pre- 
vent atrophy, the careful employment of the sinusoidal, 
Bristow coil or rythmic galvanic current will be effici- 
ent in keeping up muscular nutrition so that in the event 
of nerve regeneration the muscles will at once be capa- 
ble of resumption of function. 
Even the gravest cases are often improved by these 
currents, but to obtain their full effect the treatment 
must be persevered in for months and in some cases for 
years. Never despair of doing good in these cases. 
PARALYSIS AGITANS. 
Paralysis Agitans is a disease characterized by mus- 
cular rigidity and is generally considered incurable; 
but often much relief may be obtained by auto-conden- 
sation with moderately high milliamperage which will 
cause perspiration. The treatment should be repeated 
three times a week for many weeks. 
PNEUMONIA. 
In the near past much has been written about the 
jugulation of disease, and this is especially true in cases 
of pneumonia. Our best medical authors agree that HIGH-FREQUENCY THERAPY 
269 
pneumonia is a self-limited disease and runs its course 
uninfluenced by medication. Since the advent of high- 
frequency currents much has been accomplished in the 
jugulation of pneumonia when applied during the 
congestive stage. Even after hepitization has occurred 
much may be done toward relieving the dyspnea, cough, 
cyanosis, pain and nervousness. 
In cases of unresolved pneumonia the alternation 
of diathermy and roentgen ray every third day will 
be followed with excellent results. 
Technic.—Place electrodes having an area of 36 to 
48 inches in such a position as to bring the involved tis- 
sue between them, one on either side of the chest. The 
electrodes must be so constructed as to make coapta- 
tion perfect, and in order to do this it may be necessary 
to employ several layers of gauze underneath the metal 
electrodes. The pads of gauze should be kept thor- 
oughly saturated with a hot solution of sodium chlo- 
ride (10%). See Figs 56 and 57. An electrode of 
metal mesh which conforms to uneven surfaces is ideal 
for chest application. 
Begin with a low amperage, consuming 5 minutes 
in reaching point of toleration which should be between 
1700 and 2000 milliamperes. When the toleration point 
is reached reduce the current to comfortable toleration 
and continue for 20 minutes, then gradually reduce to 
zero, consuming 5 minutes in so doing. The treatment 
should be repeated every 6 hours. If this treatment be 
instituted early in the stage of congestion a jugulation 
may be expected. If applied in the stage of hepitiza- 270 
HIGH-FREQUENCY PRACTICE 
tion an amperage of 1400 should not be exceeded but ap- 
plied in the same manner as stated above. In this stage 
jugulation is not to be looked for, the pulse becomes 
softer and slower, respirations slower and deeper, the 
expectoration loses its tenacity, nervousness is reduced 
and patient often falls asleep during treatment. 
PLEURISY. 
High frequency vacuum electrode application 
soothes the pain from pleuritic affections but is scarce- 
ly a factor in controlling the disease. The best treat- 
ment for acute pleurisy is diathermy applied in the 
same manner as in pneumonia. The tissues are drained 
and cellular activity restored. Diathermy may be em- 
ployed in pleurisy with effusion but should not be used 
if there be pus within the pleural cavity. Empyema is 
a case for the surgeon. 
Fig. 77.—Normal Prostate. HIGH-FREQUENCY THERAPY 
271 
PROSTATE. 
The prostate is an important sexual organ of the 
male, situated behind the pubes and surrounds the neck 
of the bladder. It is pear shaped with base upward 
into which the neck of the bladder fits. It is about one 
and one-half inches wide, one and one-quarter inches 
from tip to base and three-quarters of an inch in thick- 
ness. It is pierced by the urethra slightly anterior to 
its center. It is a firm organ composed of glandular 
and muscular tissue. It contains upward of 20 acini 
thru which the secretion reaches the urethra. 
Fig. 77 illustrates a transverse section of a normal 
prostate. This depicts the many glands and ducts which 
may harbor infection and the improbability of expres- 
sion of their contents by simple massage. 
Examination.—Not all abnormal conditions of the 
prostate are amenable to high-frequency currents, con- 
sequently the operator should be able to make a differ- 
ential diagnosis on evidence produced by examination. 
There are two routes of access to the prostate, urethral 
and rectal. The urethral route will enlighten us on the 
size of the prostate. If the distance from meatus to 
bladder exceeds 8 inches, the prostate is enlarged. If a 
straight sound meets obstruction other than that of 
foreign bodies or strictures of the urethra, it is prob- 
ably due to dislocated urethra due to prostatic enlarge- 
ment. 
The preponderance of information gained by exami- 
nation comes from the rectal route. Visualizing the 
rectum will elicit but little, so far as the prostate is 272 
HIGH-FREQUENCY PRACTICE 
concerned, but the digital touch availeth much. Every 
operator prefers his own examination technic. More 
information will be gained as to size and contour of the 
prostate if the bladder be moderately filled. 
In making examination per rectum, the writer pre- 
fers to have the patient stand firmly on both feet with 
the knees unflexed but body inclined by placing both 
hands upon the operating table. In gaining entrance 
haste should be made slowly, giving time for the sphinc- 
ter muscles to relax. After gaining entrance what do 
you feel ? The finger at once comes in contact with the 
prostate, and if normal it will feel smooth and firm but 
not tense. As the finger passes over the gland it will 
be found to be about one and one-half inches in trans- 
verse diameter and about one and one-quarter inches in 
its vertical diameter. If the bladder be moderately 
filled the seminal vesicles will be within easy reach 
and not tender. 
What are the deviations from normal which we may 
see from the end of the finger? (1) Anomalies: there 
may be complete absence of prostate; congenital defor- 
mities, among which may be absence of one-half the 
gland and corresponding seminal vesicle, infantile pros- 
tate, etc. (2) Enlargement due to hypertrophy, a cyst, 
stone, abscess, malignant growth or inflammation. (3) 
Diminution due to atrophy or chronic atonic process 
from an old infection. (4) Hardness which may be due 
to fibrosis, malignancy, calculus, tuberculosis or in- 
tense inflammation. (5) Softness due to want of tone 
or abscess. (6) Character of surf ace.—A general bulg- 
ing suggests a cyst; one lobe enlargement points to HIGH-FREQUENCY THERAPY 
273 
parenchymatous prostititis; hard nodules may be tu- 
berculous, but more likely due to follicular inflamma- 
tion ; crepitation, if present, is due to calculus. 
Prostatic Cysts.—Cysts of the prostate are quite 
rare and the diagnosis is not always easy, being con- 
fused with hypertrophy, distended bladder and bladder 
diverticula. 
Prostatic Calculus.—Stone in the prostate is not 
difficult to diagnose. Embeded calculi may give rise 
to no symptoms, whatever, but their presence usually 
is accompanied by those of prostatitis. If there be sev- 
eral calculi, crepitation may be elicited by pressure of 
the finger. Calculi which give rise to prostatitis may 
be diagnosed with the aid of the X-ray. 
Fig. 78.—Prostatic Abscess pointing into rectum. 
A, abscess; B, bladder; P, prostate; U, urethra. (From 
Guiteras). 
Prostatitis.—Inflammation of the prostate may be 
divided into three classes: acute, subacute and chronic. 274 
HIGH-FREQUENCY PRACTICE 
Of acute prostatitis there are two varieties: The 
follicular, characterized by a marked acute inflamma- 
tion of one or more follicles; the parenchymatous, char- 
acterized by inflammation of many follicles as well as 
the stroma, (one or both lobes may be involved). 
The follicular variety usually results in the forma- 
tion of small abscesses which eventually drain into the 
urethra. 
The parenchymatous variety involves the follicles 
and stroma and tends toward the formation of one large 
abscess which may rupture spontaneously into the ure- 
thra, rectum, perineum or inguinal region, the major- 
ity, however, breaking into the urethra. 
Fig. 79.—Prostatic Abscess pointing into urethra. 
A, abscess; B, bladder; P, prostate; U, urethra. (From 
Guiteras). 
Subacute Prostatitis.—This form of prostatitis is 
usually due to an extention to the prostate of the infec- 
tion of posterior urethritis and involves few follicles. 275 
HIGH-FREQUENCY THERAPY 
It is catarrhal in nature and milder in degree than the 
acute form and does not tend to abscess. 
Chronic Prostatitis.—This form may follow any 
form of prostatitis but usually is of gonorrheal origin 
and follows the subacute or catarrhal form. The gland 
is enlarged and of soft consistence, the walls of the 
ducts are thickened, the acini dilated and filled with 
inflammatory products. See Fig. 79. 
Hypertrophy.—Nearly all men past 60 years of age 
have hypertrophy of the prostate. Many cases are ex- 
tremely troublesome while others are scarcely notice- 
able. There are many theories advanced regarding the 
cause of this condition, none of which is as plausible as 
“a provision of nature.” 
Fig. 80.—Chronic Prostatitis. A, walls of duct; B, 
acini. (Drawing from Guiteras). 
There are two forms of prostatic hypertrophy, the 
adenomatous, when the glandular tissue enlarges at the 276 
HIGH-FREQUENCY PRACTICE 
expense of the muscular; the fibrous, when the muscular 
fiber takes on growth at the expense of the glandular 
portion. 
Atrophy.—There are several forms of atrophy of 
the prostate: Congenital, senile and those due to pres- 
sure and inflammation. There are but few cases of 
atrophy due to retrogressive changes of old age. Pres- 
sure from calculi and destructive inflammation are the 
principal causes of atrophy. The symptoms are not un- 
like those of chronic prostatitis. 
Therapy.—High-frequency currents are contrain- 
dicated in the following prostatic conditions: Cystic 
degeneration, calculus, tuberculosis, malignant growths 
and closed abscess. 
In all forms of prostatitis the first sidestep from 
normalcy is congestion, followed by infiltration, stasis 
and degeneration. For the why-and-wherefore of re- 
lief from these conditions the reader is referred to the 
physiological action of high-frequency currents. 
Fig. 81.—Willmoth. Prostatic Electrode. 
Acute Follicular Prostatitis.—Unfortunately this 
condition is not diagnosed until considerable infiltration 
and possibly pus formation have taken place. The folli- 
cles and ducts are soon filled with inflammatory prod- 
ucts. Epithelium and pus are found in the urine quite 
early in the disease. HIGH-FREQUENCY THERAPY 
277 
The physiological treatment of this condition is the 
application of heat. Rectal irrigation of hot water for 
this condition has been in vogue for many years. We 
are all familiar with the effects of convective heat in all 
inflammatory conditions and the comfort afforded 
by poultices. Not until the discovery of high-frequency 
currents were we able to apply a poultice directly to the 
prostate, but had to content ourselves with rectal irriga- 
tions of hot water. 
While monopolar application of the high-frequency 
current will raise the temperature of the prostate, the 
bipolar application is more efficient in this condition. 
A better idea of its application may be gained by ref- 
Fig. 82.—Monopolar Application in Prostatitis. B, bladder 
E, electrode; P, prostate; R, rectum. 
erence to the following illustrations than by any verbal 
explanation. 
The above figure illustrates the Willmoth insulated 
electrode thru which heat may be conducted to the 
prostate. 278 
HIGH-FREQUENCY PRACTICE 
The above drawing illustrates the position of the 
Willmoth electrode in its unipolar application. 
In the above illustration it will be seen that the po- 
sition of the prostatic electrode is the same as in the 
monopolar application, the indifferent electrode of flex- 
ible metal (4x6 inches) being placed on the abdomen 
immediately above the pubes. In either application the 
current should be turned on gradually, reaching point of 
comfortable toleration in one minute and maintained for 
6 minutes, then gradually reduced to zero. The heat 
generated in the prostate will remain longer if radiant 
Fig. 83.—Bipolar Application in Prostatitis. B, bladder 
E, electrodes; P, prostate; R, rectum. 
heat and light be applied over the lower lumbar region 
during the application of diathermy and for one hour 
afterward. 
In addition to the above the patient should be ad- HIGH-FREQUENCY THERAPY 
279 
vised to employ heat from an ordinary 50-watt lamp 
directed to the perineum for two daily periods of one 
hour each. The greater number of hours the patient 
remains at home and in bed the shorter the course of the 
disease. Hot sitz baths are also efficacious. Alkaline 
laxatives should be administered daily. The urine 
should be made bland by the administration of potas- 
sium citrate and tincture of belladonna. While the deep 
urethritis should be properly treated with instillations 
of one or two per cent solution of mercurochrome it is 
well to forego urethral treatment for three or four days 
during the treatment by diathermy. Theoretically blad- 
Fig. 84.—Unipolar Application to Enlarged Prostate. 
B, bladder; P, prostate; U, residual urine; R, rectum; E, 
Willmoth electrode. 
der irrigation is indicated, but the good that might be 
accomplished is surmounted by the traumatic effects 
of urethral instrumentation. 280 
HIGH-FREQUENCY PRACTICE 
Acute Parenchymatous Prostatitis. — During the 
stage before the accumulation of pus the same treat- 
ment as outlined for the follicular form is apropos. 
After abscess formation the case becomes one for the 
surgeon. 
Subacute and Chronic Prostatitis.—While high-fre- 
quency currents are useful in these conditions there is 
not a therapeutic measure known that will so effec- 
tually clear the seminal vesicles -and prostate of gon- 
orrheal infection as the static wave current properly 
applied. I cannot advise the use of vacuum electrodes 
within the urethra for this or any other disease. 
Prostatic Hypertrophy.—High-frequency currents 
are useful in the enlargement of the glandular portion 
Fig. 85.—High-Frequency in Prostatic Atrophy. 
of the prostate but are absolutely useless in the fibrous 
form. The fibrous prostate may be reduced by the 
roentgen ray and a follow up treatment of high-fre- 
quency or what is better the static wave current. 
Pro static Atrophy.—The symptoms of this condi- HIGH-FREQUENCY THERAPY 
281 
tion simulate those of chronic prostatitis. While high- 
frequency currents are useful in flooding the parts with 
new blood, a dilatation of the prostatic urethra is nec- 
essary to relieve the urgent urinary distress. The ure- 
thra should be dilated gradually by steel sounds once a 
week and each dilatation followed by instillations of a 
one per cent solution of mercurochrome or a ten per 
cent solution of Argyrol. Two high-frequency treat- 
ments should be given between the dilations, employing 
the unipolar or bipolar application with same technic 
as for acute prostatitis. 
Pruritus ani, a most distressing condition, is pres- 
ent in many rectal conditions such as ulcers, fissures, 
fistulas, hemorrhoids, etc. Urethral stricture and pros- 
tatic atrophy are sometimes causative factors. The 
itching may be due to diseases of the skin or a neurosis. 
