H2O2 SOL. 
NO 1 
CATAPHORESIS 
H2O2 SOL. 
NO. 2 CONTROL 
BLEACHING EFFECT OF CATAPHORESIS. " CATAPHORESIS" 
OR 
ELECTRIC MEDICAMENTAL DIFFUSION 
AS APPLIED IN MEDICINE, SURGERY AND DENTISTRY 
BY 
WILLIAM JAMES MORTON, M. D. 
Professor of Diseases of the Mind and Nervous System and Electro-Therapeutics in the 
New York Post Graduate Medical School and Hospital; Member of the Medical So- 
ciety of the County of New York; Permanent Member of the Medical Society 
of the State of New York; Member and Past President of the American 
Electro-Therapeutic Association; Member of the New York Academy 
of Medicine, American Neurological Association, Harvard Medical 
Society of New York City, American Medical Association, 
Society Fran^aise d'Electro-Therapie, New York Elec- 
trical Society, Etc., Etc. Author of the " X Ray, 
or Photography of the Invisible and its Value 
in Surgery," Etc., Etc. 
MEMBER OF THR. 
ROENTGEN SOCIETY QF LONf)$)$. 
NEW YORK 
AMERICAN TECHNICAL BOOK CO. 
45 Vesey Street 
1898 Copyright, 1898, 
BY 
AMERICAN TECHNICAL BOOK CO. 
BRAUNWORTH, MUNN & BARBER, 
PRINTERS AND BINDERS, 
BROOKLYN, N. Y. CONTENTS. 
PAGE 
Preface iv 
Introductory Remarks 7 
chapter. Part I.-Historical. 
I. Early Experimenters 11 
II. Modern Revival 17 
III. Developments in Dental Surgery 24 
IV. The Writer's Contributions 34 
Part II.-Physics and Physiology. 
I. Elementary Electrical Principles 51 
II. Sources of Electricity 59 
III. Simple or Chemical Osmosis 72 
IV. Electrical Osmosis or Cataphoresis 76 
V. Electrolysis and Cataphoresis 87 
VI. Physical and Physiological Experiments 91 
Part III.-Apparatus and Outfit. 
I. Electrodes for Medicamental Diffusion 95 
II. Electrodes for Metallic Electrolysis 104 
III. Dental Electrodes 108 
IV. Batteries and Central Station Circuits 117 
V. Rheostats 122 
VI. Milliampere Meters 138 
VII. Medicaments 142 
Part IV.-Applications in Medicine and General Surgery. 
I. Simple Cataphoresis 145 
II. Cataphoric Medication or Electric Medicamental Diffusion. 149 
III. Electro Cocaine Local Anaesthesia 163 
IV. Electric Diffusion from Soluble Electrodes 171 
3 4 
Contents. 
Part V.-Special Applications in Dental Surgery. 
CHAPTER. PAGE. 
I. Anesthetization of Sensitive Dentine 197 
II. Anesthesia of the Gums 219 
III. Bleaching of Teeth by Cataphoresis 224 
IV. Antisepsis, or Sterilization of the Teeth 234 
V. Diffusion from Soluble Electrodes 244 
Part VI.-Applications in Microscopical Work. 
Electric Staining of Tissue 247 LIST OF ILLUSTRATIONS. 
FIGURE. PAGE. 
1. Anaemic Cataphoresis with Esmarch's Bandage 35 
2. Anaemic Cataphoresis with Rubber Ring 36 
3. Cataphoric Disc adapted to use with ordinary Electrodes ... 36 
4. Morton's Reservoir Cataphoric Electrode 47 
5. Analogy between Water and Electricity 53 
6. Holtz, or Wimshurst Frictional Machine 61 
7. Simple Voltaic Battery 62 
8. Leclancbe Battery 63 
9. Daniell Battery 63 
10. Gravity Battery 64 
11. Storage Battery (being charged) 64 
12. Storage Battery (discharging) 65 
13. Simple Alternating Current Dynamo 67 
14. Modern Alternating Current Dynamo 67 
15. Simple Continuous Current Dynamo 68 
16. Diagram of Commutator and Brushes 69 
17. Modern Edison Continuous Current Dynamo 69 
18. Batteries grouped in Series 70 
19. Batteries grouped in Multiple-Arc 70 
20. Batteries grouped in Multiple-Series 71 
21. Vessel before Simple Osmosis begins 72 
22. Vessel during Osmotic Action 73 
23. Vessel after Osmotic Action 73 
24. Experiment showing Endosmosis 74 
25. Experiment showing Exosmosis 75 
26. Vessel arranged for Electrical Osmosis 76 
27. Vessel during Electrical Osmosis 77 
28. Vessel during Electrical Osmosis with Polarities changed.... 77 
29. Globule of Mercury moved by passage of Electricity 78 
30. Experiment showing Zone of Cataphoric Activity. .(Frontispiece) 
31. " Galvanotrophism " as shown with Infusoria 93 
32. Rod Electrode for Bath 96 
33. The Peterson Electrode 96 
34. Reservoir Electrode with Perforated Disc 97 
34a, b, c, d. Large Electrodes with Perforated Discs 98, 99 
35. Hypodermatic Injection Electrode 100 
36. Nasal Electrode 101 
5 6 
List of Illustrations. 
FIGURE. PAGE. 
37. Ear Electrode 101 
38. Brush Electrode 101 
39. Vaginal Electrode 102 
40. Soluble Needle Electrodes 104 
41. Soluble Bulb Electrodes 105 
42. Soluble Bulb Electrodes 105 
43. Protected Soluble Electrodes 105 
44. Protected Electrode with Handle . 106 
45. Soluble Bulbs attached to Handles 106 
46. Protected Sound of Soluble Metal 106 
47. Protected Nasal Electrode 107 
48. Rectal Electrode, Olive Tip .... 107 
49. Dispersing Electrode (Amadou) 108 
50. Tongue Electrode 109 
51. Morton's Mouth Electrode 109 
52. Morton's Tong-shaped Duplex Electrode 109 
53. Double Rubber Cup Positive Electrode 110 
54. Single Rubber Cup Electrode 110 
55. Morton's Tubular Applicator. Ill 
56. Plain Platinum Applicator 112 
57. Spring Dental Electrodes (in position) 113 
58. Disc Applicators 115 
59. Disc Applicator (in position) 116 
60. Diagram of Alternating Current 117 
61. Diagram of same " Commuted " to Continuous 118 
62. Diagram of two Continuous Currents from Dynamo 119 
63. Diagram showing Resulting Current from Fig. 63 119 
64. Lamps in Series Relation with each other 122 
65. Lamps in Shunt Relation with each other 123 
66. Clark & Mills Series Rheostat 123 
67. Diagram of Connections, Clark & Mills Rheostat 124 
68. Van Woert Current Controller 127 
69. Wheeler Fractional Volt Selector 129 
70. Diagram of Connections, Wheeler Volt Selector 130 
71. Diagram of two Resistances in Series 131 
72. Diagram with Patient as Shunt to one Resistance 132 
73. Diagram with Patient as Shunt to part of one Resistance.... 133 
74. Diagram of Connections between Battery, Rheostat, Milliam- 
pere Meter and Patient 138 
75. Illustration of Bleaching Experiment (XII) 226 
76. Illustration of Bleaching Experiment (XIII) 22T PREFACE. 
This treatise has been written at the request of 
some of my friends, earnest practitioners in medicine 
and dentistry-particularly in the latter profession- 
who desire information, not alone in regard to the 
mere practice of the art of electric diffusion but also 
in the fundamental principles which govern this art. 
For many years, certainly since 1853, this pecul- 
iar property of the electric current, of driving med- 
icines into living tissue, has hung, suspended in the 
air, so to speak, and has never been brought down to 
practical bearings, in spite of continuous and in- 
genious effort on the part of numerous individual ex- 
perimenters. Each effort, while adding something 
fragmentary to the structure, in itself had never 
been so completely demonstrative as to reduce the 
art to a basis where others could invariably and 
successfully follow. 
It so happens, at the present moment, that in- 
terest is largely centered in the application of the 
principle of Cataphoresis to Dental practices, but it 
takes no special prescience to foresee a time, and 
that not far distant, when this interest will spread 
into medicine and surgery, particularly in its rela- 
tions to the production of an effective local anaes- 
thesia in minor surgical operations. Indeed this 
latter, as I have for many years demonstrated, is 
even now an available, but it would seem a much 
neglected, operation. But since electro-cocaine local 
anaesthesia is but one branch of a large subject, the PREFACE. 
writer lias thought it best to present the subject in 
its entirety rather than in a special and therefore 
limited manner. 