Therapy.—Snow says: “Patients who have pruri- 
tus ani may often be promptly relieved by treatment 
with glass hemorroidal electrode as large as can be 
placed in the anus without causing too great discom- 
fort, employing the static wave current followed by 
the wave current applied over the liver.” 
The unipolar high-frequency current may be used 
in the same manner with almost as good results. 
Pruritus about the anus due to eczema is promptly 
relieved and most cases cured by fractional doses of 
the roentgen ray. Some cases are cured promptly by 
one intensive (3 H.) treatment. 
PRURITUS ANI. 282 
HIGH-FREQUENCY PRACTICE 
Actinic rays have been proven of value in this con- 
dition. 
High-frequency currents have been employed in this 
disease with some beneficial results probably due to the 
general effects upon the nervous system. A cure 
should not be expected. 
Technic.—A slight sparking effect as secured thru 
the ordinary light underwear is desirable. Employ a 
large vacuum or non-vacuum electrode attached to the 
Oudin coil. A current of sufficient strength for a one- 
inch spark should be employed, the application being 
made in sliding contact with the underwear. 
It is said that actinic rays will cause a disappearance 
of the lesions, but they will recur. 
The best results obtained in this disease are se- 
cured thru semi-intensive treatment by x-rays. 
PSORIASIS. 
If electricity in any form be employed in this condi- 
tion there must be adequate drainage. Such cases are 
benefited by diathermy, the technic of which is the 
same as in “Endometritis/’ (See Fig. 64). Even when 
there appears to be free drainage thru the uterus there 
is a possibility of existing closed pus pockets, making 
treatment by electric currents hazardous. Such cases 
require the service of a surgeon. 
PYOSALPINX. 
While high-frequency currents thru properly shap- 
ed electrodes combined with roentgen radiations are 
PYORRHEA (Riggs’ Disease,). HIGH-FREQUENCY THERAPY 
283 
useful in controlling this disease, the patient will be 
better pleased with the service of a good dentist. 
RHEUMATISM AND RHEUMATOID ARTHRITIS. 
For discussion and treatment of these conditions 
see “Arthritis.” 
RHINITIS. 
Hypertrophic rhinitis is promptly relieved by semi- 
intensive treatment by x-rays. The atrophic form is 
benefited by a mild high-frequency current thru an in- 
sulated vacuum electrode. The current stimulates the 
shrunken membrane, and if it is not entirely destroyed 
regeneration may be looked for. The application must 
not exceed 5 minutes in duration and may be employed 
three times a week. It should be unnecessary to state 
that the parts must be cleansed of all crusts and nasal 
secretions before the high-frequency treatment. 
SCIATICA. 
The term sciatica is commonly applied to pain 
along the course of the sciatic nerve and its branches. 
The pain may be due to neuritis or neuralgia, and a 
painstaking examination should always be made to 
differentiate neuritis from referred pain (neuralgia) 
due to some diseased joint or viscus. 
Sciatic Neuralgia.—This has among its causative 
factors: diseases of hip and sacroiliac joints, bones 
of the pelvis and spinal column; disease of the pros- 
tate, malpositions of the uterus, pelvic inflammations, 284 
HIGH-FREQUENCY PRACTICE 
malignant or other tumors pressing on the pelvic 
plexus, hemorrhoids and other rectal diseases, tuber- 
culosis of the sacroiliac joint and lower vertebrae and 
some lesions of the spinal cord. 
Therapy.—The treatment of sciatica wholly de- 
pends upon whether it be a neuralgia or a neuritis. A 
serious mistake might be made in the application of 
diathermy to a diseased hip joint, believing the case 
to be one of neuritis. 
After the witnesses are all sworn and a verdict of 
neuritis returned, the management of the diseased 
nerve should be similar to that in neuritis, elsewhere. 
Diathermy if judiciously applied will relieve the 
congestion about the nerve and prevent infiltration 
which marks the beginning of muscular atrophy. (See 
Fig. 74.) 
As in diathermy elsewhere, the current should be 
turned on gradually, consuming at least 3 minutes in 
reaching the toleration of the patient, then it should 
be reduced to comfortable toleration and continued for 
20 to 30 minutes then gradually reduced to zero, con- 
suming at least three minutes in the reduction. 
While a high-frequency current from a vacuum elec- 
trode passed along the course of the sciatic nerve some- 
times gives immediate relief, the pain will return and 
probably be more severe than before. The effluve 
from a multiple-point electrode is very soothing and is 
followed by no reaction. The effects of these spectacu- 
lar applications are more fanciful than real. HIGH-FREQUENCY THERAPY 
285 
In some cases the most painful area is between the 
sciatic notch and knee. Wherever the greatest degree 
of pain and tenderness may be, that is the point which 
should be diathermatized. The treatment of sciatic 
neuralgia should be directed to the disease itself rather 
than to the painful area. 
SPRAINS AND STRAINS. 
The superficial stasis resulting from sprains may be 
dissipated by radiant light and heat from an ordinary 
electric light lamp, followed by the unipolar application 
of high-frequency current thru a vacuum or non-vac- 
uum electrode. For deeper effects diathermy should 
be employed. After the part has been thoroughly 
heated the infiltration may be dissipated by the blue 
pencil or spark discharge from a static machine or the 
proper application of the sinusoidal or Bristow coil 
current. The treatment should be 'employed twice a 
day. All mild sprains will yield to this treatment with- 
in 48 hours. 
SYPHILIS. 
Inflammatory deposits without regard to character 
are amenable to absorption by high-frequency currents 
when properly applied. While the specific infection is 
not directly influenced by these currents, their ability 
to promote reparative processes, stimulate phagocyto- 
sis and hasten elimination makes them ideal as an ad- 
juvant in the treatment of syphilis. 
The medicinal treatment of syphilis often fails in 
patients with faulty metabolism. In such cases auto- 286 
HIGH-FREQUENCY PRACTICE 
condensation will dilate the blood-vessels and permit a 
better diffusion of mercury, iodine and salvarsan thru- 
out the entire body and aid materially in shortening 
the period of treatment. 
TATOO, POWDER AND COAL MARKS. 
The pigments of tatoo dyes, powder and coal may 
be removed by desiccation. 
Technic.—The stained area is desiccated with a fine 
needle by cross-lines one-eighth inch apart. The de- 
hydrated epidermis is scraped away and the desiccated 
surface macerated for three days with salt solution, 
after which the pigment is removed by a curette. The 
wound heals rapidly. Care should be exercised not to 
overheat the true skin as keloid may result. 
TONSILS DISEASED. 
Infected teeth and tonsils are frequently, though 
not always, concerned in the etiology of arthritis, en- 
docarditis, neuritis, etc. The experience of the physi- 
cians of John Hopkins Hospital shows that even after 
the nose, throat and teeth have been put in normal con- 
dition by operative measures these diseases may recur. 
Their experience further shows that the removal of 
the tonsils in an interval free from symptoms can be 
justified only on the plea of preventing further cardiac 
lesions which may result from subsequent tonsilitis. 
It is also their experience that tonsillectomy rarely 
benefits chronic deforming types of arthritis and often 
does more harm than good. HIGH-FREQUENCY THERAPY 
287 
Diseased tonsils may be treated by actinic rays, 
roentgen rays, surgery or desiccation. 
Advantages of Desiccation: 
No surgical shock. 
No primary or secondary hemorrhage. 
No embolism. 
No secondary infection. 
No trauma to adjacent tissues. 
Complete sterilization . 
Very little post-operative discomfort. 
No contracting cicatrix. 
A safe procedure where a general anesthetic is 
contraindicated. 
Normal portions of tonsils may be retained. 
Disadvantages: 
Constitutional effects of cocaine. 
Children require a general anesthetic making the 
treatment difficult. 
It is better to avoid treatment during the acute 
stage of tonsillitis. The most favorable time is during 
the stage of quiescence. The thoroughness of the treat- 
ment required, from light desiccation of the crypts in 
follicular tonsillitis to complete destruction of the ton- 
sil in cases of widely disseminated infection, depends 
upon the degree of infection. Desiccation is the ideal 
treatment for tubercular ulcers of the tonsil. (Due 
credit should be given Dr. Wm. L. Clark for the name 
‘‘desiccation” as well as for the technic of application.) 288 
HIGH-FREQUENCY PRACTICE 
Technic.—The purchase of expensive electrodes for 
desiccation of the tonsil is unwarranted. They may be 
made from steel knitting needles six inches long and 
bent at convenient angles for the work, the bending 
being easily accomplished by heating over a flame. 
These needles will fit into the ordinary so-called figu- 
ration handle. The home-made electrodes may be insu- 
lated by slipping on the needles a small rubber cathe- 
ter or they may be wound with adhesive plaster. 
Neither rubber nor adhesive plaster will completely in- 
sulate .them, but will sufficiently so for a careful oper- 
ator. No foot switch or assistant to turn the current 
on and off is necessary. Some form of a suction bottle 
is convenient to clear the pockets of pus. A good tongue 
depressor may or may not be needed. 
The unipolar current from a standard high-fre- 
quency apparatus is employed, so regulated that the de- 
gree of heat will desiccate and not cauterize, the object 
being to dehydrate rather than burn the tissues. If 
the tissues are not cauterized there will be no resulting 
cicatrix. 
The first step is the complete anesthetization of the 
tonsils and tonsillar pillars, base of the tongue, pharynx 
and soft palate by cocaine. Often a 5 to 10 per cent so- 
lution of cocaine applied topically will suffice; however, 
some cases require the injection of the solution when 
a weaker one will answer the purpose. 
Seat the patient in a chair with a good head rest. 
Either natural or reflected artificial light may be used. 
The next step is to insert the needle into that portion of HIGH-FREQUENCY THERAPY 
289 
the tonsil to be destroyed, care being taken to see that 
no portion of the conductor or electrode except the ac- 
tive point touches any part of the patient. The cur- 
rent is turned on for sufficient time to do the work. The 
needle may be forced into the deeper portion of the 
tonsil while the current is still on. When steam is seen 
coming from the tonsil dehydration has taken place. A 
whole tonsil may be destroyed in this manner. One 
operation if thoroly done is sufficient; however, it is 
better in some cases to sterilize only a portion of the 
Fig. 86.—Special Tonsil Electrode. 
tonsil at a sitting. This must be left to the judgment 
of the operator. The completeness of the treatment de- 
pends upon the skill of the operator. 
It is possible to shrink enlarged tonsils by the in- 
direct application of the high-frequency current. The 
patient is seated on the autocondensation chair pad 
which is connected to the Oudin coil of the machine. 
The operator employs an ordinary vacuum throat elec- 
trode held in his hand, the connection being made 
through the operator’s body to the ground. The elec- 
trode is placed in contact with the tonsil and rapidly 
passed over it. The application may be repeated at 
weekly intervals until the desire result is obtained. 
TUBERCULOSIS. 
There are some points in blood-pressure worthy of 
note in tuberculosis. It is well known that a condition 290 
HIGH-FREQUENCY PRACTICE 
of hypotension prevails in advanced cases, and as the 
case becomes farther advanced there is a gradual re- 
duction in pulse pressure. Hypotension is often ob- 
served before any clinical signs are manifest. This is 
especially true if no other cause of impaired health is 
found. Hypotension is always present in the so-called 
pretubercular stage. Tuberculosis is often suspected, 
but if hypotension is not present we may be almost cer- 
tain that our suspicions are groundless. 
A reversal of pressures without clinical signs of oth- 
er disease points to tuberculosis. Early pleurisy with 
effusion is sometimes difficult to differentiate from tu- 
berculosis. If blood-pressures are normal or above, 
pleurisy is suspected; if hypotension is present it points 
to tuberculosis. Hypotension always puts us on our 
guard, and in absence of infectious and wasting dis- 
ease points to tuberculosis. 
It is possible in cases of nephritis combined with 
tuberculosis that the effects of the nephritis on the vas- 
omotor mechanism may offset the hypotension of tuber- 
culosis, but a case of nephritis with low blood-pressure 
suggests a tuberculous kidney. A gradual rise in the 
systolic pressure in a case of tuberculosis points to an 
arrest of the disease. 
Therapy. — High-frequency currents have been 
proven to be of great value in the treatment of pulmo- 
nary tuberculosis. The disease always has its compli- 
cations and we are compelled to treat the patient in- 
stead of the disease. HIGH-FREQUENCY THERAPY 
291 
There are cases of pulmonary tuberculosis which 
should not be treated by diathermy; however, the se- 
lection of cases for its application is not difficult to one 
experienced in treating pulmonary affection. 
Technic.—Apply a large electrode anteriorly and 
one posteriorly in such a manner as to bring the af- 
fected area between them. If the contour of the chest 
be such as to preclude perfect coaptation of the elec- 
trode, several layers of gauze previously soaked in hot 
salt solution should be placed between the electrode 
and the skin. When the electrodes are in position and 
connected to the d’Arsonval apparatus turn on the cur- 
rent to the point of comfortable toleration which will 
be found between 1000 and 2000 milliamperes. (See 
Figs. 56 and 57). 
The current should be continued for 20 to 60 min- 
utes, depending always upon the effect produced on the 
patient. 
The treatment in some cases should be repeated 
daily, while in others three times a week is best. In 
some cases the cough and expectoration will be in- 
creased for several days; the patient may be inclined to 
believe that he is made worse by the treatment, there- 
fore, he should be advised of this probable effect be- 
fore beginning treatment. The treatment must be 
persisted in for a period of from one to three months. 
Physiology.—The effects upon the blood are: In- 
crease in the number of red cells, hemoglobin and 
lymphoctyes and a decrease in the polymorphonuclears. 
The increased hyperemia induces an increased flow of 292 
HIGH-FREQUENCY PRACTICE 
lymph and a consequent increase of expectoration. The 
expectoration, however, after from one to three weeks 
gradually becomes less, the appetite improves and there 
is a general feeling of well-being; the ashen hue of the 
skin is replaced by natural color, temperature falls 
to normal and a progressive increase in weight results. 
Hypotension is the rule in the tuberculous. Under 
treatment by diathermy all metabolic functions are in- 
creased, and thru cardiac stimulation there is a gradual 
increase of all blood-pressures. 
Precautions.—There is always a chance of lung dia- 
thermy being followed by a hemorrhage, but I have 
never seen a case where it became serious. If there is 
a previous history of hemorrhage the first few treat- 
ments should consist of a low amperage and short time 
until there is an assurance of no likelihood of hemor- 
rhage. Diathermy always increases the body tempera- 
ture and should not be employed in cases with a tem- 
perature over 100 degrees F. 
Vesical Tuberculosis.—Tuberculous ulcers of the 
bladder usually yield to desiccation. 
Joint Tuberculosis.—Diathermy should not be em- 
ployed except there be free drainage. 
Kidney Tuberculosis.—Diathermy is of inestima- 
ble value if there be good drainage. 
TUMORS OF THE BLADDER. 
In the management of tumors of the bladder we 
have at our command four methods of treatment: The 
knife, desiccation, electrocoagulation and radium. The HIGH-FREQUENCY THERAPY 
293 
choice of these methods depends upon the character 
and extent of the growth. Benign tumors without or 
with little basal infiltration yield promptly to desicca- 
tion. If the papilloma is large and seems to have a 
deepy infiltrated base, electrocoagulation is the method 
of choice. All tumors that are histologically benign 
disappear with astonishing rapidity under either of 
these methods. When, however, the growth is malig- 
nant the response to treatment is slow and often dis- 
couraging. There is a marked tendency to recurrence 
of all malignant tumors of the bladder when operated 
upon by any method, the frequency of recurrence be- 
ing in the following order: (1) the knife; (2) desic- 
cation; (3) electrocoagulation; (4) radium. Electro- 
coagulation followed by radium offers the best insur- 
ance against recurrence at the original site or by me- 
tastasis. Whenever the bladder wall shows consider- 
able involvement relief only can be expected from any 
method of treatment. 
All benign tumors of the bladder are amenable to 
surgical diathermy thru the natural channel, the ure- 
thra, the opening of the bladder by incision being nec- 
essary for drainage only in cases of extreme urosep- 
sis. 
Therapy.—In all cases of papilloma there is more or 
less hematuria, and this should be controlled before 
desiccation or electrocoagulation is attempted. If the 
hematuria does not clear up from rest in bed for a few 
days, the bladder may be irrigated with a weak solu- 
tion of silver nitrate (1 to 5000) or a solution of adre- 
nalin. The clearing of the urine is absolutely essential 294 
HIGH-FREQUENCY PRACTICE 
in order to have a clear vision of the operative field. A 
ureteral catheter carrying cystoscope is employed. 
After the urine has been cleared fill the bladder with a 
solution of boric acid. 
An electrode made from a ureteral catheter which 
fits the cystoscope can be easily made by passing a steel 
wire thru the lumen of the catheter in such a manner 
that the wire will protrude about one-eighth inch. Hav- 
ing placed the electrode in position an assistant will 
Pig. 87.—Position of cystoscope in desiccation of 
papilloma of bladder. 
operate the current in the same manner as in desicca- 
tion of neoplasms elsewhere. The current should be di- 
rected into the base of the tumor and continued until 
destruction has taken place. The patient should be 
placed in bed and hexamethylene administered. There 
should be no further hematuria. The mass will slough 
in a few days and be voided with the urine. HIGH-FREQUENCY THERAPY 
295 
VAGINITIS. 
The human vagina in a normal state harbors many 
types of bacteria. When it becomes infected with 
specific germs an inflammation of its mucous surface 
results and the condition is known as vaginitis. 
Therapy.—The first step in treatment is to remove 
by douching or swabbing any discharge that may be 
present. A large vacuum electrode, insulated where it 
comes in contact with the vulva, should be chosen. The 
electrode is connected to the Oudin post and inserted 
into the vagina. A current of toleration is employed 
for 5 to 7 minutes every day. 
Physiology.—Increased temperature to a point in- 
compatible with germ viability; glandular stimulation 
and consequent drainage. 
Fig. 88.—Unipolar Vaginal Application. 
URETHRAL GROWTHS, ETC. 
There are many pathological conditions of the ure- 
thra which are amenable to treatment by high-fre- 
quency currents. 296 
HIGH-FREQUENCY PRACTICE 
Fig. 89 illustrates three forms of polypoidal 
growths which are more or less common, (a) Pedun- 
culated polyp; (b) sessile polyp in the bulbar portion; 
(c) polyp on edge of crypt of Morgagni. 
These growths are easily destroyed by desiccation. 
The technic is simple. After anesthetization by a four 
per cent solution of cocaine the urethroscope is intro- 
duced in a manner to bring the growth well into view. 
An electrode for this purpose consists’ of a small needle 
of sufficient length inserted into the ordinary figura- 
tion handle. Care should be exercised during treat- 
ment not to allow the electrode to touch any part of the 
urethroscope as the current will be dissipated. Plunge 
the point of the needle into the base of the growth and 
turn on sufficient current to blanch the tumor. Usu- 
ally no after treatment is required. If the reaction be 
intense it may be relieved by irrigations of hot boric 
acid solution. 
Chronically inflamed crypts may be relieved in 
the same manner. Cysts of Littre’s glands are best 
treated by dilatation. 
VARICOSE VEINS AND ULCERS. 
The stimulating effects of vacuum application are 
sometimes useful but high-frequency currents are in- 
ferior to actinic and x-rays in varicose ulcers. DISEASES OF THE EYE 
297 
Fig. 89.—Urethral Growths. CHAPTER VIII. 
Diseases of the Eye CHAPTER VIII. 
DISEASES OF THE EYE. 
Conjunctivitis. Granular conjunctivitis. Diseases of the 
cornea. Iritis. Opacities of the vitreous. Chorioiditis. Glau- 
coma. Retinitis. Cataract. Atrophy of the optic nerve. Toxic 
amblyopia. Amblyopia ex anopsia. Hermeralopsia. Nervous 
asthenopia. Hysterial amblyopia. Muscular dysfunction. Ptosis. 
Diseases of the lids. 
The electrotherapeutic management of diseases of 
the eye is of quite recent date and is employed by opth- 
almologists and general practitioners in a more or less 
perfunctory manner. The author knows of no book 
devoted to the subject, and current literature is very 
meager. 
I would that it be definitely understood that when- 
ever electric modalities are herein mentioned in the 
treatment of ocular conditions they are to be considered 
as adjuncts to other well known measures ordinarily 
employed by opthalmologists; that electricity is not be- 
ing heralded as a cure-all, but rather as a helpmate to 
other well recognized methods. 
The treatment of ocular diseases by electricity men- 
tioned herein, not only is based upon the established 
physiology of the orbital contents, the pathology of the 
conditions present and a knowledge of the fundamental 
principles of electricity and its physiological action up- 
301 302 
HIGH-FREQUENCY PRACTICE 
on living tissues, but reflects a collation of experiences 
of eminent opthalmologists. 
While this work is intended to be a treatise on the 
use of high-frequency currents, the part played by other 
electric modalities in the treatment of ocular conditions 
is of such importance as to make the consideration of 
these modalities an important matter. 
The direct constant, sinusoidal and high-frequency 
currents are employed, each having its particular field 
of operation. The high-frequency current in the form 
of vacuum-tube application, for the induction of super- 
ficial hyperemia; the bipolar application for thermo- 
penetration; surgical diathermy for the destruction of 
growths are all important in the management of the 
diseases under consideration. 
In addition to the above mentioned modalities, ra- 
diant-light and heat reflected from an incandescent 
lamp also the vacuum electrode energized by the static 
machine play important roles in the therapy of ocular 
disease. 
As a result of the application of high-frequency 
currents inflammatory exudates irrespective of their 
character are absorbed. The hyperemia induced by 
these currents increases local reparative processes thru 
increased blood supply thereby increasing the number 
and activity of the phagocytes. The nutrition of the 
cells is enhanced which plays an important part in 
raising the resistance to bacterial invasion. 
Inflammation anywhere is usually due to invasion 
of bacteria of some kind. The important thing to be DISEASES OF THE EYE 
303 
done, therefore is to increase the resistance thru the 
blood supply. When the inflammatory process is very 
acute and painful the application of cold compresses is 
indicated, but this procedure should soon be followed by 
heat. 
Where drainage is good, the value of high-frequency 
currents is firmly established in the treatment of local 
streptococcic and staphylococcic infections. However, 
it should not be forgotten that closed accumulations of 
pus are positive contraindications to the use of high- 
frequency currents. 
CONJUNCTIVITIS. 
In conjunctivitis the entire ocular conjunctiva is 
red, rough, and painful. The arteries and veins are dis- 
tended and tortuous; the tears soon lose their salinity 
on account of excessive secretion; the mucous glands 
soon cease to functionate leaving the eye dry with a 
sensation as though full of sand. This condition if not 
corrected will soon destroy the cornea thru macera- 
tion. 
Mechanical irritants such as dust may carry along 
with them pathologic bacteria which soon change the 
active hyperemia to a purulent inflammation. The lids 
soon become edematous red and thickened. In some 
cases a grayish pellicle is seen and in others it is rolled 
into strings and shreds. The eyes are acutely painful. 
Practically all cases of conjunctivitis are contag- 
ious. 304 
HIGH-FREQUENCY PRACTICE 
CHRONIC CONJUNCTIVITIS. 
Chronic conjunctivitis is probably the most frequent 
of all diseases of the eye. Its duration is usually pro- 
longed ; many people suffer from it for many years. 
Often these cases present thickened lids, stunted 
lashes scattered along the margin of the lid. The se- 
cretion from the glands is thick and abundant, the 
tears are excessive and epiphoria occurs upon expos- 
ure to wind and changes in temperature. The mucous 
membrane is more or less palid in color, not as smooth 
as normal, is often covered by viscid mucus and at 
other times is dry and burning. The cornea is some- 
times discolored by scars and lowered in luster by mac- 
eration of the epithelium. The papillae of the retro- 
tarsal folds are very large. 
Cases of chronic conjunctivitis of long standing are 
often accompanied by chronic rhinitis, nasal granula- 
tions, polypoid growths and post-nasal adenoids which 
must be removed before the condition of the eye is re- 
lieved. 
The duration of conjunctivitis while often self lim- 
ited may be considerably shortened and development 
of the chronic form prevented by institution of suit- 
able treatment. 
The first indication to be met in acute or chronic 
stage of the disease is to clear the entire ocular field 
which is best accomplished by mild irrigations of hot 
(110 F.) water; ordinary antiseptics are of little avail. 
TREATMENT. Pages 305-320 missing DISEASES OF THE EYE 
321 
Technic.—The technic of local application is simple, 
and is practically the same as previously given in the 
treatment of conjunctivitis. 
Some cases are benefited by negative galvanism with 
a current of toleration for ten minutes, cathode to closed 
lids and anode to the cervical region, followed by pneu- 
mo-massage. Myotics should be used in conjunction 
with the electric treatment. 
Conclusions.—Quinine will not cure all cases of ma- 
laria, neither will electricity cure all cases of glaucoma, 
but in recent cases much can be done toward relief. In 
cases far advanced little can be done with high-fre- 
quency currents except to alleviate pain. Some cases 
can be kept in a state of quiescence. In late cases when 
blindness has occurred there is no benefit to be expected 
from any electric modality. 
RETINITIS. 
Retinitis as a purely local lesion is very rare; in 
most cases it is a symptom of some general disease such 
as albuminuria, diabetes, syphilis, gout and cardiovas- 
cular disorders, therefore the treatment should be di- 
rected to the causative factor. Cardiovascular condi- 
tions accompanied by hypertension are generally bene- 
fited by auto-condensation. Albuminuria with kidney 
inefficiency is best treated by kidney diathermy alter- 
nated with static insulation. Gout and syphilis are 
greatly benefited by heavy auto-condensation and dia- 
thermy to the liver. 322 
HIGH-FREQUENCY PRACTICE 
Hemorrhagic Retinitis.—After the acute stage has 
passed the high-frequency current may be employed 
with a reasonable expectation of clearing up the field 
by stimulating the process of absorption. These cases 
are often accompanied with high blood-pressure which 
may be greatly reduced by auto-condensation. 
CATARACT. 
“Since cataract seems to be a failure of nutrition of 
the lens, we would naturally expect it to be one of the 
diseases most especially adapted to treatment by the 
electrical current; yet we are forced to admit that, 
thus far, all attempts in this direction have been at- 
tended with negative results; but I do not feel that we 
are justified in saying that further experimentation may 
not be attended by more happy results.”—Alleman. 
The above was written by Alleman when but little 
was known of the physiological action of the high-fre- 
quency current. During the few years just passed 
considerable experimentation has been made with the 
hope that some benefit might be derived thru this 
agency in the treatment of cataract. 
Reports of investigators along this line are widely 
at variance. Occasionally enthusiastic reports of cures 
by this method appear in medical literature, while a 
much larger number of reports agree that after trials 
extending over long periods of time no appreciable 
benefit could be observed. 
The variance of reports is probably due not so 
much to the result of the application of this modality 
as to the actual condition existing in the many cases in DISEASES OF THE EYE 
323 
which it has been tried. Cataract being frequently com- 
plicated by some disease of other portions of the light- 
receiving apparatus in which an improvement of vis- 
ion may result from any or no treatment, makes the 
claim for beneficial results for any method of treat- 
ment appear more or less fallacious. However, the 
number of favorable reports justify further trial of this 
method of treatment. If there is any benefit to be de- 
rived from this treatment, it must come thru the effects 
produced by hyperemia of the parts about the lens. 
It is well known that bone is the last tissue to be- 
come heated by diathermy and when heated will hold 
the heat for many hours, therefore, it is but logical, not 
only to produce hyperemia of the soft tissues but to 
heat the surrounding wall of bone, which will slowly 
give up its heat to the adjacent tissues and maintain 
the hyperemia for a considerable period of time. This 
may be accomplished by passing the current from tem- 
ple to temple. The bones composing the orbit being sit- 
uated almost immediately underneath the skin can be 
thoroughly heated in a few minutes. The current from 
a perfectly constructed d’Arsonval machine is turned 
on at zero and gradually increased, consuming 5 min- 
utes in reaching the point of toleration, when it is al- 
lowed to remain for a period of 10 minutes, then slowly 
returned to zero, consuming at least 2 minutes in the 
reduction. This application should be alternated with 
the high-frequency vacuum application on alternate 
days. 324 
HIGH-FREQUENCY PRACTICE 
Some investigators report favorable results from 
the galvanic current in 2 to 5 milliampere doses alter- 
nated or followed by the vacuum tube application. 
ATROPHY OF THE OPTIC NERVE. 
Atrophy of the optic nerve develops either as a 
primary affection or secondary to a previous neuritis or 
retinitis. Among the causes of primary atrophy may 
be mentioned cerebrospinal diseases including tabes; 
progressive paralysis and disseminated sclerosis; brain 
tumor and focal infection. In the acute stage of in- 
flammatory atrophy the veins are distended, but this 
condition is soon followed by contraction of both arter- 
ies and veins. 
TREATMENT. 
Atrophy of the optic nerve especially in the primary 
form is generally considered incurable; hence any 
promise of remedial benefit from any therapeutic meas- 
ure is usually taken cum grano salts. 