The author's aim has been to gather between two 
covers and to put forth to the medical and dental 
professions much of what has been done, including 
his own work upon Electric Medicamental Diffusion. 
The perforated electrodes alone, devised by the 
writer, make possible an extension of electro-cocaine 
anaesthesia into surgery hitherto impossible. 
And here a word as to the subdivisions of this 
work and the plan upon which it is written. The 
author has found it impossible to write a book for the 
dental profession alone without including in it much 
that had been done in the broader branch of general 
medicine, for so enlarged has now become the scope 
of dental practice that it in reality is inseparable 
from medical and surgical practice. Indeed it 
should be at once and finally conceded that the 
dentist is the physician whose specialty is the dis- 
eases of the mouth and its appendages, both in a 
surgical and medical sense as well as in mechanical 
details. Both dentist and physician, therefore, if he 
reads it at all, should read the entire work, to gain 
a comprehensive view. 
But it is exactly in the line of dental experience 
that the author has most keenly felt his own short- 
comings and must crave the indulgence of his read- 
ers in that profession. His sincere thanks are due 
to Dr. M. L. Rhein for carefully reading over the 
advance sheets of Part V, namely, Special Applica- 
tions to Dental Surgery, and for many valuable 
suggestions. Also he desires to thank Dr. R. Otto- 
lengui for his courtesy and advice in relation to the PREFACE. 
same part. Also, it should be added that this book 
would never have been written at all except for the 
initiative taken by the First District Dental Society 
of the State of New York, upon whose invitation, 
and before whom, the writer's first address upon 
this subject was given. Also a similar courtesy 
was extended by the New York Institute of Stom- 
atology and the Academy of Stomatology of Phila- 
delphia. To Dr. Edward C. Kirk in particular 
throughout the early period of presenting this sub- 
ject the writer owes thanks for most valuable ad- 
vice and assistance, as well as to Mr. William J. 
Evans of the firm of McKesson & Robbins. INTRODUCTORY REMARKS. 
When the fear of the surgeon's knife was dis- 
sipated by the discovery of a means for rendering 
a patient unconscious to physical and mental tor- 
ment, the world was grateful. 
This power of producing a condition of general 
anaesthesia by the introduction of drugs into the 
system through the lungs has been of the greatest 
value to the surgeon also. His sensibilities are not 
shattered by scenes of agony caused by his manip- 
ulations ; the work he does is of a better quality, 
and so again is the patient directly benefited. 
But since the announcement of the great and 
primary discovery of means for producing general 
anaesthesia there has been a constant search for 
means by which local anaesthesia might be pro- 
duced. Some experimenters have worked in one 
direction and some in another, but all have earn- 
estly hoped to come across a method, or an applica- 
tion, or a process, which would permit, say, a finger 
to be amputated, or a tooth to be filled, without the 
necessity for the use of a general anaesthetic. 
Lethal, or numbing, or anaesthetic effects were 
wanted, but it was desired to narrow down their 
sphere of activity to their sphere of usefulness. 
It often happens in medicine that a new method 
of procedure makes its way to success by a series of 
steps not seemingly related to each other in time or 
7 8 
IN TH OD U CTO II Y HEMA HKS. 
relevancy. This would seem to be especially true of 
a number of individual therapeutic measures which 
have, during recent years, been brought to the 
attention of those interested in applying electricity 
to the cure of disease. 
A safe, convenient and perfectly feasible method 
of producing local anaesthesia has been developed, 
and it will be the aim of the writer to state in this 
little work the history of this development, the 
principles which underlie its action and-what will 
appeal to the practical dentist and surgeon-the 
technique of operation. 
This method of producing a state of local anaes- 
thesia depends upon the peculiar characteristic pos- 
sessed by an electric current of driving drugs held 
in solution into human tissue. A great variety of 
terms have been invented to express special views 
of the general facts. We hear of "osmosis," " elec- 
tric osmosis," "anodal diffusion," "metallic elec- 
trolysis," "anaphoresis," "interstitial electrolysis," 
" electric transfer of particles and fluids," and " elec- 
tric transportation." In place of these terms we 
will use those forming the title of this book, " cata- 
phoresis " or "electric medicamental diffusion," 
the latter terminology expressing what will here be 
demonstrated and enlarged upon, namely, that elec- 
tricity does diffuse liquids and substances through- 
out other liquids and substances, and through soft 
and hard living tissues, including the hard tissue 
known as dentine. 
This property of the electric current is one which 
will be found most useful in general surgery, and 
especially in the domain of dental surgery, as will be 
seen from the following extract from an editorial IN THOD ECTO II Y HEMA HKS. 
9 
on the subject which appeared over a year ago in a 
prominent publication devoted to the interests of 
dentists :1 
" In the first efforts at securing dentinal anaes- 
thesia, we were without a specific anaesthetic agent 
suitable for local application. When the agent was 
discovered it was found impossible to secure its 
action upon the pulp through even thin walls of 
dentine, hence its value in this connection is ques- 
tionable, if any. The difficulty just noted seems 
now to have been overcome by enlisting the cata- 
phoric principle of the galvanic current, and the 
feat of causing cocaine to penetrate to the pulp, 
producing a total anaesthesia of that organ through 
walls of dentine having considerable thickness is 
claimed to be a demonstrated fact. The signifi- 
cance of such a result cannot well be overestimated. 
If the dental pulp may with impunity be totally 
anaesthetized by cocaine for a reasonable length of 
time, the nervous wear and tear upon both patient 
and operator, which has been little short of a curse 
upon our work as dentists, will be almost complete- 
ly removed." 
As will be seen by a perusal of the following 
chapters, the demonstration is a complete one, and 
enough will be found there disclosed to warrant a 
belief in the practicability of electric local anaes- 
thesia. Many have already been convinced by per- 
sonal experimentation as to its value, and it is the 
sincere hope of the writer that his words will lead 
others to undertake its practice. 
1 The Dental Cosmos, Vol. XXXVIII. No. 3; March, 1896; 
page 256. PART I.-HISTORICAL. 
CHAPTER I. 
EARLY EXPERIMENTERS. 
We shall be in a better position to understand the 
rationale of medication by electricity if we devote a 
little time to the consideration of the steps which 
have been taken in the past by various experimenters 
and observers in its development. 
It will be recollected that the tendency of fluids 
to mix, or become equably diffused, when in con- 
tact, is called "osmose" or "osmosis." This ten- 
dency is marked and was first observed between 
fluids of differing densities and as taking place 
through a membrance or an intervening porous 
structure. It was discovered by Reuss in 1807 that 
this tendency is intensified upon the application of 
a galvanic current to the two fluids-one battery 
terminal or electrode being immersed in one of the 
fluids and the other battery terminal in the other 
fluid. The first to claim the transportation of med- 
icines by electricity was Pirvati of Venice, whose 
experiments date back to 1747 ; these claims merit 
slight confidence. It was found by Porret, in 
11 12 
CATAPHORESIS. 
1815, that the direction in which this tendency 
manifested itself depended on the direction of flow 
of the electric current. It is now known that this 
direction of flow is almost always from the positive 
to the negative terminal of the battery circuit. This 
transportation of a fluid through a porous septum 
is called " Electric Endosmose " (endosmose signify- 
ing a pushing from without inwardly). 
Fabre-Palaprat. The first account of an at- 
tempt to introduce medicines into the animal body 
by the galvanic current, known to the writer, is 
that of Fabre-Palaprat,1 who, in 1833, employed a 
compress covered with a platinum disk on each arm. 
The negative battery terminal was attached to the 
platinum disk over one compress saturated with a 
solution of potassium iodide, and the positive termi- 
nal was brought to the disk over the other compress, 
which was saturated with starch-water. He stated 
that after allowing the current to pass for a short 
time the starch compress became of a blue color, 
thus indicating that the iodine had travelled from 
the negative pole through the arms and body to the 
positive pole. From this experiment he concluded 
that medicinal substances could be introduced into 
the human system. 
On two occasions I have carefully repeated this 
experiment and found that the action which was 
reported does not take place. It is not credible that 
potassium iodide placed at the negative pole would 
produce any reaction at the positive as above 
described. 
1 " Archives generales de medicin," Vol. II. p. 422. Paris, 1833. EARLY EXPERIMENTERS. 
13 
As was natural, when Fabre-Palaprat's experi- 
ments had-been repeated by others and always with- 
out success, they were discredited and nothing 
came of them. 
Dr. Klenke and Dr. Hassenstein. In 1847,1 Dr. 
Klenke described and claimed the success of a 
method for the galvanic introduction of medicines, 
such as potassium iodide and mercury, into the 
system, while in 1853,2 Dr. Hassenstein made similar 
claims, but both failed to convince the medical pro- 
fession. 
G. Wiedemann. The researches of this noted 
physicist have contributed an important share in 
the development of this subject. He made numerous 
measurements which demonstrated to him the ex- 
istence of certain laws governing the diffusion or 
transportation of liquids by the current. He form- 
ulated and published the following laws in 1853 : 3 
"1. The quantities of liquid transported within 
equal times are proportional to the intensities of the 
currents." 
"2. The quantities of liquid transported by a 
galvanic current through a porous partition are in- 
dependent of the width of the partition." 
"3. For a given battery intensity, the quantity 
of liquid transported is independent of the thickness 
of the porous partition traversed." 
Richardson. In 1859, Dr. (later Sir) Benjamin 
1 "Zeitschrift Wiener Aerzte," Mai, 1747. 
2 " Chemisli-electrische Heilmethode. " Leipzig, 1852. 
3 See, " Traite Theorique et Pratique d'Electrochimie," par 
Donato Tommasi. Paris, 1890, page 42. 14 
Ward Richardson,1 made a notable attempt to in- 
troduce into practice a method of local anaesthesia 
by the use of electricity and narcotics, terming the 
procedure Voltaic Narcotism. The medicines em- 
ployed were aconite and chloroform, as follows :- 
Tine. Aconiti drachms 3 ; 
Ext. " scruple 1; 
Chloroformi drachms 2. Mix. 
Employing this mixture at the positive pole and 
applied to the leg of a dog, complete anaesthesia was 
produced in eleven minutes and later the limb was 
amputated without pain. He also operated pain- 
lessly on a naevus anaesthetized in the same manner, 
and reported five cases of painless extraction of 
teeth, using in the latter cases a small wire at the 
positive pole wound with cotton and soaked in the 
solution mentioned. 
There is little doubt but that Richardson's experi- 
ments were in a degree successful, and that, had 
they not been met with incredulity and extreme 
opposition, cataphoric medication would long ago 
have been practically developed. His opponents 
claimed that the topical application of the aconite 
and chloroform would produce a similar effect; that 
the aconite was dangerous by absorption ; that the 
succeeding local inflammation was severe. On the 
other hand it should be said that discoveries often 
seem to have been forestalled by the work of others, 
when, in reality, did we know and employ their 
exact technique, we should fail. The opposition to 
Richardson's experiments and conclusions was most 
marked in the publications of A. Waller,2 and his 
CATAPIIORES1S. 
1 " Medical Timesand Gazette." Feb. 12 and June 25, 1859. 
2 " Med. Times and Gazette," March 19 and July 30, 1859. EARLY EXPERIMENTERS. 
15 
views were substantially those of many others, in- 
cluding J. Althaus.1 It is interesting to note that 
this opposition was so strong that Richardson was 
constrained to recede2 from the position which he 
had taken concerning voltaic narcotism. 
The influence of his work was, however, for a long 
time discernible in medical and dental literature. 
Quite a furor in regard to using electricity to annul 
the pain of the extraction of teeth, both with and 
without anaesthetic drugs, was excited in this 
country.3 
"About 1859," says Dr. J. Foster Flagg,4 "a 
man named Francis came along and gave us a 
secondary current by means of which we were to 
extract teeth painlessly." The current was applied 
directly to the tooth through the forceps. " In 
forty per cent, of the cases the patients said they 
had felt no pain, another forty per cent, said the 
method was as painful as any they had ever expe- 
rienced in connection with the extraction of teeth ; 
and in twenty per cent, of the cases the patients 
stated they never would have teeth extracted in 
that way again if they knew it." 
"With the aid of a friend (an electrician by the 
name of Otto Flemming), some time in 1870, I think 
it was, I developed what is known to-day as the 
Dental Helix, and instead of getting a secondary 
1 " Wien. Med. Woch.," IX., 1859, page 433. 
2 " Med. Times and Gazette," Feb. 3, 1866. 
3 See " Dental Cosmos," Vol. I. (1859), pp. 104, 142,177, 300, 350, 
551 (Cataphoresis); Vol. IV. (1863), p. 227 ; Vol. VI. (1865), pp. 
582-634; Vol. X. (1869), p. 103; Vol. XI. (1870), pp. 608; Vol. 
XXIII. (1882), p. 280. 
4 " Items of Interest," Oct. 1896, p. 575. 16 
CATAPHORESIS. 
current we gave a primary current, which is very 
mild. We did not call it cataphoresis or any other 
'resis,' we called it substitution. We simply put 
into existence another sensation, which overcame 
the sensation of cutting the sensitive dentine." MODERN REVIVAL. 
17 
CHAPTER II. 
MODERN REVIVAL. 
The apparent settlement of the dispute over Rich- 
ardson's achievements, in a manner adverse to his 
claims, was undoubtedly the reason why, for over 
twenty years, practically nothing was heard of the 
cataphoric administration of medicines. It was not 
until 1886 that the subject was again brought to 
the attention of the profession in an article by Wag- 
ner,1 who suggested that possibly anaesthesia might 
be produced by the combination of cocaine with the 
galvanic current. This suggestion was not accom- 
panied by the record of any experiments in this 
direction. 
Erb, in 1884, introduced medicines through the in- 
tact living skin, and discovered their presence in the 
saliva and in the urine of the subject. Lewandowski 
did the same. Boccalari and Manzieri2 introduced 
strychnine, atropine, quinine and iodide of potassium 
through the unbroken skin, frequently changingthe 
direction of the current as first indicated by Erb. 
In 1885, Lauret claimed that some substances 
electrically introduced through the intact skin, and 
that others were not.3 
Later on in 1886 Adamkiewicz professed4 to have 
introduced chloroform into tissues and thereby pro- 
1 " Wiener Med. Presse," 1886, S. 212. 
2 Rivista clinica, 1888. Reference from article by Fubini and 
Pierini, Arch. d'Elect. Medicale, Aug. 1897. 
3 De 1'introduction, des substances medicamenteuses a travers 
la peau same par 1'influence de 1'eletricite. Montpellier, 1885. 
Reference from Arch. dE'lect Medicale, Aug. 1897. 
4 " Neurolog. Ctribl," Bd. V., S. 219-497. 18 
GA TAPHORESIS. 
duced local anaesthesia. He had found chloroform 
evaporated so rapidly from the ordinary sponge 
electrode that some other arrangement was neces- 
sary. He therefore devised what he termed his 
diffusion electrode which was a hollow brass vessel 
holding about three cubic centimeters of fluid with 
a piece of moistened linen stretched over the bottom 
made of porous carbon. He claimed to have em- 
ployed the cataphoric method with chloroform in 
rheumatic pains and in some forms of neuralgia, 
obtaining a gradual anaesthesia with disappearance 
of pain. 
Paschkis and Wagner1 denied the possibility of 
chloroform being so used as it was almost a com- 
plete insulator. They also said that, although 
anaesthesia may have been produced, it was only 
because the chloroform was in contact with the 
skin. Adamkiewicz answered that although chloro- 
form was a poor conductor yet it did conduct some- 
what, and that anaesthesia was produced in four 
minutes, first to temperature and then to pain. 
Many others, including Lombroso and Matteini,2 
have made this attempt with chloroform but with 
limited success, obviously because of the poor con- 
ductivity of chloroform to electricity. The possi- 
bility that chloroform may thus act to a certain 
extent must not be absolutely denied, since the 
obstacle of its non-conductivity may be overcome to 
a great extent by methods of technique. The fact 
that dermatitis, more or less severe, attends the use 
of chloroform would seem to preclude the hope of 
its practical employment. 
1 " Neurolog. Ctrlbl., Bd. V., S. 413. 
2 " Sulla cataforesi electrica," " La Riforma medica," July and 
November, 1886. MODERN REVIVAL 
19 
Then Dr. J. Leonard Corning,1 of New York City, 
produced anaesthesia by the introduction of cocaine 
through the human skin by making minute punct- 
ures through the skin with the old Baunscheidt 
needles for counter-irritation, together with the use 
of the electric current. In this way he secured 
very profound anaesthesia of the parts operated on. 
He, however, reported no cases. 
Other observers repeated and modified these ex- 
periments, using cocaine chiefly as the medicament. 