While in the treatment of this condition, the obser- 
vations of different investigators are most widely at 
variance, the probability and possibility of improve- 
ment, or at least a cessation of the process by the em- 
ployment of electrical modalities may more or less be 
assured. 
First of all if possible the cause must be ascertained. 
While syphilitic infection is the most common cause, 
foci of infection may exist in the body especially in the 
para nasal sinuses and should be treated secundem 
artem. DISEASES OF THE EYE 
325 
The consensus of opinion of the majority of those 
who employ electric currents in this disease is that in 
the early stage there is hope at least of inhibition in 
about 20 per cent of cases. Any form of remedial ap- 
plication which promises even less favorable results 
should receive our consideration. Of course, the greatest 
benefit is to be expected from treatment of the secon- 
dary form of the disease. 
The first step in treatment should be directed 
against the lesion which causes the atrophy. There is 
no treatment of so much avail in neuritis as heat by dia- 
thermy and there can be no objection to its applica- 
tion in optic neuritis. 
Technic.—Bare metal electrodes inches in diame- 
ter are applied to the temples, being best held in place by 
means of the Universal Diathermy Clamp. The elec- 
trodes are connected to the poles of a d’Arsonval ma- 
chine. The current is turned on very slowly reaching 
the stage of toleration on the patient in 5 minutes, then 
the current strength is slightly reduced and allowed to 
remain for 15 minutes then slowly returned to zero. The 
treatment is employed daily until the acute inflamma- 
tion subsides, when the modality is changed to the direct 
constant (galvanic) current. The negative pole is 
placed over the closed lids, the positive pole over the 
cervical region. A current strength of toleration (1 to 
4 milliamperes) is allowed to flow for 10 minutes. 
This treatment is employed daily for 10 days then 
every other day for two or three months. After a rest 326 
DISEASES OF THE EYE 
of 2 or 3 weeks is taken treatment is resumed twice 
a week alternating with intervals of rest and thus 
continued for 2 or 3 years. 
While the general application of all electric currents 
promotes metabolic changes, the most useful are the 
high-frequency and static. If there be no contraindi- 
cation to auto-condensation its application 2 or 3 times 
a week will materially aid the elimination of toxins 
and the excitation of cellular activity. 
Static insulation alternated with auto-condensation 
is an excellent procedure. The application of the vac- 
uum electrode, energized by the static current, to the 
temples will also be found useful. Spinal diathermy 
stabilizes the cerebral circulation and should be of ser- 
vice in this disease. 
TOXIC AMBLYOPIA. 
Amblyopia due to poisoning from nicotine or alcohol 
is greatly benefited by high-frequency and static cur- 
rents. 
There is no measure known to the writer that will 
so promptly and efficiently remove nicotine from the 
body as auto-condensation, hand to hand diathermy 
and static sparks. In auto-condensation the current 
must be heavy (800 to 1500 milliamperes) and suffici- 
ently prolonged to raise the body temperature at least 
one degree F. Profuse diaphoresis will materially aid in 
the elimination of nicotine. Subsequent to each treat- 
ment by heavy auto-condensation or hand to hand dia- DISEASES OF THE EYE 
327 
thermy a dose (at least one ounce) of castor oil must 
be administered to carry off the products of increased 
combustion. 
Alcoholic amblyopia which is often accompanied 
with multiple neuritis is greatly benefited by daily 
treatments of static insulation. 
If alternated on alternate days with hand to hand 
diathermy a successful termination of the alcoholic 
poisoning may be assured. When not accompanied by 
neuritis a course of 30 daily treatments is usually suffi- 
cient. In multiple neuritis an occasional static spark- 
ing of the spine and legs by the indirect method in addi- 
tion to static insulation and diathermy will usually re- 
sult in a cure of the neuritis in from one to six months. 
The amblyopia should disappear with the removal of the 
other effects of the alcohol. The local application of the 
high-frequency current by means of a vacuum or non- 
vacuum electrode directly over the closed lids will stim- 
ulate local metabolism and materially assist in restoring 
the sight. Spina diathermy will also be useful in this 
condition. 
Amblyopia ex Anopsia.—It is the experience of many 
observers that in many cases of amblyopia ex anopsia 
vision can be brought up to normal and with aid of cor- 
rection of the refraction remains there by the aid of lo- 
cal application of the high-frequency current. 
Hermeralopsia (Night Blindness.)—The disturb- 
ance of nutrition of the retina calls for increased cellu- 
lar activity and as one of the effects of the high-fre- 
quency current is to increase metabolic activity it is 
indicated in this condition. 328 
HIGH-FREQUENCY PRACTICE 
Nervous Asthenopia.—A condition which occurs 
both in hysterical subjects and neurasthenics, consists 
of an incapacity of the eye for any continuous exertion, 
in spite of good visual power. 
Therapy.—Not only should local application of the 
high-frequency current be made to the eyes, but a gen- 
eral application, by means of a large body electrode, to 
the spine should also be made. These cases are more or 
less toxic due to intestinal ptosis and stasis. The Morse 
wave current is very efficient in restoring to normal 
position the displaced viscera as well as toning up the 
intestinal musculature and overcoming the stasis. 
Hysterical Amblyopia.—A condition characterized 
by dimunition of the visual acuity, a contraction of the 
field of vision and a diminution in the color and light 
sense. 
The treatment of this condition is essentially the same 
as that of nervous asthenopia. 
Dr. Samuel J. Harris, Boston, says: “The cases of 
muscular im-balance form a most interesting group for 
they vary from the slight case of which the patient is 
often not aware to the various phorias where there is 
binocular vision to where only minocular vision ex- 
ists. These cases sometimes cause a train of reflex 
symptoms which make diagnosis difficult. I have seen 
many cases where treatment has been given for many 
different conditions which were really only cured by re- 
lief of the muscular strain. In cases where there is 
MUSCULAR DYSFUNCTION. 329 
DISEASES OF THE EYE 
binocular vision the inability to focus properly may 
lead to a nervous condition which often becomes alarm- 
ing.” 
His treatment of these conditions depends upon the 
degree of im-balance. Ionic medication of iodine is 
used for a few days then followed by the sinusoidal 
current. He says: “The binocular cases are the ones 
which are most troublesome. Many cases where proper 
correction has been made still suffer great inconven- 
ience and it is necessary often to give prolonged treat- 
ment.” 
The technic of iodine ionic medication is as fol- 
lows: A pleget of cotton saturated with a two per 
cent solution of potassium iodide (or Glyodine) is 
placed in a cup-shaped electrode which is placed over 
the closed lids. This electrode is connected with the 
negative pole of a galvanic battery. 
The inactive or positive electrode may consist of 
metal with several layers of gauze which have been 
previously saturated with hot salt solution intervening 
the metal and skin. This electrode is attached to the 
positive pole of the battery and placed at some indif- 
ferent point of the body, usually over the cervical reg- 
ion. A current strength from 2 to 5 milliamperes is 
gradually turned on, the current being allowed to flow 
for 10 minutes, then gradually returned to zero. 
(Alypin, cocaine and halocaine may be introduced into the 
tissues in order to anesthetize them for operation, the technic 
being the same as in iodine medication, except that they must 
be placed on the positive pole.) 330 
HIGH-FREQUENCY PRACTICE 
Not all patients will tolerate a current strength of 5 
milliamperes but the milliamperage should approximate 
this strength in order to ionize the iodine and drive it 
into the tissues. This treatment should be given daily 
or twice daily provided the condition of the sKln will 
allow, for a period of a week or ten days then followed 
by the sinusoidal or Morse wave current every day for 
ten days. The same electrodes as employed in ioniza- 
tion minus the iodine, may be used in application of the 
sinusoidal current. Usually a sinusoidal with about 22 
alternations per minute is best. If the tissues be thor- 
oughly warmed by the vacuum tube application prior 
to the ionization application, the effects are enhanced. 
It is claimed by those who are familiar with high- 
frequency application that this current alone often cor- 
rects mild cases of muscular im-balance. 
The sinusoidal current does good service in spasm 
or paralysis of the obicularis: it is also of service in 
ptosis, but too much should not be expected in paralysis 
of the eye muscles. The benefit derived is not thru 
muscular contraction as it is doubtful if the eye mus- 
cles can be made to contract thru the agency of any 
electric current; but cellular activity is increased by 
the application of the galvanic, sinusoidal or high-fre- 
quency currents. As a general proposition muscles de- 
prived of their nerve supply soon undergo atrophic 
changes, but their nutrition may be maintained for 
months by the proper application of diathermy. 
Whether diathermy to the muscles of the eye will re- 
store them to normal function in case of paralysis is 
doubtful. DISEASES OF THE EYE 
331 
Fig. 91.—Bye, Bar, Nose and Throat Cabinet. This 
apparatus fulfills all the demands of the specialist in high- 
frequency work. HIGH-FREQUENCY PRACTICE 
333 
Fig. 92.—High-Tension “Standard.” This machine 
has been built to embody the features necessary for the 
scientific employment of high-frequency currents with a 
range of usefulness from the most delicate desiccation 
current to heavy diathermy and auto-condensation. 
It is equipped with an auto-transformer control of 
six selections with an additional voltage regulator, giving 
six intermediate points of adjustment, thus making the 
machine adaptable for all forms of treatment work.— 
High Tension Transformer and Equipment Company. HIGH-FREQUENCY PRACTICE 
335 
PTOSIS. 
Ptosis is a condition that frequently responds to 
electrical stimulation. The affected part should be 
thoroughly warmed by the vacuum tube application 
followed by the sinusoidal current at the rate of about 
22 alternations per minute. The treatment should be 
repeated daily. 
The application of the galvanic current, 2 milliam- 
peres for 10 minutes may be alternated on alternate 
days with the sinusoidal, with benefit. 
DISEASES OF THE LIDS. 
Not unlike other parts of the body the skin of the 
lids suffers from diseases amenable to electric currents. 
For the removal of benign and some malign tumors 
surgical diathermy is especially indicated. 
Chalazion a chronic affection of the Meibomian 
glands is amenable to desiccation. After complete 
anesthetization a needle electrode is passed into the sac 
and a mild Oudin current turned on; the current 
strength should be just enough to effect superficial 
stimulation to obliterate the sac; too strong a current 
will destroy considerable tissue resulting in a large 
slough and consequent cicatricial contraction which 
should be avoided. However, the resulting contrac- 
tion will be much less and of a softer nature than that 
following the knife. After operations with the knife 
the desiccation of the field of operation will prevent a 
recurrence. 336 
HIGH-FREQUENCY PRACTICE 
Herpes Zoster is an essential neuritis accompanied 
by a herpetic eruption. 
The treatment should follow the lines of that of neu- 
ritis elsewhere. The affected branch of the nerve 
should be brought under direct influence of diathermy 
and the parts thoroughly heated after which a mild 
constant current is applied for ten minutes. The treat- 
ment should be repeated twice daily for 3 days when 
all active symptoms should cease. 
Partial Trichiasis.—When there is but a limited 
number of cilia growing in the wrong direction and 
irritating the eye, they may be successfully removed by 
electrolysis. The operative technic being the same as 
that of hypertrichosis. 
Benign Tumors such as Xanthelasma, molluscum 
simplex, molluscum contagiosum, warts, moles, cuta- 
neous horns, vascular tumors are all amenable to sur- 
gical diathermy. 
Epitheliomata especially when superficial are amen- 
able to electrocoagulation, radium and x-ray. 
Dr. William Benham Snow says: “The use of vac- 
uum eye electrodes with the static current is of great 
value in the treatment of epiphora when the tear duct 
is closed, but not stenosed; if a vacuum electrode is 
held against the canal and a short spark gap em- 
ployed, it will remove the infiltration and open the 
canal.” 
EPIPHORA. HIGH-FREQUENCY PRACTICE 
337 
Fig. 93.—In this new high-frequency machine called 
“DYNELECTRON” the spark gap is of the quench type 
and can be run continuously without harm, 
High-frequency, diathermy, autocondensation, elec- 
trocoagulation, from separate transformer taps, makes 
each modality especially efficient. 
The cabinet also contains tankless air features. 
Manufactured by Liebel-Flarsheim Company, Cincinnati, 
Ohio. 338 
HIGH-FREQUENCY PRACTICE 
Fig. 94.—The New Actual Portable outfit of high 
power, embracing high-frequency, diathermy, auto-con- 
densation, and electrocoagulation, adaptable for both of- 
fice and hospital use. Separate taps from the transformer 
for each modality give the desired current. 
Extra fine control, high and low reading meters, 
quench type gap, for continuous service, are some of 
the advantages. Manufactured by Liebel-Flarsheim 
Company, Cincinnati, Ohio. APPENDIX “A” 
Questionnaire APPENDIX “A.” 
QUESTIONNAIRE. 
This questionnaire is appended for the purpose of 
allowing the physician to examine himself. He, who 
can answer these questions promptly and accurately is 
sufficiently informed to undertake high-frequency 
practice. 
What is meant by high-frequency? 
From what source is a high-frequency current ob- 
tained ? 
What is an alternating current? 
How does it differ from a direct continuous current? 
What is understood by an alternation? 
What does the word cycle mean? 
What is a period ? 
How may the number of cycles be changed? 
What is the best source of supply for high-frequency 
currents ? 
What is necessary to change a low to a high fre- 
quency ? 
What is a transformer? 
What is its function? 
341 342 
HIGH-FREQUENCY PRACTICE 
What are the requisites for a high-frequency cur- 
rent? 
What is a condenser and its function ? 
What is a spark gap and its function? 
What is understood by the word induction? 
How are induced currents produced? 
What is a primary coil? 
What is a secondary? 
What is a core and how made? 
What is meant by closed and open cores ? 
What is a volt? An ampere? An ohm? 
What is meant by current strength? 
How should a transformer be constructed to in- 
crease voltage? 
What effect has the voltage of a transformer upon 
the amperage ? 
Why is a current coming from the secondary of a 
transformer dangerous to handle? 
What is a solenoid? A d’Arsonval solenoid? Its 
function ? 
What is a resonator and how constructed ? 
What is an oscillating current and how does it dif- 
fer from an alternating current and how is the modi- 
fication brought about? 
What is understood by a Tesla current and how is 
it produced ? 
What advantage has the Tesla current over other 
currents in medical work? QUESTIONNAIRE 
343 
What are its disadvantages? 
What is understood by an Oudin current? 
What are its advantages, if any, over other cur- 
rents ? 
What is understood by monopolar and bipolar ap- 
plications? 
What is a d’Arsonval current and its advantage 
over other currents? 
Name some forms of spark gaps? 
What are the requisites for an efficient spark gap? 
Why does a spark gap get hot? 
How are high-frequency currents applied to the 
body? 