Among the more prominent of these is Dr. Frederick 
Peterson, of New York, who, during 1888 and 1889,2 
undertook a series of experiments which settled 
definitely many disputed points. He reported that 
the Adamkiewicz electrode was practically worth- 
less and pointed out its defects ; that there was no 
anaesthesia with cocaine alone ; that there was no 
anaesthesia with current alone, but that current and 
cocaine together caused marked anaesthesia ; that 
the effect was produced only when the drug was in 
connection with the anode terminal of the electric 
circuit. He also cited several instances where 
cocaine had been cataphorically administered for 
the relief of neuralgic pain with satisfactory results. 
Dr. Peterson's experiments, however, did not extend 
to the point of the production of local anaesthesia 
for the performance of surgical operations. 
In 1889, Mr. Newman Lawrence and Dr. A. Har- 
ris, both of London, separately and conjointly de- 
scribed the cataphoric method of medication, invent- 
ing the term " cataphoric medication " to describe 
it. Their paper was read before the Society of Arts. 
1 " New York Med. Jour.," Nov. 6, 1886. 
2 Ibid, April 27,1889. 20 
In November of the same year, Dr. Cagney, also 
of London, treated a variety of diseases by this 
method, reading a paper on the subject before the 
Harveian Society. Among other remedies he used 
iodide of potassium in cases of labyrinthine deafness, 
lead palsy, etc. These English publications revived 
the interest in the subject on the other side of the 
water. 
At the International Congress held in Berlin, in 
August, 1890, a paper was read from Mr. Thomas 
A. Edison upon the employment of cataphoresis for 
the relief of gout. He had found that he was able 
to reduce the size of enlarged joints in a gouty sub- 
ject by carrying lithium salts into the human body 
by means of the electric current. He placed the 
right hand, for instance, in a jar of chloride of 
sodium solution, and the left hand in a jar contain- 
ing a solution of the chloride of lithium. He then 
passed a current of a certain strength from the 
positive pole or lithium side to the negative or 
sodium side and lithium was detected in the urine. 
As a whole these experiments of Mr. Edison were 
conclusive. 
In later years some excellent and elaborate papers 
upon the same subject have been published in 
France. Among the writers of these may be men- 
tioned Dr. Leon Danion, M. Labatut, M. Destot and 
Donato Tommasi. Dr. E. Grosheintz, of Basle, has 
also written a valuable paper on "Anaesthesia of 
Dentine and the Dental Pulp " which appeared in 
the December (1896) number of " L'Odontologie," 
page 727. 
In September, 1891, Dr. Imbert de la Touche, of 
CA TAPHORESIS. MODERN REVIVAL. 
21 
Paris, read an extended paper upon the treatment 
of gout and rheumatism by cataphoric medication. 
The remedies in solution, principally lithia salts, 
were applied by aid of a large sponge or absorbent 
cotton, and made to constitute a positive pole. 
Cases were carefully reported, and the results were 
excellent. 
Gartner & Ehrmann,1 of Vienna, introduced cor- 
rosive sublimate cataphorically by an electric bath 
in syphilitic cases and discovered the mercury in the 
urine. 
About 1855, a Mr. Vergnes, an electroplater, of 
Havana, Cuba, found that he had an incurable ulcer 
which had been produced by his having repeatedly 
to plunge his hands into solutions of cyanide and 
nitrate of silver and gold. One day, having acci- 
dentally placed his hands into a bath already pre- 
pared for plating he found the negative element had 
received a metallic coating. The hint was acted 
upon, and a number of similar treatments resulted 
in the rapid cure of the ulcer. 
From this incident sprung the Vergnes " electro- 
chemical bath," as it was named. A Mr. A. W. 
Royal practised the method in New York City. It 
will be interesting to note some portions of a circu- 
lar issued from this establishment under date of 
May 29, 1885 : 
" This is the only establishment of these Baths in 
New York City. 
" They are widely known for the cure of Rheu- 
matism, Gout, Neuralgia, Sciatica, Paralysis, Ma- 
laria, Liver and Kidney Complaints. 
1 Lewandowski, " Electro-diagnostik and Electro-thei'apeutic." 
Wien and Leipzig, 1892. 22 
CATAPHORESIS. 
" By tests made in 1881, it was proved that they 
are a remedy for Hay Fever. 
" The Baths are pleasant and agreeable to take ; 
they operate directly and powerfully on the nervous 
system, and on all the organs of life. 
" Nervous sufferers, from business excitement or 
other debilitating causes, as well as those suffering 
from chronic nervous disorders, promptly experience 
their beneficial effects. 
" They are known to the Medical Profession as 
a specific against metallic poisons. MERCURY- 
which is the potent cause of so many ills, is thor- 
oughly eradicated by their use." 
The vogue of these baths seems to have depended 
largely on an idea that mercury clung to the system 
of many unfortunates and should be eliminated by 
this method. It is scarcely probable that anything 
more than unusal circumstances would call for the 
elimination of medicinal substances from the body 
by means of electricity, since it is probably impos- 
sible to prevent their natural elimination, and since, 
again, other simple means of elimination are avail- 
able, as, for instance, the administration of iodide 
of potash in lead poisoning. 
In the practice of the Vergnes method of cata- 
phoric demedication the bath-tub was of copper 
and insulated from the earth. The patient was also 
insulated from the tub by sitting on a wooden seat. 
The water (in case gold, silver or mercury was to 
be eliminated) was acidulated with nitric or hydro- 
chloric acid. The positive pole of a thirty-cell gal- 
vanic battery was held in the hands while the neg- 
ative pole was connected to the copper bath-tub.1 
1 See " A Treatise on Medical Electricity," by Julius Althaus. 
Philadelphia, 1873. MODERN REVIVAL. 
23 
This plan was further advocated and published1 
by M. Poey of Paris. 
Vergnes also reversed the current in his bath and 
claimed to introduce medicinal substances, notably 
phosphate of iron in a solution to which nitric acid 
was added, and also quinine. The patient sat in a 
bath containing the solution of the medicine, holding 
the negative pole in the hands and out of the bath. N o 
physician could consent to put in practice a method 
as inexact as that outlined above, unless advantages 
not obtained by other administrations can be de- 
monstrated. Nevertheless, we see here outlined, in 
the system of the Vergnes baths, both medicating 
and demedicating, a crude germ of practice which 
may easily expand into fruitful results. 
For, a careful study of the physics and physiology 
of the subject will convince even the most sceptical 
of the fact that medicine can be introduced through 
the unbroken skin by immersing the patient in a 
fluid electrode which, in fact, such a bath consti- 
tutes. Mr. Edison's experiment of causing the 
patient to immerse the hands in fluid was in reality 
a limited electric bath, and now that we have his 
authority as well as that of Dr. A. E. Kennelly, 
who personally superintended the experiments, we 
may accept without shrinking the principle of the 
" medicated " electric bath. While we must grant 
the solidity of the physical facts, we yet need much 
clinical experience, and the time has not yet come 
for a judicial expression as to the value of these 
methods. 
1 Manuel d'Electricite, etc. Par le docteur A. Tripier. Paris,, 
1861, p. 603 and Comptes rendus de l'Acad, des sciences, 1855. / 24 
CATAPHORESIS. 
CHAPTER HI. 
DEVELOPMENTS IN DENTAL SURGERY. 
It is interesting to note which of the many ex- 
perimentalists was the first who "obtunded sensi- 
tive dentine" by cataphoresis. This is, perhaps, a 
minor consideration, as it goes without saying that 
if other tissues have been thus anaesthetized, den- 
tine could be. Still it is noteworthy that the dis- 
tinction of having first put himself on record belongs 
to Dr. D. F. McGraw, of San Jose, California. He 
has written a letter on the subject which appeared 
in the October (1896) number of the "International 
Dental Journal," pages 678 and 679, in which he 
recalled the fact that he had read a paper before 
the Minnesota State Dental Society at its annual 
meeting in the summer of 1888, and also before the 
Southern Minnesota District Society at its semi- 
annual meeting in the fall of 1888, as well as at the 
twenty-fifth annual meeting of the Chicago Dental 
Club, held in the Grand Pacific Hotel on Feb. 5, 6 
and 7,1889. Thejransactions of this Chicago meet- 
ing were printed in the February (1889) number of 
the " Dental Review," and subsequently in book form, 
his paper appearing at page 113 of that volume. 
Dr. McGraw states that at the Chicago meeting, 
Professor Weeks, of the Dental Department of the 
University of Minnesota, also read an article on the 
subject. The attention of the latter had been called DEVELOPMENTS IN DENTAL SURGERY. 
25 
to the application of cataphoresis by the papers Dr. 
McGraw had read in 1888. 
As a bit of history, the following extract from 
Dr. McGraw's early paper will be interesting : 
" This method that we shall present to you at this 
meeting to gain insensibility in the teeth is the fol- 
lowing : 
" To a twelve per cent, solution of cocaine, add an 
equal amount of absolute alcohol, making a six per 
cent, solution of cocaine in alcohol. In connection 
with this I use the galvanic current, varying the 
power as the needs of each case may indicate. The 
method of application is as follows : 
"First apply the rubber dam ; wet a pledget of 
cotton in the solution, placing it in the cavity of the 
tooth, pressing the point of the positive pole on to 
the cotton, and the negative pole, with sponge at- 
tachment thoroughly wet, to the cheek, turning on 
the current. Rarely will more than four cells 
be necessary, if the battery is in good working 
order. 
" An application of three minutes, with an inter- 
val of three minutes, and then another three min- 
utes application, are sufficient in the majority of 
cases, although I have to occasionally make the 
third application, then dry the cavity thoroughly 
and begin excavating. My deductions as to the 
physiological effects are as follows : The galvanic 
current acts as a vehicle for conducting the medic- 
inal agents ; the cocaine anaesthetizes the odonto- 
blastic cells and the pulp ; the styptic properties of 
the alcohol act upon the dentinal fibrils, they being 
of an albuminous nature, causing contraction and 
increased density and firmness. 26 
CATAPHORESIS. 
" My reasons for drawing these conclusions are 
these: 
' ' I have found that the most sensitive teeth can 
be obtunded ; that after a certain period of rest sen- 
sitiveness returns, but never to that degree that 
existed before the application of the obtundent. 
Therefore I conclude that a change had taken place 
in the dentinal fibrils, ■which I maintain is due to 
the styptic properties, and not to the electrolytic 
actions of the galvanic current. Another reason is, 
that a tooth in which the pulp is devitalized is a 
non-conductor of the electric current. A tooth 
which had been extracted was subjected to a twelve- 
cell current of a freshly-charged battery and proved 
an absolute non-conductor. 
The next we hear of the application of catapho- 
resis in dentistry is from a paper1 read before the 
Dental Society of the State of New York on May 
12, 1892, by Albert C. Westlake, D. D. S., of Eliza- 
beth, N. J. The method used by Dr. Westlake in 
the preparation of cavities, is set forth by him in 
his description of a case where the patient was a 
lady, age thirty-four, of a nervo-sanguine tempera- 
ment. He says "The two cuspids on superior arch 
presented labial and approximate cavities. The 
dentine was hypersensitive, and there was slight 
recession of the gum. Before applying the rubber- 
dam, 1 gave her the negative electrode to hold in 
the hand, and fitted a thin wire of silver in one of 
Kidder's universal holders, attached to the positive 
pole. I wound a few threads of cotton around the 
wire, and saturating it with a ten per cent solution 
1See " Dental Cosmos," November, 1892, page 887. DEVELOPMENTS IN DENTAL SURGERY. 
27 
of cocaine, applied it to the margins of the gum. I 
first passed about one milliampere of current, and 
gradually increased it to four, which I continued 
for less than two minutes. I then adjusted the 
rubber-dam, pressing the gum well up, with no ap- 
parent pain to my patient. 
"Before excavating the cavities, I saturated the 
cocaine crystals with ten per cent, solution of warm 
carbolic acid, into which I dipped the cotton on the 
positive electrode, and found that after applying 
about eight milliamperes of galvanic current for 
fully one min ute I could prepare the cavity without 
the patient protesting. I joined these cavities in 
each tooth, making almost a circle, and filled them 
with gold by aid of the electric mallet. She does 
not appreciate the thermal changes complained of 
before filling, and the teeth are comfortable." 
Dr. Westlake proposed that when teeth were to be 
extracted the electrodes should be applied to the 
gum, one on each side of the root or tooth to be ex- 
tracted. He says, in the article above quoted from, 
that the ends of the electrodes applied to the gums 
are in the form of a cup " within which is placed 
sponge or cotton saturated with a four or six per 
cent solution of cocaine, or absolute alcohol, ether 
and chloroform combined, or some other properly 
selected vegetable anaesthetic, and if the current is 
turned on gently to the required degree, this prep- 
aration can be forced into the tissue sufficiently 
to cause local anaesthesia." This method and the 
electrodes he proposed for the purpose will be 
spoken of in the following chapter. 
Another department of work in which Dr. West- 
lake has been interested is that of bleaching of 28 
teeth cataphorically by the use of pyrozone. He 
described some of his experiences in an article 
which appeared in "The International Dental 
Journal," on page 213 of the April, 1895, number. 
He there says : "This first experiment in catapho- 
resis for bleaching took place on Friday, March 8. " 
This was apparently in 1895. 
In 1891, Dr. J. S. Marshall presented a paper1 be- 
fore the American Academy of Dental Science on 
"Electricity as a Therapeutic Agent in the Treat- 
ment of Hypersemia and Congestion of Pulp and 
the Peridental Membrane." This article demon- 
strated that the continued use of applications of 
electricity for morbid and irritable conditions of the 
pulp did not produce any ill effects on the pulp 
itself. Dr. Marshall did not employ cocaine or any 
other ansesthetic drug. 
While during all this period a great amount of 
work was being done in the field of general medicine 
with cataphoresis, little attention, if any, was paid 
to its application in anaesthetizing sensitive dentine 
for several years after the publication of Dr. West- 
lake's paper, in 1892. The next publication on the 
subject was an article which appeared in the " Den- 
tal Cosmos " for January, 1896, under my own sig- 
nature. This article not only referred to the anaes- 
thetic properties of cocaine when used with electricity, 
in dental work, and especially upon sensitive dentine 
but described a new medicament-that of guiacol- 
cocaine-for the same purposes, the whole forming 
a natural sequence to what I had already pub- 
lished concerning the bleaching of teeth. (See my 
CATAPHORESIS. 
1 " Dental Cosmos," November, 1891. DEVELOPMENTS IN DENTAL SURGERY. 
29 
article on the cataphoric use of pyrozone for bleach- 
ing which appeared in the "Dental Cosmos," for 
June, 1895). The next chapter has been devoted to 
my personal investigations and these matters will 
there be gone into more fully. 
The following month (February, 1896) an article 
appeared in the "Dental Cosmos," written by 
Henry W. Gillett, D. M. D., of Newport, R. I. 
This was a paper he had read before the American 
Dental Association on August 8, 1895, but which 
had not been published until this time. He said, in 
the article referred to : 
" Is there any one pain that has been more dreaded 
by the civilized race than the pain from the sensi- 
tive tissues of the human tooth, when it becomes 
necessary to treat those tissues surgically ? 
" Is there any one object for which our profession 
has sought more earnestly, and less successfully, 
than it has to find a generally applicable means for 
preventing this pain ? 
"We have striven unceasingly with caustics, 
with desiccants, with anaesthetics both local and 
general, with administration of drugs and applica- 
tions of washes, but with all our strivings we hear 
it constantly reiterated in our discussions, that the 
keen excavator arid the firm touch are our main 
reliance. 
"We have been able to soften the blow some- 
times, but very generally the profession seems to 
have come to feel that prompt and heroic measures 
are best, and have prepared themselves for action 
on these lines. 
"In common with the rest of the profession I 
have many times had cause to be grateful, in individ- 30 
CATAPHORESIS. 
ual cases, for some of the above enumerated aids, 
and I would by no means discredit the bridge when 
it has safely carried me over a chasm ; but, after 
many trials and many failures, my sense of relief 
in having a means for the control of sensitive den- 
tine which seems to be universal in its application, 
and the relief afforded to some otherwise untreat- 
able cases has been so great that I am anxious to 
have the knowledge of the success of this method 
more widely spread than it now is, to the end that 
human suffering may be made less. As I have in- 
timated, in my own practice this step in advance 
has been made by using cataphoresis." 
Dr. Wendell C. Phillips, of New York, who was 
interested in Dr. Gillett's early work, writes of it 
as follows :1 "Dr. Gillett's first experiments and 
demonstrations were made with an ordinary adapter. 
In showing him the apparatus which I had, and 
which was used for the ordinary "(therapeutic)" 
purposes of the continuous current, he said he 
thought it might be used in obtunding sensitive 
dentine. The next day he brought a patient, the 
first experiment was made, and it was successful. 