What is an electrode? 
What kind of electrodes are preferred in high-fre- 
quency work ? 
Describe a vacuum electrode? 
What is a non-vacuum electrode and its advantages? 
For what purpose are vacuum electrodes used? 
What kind of electrodes are used on mucous sur- 
faces ? 
What are the contraindications for the use of vac- 
uum electrodes on mucous surfaces? 
What is the object of insulating a vacuum elec- 
trode ? 
How can a dose from a vacuum electrode be esti- 
mated ? 
What is a cataphoric electrode? 344 
HIGH-FREQUENCY PRACTICE 
What phoretic effect has a high-frequency current? 
What are the objections to the use of a vacuum 
electrode in the male urethra? 
Name the principal physiological effects of the high- 
frequency current. 
Name some contraindications for its use. 
What preparation of the patient is necessary in the 
application of high-frequency currents? 
Does a vacuum electrode emit ultra-violet rays? 
What is a violet ray? 
How may the degree of vacuum of a tube be esti- 
mated? 
Name some indications for the use of high-fre- 
quency vacuum electrodes. 
When should bare metal electrodes be employed? 
What effect upon high-frequency currents has 
padded electrodes wet with salt solution ? 
Under what circumstances should salt pads be used? 
What is understood by auto-condensation? De- 
scribe it fully. 
What are the physiological effects of auto-conden- 
sation ? 
How is the current measured in auto-condensation 
treatments ? 
What amperage should be used and why? 
What precautions should be exercised in auto-con- 
densation treatments? QUESTIONNAIRE 
345 
What is understood by local auto-condensation? 
How is it applied? 
What is auto-conduction? How applied? Its ad- 
vantages and disadvantages compared with auto-con- 
densation ? 
What is understood by medical diathermy? 
What are the physiological effects of medical dia- 
thermy? 
What is the relative resistance offered by the tis- 
sues of the body to the passage of high-frequency cur- 
rents ? 
How does the resistance to high-frequency current 
differ from that of the direct continuous current? 
What is understood by current density? What is 
its importance? 
What precautions should be taken in the application 
of diathermy? 
What is understood by surgical diathermy? How 
applied ? 
What are the indications for its employment? 
What are its advantages over the knife? Its disad- 
vantages? 
Mention some types of diathermy electrodes. 
Upon what does the dose of diathermy depend? 
What effect does diathermy have on the body tem- 
perature ? 
What is understood by fulguration? When and 
for what purpose is it employed? 346 
HIGH-FREQUENCY PRACTICE 
What is meant by desiccation? When, where and 
how is it applied? 
What are its physiological effects ? 
What is electrocoagulation? What are its effects? 
When and where is it indicated ? 
How do fulguration, desiccation and electrocoagu- 
lation differ in effects? APPENDIX “B” 
The Doctor’s Duty APPENDIX “B.” 
THE DOCTOR’S DUTY. 
Burton Baker Grover. 
(Presidential address, third annual meeting of the 
Western Electro-Therapeutic Association, Kansas City, 
Mo., April 21, 1921.) 
Fellow Members of the Western Electrotherapeu- 
tic Association: Again we are assembled for the pur- 
pose of exchanging ideas of how best to care for the 
afflicted who are submitted to our charge and keeping. 
Last year’s meeting was an occasion of universal 
profit and pleasure to the members who attended its 
sessions. The papers presented by our invited guests 
and the interest with which they were received will 
never be forgotten. For a society so young the papers 
presented at the meeting were remarkable for their 
excellence. 
In choosing a subject for this address it occurred 
to me that, instead of a scientific paper on some branch 
of physiotherapy, a plain talk about ourselves and the 
duties we owe to our profession and the public might 
prove as profitable. I want to emphasize that we who 
employ physical measures when indicated are making 
no effort to set up a government outside of our profes- 
sion nor are we in a single instance antagonistic to it. 
349 350 
HIGH-FREQUENCY PRACTICE 
Our efforts should be considered evolutionary rather 
than revolutionary. Physiotherapeutic methods are 
entitled to recognition by our national association, but 
until that time comes we must be organized in such as- 
sociations as this. The highest degree of co-operation 
should exist between the physiotherapist and the regu- 
lar physician, and the day is not far distant when every 
physician will be using physical measures and the 
words “skeptic” and “unethical” be consigned to 
oblivion. 
Bombastic pretense on one hand and superstitious 
credulity on the other which controlled medicine for 
hundreds of years gave way to ultra-scientific theories 
which, not being understood by the laity, gave an im- 
petus to many isms and quackery. 
Times are changing rapidly; the physician of today 
is rapidly separating himself from exhibiting his pa- 
tients as case numbers and is becoming attached to mod- 
ern methods of treating them as human sufferers. 
There is an old saying “no great loss without some 
gain.” The losses incurred by the late war were almost 
beyond calculation, but advancement along many lines 
has been the result. The advance made in medicine 
along therapeutic lines has made greater strides than 
during the same time of any other known period. The 
medical profession has been awakened from its dreamy 
stupor of therapeutic neglect by the penetrating rays 
of physio-therapeutic light. The war furnished the ma- 
terial and the military hospitals furnished the means THE DOCTOR’S DUTY 
351 
in the way of physiotherapeutic apparatus for restora- 
tion to service of thousands who otherwise would have 
become subjects for charity. The profession is aroused 
to the conviction that there is something after all in 
physiotherapy. 
Last year I made an appeal for facilities within the 
profession to teach these methods in our medical 
schools. I take no credit for what has been accom- 
plished, but it is very gratifying indeed to be able to 
announce that physiotherapy is receiving recognition 
from the leading medical universities of America. Har- 
vard University through the efforts of Dr. Frank E. 
Granger has established a department of physiother- 
apy. Jefferson Medical College has as instructor, Dr. 
W. L. Clark, one of the leading men along these lines. 
Dr. Wm. T. Johnson has been chosen as head of the 
department of Physiotherapy in the University of 
Pennsylvania. The University of Indianapolis has es- 
tablished a department of physiotherapeutics. 
As the avalanche has started in the right places we 
may confidently expect other schools to follow and or- 
ganize departments of rational therapy. The pioneers 
of the movement are to be congratulated for their un- 
tiring efforts to bring about this recognition. 
The honest-to-humanity physician is suffering from 
therapeutical hunger. His alma, mater has impressed 
upon his mind the necessity of a correct diagnosis, and 
to this end has led him along labyrinthmal channels of 
investigation without end and has dropped him at the 352 
HIGH-FREQUENCY PRACTICE 
threshhold of therapeutics. When a physician has ar- 
rived at a diagnosis satisfactory to himself he turns to 
his volume on therapy there to find at his dismay noth- 
ing positive or tangible. All is palliative, symptomatic 
and empiric and treatment becomes a personal choice 
in experimentation. 
The physician suffering from therapeutical hunger 
is most naturally driven to drug nihilism. If he will 
but investigate the positive capabilities of physiother- 
apy, his hunger, to a certain extent, may be appeased. 
The old stereotyped saying “the disease is self limited” 
will no longer remain as a pillow on which to fall, for 
if he be up and doing he will find to be completely sub- 
servient to physical measures many conditions which 
heretofore have been treated expectantly. 
The persistent mystery of electricity, its intense 
modernism and its unlimited possibilities make it the 
most interesting and fascinating study of this progres- 
sive age. The more one studies the marvelous move- 
ment of electrons of matter the greater his profound 
belief in the scientific creation of the universe and his 
respect for the one great universal law which regu- 
lates the creation of material things. 
To one interested in physics the study of electricity 
affords not only a broader grasp of tangible things but 
a view into the chest of speculative phenomena and a 
realization of some of the things of which he has 
dreamed. When once aboard the ship of electrical in- 
vestigation he becomes anxious to sail with the hope 353 
THE DOCTOR’S DUTY 
of landing in the harbor of scientific attainment and 
there to taste of the fruit of knowledge of creative phe- 
nomena. 
The mysticism and assumption of yesterday are ca- 
pable of demonstration today. The world’s labyrinths 
which heretofore have been unfathomable are becoming 
easy of access and an understanding of creative phe- 
nomena is becoming more and more a possibility. 
We are under the greatest obligation to those men 
who are burning the candle of investigation to the 
wick and who will, in my opinion, be able in time to 
raise the curtain and expose to view the mystery of 
life itself. 
With the aid of the X-ray tube and the ultra-micro- 
scope the theory of electricity being a condition has 
been exploded and the proof that it is a definite sub- 
stance realized. We now know that a current of elec- 
tricity consists of the journey of electrons over and 
through a conductor. 
When one views the wonderful achievements in com- 
merce that man has been able to accomplish with an 
electrical current, he is appalled by its stupendous mag- 
nitude. We all recognize the usefulness of electricity 
in a commercial way, but comparatively few realize its 
possibilities as a therapeutic measure. 
The medical profession is conservative and rightly 
should be so. The medical man comes in contact with 
more failures of things to fulfill promises than those en- 
gaged in any other line of human endeavor, so it is not 354 
HIGH-FREQUENCY PRACTICE 
uncharitable to say that the medical man is more or 
less a skeptic. Having seen so many complete failures 
in drug therapy he comes to disbelieve in therapeutic 
promises, yet is often the most gullible to the promises 
of visionary promoters. 
When he went forth from his alma mater to fight 
disease he was full of enthusiasm and confident that he 
would be able to cope successfully with the afflictions of 
mankind; but gradually one by one, his idols fell to 
earth and were crushed by the heel of experience. There 
have been so many unfulfilled promises of what elec- 
tricity would do in a therapeutic way, made by honest 
but over-enthusiastic men, that not only distrust but 
disgust has seized hold of the medical profession. Then 
again a physician may become interested in the prom- 
ises made, and being willing to make a trial of its effi- 
ciency, purchases an apparatus, the workings of which 
in a few minutes are explained by the salesman who 
gives a glowing account of its wonderful capabilities, 
gives him a cordial handshake and bids him a friendly 
adieu. The physician knowing little or nothing of the 
fundamental principles of electricity must perforce ap- 
ply it in the scientific manner of the Indian voo-doo. 
He fails to secure results and decides that he is stung 
again. 
Allow me to say to the prospective employer of 
electricity as a therapeutic agent: do not attempt to 
erect a structure without a proper foundation. No one 
would employ a man to wire his house unless he be- 
lieved that man to understand the fundamentals of elec- THE DOCTOR’S DUTY 
355 
tricity. How much greater the necessity for a physi- 
cian to understand the fundamental principles of elec- 
tricity in wiring the human body. Can anyone know 
anything about the action of drugs without a study of 
materia-medica? Yet you will undertake the employ- 
ment of electricity after a few instructions from a man 
who makes no pretensions of a knowledge of medical 
subjects. 
One of the important duties of the physician is his 
obligation to the public in matters of public health. 
Health is civic. Sound men eliminate poverty, which 
fact should make us all sanitarians. Both employers 
and employees need to be convinced of the fact that the 
sound man is the most efficient as well as the cheapest 
employee and that any reasonable expense to maintain 
him in health is a profitable investment. 
Every 31 minutes someone dies of tuberculosis. 
Every 5 minutes someone succumbs to cardiovascular 
disease. Every 4 minutes someone is taken away by 
disease of the nervous system. Every 7 minutes some- 
one’s suffering is ended by cancer. I am within the 
limits of conservatism when I say that 60 per cent of 
the deaths mentioned are preventable and under ideal 
conditions all are preventable. The life of some pupil 
of our public schools goes out every minute from some 
preventable disease. There are in our public schools 
over 20 million pupils, 14 million of them being in some 
way defective. Practically all these deficiencies can be 
corrected. A debt we certainly owe to humanity is to 356 
HIGH-FREQUENCY PRACTICE 
teach the parents of these defectives how to correct ex- 
isting conditions to the end that these children may be- 
come useful citizens. 
As the world advances in this wonderful epoch of 
intellectual development and physical betterment there 
is a constant requirement for better things. The in- 
dividual feels that requirement and heeds it or fails in 
life’s endeavor. 
Modern medicine realizes that it is not enough to 
build hospitals for the sick; it is not enough to cure 
those already ill; it is not enough for the doctor to re- 
lieve the pain of those actually suffering. All this is a 
part of modern medicine, but a still greater part lies in 
the prevention of illness, in creating favorable condi- 
tions to health and in so dealing with the problem of 
public health that there shall be a minimum of dis- 
ease, a minimum of ill health and a minimum of suf- 
fering. 
The duty of the family physician of the near future 
will be, not so much the administration of drugs as the 
teaching of the family how to keep well. His services 
will be needed more and more in this new line of duty 
and less and less as a pill peddler. His relations to the 
family will be even more sacred than in the so-called 
“good old days.” He will be expected to keep the babies 
well; he will be called upon to examine children of 
school age from time to time, to give advice as to their 
work and play; he will be called to give advice to boys 
and girls who are coming into manhood and womanhood 
and he must keep track of father and mother to see that THE DOCTOR’S DUTY 
357 
they do not fall ill and advise them how to live better 
and get more out of life which under such conditions is 
bound to be prolonged. 
It is through physical measures that the greatest 
good must come to preventive medicine. Allow me to 
urge you at every opportunity offered in your medical 
society discussions, to present the advantages of physi- 
cal methods in therapeutics as well as in preventive 
medicine. Invite the physicians of your town to your 
office and prove to them that physical measures have a 
place in medicine. The advantages of physical therapy 
over other methods are numerous enough to convince 
any physician. There are so many conditions called 
functional which may be restored to normal before or- 
ganic changes take place, that make the methods under 
consideration of great value in restoring health to the 
individual. 
The sphygmomanometer is the physician’s Paul Re- 
vere in cardiorenal disturbances. It brings him a mes- 
sage of danger to come to the individual who has hy- 
perpiesia. Every progressive physician is anxious to 
know about the virtues of any remedial agent, but he 
has seen so many promises fail to make good that he is 
skeptical. Invite him to your office and show him how 
arterial tension may be reduced and with the aid of 
hygienic measures a normal tension be maintained. 
Show him how to unload an engorged liver. Show him 
how physical measures will relieve myalgias and mus- 
cular spasm; show him the advantages of electrolysis 358 
HIGH-FREQUENCY PRACTICE 
over the knife in stricture; how to cure diseased ton- 
sils without tonsillectomy; how to remove warts, moles, 
facial blemishes, epitheliomas and neoplasms as well 
as papilloma of the bladder. Show him how inflamma- 
tory engorgements in any part of the body may be ef- 
fectually drained and exudates absorbed. Show him 
how to relieve pain without analgesic drugs; how to 
prevent ankylosis of joints after accidents and opera- 
tions. Show the specialist how to abort an otitis media. 