But we found that when the current was increased 
the patient experienced pain, and he thought it was 
necessary to overcome those jumps of the current 
in order to make a perfect application of catapho- 
resis. A successful application of cataphoresis in 
obtunding must depend upon the relief of one 
pain without the introduction of another. Dr. 
Gillett purchased one of the same adapters. He 
1 Paper read before Central Dental Association of Northern 
New Jersey on March 16, 1896. See "International Dental 
Journal," July, 1896. DEVELOPMENTS IN DENTAL SURGERY. 
31 
made some changes in it from time to time, but 
finally found it would not answer the purpose unless 
the current could be so controlled that the changes 
in its gradations or steps would not be painful to 
the patient. He called to his assistance Mr. G. M. 
Wheeler, of the Electro-Therapeutic Company, and 
explained what he wanted. The result of his sug- 
gestion, in conjunction with Mr. Wheeler's mechan- 
ical and electrical skill, is the instrument known as 
the Wheeler fractional volt-selector. * * * Dr. 
Gillett says the voltage must be turned on in steps 
of less than half a volt. * * * The fractional 
volt-selector will give you gradations of less than 
one-quarter of a volt, and with that perfect control 
of the current the possibility of giving pain to the 
patient is extremely remote. After careful experi- 
ments I have found that it will do the work." 
In the " International Dental Journal " for Feb- 
ruary, 1896, appeared a paper1 by Dr. Gillett on 
" Electrical Osmosis for the Treatment of Living 
Dentine." In this paper he covers the ground of his 
experimental and practical work with candor and 
completeness. He says : " I approached the matter 
with great hesitation because of my lack of knowledge 
of electrical principles. Finally, however, I found the 
key which simplified the problem for me. It has 
taken much labor to reduce the matter to a point 
where it is practicable. Since March (1895), I have 
been able to command, for daily use, a process for 
the control of the sensitiveness of dentine, which 
seems to be practically universal in its application, 
and from which I can conceive no possibility of ill 
1 Read before the "New York Institute of Stomatology" on 
November 26, 1895. 32 
CATAPHORESIS. 
results. As I go on I find others have considered 
the same possibilities. The earliest efforts along 
this particular line that I have been able to hear of 
are those of Dr. D. F. McGraw, now of California." 
"The effect of the cocaine in these applications 
does not seem to reach deeply into the dentine in 
most cases. By prolonging the application, how- 
ever, the pulp itself may, in favorable cases, be 
anaesthetized, even through a layer of dentine." 
"It is quite often the case that a ten or twelve- 
minute application will anaesthetize the dentine 
deeply enough to allow the greater portion or all of 
the cutting to be done painlessly, but for deep 
grooves it may be necessary to repeat the applica- 
tion. In cases where there is much sensitiveness, 
and consequently there will be much time required 
to prepare the cavity at all, I find the time re- 
quired for applying the cocaine is fully made up by 
the increased speed possible after the sensitiveness 
is under control." 
" I do not need to enlarge upon so familiar a fact 
as the comparative consumption of time in prepar- 
ing cavities, similar, except for their degree of sen- 
sitiveness, or to recall how, in the case of a sensitive 
cavity for a nervous patient, it often requires an 
hour to do what may be done in ten minutes after 
the cavity has been thoroughly anaesthetized." 
"This treatment renders it possible to do for 
these nervous and hypersensitive organizations 
desirable operations, which, without some such 
means, are utterly impossible." 
In this paper Dr. Gillett explains his method of 
application in detail, and gives some experiments 
tried by him which corroborate those tried by Dr. DEVELOPMENTS IN DENTAL SURGERY. 
33 
Peterson in 1888 and 1889. He also cited four cases 
in which he had applied cataphoresis successfully in 
the obtunding of sensitive dentine. Dr. Gillett, in 
all his work, used the Edison 110 volt street current 
as his source of power. 
Immediately following my publication of January, 
1896, Electro-cocaine anaesthesia of sensitive dentine 
useing aqueous or guaiacol solutions of cocaine 
was quickly adopted in Europe. The first to prac- 
tice it were Dr. E. Grosheintz and Dr. Respinger, 
of Bale, Switzerland, both of whom met with great 
success. Dr. Marcus and Mr. Liebmann, chemist of 
Frankfort (on the Main), assisted by Prof. Freund, 
likewise made successful experiments. 34 
CATAPHORESIS. 
CHAPTER IV. 
THE WRITER'S CONTRIBUTIONS. 
My interest in cataphoric medication was aroused 
when I purchased, in 1873, the " Treatise on Medical 
Electricity," by Julius Althaus, M. D., published in 
Philadelphia. This volume described the experi- 
ments of Fabre-Palaprat, Klenke, Hassenstein and 
Richardson, as well as those of Vergnes, the electro- 
plater of Havana, with his electric baths. I repeated 
the experiments of Fabre-Palaprat on several oc- 
casions without obtaining the results he had re- 
ported. From this time up to 1886, when Wagner 
suggested that cocaine might be used cataphorically 
for producing local anaesthesia I did little with the 
principle except to make use in my practice of medi- 
cine and before my classes of that application which 
tends to concentrate at some point in the tissues, 
fluids which have been drawn from other points. 
In common with many others I was much im- 
pressed by the suggestion of Wagner and the ex- 
periments of Adamkiewicz and especially because 
of my previous experiments. The electrodes which 
I first devised for use in continued research in these 
directions were quite large and held considerable 
fluid. The metal terminals in these electrodes were 
some distance from the tissues upon which the 
electrodes rested and I soon found that the very 
small degree of success I met with was due to the 
fact that my current of electricity was being used 
to set up an action in the medicated fluid of the THE WHIT Eli'S CONTRIBUTION S. 
35 
electrode instead of being effective in driving the 
medicated fluid through the tissues. This led to 
my invention of a perforated disc-electrode which 
brought the medicine and the metal terminal down 
close to the tissue where all the electric energy was 
available to project the drug into the tissue. 
In the "New York Medical Journal" for April 
25, 1891, I described a new method of cataphoric 
medication which I had devised and which, in my 
experience, afforded much better results than the 
old. I gave the name "Anaemic Cataphoresis" to 
this new method and spoke of it as follows (p. 474) : 
" To introduce a drug into the human system by 
the mouth hypodermically or by cataphoresis as 
ordinarily practiced is to introduce it by means of 
the blood stream into the entire body. To reach a 
local part we saturate all parts. 
' ' By the method here described I cause it to act 
upon that part alone for which it is intended. This 
I accomplish by cutting off the blood stream in the 
part to be treated by means of an Esmarch bandage 
(See Fig. 1) or by a rubber ring, especially for the 
Fig. 1.-Anaemic cataphoresis with Esmarch's bandage. 36 
CATAPHORESIS. 
fingers, after the fashion of an umbrella ring (See 
Fig. 2), and then treating by cataphoresis. 
Fig. 2.-Anaemic cataphoresis with a rubber ring (electrical applications as in 
Fig. 1). 
"By means of the anaemic method of cataphoresis 
here outlined, the medicine employed, or some elec- 
trolytic modification of it, comes in direct contact 
Fig. 3.-A cataphoric disc adapted to use with ordinary electrodes, a, a, an 
ebonite ring ; b, b, a metallic plate ; c, c, a spring to hold the plate in place ; 
d, d, the parts united for use. THE WRITER'S CONTRIBUTIONS. 
37 
with the affected tissue or the tissue to be affected, 
and remains for a considerable time (as long as the 
bandage remains on) in relation with it." 
In this same article I described my small disc- 
electrode, mentioned above (see Fig. 3), as well as 
a further innovation for which I was responsible. 
This was to incorporate the medicine in a small 
plaster composed of conducting material not capable 
of electrolysis. " Such a material is pulverized gas- 
carbon, though other non-electrolytic conducting 
substances may be used. Cohesion into a plaster 
and adhesion to the skin are obtained by gelatin or 
other adhesive substances. The gelatin, carbon, 
and medicine in measured dose are mixed, formed 
into a small plaster, and dried." 
I also there mentioned an experiment which I had 
tried upon myself and which showed the ease with 
which even solid particles might be driven into 
tissue by the action of an electric current. Some 
finely-powdered lamp-black or graphite was incor- 
porated with some salicylate of soda and placed on 
my arm under the positive electrode. The current 
was turned on and the particles of graphite were 
carried into the sweat follicles, making small black 
spots, like bird shot, which were so deeply embedded 
that they did not disappear for several weeks. In 
the third of a series of clinical lectures on Electro- 
Therapeutics which I delivered before the New York 
Post-Graduate Medical School, on Feb. 8th, 1892, 
the following language was used : 
"Whether iodide of potassium, salts of lithium, 
cocaine, etc., be employed we should bear in mind 
that there are reasons why medication by this 
method should be superior in selected cases to medi- 38 
CATAPHORESIS. 
cation by any other method. By selected cases I 
mean, for instance, diseases of the skin and mucous 
membranes, and of growths immediately beneath 
the mucous membranes ; diseases resembling lupus, 
carcinoma or open neoplasms, or such lesions as 
superficial syphilitic gummata. But you ask, Why 
not introduce the medicines by the mouth or hypo- 
dermically ? The answer is that by cataphoresis the 
medication may be localized and driven in upon the 
diseased tissue. There is also a theoretical reason 
why medication by this method should be of ex- 
traordinary value, i. e., these remedies are carried 
into the part to be affected, in their nascent condi- 
tion, when they are remarkably active." 
At this period I was constantly experimenting and 
making numerous researches on original lines. I 
found that the resistance of the fluid conductor had 
a great bearing upon the success of cataphoric ap- 
plications and in a paper read by me1 on October 
4, 1892. I summarized my observations concerning 
these points as follows: c£If the fluid has little 
resistance, as in acidulated water, there is little or 
no movement, but if the resistance of the fluid is 
increased the rate of flow is increased and for a 
given resistance its flow will be proportional to the 
current strength. On the other hand, the resistance 
may be so increased that there is no cataphoresis, 
as in the case of oils, but there is also little or no 
current. May we not assume, to explain the trans- 
fer of fluids by cataphoresis that the action is me- 
chanical, that the partially conducting molecules 
which constitute the electric resistance are borne 
along bodily, to use a rough comparison, like chaff 
iSee " Trans. Am. Electro-Therapeutic Assn.," 1892, p. 62. THE WRITER'S CONTRIBUTIONS. 
39 
before the wind-become in short, since the mass 
is fluid, a resistance which may be moved along, 
while the conducting molecules dissipate the energy 
they receive to form the current? We might 
designate this a theory of movable resistance." 
Several experiments were then cited in support of 
this view. 
Another paper on this same general subject was 
read by me at the Fourth Annual Meeting of this 
Association,1 on September 25, 1894. It was at this 
time I coined the phrase which has been used as the 
sub-title of this book. After describing the various 
phenomena of cataphoresis I said : 
"It matters not whether the medicine in solu- 
tion be applied by a sponge or blotting-paper against 
the skin (cataphoric medication), be held in solution 
in the water of an electric bath (again cataphoric 
medication), be injected into a cavity and decom- 
posed (interstitial electrolysis), be dissolved by the 
action of a current off of a needle perforating the 
tissue (metallic electrolysis), or be dissolved from an 
electrode held in contact with mucous membrane 
(also metallic electrolysis) ; the result is the same- 
a foreign substance in solution, viz., a medicine is 
caused to enter and permeate the tissue. It there- 
fore seems to me to be a proper time to generalize 
the entire facts under the term of electric diffusion 
of medicines into human tissue, or, simply, electric 
medicamental diffusion. " 
This paper also gave quite fully a statement as to 
the beneficial effects resulting from the use of 
1This paper was subsequently printed in " The Journal of the 
American Medical Association," for May 4, 1895, as well as in the 
Trans. Am. Elec. Ther. Ass'n., for 1894. 40 
"soluble " electrodes, or electrodes which, when im- 
bedded in or applied to tissue, would become decom- 
posed electrolytically and the chemical products so 
formed be projected into the tissue. I noted the 
early experiments with these electrodes but re- 
marked : "It remained for Dr. Georges Gautier, of 
Paris, to grasp the broad idea of diffusing metallic 
salts from soluble electrodes and to inaugurate by 
a series of experiments this new system of proce- 
dure.1 
" At once appreciating the far-reaching merits of 
the new method, I established its use in a great 
variety of cases in my clinic at the New York Post- 
Graduate Medical School and Hospital as early as 
1891, and also at the same time in private practice. 
The method was taught to matriculates by actual 
demonstrations. Experiments were made of its 
effects in trachoma, hypertrophic nasal catarrh and 
ozena, gonorrhea and keloid, and continued in a 
great variety of diseases, and with a variety of 
metals at the positive pole. Obviously, the method 
once understood implies its application to a large 
number of cases and by any soluble metal. " I also 
illustrated various forms of needle and bulb elec- 
trodes for this purpose, several of which were devised 
by me. These were of the " protected " type, allow- 
ing the electrolytic action to take place at a given 
point only. These had been made by me early in 
1894. I also cited cases, cured by cataphoresis, of 
the following diseases : chronic Tinnitus Aurium, 
Trachoma, Hypertrophic Rhinitis and Pharyngitis, 
CA TAPH0HE8I8. 
1 " Revue Internationale d'Electroth erapie," July, 1891, August 
and September, 1892. Also " Technique d'Electrotherapie," by 
Drs. Gautier and Larat. THE WRITER'S CONTRIBUTIONS. 
41 
Follicular Tonsillitis, Urethritis, Tumors and Sycosis 
Parasitica. 
It was well known that peroxide of hydrogen, 
when applied to human teeth topically, tended to 
bleach them, but its action was slow and merely 
superficial. In an article 1 on " Cataphoresis and 
solution of H2O2 for Bleaching Teeth," I demon- 
strated the efficiency of hydrogen dioxide for this 
purpose when diffused into the tissues of teeth 
cataphorically. With a view of ascertaining if dis- 
colored teeth could be actually and practically 
bleached by this method I performed a number of 
experiments, being assisted by Mr. Wm. J. Evans, 
of the firm of McKesson & Robbins. 
These experiments showed a most important fact, 
namely, that while ethereal solutions of H2O2 do 
not conduct electricity, and cannot therefore be used 
by themselves for cataphoric action, still this effect 
can be readily obtained when the porous material 
which holds such an ethereal solution has been 
previously moistened with a solution of sulphate of 
soda or some similar conductor, thus constituting 
what I termed a "solution electrode." 
So far as relates to the anaesthetization of sensi- 
tive dentine the early experimental work of Drs. 
McGraw and Westlake seemed to have had no per- 
manent effect in the practice of dentistry. They 
were buried in that limbo of forgotten observations 
which their authors had not the time or conviction 
to follow up to the point of making them an estab- 
lished procedure. The first publication and pub- 
lished cases of record which produced a real effect 
1See "Dental Cosmos," June, 1895, p. 484. 42 
CATAPHORESIS. 
upon the members of the dental profession, causing- 
them to at once adopt cataphoresis largely, as a prac- 
tical procedure, were those of the writer published 
in the " Dental Cosmos" for January, 1896. Cata- 
phoresis immediately became a burning issue and 
was placed upon a scientific basis which every prac 
titioner could easily comprehend-what is more im- 
portant, could easily practise. The procedure was 
at once adopted by a great number of practical den- 
tists throughout America and Europe, this paper of 
January, 1896, having been extensively read and 
quoted at home and translated into German and 
French and published in foreign dental journals. 
Several cases were mentioned in this paper of 
mine, two of which are quoted below. 
These cases are of special interest as they were 
the first cases in which guaiacol in combination with 
cocaine was first employed. 
" Case 1. Patient, Miss M. W., age eighteen, 
brought to my office by Dr. M. L. Rhein, and oper- 
ations on the teeth by him. Patient of extremes! 
hyperesthetic state. Deep crown cavity in second 
superior right molar, almost to the horns of the 
pulp of the buccal root. Very sensitive, especially 
as it approached the horn of the pulp. Electro- 
guaiacol-cocaine anaesthesia, seven minutes in two 
applications. Result, perfect anaesthesia to hand 
excavation. Patient experienced no pain from the 
current." 
" Case 2. Same patient. First right superior 
bicuspid, posterior approximal and crown cavity. 
Had attempted to prepare the tooth at a previous sit- 
ting, but on account of the extreme sensitiveness, THE WRITER'S CONTRIBUTIONS. 
43 
work had been abandoned before the cavity had been 
entirely excavated ; the bottom of the cavity was 
covered with asbestos paper, over which was packed 
a filling of gutta-percha. On removal of the filling, 
after having been in place about six weeks, the 
tooth was found exquisitely sensitive to the slight- 
est touch. Electro-guaiacol-cocaine anaesthesia. 