Show him how to treat abscesses by ionization. Show 
him the advantages of diathermy in neuralgia, neuritis, 
bronchitis and selected cases of pulmonary tuberculo- 
sis. Show him how to relieve any one of the conditions 
mentioned and another convert is added to physical 
medicine. Do not stand aloof from the profession and 
make exaggerated claims. There is no method of ther- 
apy known but what rightfully belongs to the medical 
profession. The shortest route to destruction of quack- 
ery and isms in medicine is through the channel called 
“show me” which wends its way through the posses- 
sions of the medical fraternity. There is nothing about 
electricity or other physical measures one-half as mys- 
terious in effects as drugs. Calomel is prescribed al- 
most daily for so-called biliousness. Just why the pa- 
tient is benefited is not easy of explanation. One of 
the most important drugs in the materia-medica in 
acute respiratory affections is ipecac. Is its physiolo- 
gical action easily explained? As a matter of fact we 
know it to be beneficial in certain conditions without 
asking ourselves the whys and wherefores, but when 
physical measures are suggested for this or that, we THE DOCTOR'S DUTY 
359 
want to be shown. Ipecac relieves bronchial spasm 
through its effects on the vagus. We accomplish the 
same result by physical methods, minus the nausea. 
Every effect has its cause, but the fact is not always 
easy to explain. Nevertheless the relation of effect to 
cause of physical measures is easier of explanation 
than that of drugs. 
The charge that physiotherapists are drug nihilists 
will not stand. We all believe in the efficacy of drugs, 
but we have learned that physical measures will relieve 
many conditions where drugs signally fail and we also 
have learned that many conditions are relieved more 
easily by physical methods than by drugs. Let us all be 
true to the tenets of our profession; while we need all 
laboratory methods to aid us, let us not forget that the 
proper study of mankind is man and that a true clini- 
cal picture, after all, is more important to us than one 
taken in the laboratory. 
Every time a physician ignores or berates physical 
measures in therapeutics he is placing a stone in the 
structure of unethical practice. He who thinks that 
physiotherapy is all that is necessary in treatment of 
disease is building air castles; he who thinks there is 
nothing worth while in physical therapy may still be- 
lieve that the world is flat; but he who believes that 
electricity and other physical measures are potent 
agents in the treatment of disease is safe and sound. 
We are not asking the profession to drop one single 
useful method of therapy, but we do ask the privilege of 360 
HIGH-FREQUENCY PRACTICE 
allowing reason to triumph and be recognized as hon- 
est toilers in the field of constructive medicine. 
Our banner is not of reddish hue but red, white and 
blue, the symbol of unity of purpose, submission to law, 
fidelity to a trust and charity to all. 
My duties as presiding officer of this association are 
drawing to a close and I desire to thank you one and 
all for your loyal support and co-operation. As I take 
my place in the rank and file I feel no better than the 
best of you; no worse than the worst of you but just one 
of you who believe that physical measures in therapeu- 
tics are of extreme importance as an adjuvant to other 
well known methods of relieving human suffering, and 
I hope that I will not be found wanting in the great 
work of dissemination of the gospel of physiotherapy. 
JUST A WORD TO MY SUCCESSOR. 
As your presiding officer I am about to go. 
May you who take my place my troubles never know. 
Some things that I have learned I’d like to pass them on 
To you who’ll succeed me after I am gone. 
I’ve only a bunch of work to leave and cares for you 
to face 
And few cheering words to speak to you who’ll take 
my place. 
The trials that I have had, may you never share; 
May the members help to carry the load you have to 
bear. THE DOCTOR’S DUTY 
361 
There will be criticism on which so many dote, 
But if it be constructive it will not get your goat. 
I leave a task unfinished and you must take it on 
And keep alive the society after I am gone. 
Of all the dreams I’ve ever had but few have come true, 
But may all your happy dreams be realized by you; 
And when your time comes to count the battles lost 
May I then share with you the tears they have cost. 
Where I have failed may you succeed and at an early 
dawn 
Our work be appreciated after we both are gone. GLOSSARY GLOSSARY. 
A. C.—Abbreviation for alternating current. 
ACROCYANOSIS.—A term employed for localized 
hypertension. 
ACTINIC.—Having the property of actinism; ap- 
plied to the quality in the sun’s rays whereby chemical 
changes are produced. 
ACTINIC RAY.—Invisible radiant energy which 
can induce chemical action; ultra-violet ray. Artifi- 
cially produced by quartz lamps. 
AIR GAP.—An open space in an electric current. 
ALPHA RAYS.—One of the three types of rays 
emitted by radio-active substances; positively charged 
electrons. 
ALTERNATING CURRENT.—A current which 
rises and falls in strength of flow alternately in oppo- 
site directions at regular intervals; abbreviated A. C. 
ALTERNATING CYCLE.—A cycle begins with 
zero current which rises to a positive maximum, falls 
to zero again, thence to a negative maximum and re- 
turns to zero; the completion of the cycle is called a 
period. 
ALTERNATION.—One-half period of an alternat- 
ing current cycle. 
365 366 
HIGH-FREQUENCY PRACTICE 
AMPERAGE.—The strength of an electric cur- 
rent measured in amperes. 
AMPERE.—Unit of strength of the electric cur- 
rent; it is the current produced by an electromotive 
force of one volt in a current having a resistance of 
one ohm. 
AMPERE HOUR.—It represents the quantity of 
electricity passed by one ampere of current in one 
hour. 
ANION.—An acid radical or ion which appears at 
the positive pole in and electrolytic cell. 
ANODE.—The positive pole of an electric cell or 
battery; the positive or anti-cathode electrode of a 
vacuum tube. 
ARC.—A flashing occurring between the terminals 
of an electric circuit when the current has been in ter- 
rupted. 
ARC LAMP.—A device for producing light by a 
voltaic arc. 
ARMATURE.—The keeper of a magnet; in a dy- 
namo, a core of metal around which is a wire winding 
constructed to rotate near the poles of a magnet. 
ARMATURE CURRENT.—The path followed by 
the electric current thru the windings of a dynamo or 
motor armature. GLOSSARY 
367 
ARMATURE of a DYNAMO.—A metallic body 
made up of coils of wire wound around an iron core in 
which electric currents are induced by its rotation in a 
magnetic field. 
ASTATIC.—Deprived of direct power; a neutral- 
ized magnetic needle. 
ATMOSPHERIC ELECTRICITY. — Free electric- 
ity always found in the air. 
ATOM.—The chemical unit: a small particle of 
matter made up of electrons. 
ATOMIC WEIGHT.—A relative weight assigned to 
atoms of the various elements as compared with that 
of an atom of hydrogen; the specific gravity as com- 
pared with hydrogen when in a gaseous state. 
ATOM OF ELECTRICITY.—The electric charge 
of an alpha particle. 
AUTOCONDENSATION. —Condensation of elec- 
tricity within the body of a patient by reason of his be- 
ing a part of the condenser. 
AUTOCONDUCTION.—A treatment where the pa- 
tient is placed within a solenoid attached to a d’Arson- 
val apparatus. 
AUTO-INDUCTION.—Self induction of magnetic 
coils. 368 
HIGH-FREQUENCY PRACTICE 
AUTO-TRANSFORMER. — A variable compensa- 
tor in which a choke coil is introduced across an alter- 
nating current supply circuit so that varying currents 
can be obtained from different points on its windings. 
Employed on x-ray machines. 
BACK INDUCTION.—An induction acting upon a 
magnetic field tending to demagnetize or weaken it. 
BETA RAYS.—One of the three types of rays emit- 
ted by radioactive substances; negative charged elec- 
trons ; their movement is slower than alpha rays. 
BIPOLAR.—Having two magnetic poles. 
BOBBIN, ELECTRIC.—A spool wound with insu- 
lated wire for conducting electricity. 
BROWN AND SHARPE GAUGE.—The American 
wire gauge adopted as standard for wires for electri- 
cal purposes; abbreviated B. & S. W. G. 
BRUSH ELECTRODE.—An electrode resembling 
a brush for application of electricity. 
BRUSH DISCHARGE.—The removal of a charge 
from an electrical conductor, in the form of a brush. 
CAGE, AUTOCONDUCTION.—A solenoid large 
enough for a patient to stand or recline in for treat- 
ment by high-frequency currents. Useful in hyperten- 
sion. GLOSSARY 
369 
CALORIE.—The unit of heat in the C. G. S. system 
equivalent to the amount of heat necessary to raise the 
temperature of a gram of water from 0 to one degree 
Centigrade. 
CANDLE POWER.—The standard candle by 
which all lights are measured; a sperm candle consum- 
ing 120 grams of wax per hour; a white light visible 
at a distance of one mile. 
CAPACITY.—The quantity of electricity which a 
condenser is able to store. The unit of capacity is 
called a farad. A microfarad is one millionth of a farad. 
CATAPHORESIS.—The act of transferring reme- 
dial agents into the tissues by means of positive elec- 
tricity. 
CATHODE.—The negative pole of a voltaic cell. 
CATHODE RAYS.—Radiations eminating from 
the cathode of a vacuum tube. 
CATION.—The ion which appears at the negative 
pole in an electrolytic cell; a kathion. 
C. G. S. UNITS.—Abbreviation for centimeter, 
gram second units. 
CHARGE.—The amount of electricity present up- 
on any substance which has accumulated static energy. 
CIRCUIT.—The course followed by an electric cur- 
rent from its source thru conductors and back again to 
its starting point. 370 
HIGH-FREQUENCY PRACTICE 
CLOSED CORE TRANSFORMER. — A trans- 
former having a core which makes a closed magnetic 
circuit. 
COIL.—Successive turns of insulated wire which 
create a magnetic field when an electric current passes 
thru them. 
COLLECTING BRUSHES. — Conducting devices 
which make sliding contact with the surface of the 
commutator of an alternator so as to draw off the cur- 
rent from the armature coils. 
COLLOIDS.—Non-crystalline semi-solid jelly or 
glue like bodies. 
COMMUTATOR.—A device for reversing the di- 
rection of electric currents; that portion of a dynamo 
which collects currents from the armature and deliv- 
ers them to the outside circuit. 
CONDENSER.—An accumulator of electrical en- 
ergy; a Leyden jar is a simple form of a condenser. 
CONDUCTOR.—A substance thru which currents 
of electricity flow easily. 
CONSTANT CURRENT.—An electric current of 
continuous and uniform strength which flows in a di- 
rect course. 
CONTINUOUS CURRENT.—A steady, non-pul- 
sating direct current as opposed to an alternating cur- 
rent. GLOSSARY 
371 
CONTROLLER.—A magnetic device for the regu- 
lation and control of an electric current. 
CORE.—The mass of iron forming the interior por- 
tion of an electro-magnet and around which the coils 
are wound. 
COULOMB.—The unit of electrical quantity; the 
quantity of electricity delivered by a current of one 
ampere maintained for one second of time. 
CURRENT DENSITY. — Current concentration; 
the density of a current increases in inverse proportion 
to the square of the surface of the electrode. 
CURRENT ELECTRIC.—The flow of electrons 
over or thru a conductor from a higher to a lower po- 
tential. 
CURRENT STRENGTH.—In a continuous cur- 
rent, the relation of the electromotive force to the re- 
sistance of the circuit. 
DAMPING.—Retarding swinging vibrations. 
d’ARSONVAL A.—A French physicist noted for 
his scientific researches. 
d’ARSONVAL CURRENT. — A high-frequency 
current of low voltage and high amperage produced by 
specially arranged coils. 
D. C.—Abbreviation of direct current. 372 
HIGH-FREQUENCY PRACTICE 
DIATHERMY.—The passage of a high-frequency 
current thru the tissues of the body for the purpose of 
raising their temperature; Thermopenetration; endo- 
thermy; transthermia. 
DIALECTRIC.—A non-conducting medium like air 
which admits the passage of an electric current. 
DIFFUSION.—The power of a current to extend 
its influence in all directions. 
DIRECT CURRENT.—An electric current con- 
stant in direction; abbreviated D. C. 
DIRECT INDUCED CURRENT.—The current in- 
duced in an electric circuit by breaking of the circuit. 
DISCHARGE.—The sudden equalization of electric 
potentials. 
DISPERSING ELECTRODE.—A large electrode 
for diffusion of currents over a wide area. Employed 
in surgical diathermy. 
DRY TRANSFORMER.—A transformer employ- 
ing air in the place of oil as a cooling agent. 
DYNAMIC ELECTRICITY.—A term applied to 
electricity in motion as distinguished from static elec- 
tricity. 
DYNAMO.—A machine for converting energy in 
the form of mechanical power into electrical energy by 
means of electromagnetic induction. GLOSSARY 
373 
ELECTRICITY.—The modern theory is that elec- 
tricity is a substance composed of electrons and is 
made manifest by its magnetic, thermal and chemical 
effects. 
ELECTRO-ANESTHESIA.—Loss of sensibility to 
pain by application of electricity. 
ELECTROCOAGULATION.—Cooking tissues by 
means of high-frequency currents; surgical diathermy. 
ELECTRODE.—A device attached to an electric 
terminal for the purpose of delivery of electricity to 
the body. 
ELECTRO DIAGNOSIS.—The application of 
electricity to the tissues of the body as an aid in diag- 
nosis. 
ELECTROLYSIS.—The decomposition of a chem- 
ical compound in solution into its constituent elements 
by the passage of an electric current thru it. 
ELECTROLYTE.—The liquid decomposed in elec- 
trolysis. The exciting fluid of a voltaic cell. 
ELECTROLYTIC COPPER.—Copper that has 
been freed from impurities by electrolysis. It is 98 
per cent pure copper. 
ELECTROMAGNET.—A magnet produced by 
passing an electric current thru an insulated wire con- 
ductor coiled around a core of soft iron as in the field 
of a dynamo or motor. 374 
HIGH-FREQUENCY PRACTICE 
ELECTROMOTIVE FORCE.—The force which 
starts and maintains a current of electricity thru a 
conductor. Its unit is called a volt. Abbreviated E.M.F. 
ELECTRON.—The smallest conceivable amount of 
electricity. Atoms of all substances are composed of 
electrons. The basis of all fundamental matter. 
ELECTROPHOBIA.—Unreasonable fear of elec- 
tricity. 
ELECTRO-NEGATIVE. — Possessing negative 
electrification; the element in electrolysis that appears 
at the positive pole. 
ELECTRO-PHYSIOLOGY.—The science of elec- 
tric phenomena in animal and vegetable systems. 
ELECTRO-POSITIVE.—Possessing positive elec- 
trification; the element in electrolysis that appears at 
the negative pole. 
ELECTROSCOPE.—An instrument used to detect 
a positive from a negative charge. 
ELECTROTHERAPEUTICS.—The use of electric- 
ity in the treatment of disease; electrotherapy. 
ELECTROTHERAPEUTIST.—One skilled in elec- 
trotherapeutics. 
ELECTROTONUS.—The altered state of a nerve 
or muscle resulting from the application of an electric 
current. GLOSSARY 
375 
ENDOSCOPE.—A lamp for illuminating internal 
cavities of the human body. 
ENDOTHERMIC.—Relating to the absorption of 
heat. 
ENERGY, ELECTRIC.—The work done in a cir- 
cuit or conductor by a current passing thru it. 
EXCITATION.—The stimulation of muscular or 
nerve tissue in the body. 
FARAD.—The unit of electrical capacity. 
FARADAY MICHAEL.—An English scientist, fa- 
mous for his discoveries in chemistry and electricity. 
Born 1791; died 1867. 
FARADIC.—Relating to induced electric currents. 
FARADIC COIL.—A medical induction coil; a far- 
adic battery. 
FARADIC CURRENT.—An alternating current 
produced by a faradic coil. 
FIELD.—A term employed to the space occupied by 
magnetic or electric lines of force. 
FIELD COILS.—Coils of insulated wire wound up- 
on the field magnets of a dynamo. 
FRANKLINIC ELECTRICITY. — Frictional or 
static electricity. 
FREQUENCY.—The number of periods made by 
an alternating electric current per second of time. 376 
HIGH-FREQUENCY PRACTICE 
GALVANI LUIGI.—An Italian physician and 
physiologist famous for his discovery of current elec- 
tricity; born 1737; died 1798. 
GALVANIC BATTERY.—A name given to a series 
of primary cells. 
GALVANIC CAUTERY.—A method of burning 
the flesh in medical treatment by heat of a continuous 
direct current. 
GALVANIC ELECTRICITY.—A name commonly 
employed for a direct continuous current of electricity. 
GAMMA RAYS.—One of the three types of radia- 
tion from radioactive substances. They accompany 
beta rays and are regarded as a part of x-rays. The 
shortest known ray of the solar spectrum. 
GAP.—An air space in a magnetic circuit. 
GENERATOR.—A machine for the transforma- 
tion of mechanical into electrical energy. 
GRID.—The lead plate of a storage cell. 
GROUND.—The earth as an electric conductor. 
GROUND WIRE.—A conductor which makes con- 
nection with the earth. 
HEAT, ELECTRIC.—The heat produced in a con- 
ductor by the passage of an electric current thru it. 
HEAT UNIT.—The amount of heat required to 
raise the temperature of a unit mass of water one de- 
gree. GLOSSARY 
377 
HELIX.—A conducting coil or solenoid. 
HENRY.—The unit of self induction. 
HERTZIAN WAVES.—Electromagnetic waves or 
frequencies first observed by Hertz, a German physi- 
cist ; the longest known rays of the solar spectrum. 
HIGH-FREQUENCY. — A periodicity exceeding 
10,000 per second. 
HIGH-FREQUENCY TRANSFORMER.—An appara- 
tus for raising or lowering the frequency of an alter- 
nating current. 
HIGH TENSION.—A term applied to high voltage 
currents. 
HIGH VOLTAGE.—A term applied to an electro- 
motive force exceeding 600 volts. 
HOT WIRE METER.—An ammeter or milliam- 
peremeter depending for its action upon the expansion 
of a wire under influence of heat produced in it by the 
passage of an electric current to be measured. 
HYPERTENSION.—A sustained blood pressure 
above normal. 
HYPOTENSION.—Sustained blood pressure below 
normal. 
HYPERPIESIA. — Hypertension without cardio- 
vascular changes. 
IMPEDENCE.—The opposition offered to the flow 
of an alternating current. 378 
HIGH-FREQUENCY PRACTICE 
IMPEDENCE COIL.—A choke coil. 
INDUCED CURRENT.—A Current caused by 
electromagnetic induction. 
INDUCING COIL.—The primary winding of a 
transformer. 
INDUCTION.—An electric or magnetic state pro- 
duced without contact with an electrified or magnetic 
body. 
INDUCTION COIL.—A transformer with open 
magnetic circuit in which a pulsating direct current in 
the primary induces an alternating current in the sec- 
ondary. 
INSULATE.—To safeguard a body against escape 
of electricity from it or a conduction of electricity to it. 
INSULATOR.—A non-conductor. 
INTENSITY OF CURRENT.—Current strength. 
INTERRUPTER.—A device for the opening and 
closing of an electric circuit. 
IONIZATION.—A breaking up of a compound into 
positive and negative ions. 
IONS.—The charged bodies of an electrolyte which 
appear at the poles of a primary cell. They are called 
“travelers” or “tramps” because they travel toward 
the poles. GLOSSARY 
379 
JOULE’S LAW.—The quantity of heat developed in 
a conductor by the passage of an electric current is pro- 
portional to the resistance of the conductor to the 
square of the strength of the current, and to the dura- 
tion of the flow. Heat equals current 2x resistance x 
time. 
KATHION.—A cation. 
KATHODE.—Cathode. 
KILO-VOLT.—One thousand volts. 
KILOWATT.—Electric power of 1,000 watts; ab- 
breviated K. W. One thousand watts equals 1.34 horse 
power. 
KILOWATT HOUR.—The work performed by one 
kilowatt of electric power during one hour. 
KINETIC ENERGY.—The energy possessed by a 
moving body distinguished from potential or energy at 
rest. 
LABILE GALVANIZATION.—The application of 
galvanic electricity from an electrode sliding over the 
parts treated. 
LEAK.—Dissipation of electricity thru faulty insu- 
lation. 
LEYDEN JAR.—A glass jar coated inside and out 
to a certain height with tin foil. It is the simplest form 
of condenser. It receives its name from the city of 
Leyden where it was first made. 380 
HIGH-FREQUENCY PRACTICE 
LEYDEN JAR BATTERY.—Several Leyden jars 
grouped together. The battery employed in the con- 
struction of some high-frequency machines. 
LINES OF MAGNETIC FORCE.—Lines or paths 
along which magnetism acts. 
LOAD.—The output in watts of a dynamo; the re- 
sistance offered to a motor by the machinery it drives 
LOW TENSION.—Low voltage. 
MAGNET.—A body possessing the property of at- 
tracting to itself particles of iron. 
MAGNET CORE.—A bar of iron or steel about 
which a magnet coil is wound to form an electromagnet. 
MAGNETIC FIELD.—The space surrounding a 
magnet thru which magnetic forces act. 
MAGNETIC GENERATOR.—A machine for gen- 
erating electricity by the use of permanent magnets; a 
magneto. 
MAGNETIC POLES.—The ends of a magnet called 
north or positive and south or negative pole. 
MAGNETISM.—The property possessed by certain 
substances in virtue of which they exert forces of at- 
traction or repulsion according to fixed laws. 
MAGNETO.—A device for generating electricity by 
electromagnetic induction produced in the field of a 
permanent magnet. GLOSSARY 
381 
MAGNET WIRE.—Fine insulated wire. 
MAIN.—One of the principal conductors in an elec- 
tric light or power system. 
MAKE AND BREAK.—Alternately opening and 
closing a circuit. 
MEDICAL ELECTRICITY.—Electrotherapeutics. 
MILLI.—One-thousandth part. 
MILLIAMPERE.—One-thousandth of an ampere. 
MILLIAMPEREMETER.—A device for measuring 
the strength of an electric current in milliamperes. 
MOTOR.—An electric motor is a machine for trans- 
forming electrical into mechanical power. 
MULTIPLE-POINT ELECTRODE.—An electrode 
consisting of many points from which electricity is dis- 
charged ; the discharge is called effluve. 
MYRIA.—A prefix meaning ten thousand times as 
great. 
NEURASTHENIA.—A complex condition of un- 
known pathology characterized by symptoms of nerv- 
ous insolvency. 
NEUROSTHENIA.—Neurasthenia associated with 
hypertension. 
NON-CONDUCTOR.—A substance which allows 
but a very small amount of electricity to pass; an insu- 
lator. 382 
HIGH-FREQUENCY PRACTICE 
OHM.—The unit of electrical resistance. It re- 
ceives its name from George S. Ohm, a German physi- 
cist. 
OHM’S LAW.—The amount of current in amperes 
is equal to the electromotive force in volts divided by 
the resistance in ohms. 
OIL TRANSFORMER.—A transformer which is 
kept insulated by being immersed in oil. 
OPEN CIRCUIT.—An interrupted electrical con- 
tinuity; a broken circuit. 
OSCILLATING CURRENT.—An electric current 
consisting of a series of waves, decreasing in ampli- 
tude in constant proportion; an oscillatory current. 
OUDIN COIL.—A resonator attached to a d’Arson- 
val solenoid. 
OUDIN CURRENT.—A unipolar high-frequency 
current of high voltage and low amperage. 
OZONE.—A gas produced by passing an electric 
current thru air, changing oxygen into ozone. 
PARALLEL CONNECTION.—A method of con- 
necting up an electric system in which all the positive 
poles are joined to one conductor and all the negative 
poles to another; multiple connection. 
PERIOD.—The time taken to execute a complete 
cycle of an alternating current. GLOSSARY 
383 
PHOTOTHERAPY.—The treatment of disease by 
application of light. 
PLANT ELECTRICIY.—Electricity exhibited in 
vegetable life. 
POLARITY.—Possession of magnetic poles. 
POLE.—An electrical terminal. 
POLYPHASE.—Having more than one phase or 
period of alternation. 
POSITIVE ELECTRICITY.—The kind of electric- 
ity which flows from the point of an electrified body. 
POSITIVE POTENTIAL.—The higher potential 
which causes electricity to flow toward a lower or neg- 
ative potential. 
POTENTIAL, ELECTRIC.—The power possessed 
by a charge of electricity for doing work. 
POTENTIAL ENERGY.—Power at rest; inherent 
energy; ready for work but not working. 
PRIMARY CELL.—A device for transforming 
chemical action into an electric current. 
RADIANT HEAT.—Heat waves passing thru 
space with the velocity of light (186,000 miles per sec- 
ond) and giving the sensation of heat only when ab- 
sorbed by the body thru which they are passing. 384 
HIGH-FREQUENCY PRACTICE 
RADIOACTIVITY.—That property of a substance 
by which it spontaneously emits rays which are capa- 
ble of penetrating opaque substances, exciting phos- 
phorescence in certain substances and ionizing the sur- 
rounding air. 
RAYS.—Lines of radiant energy emitted by 
sources of light, heat and radioactive substances. 
RESISTANCE.—The property of a substance that 
opposes the passage of an electric current thru it. It 
is measured in ohms. 
RECTIFIED CURRENTS.—Alternating currents 
which have been changed into direct pulsating currents. 
RESONATOR.—A circuit tuned to oscillate in syn- 
chronism with another oscillating current. 
RHEOSTAT.—A device for varying the resistance 
of an electric current. 
ROTARY CONVERTER.—A dynamo for generat- 
ing both direct and alternating currents; rotary trans- 
former. 
ROTOR.—The part of a machine which rotates. 
R. P. M.—Abbreviation for revolutions per minute. 
RUHMKORFF’S COIL.—A coil consisting of two 
insulated coils, the primary having few turns of coarse 
wire, the secondary with many turns of fine wire, 
wound upon a hollow cylinder enclosing a core of soft 
iron wires; the primary is joined to a battery and in- 
cludes an interrupter and commutator. GLOSSARY 
385 
SECONDARY.—A term used for secondary coil. 
SECONDARY CURRENT.—The current induced 
in the secondary of a transformer or induction coil. 
SERIES CONNECTION.—The connection of cells 
one after another, the positive of one to the negative of 
the next and so on thru the battery. 
SHUNT.—A branch conductor for the purpose of 
dividing the current allowing a part to flow thru the 
main circuit. 
SINE CURVE.—A wave like curve used to repre- 
sent the changes in strength and direction of an alter- 
nating current. 
SINUSIODAL CURRENT.—An alternating cur- 
rent which starts at zero and gradually increases to its 
limit of strength and back again to zero, then to the 
opposite polarity and back again to zero. 
SOLENOID.—A spiral of conducting wire wound 
cylindrically so that when an electric current passes 
thru it, it acquires magnetic properties. 
SPARK GAP.—The space between two electric 
terminals brought to a difference of potential, filled 
with the dialectric thru which the spark discharge takes 
place. 
SPIRAL.—Wire coiled in one plane. 
SWITCH.—A device for opening and closing a cir- 
cuit. 386 
HIGH-FREQUENCY PRACTICE 
TESLA COIL.—A form of induction coil designed 
by Nikola Tesla for obtaining high potentials and 
frequencies; it consists of few turns of wire in the pri- 
mary and many in the secondary, and immersed in 
oil. Tesla transformer. 
TESLA CURRENT.—A high-frequency current ol 
extremely high voltage and medium amperage. 
TRANSFORMER.—A device similar to the induc- 
tion coil for the purpose of transforming alternating 
currents from a higher to a lower or a lower to a 
higher potential. When the primary consists of few 
turns of wire and the secondary many turns it is known 
as a “step up” transformer. In a “step down” trans- 
former the conditions are reversed. 
ULTRA-VIOLET RAYS.—Rays existing beyond 
the violet of the visible spectrum having an exceedingly 
high rate of frequency ; actinic rays. 
UNIDIRECTIONAL CURRENT.—An electric cur- 
rent of uniform direction; a direct current. 
UNIPOLAR.—A term used when one electrode is 
applied to the body. 
VOLT.—The unit of electromotive force; it is 
that E. M. F. which will produce a current of one am- 
pere against a resistance of one ohm. 
VOLTAGE.—Electromotive force measured in 
volts. GLOSSARY 
387 
VOLTAGE DROP.—The reduction of potential in 
an electric circuit due to the resistance of the conduc- 
tor. 
VOLTAIC BATTERY.—A group of primary cells. 
VOLTAIC CELL.—A primary cell. 
VOLTAIC ELECTRICITY.—Current electricity. 
VOLT METER.—A device for measuring differ- 
ences of potential in volts. 
WATT.—Unit of electrical power; the power due 
to a current of one ampere flowing under pressure of 
one volt. 
WATT HOUR.—One watt of power expended for 
one hour. 
WIND, ELECTRIC.—A stream of electrons com- 
municating its momentum to the air. 
ZERO POTENTIAL.—The earth’s potential. GENERAL INDEX GENERAL INDEX. 
Abscess, 161 
Acne, 162 
Acne rosacea, 163 
Acrocyanosis, 122 
Adenitis, 164 
Albuminuria, 164 
Alopecia, 167 . 
Alternating current, 21, 22, 23 
generator, 23 
differs from oscillating, 30 
Altitude 
effects on blood pressure, 
124 
Amenorrhea, 169 
Anemia, 172 
blood pressure in, 138 
Aneurysm, 173 
Angina pectoris, 175 
Angiomata, 178 
Anions, 12 
Apparatus 
care of, 63 
diathermy, 69 
Appendicitis, 173 
Arterio-capillary fibrosis, 122 
Arteriosclerosis, 179 
blood pressure in, 137, 142 
Arthritis, 182 
classification, 182 
gonorrheal, 183, 186 
gouty, 183 
osteo, 183 
acute rheumatic, 182 
rheumatoid, 183 
ceptic, 182 
traumatic, 184 
tuberculous, 184 
Asthenopia., 328 
Asthma, 190 
Ataxia, 194 
Atoms, 3 
composition of, 4 
nucleus of, 4 
Amblyopia 
toxic, 326 
ex anopsia, 327 
hysterical, 328 
Atrophy 
of optic nerve, 324 
muscular, 198, 265, 267 
Autocondensation, 54 
chair pad, 55 
couch, 54 
effects of, 58 
contraindications in, 61 
local, 57 
in amblyopia, 326 
in amenorrhea, 169 
in angina pectoris, 175 
in arteriosclerosis, 179 
in ataxia, 194 
in chorioiditis, 319 
in chorea, 217 
in cirrhosis of liver, 213 
in diabetes, 221 
in eclampsia, 224 
in glaucoma, 320 
in hypertension, 141 
in iritis, 317 
in migrain, 240 
in retinitis, 321 
in syphilis, 285 
Autoconduction, 57 
391 392 
GENERAL INDEX. 
Backache, 152 
Bladder tumors, 292 
Blindness, night, 327 
Blood pressure, 119, 138, 140 
chronological data of, 121 
diastolic, 130, 132, 135 
effects of altitude on, 124 
effects of age on, 129 
effects of digestion on, 128 
effects of excitement on, 127 
effects of pain on, 129 
effects of locality on, 128 
effects of sleep on, 128 
effects of time of day on, 
128 
effects of position on, 127 
etiology, 120 
factors in, 119 
fixed tension in, 141 
how reduced, 58, 141, 143 
how raised, 143 
interpretation, 131 
in anemia, 138 
in arteriosclerosis, 137, 142 
in heart disease, 136, 137, 
138, 139, 142 
in infection, 137, 138 
in neurasthenia, 121, 137, 
260 
in tuberculosis, 134, 290 
in typhoid, 133 
local, 122 
normal, 126 
physiology, 119 
proteins in, 121, 124 
position of body in, 135 
reading, 124 
systolic, 130, 132, 133, 138, 
140 
table, 129 
Body currents, 10 
how reversed, 11 
voltage, 11 
Bronchiectasis, 200 
Bronchitis, 204 
Bruises, 204 
Burns, 206 
Bursitis 
mucosae, 206 
subacromial, 155 
treatment of, 156 
Cancer, 207 
Caruncle, 101, 211 
Cataract, 322 
Cations, 12 
Cell 
electric, 14 
living, 17, 71 
physiology, 71 
primary, 12, 71 
Cervix 
erosions of, 212 
Chalazion, 335 
Chancroid, 212 
Charcot’s disease, 184 
Chilblains, 215 
Chlorosis, 216 
Cholelithiasis, 216 
Chorea, 216 
Chorioditis, 319 
Coccyx, painful, 217 
Coil 
Oudin, 29 
primary, 24, 25 GENERAL INDEX. 
393 
secondary, 24, 25 
Condenser, 27 
function, 27 
Conductors, 14 
Conjunctivitis, 303 
chronic, 304 
granular, 306 
Core, 24 
closed, 24, 25 
Cornea 
diseases of, 309 
opacities of, 312 
ulcer of, 310 
Crises, 151 
Cruritis, 246, 255 
Current density, 79, 81, 83 
Currents 
alternating, 21, 22, 23 
body, 10 
cycle, 25 
electric, 12 
high frequency, 21, 22, 2'3 
oscillating, 28, 29 
Oudin, 29 
unipolar, 29 
Tesla, 30 
Cycle, 21, 23 
currents, 25 
D’Arsonval, 22, 67 
machine, 30 
solenoid, 28 
Density current, 83 
Desiccation, 98 
advantages of, 98 
effects of, 101 
indications for, 101 
in acne rosacea, 163 
in angiomata, 178 
in cervical erosions, 212 
in caruncle, 211 
in corneal ulcer, 311 
in chancroid, 212 
in diseased tonsils, 287 
in fissures, 228 
in granular conjunctivitis, 
306 
in hemorrhoids, 233 
in lupus, 239 
in moles, warts, etc., 102, 
241 
in tattoo marks, 286 
in urethral growths, 296 
methods of, 98, 99 
Diabetes, 217 
Dialectric, 22 
Diathermy apparatus, 69 
Diathermy medical, 67 
contraindications for, 88, 
292 
definition, 67 
differentiation, 68 
electrodes, 85 
foot to foot, 74, 89 
general technic, 85 
hand to hand, 74, 88 
physiology of, 69 
position of electrodes in, 91 
salt pads in, 86 
technic, 87 
treatment time, 87 
in adenitis, 164 
in amenorrhea, 169 
in appendicitis, 173 
in arthritis, 189 394 
GENERAL INDEX. 
in atrophy of optic nerve, 
325 
in ataxia, 195 
in bronchitis, 204 
in bursitis, 156 
in cancer, 208 
in cataract, 323 
in chilblains, 215 
in cirrhosis of liver, 215 
in epididymitis, 227 
in endometritis, 225 
in dysmenorrhea, 222 
in fractures, 229 
in gangrene, 229 
in goiter, 230 
in heart disease, 178 
in impotence, 235 
in iritis, 317 
in lumbago, 237 
in muscular atrophy, 198, 
265 
in neuritis, 247, 257 
in obesity, 76 
in painful coccyx, 217 
in paralysis, 265 
in pneumonia, 269 
in poliomyelitis, 267 
in pleurisy, 270 
in sciatica, 284 
of thyroid, 171 
in tuberculosis, 291 
Diathermy, surgical, 97 
definition, 97 
electrodes, 105, 107 
experiment, 104 
in angiomata, 178 
methods of, 98 
technic, 106 
Dynamo 
function of, 8 
Dysmenorrhea, 221 
Dyspnea, 191 
Eclampsia, 224 
Eczema, 224 
Electrical charge, 3, 17 
Electric 
cell, 13 
current, 6, 12 
energy, 8 
reaction, 14 
Electricity 
animal and vegetable, 13 
conductors of, 14 
defined, 6 
dominates reproduction, 13 
Electrocautery 
distinguished from electro- 
coagulation, 105 
Electrocoagulation, 103 
advantages of, 104 
disadvantages of, 104 
distinguished from cautery, 
105 
dose, 105 
experiment, 104 
technic, 106 
types of electrodes, 106 
Electrodes, 42 
care of, 45 
cataphoric, 46 
diathermy, 106, 107 
diathermy hand, 46 
insulated, 43, 45 
non-vacuum, 47 GENERAL INDEX. 
395 
position of, 91 
Prostatic, 276 
Epithelioma, 228 
tonsil, 289 
precautions in use of, 48 
rays from, 45, 46 
vacuum, 42 
Electrolyte, 12, 14 
Electro-physiology, 13 
Electrons, 3 
features of, 5 
size of, 4 
of sunlight, 15 
Endometritis, 225 
Endothermia, 67 
Energy, 8 
index, 130 
potential, 8 
source of, 9 
transferred, 8 
Epididymitis, 226 
Epithelioma, 228 
Epilepsy, 227 
Epiphora, 336 
Eye, diseases of, 301 
Eyelids, diseases of, 335 
Fatigue 
polarity reverses in, 11 
Fissures, 228 
Fistulas, 228 
Foot switch, 110 
Fractures, 228 
Fulguration, 103 
Gamma rays, 16 
Gangrene, 229 
Generator 
motor, 22 
alternating current, 23 
Glaucoma, 319 
Goiter, 230 
Gonorrhea, 230 
Gout 
See Arthritis 
Headache, 156 
Heart disease 
blood pressure in, 136, 13?, 
138, 139, 142 
pulse pressure in, 136 
treatment of, 140, 178 
Heat 
conductivity, 76 
density, 79, 83 
in diathermy, 70 
in metabolism, 72 
penetration of, 70, 75, 77 
Helium, 6 
Hemiplegia, 231 
Hemorrhoids, 232 
Heredity, factor, 123 
Hermeralopsia, 327 
Herpes, 234, 336 
Hertzian waves, 14 
High frequency currents, 21 
change of frequency, 24 
definition, 21 
electrolytic effects of, 78 
how measured, 31 
how produced, 24 
modified by salt, 86 
physiology of, 33, 69,. 78 
potential, 28 
source of, 22 396 
GENERAL 
INDEX. 
transformer, 25 
voltage of, 26 
in abscess, 161 
in acne, 162 
in adenitis, 164 
in albuminuria, 164, 224 
in alopecia, 167 
in amenorrhea, 169 
in anemia, 173 • 
in arthritis, 185 
in asthma, 192 
in ataxia, 194 
in diabetes, 217 
in dysmenorrhea, 223 
Human mechanism, 9, 71 
Hyperpiesia, 130, 139 
treatment of, 141 
Hypertension, 121, 122, 130 
treatment of, 141 
See Blood pressure 
Hyperthyroidism, 122 
Hypotension, 121, 122, 130, 
134 
See Blood pressure 
Hysteria, 235 
Impotence, sexual, 235 
Index, energy, 130 
Induction, 24 
Infantile paralysis, 266 
Infection, 235 
blood pressure in, 122, 133 
Insomnia, 236 
Insulators 
disease and, 11 
salt, 86 
vegetable, 14 
Insulation 
in auto-ccndensation, 63 
Ionic medication 
in diseases of the eye, 329 
Ions, 12 
Iritis, 314 
treatment of, 315 
Joints 
See Arthritis 
Keloid, 101 
Leukemia, 23 
Leyden jar, 27 
care of, 63 
Light, 15 
frequencies, 16 
physiology, 16 
source of, 15 
speed of, 15 
Lichen, 237 
Liver 
cirrhosis of, 213 
Locomotor ataxia, 194 
Lumbago, 237 
Lupus, 238 
Machines 
types of, 30 
Mastoiditis, 240 
Mechanism, human, 9, 71 
Menopause, 240 
Menorrhagia, 239 
Metrorrhagia, 239 
Metabolism 
deranged, 78 
effects of autocondensation 
in, 61 
faulty, 121 
of cell, 72 GENERAL INDEX. 
397 
Meters, 31 
Migraine, 240 
Moles, 101, 240 
Motor 
care of, 63 
generator, 23 
Muscular dysfunction, 328 
Morse wave in, 330 
Muscular spasm, 152 
sinusoidal in, 330 
Nerves, 54 
Neoplasms, 101 
Nephritis, 122 
Neurasthenia, 121, 257 
Neuralgia, 241 
brachial, 242 
intercostal, 246, 256 
metatarsal, 246, 255 
sciatic, 245, 255, 283 
trigeminal, 243, 251 
Neuritis, 241 
brachial, 243 
multiple, 246, 257 
sciatica, 254 
Neuroses, occupational, 150 
Neurosthenia, 257, 261 
Nevi, 101 
Opacities of the vitreous, 318 
of the cornea, 312 
Optic nerve 
atrophy of, 324 
Orchitis, 226 
Oscillating currents, 28, 29 
differs from alternating, 30 
Otitis media, 263 
Oudin coil, 29 
voltage of, 30 
Pain, 147 
classification of, 148 
definition, 147 
digestive, 152 
effects of diathermy in, 76 
effects on blood pressure, 
129 
general technic in, 53 
inflammatory, 150 
paroxysmal, 151 
persistency of, 151 
referred, 148 
reflex, 149 
subjective, 147 
susceptibility, 151 
in back, 152 
in limbs, 152 
in muscular spasm, 152 
in penis, 153 
in shoulder, 153 
in spine, 260 
Papillomata, 101 
of bladder, 293 
of urethra, 295 
of nose, 192 
Paralysis, 264 
facial, 264 
infantile, 266 
Paralysis agitans, 268 
Patient, preparation of, 53 
Pleurisy, 270 
Pneumonia, 268 
Polarity 
in fatigue, 11 
Poliomyelitis, 266 
Potential, 11, 28 398 
GENERAL INDEX. 
Prostate, 271 
atrophy of, 276, 280 
cysts of, 273 
calculus in, 273 
electrode, 276 
hypertrophy of, 275, 280 
precautions in treatment 
of, 46, 48, 62, 63, 88 
Prostatitis, 273, 280 
Protein test, 124 
Pruritis ani, 281 
Psoriasis, 282 
Ptosis, 335 
Pulse pressure, 132, 136 
See Blood pressure 
Pyosalpinx, 282 
Pyorrhea, 282 
Radiant light and heat 
in hruiess, 204 
in chorioiditis, 319 
in gangrene, 229 
in lumbago, 237 
in neuritis, 248 
in otitis media, 263 
Radioactivity, 76 
Raynaud’s disease, 215, 229 
Resistance 
spark gap, 32 
of skin, 70 
Resonator, 29 
Retinitis, 321 
Rheumatism, 283 
Rhinitis, 283 
Rotor, 22 
Sciatica, 245, 254, 283 
Sinusoidal current 
in spasm of eye muscles, 
330 
in asthma, 193 
Spark gap, 31 
function of, 32 
forms of, 32 
Sphygmomanometer, 125 
Sprains, 285 
Syphilis, 285 
Tabes, 194 
Tattoo marks, 101, 286 
Tension fixed, 61, 135 
Tesla Nikola, 2'2 
Test 
sensitization, 124 
Thermopenetration, 67 
Tonsils, 286 
Toxins, 120 
Transformer, 25 
step down, 26 
step up, 26 
secondary of, 28 
Transthermia, 67 
Trench foot, 215 
Trichiasis, 336 
Tuberculosis, 289 
blood pressure in, 134 
Tubes 
vacuum, 29, 
Ulcers 
See Abscess 
Ultra-violet rays, 16 
Unipolar current, 29 
Urethral growths, 295 GENERAL INDEX 
399 
induced, 2'5 
transformation of, 26 
Vitreous 
opacities of, 318 
Warts, 162 
X-rays, 16 
production of, 5 
Vaginitis, 295 
Varicose ulcers, 296 
Varicose veins, 296 
Voltage 
of body currents, 11 
of Oudin current, 30 
of Tesla current 30