The first approaches of the current (not noted on 
the milliamperemeter) gave severe pain, which 
gradually subsided, and each subsequent increase of 
current caused pain. Three applications on cotton 
were made. After seven minutes of about one- 
tenth of one milliampere I was able to carry the cur- 
rent up to two-thirds of a milliampere without pain. 
Complete anaesthesia. On exploration, it was found 
that after the removal of a thin film of leathery den- 
tine, the point of an excavator readily entered into 
the pulp-chamber without any consciousness of pain 
on the part of the patient. Completely successful. 
No hyperesthesia of the tooth the next day. 
Although these two cases were first printed in 
January, 1896, they had been first mentioned in a 
paper I read before the First District Dental Society, 
State of New York, at the regular meeting held in 
the Academy of Medicine, New York city, on De- 
cember 10, 1895.1 
In the previous chapter it was developed that Dr. 
Westlake had suggested that for tooth-extraction it 
would be proper to use a double electrode which 
would fit the gum both back and front of the tooth 
to be operated on and that one of these terminals of 
the electrode should be made positive and the other 
negative. This method I did not approve of as was 
1 " Dental Cosmos," March, 1896, page 210. 44 
CATAPHORESIS. 
indicated by my lecture, mentioned above as having 
been delivered on December 10, 1895, when the fol- 
lowing language was used : 
"I want to say right here that the effect of a 
medicine placed at the positive pole only extends 
half way. That is to be borne in mind. It does 
not extend all the way. If you apply to one side 
of the gums the negative pole, and to the other the 
positive pole, and the positive has cocaine on it, the 
cocaine effect will only reach half-way ; the other 
half will rather be hypersensitive than anaesthet- 
ized." Later on in the same lecture, after trying 
certain experiments demonstrating the carrying 
capacity of electric currents, the subject was again 
reverted to, as follows : 
"You cannot get the effect of any medicine all 
the way from a positive to a negative pole. Its 
effect will go just about half way, measuring by 
resistance. This was a deficiency in the electro- 
cocaine electrode made by Dr. Westlake for produc- 
ing anaesthesia in extracting teeth. One of the 
cups was placed on one side of the tooth and the 
other on the other side; cocaine was placed in the 
cups on a sponge. One side was made positive and 
the other negative, and it was expected that the 
cocaine would be driven through from one side to 
the other, and make the gums, all the way across, 
so numb that the tooth could be drawn without 
pain, but that is impossible. One side would be 
numb and the other would not and the patient 
would experience pain. It would be impossible 
with this apparatus to pull a tooth without pain." 
I then showed that better results would be ob- 
tained if the two cup-electrodes were made positive 777 £ WRITER'S CONTRIBUTIONS. 
45 
with the negative electrode placed elsewhere, as in 
the patient's hand. I also pointed out that under 
certain circumstances it would be necessary to use 
other methods, for I said : " But to successfully ex- 
tract a tooth painlessly by electro-cocaine anaes- 
thesia I have found it necessary, if the pulp is not 
dead, to go still further when a cavity exists and be- 
numb the contents of the pulp-cavity by applying 
the same solution electrically to absorbent cotton 
placed in a cavity in the tooth." 
The two cases quoted above from my article 
published in January, 1896, referred to "electro- 
guaiacol-cocaine anaesthesia," and it is my desire 
to briefly state, at this point, what this means. My 
December, 1895, lecture (printed in March, 1896) 
first described this method and I had this to say on 
the subject: 
" A few weeks ago I made some experiments with 
guaiacol for producing local anaesthesia electrically. 
I made over one hundred experiments, and I was 
determined to find something that would enable me 
to use it. Guaiacol is one of the plenols. It is an 
extract from creasote, which you know is one of the 
violent escharotics, and produces intense dermatitis. 
I rubbed the cork of the bottle containing creasote 
on my arm and on Mr. Evans's arm, not knowing 
how violent it would be, and I have still a sore spot 
on my arm, and I presume he has too. Guaiacol, 
however, is almost absolutely bland. It is creasote 
freed from its irritating hydroxyl. It can be used 
without producing pain. I use guaiacol alone or 
eight per cent cocaine with guaiacol, and then I 
have the most beautiful local anaesthetic effect I 46 
CATAPHORESIS. 
have ever seen." Again, later on in the same 
lecture: 
"In my experiments upon soft tissues, as well as 
upon dentine, I find that guaiacol to which cocaine 
is added enables me to reduce the time ordinarily 
required to produce anaesthesia about two-thirds, 
and, what is still more important, enables me to 
reduce the current strength of electricity required 
also two-thirds. The important feature of guaiacol 
is that it holds on chemically to the cocaine and 
thus prevents quick absorption into the general cir- 
culation and consequent toxic effects. To prove 
this assertion take a ten per cent solution of hydro- 
chlorate of cocaine and shake it for a considerable 
time with an equal bulk of water. One-eighth of 
the cocaine only will be found to have gone to the 
water, and seven-eighths to have remained with the 
guaiacol. This is a very remarkable fact, and it 
bids fair to open the way to the adoption of electro- 
guaiacol-cocaine anaesthesia as in reality a practi- 
cable and useful procedure in minor surgery, since 
aqueous solutions on large electrodes might allow 
of too much absorption." 
I also made the suggestion in this paper that though 
guaiacol is a non-conductor "it has this peculiar 
property, that it absorbs one two-hundredth part 
of water, and water with additions will conduct. To 
this may be added one drop of sulphuric acid, which 
makes a dilute sulphuric acid. If you give the 
mixture a quick shake you have an emulsion of 
water, sulphuric acid and guaiacol, and you have 
a good conductor ; and as soon as you use it in that 
way, with one drop of sulphuric acid and one two- 
hundredth part of water, you can get guaiacol local THE WRITER'S CONTRIBUTION S. 
47 
anaesthesia, which is again entirely new. For any 
one who wishes to try two new preparations I will 
give these two receipts : 
" If-Guaiacol, one drachm ; 
Cocaine hydrochlorate anhydrous, six grains. Mix. 
" If-Guaiacol, one drachm ; 
Acidi sulphurici, one minim; 
Aquas dest., two minims. Mix. 
Sig.-Make emulsion." 
Speaking of this second mixture in my January, 
1896, paper, I said : "This also may be used to pro- 
duce local ansesthesia cataphorically, but its applica- 
tion causes slightly more pain initially, and to ob- 
viate this initial pain a very small amount of cocaine 
may be added if desired." Thus far, present prac- 
tice favors aqueous and guaiacol solutions of cocaine 
only. 
In this same paper I described my reservoir elec- 
trode made of pure block tin with hard-rubber 
covering. It had two screw joints, so that it might 
be easily taken apart and cleaned. When in use, 
blotting paper is placed over the face of the perfo- 
rated disk, which is chambered at the back to receive 
the medicine. This electrode is shown in Fig. 4. I 
summed up the paper as follows : 
Fig. 4.-Morton's Reservoir Cataphoric Electrode. 
" 1.-Electric medicamental diffusion '(catapho- 
resis) ' is not only a possible but also a practical pro- 
cedure, since, 
"2.-Sensitive dentine may, with the greatest 48 
CATAPHORESIS. 
ease, be so thoroughly anaesthetized that operations 
upon it and in it cause no pain. 
" 3.-The dental pulp, even though not fully 
exposed, may be anaesthetized so that instruments 
may enter the pulp-cavity without causing pain. 
"4.-By employing a properly constructed elec- 
trode, soft tissues like the gums may be completely 
anaesthetized to the pain of cutting and tearing 
operations. 
"5.-Soft tissues like large areas (three inches by 
one and one-half inches by one-half inches deep) of 
the derma and subjacent tissue may be completely 
anaesthetized for surgical operations. 
" 6.-Guaiacol alone, and other similar substances 
and derivatives, in themselves non-conductors of 
electricity, by the addition of a very minute quantity 
of some innocent substance of an electrolytic nature, 
may be caused to penetrate tissue by the aid of 
electricity, and thus exhibit anaesthetic effects un- 
obtainable without the aid of the added electrolyte. 
"7.-Guaiacol restrains the action of cocaine to 
local territory ; increases the rate of its cataphoric 
penetration through the epidermis and other tissues ; 
slows the rate of its absorption into the system ; 
prevents consequent toxic effects and adds its own 
anaesthetic qualities to those of cocaine." 
In the " Dental Cosmos " for April, 1896, appeared 
a paper written by me on the outfit and technique 
for Cataphoresis including Guaiacocaine Cataphoric 
Anaesthesia, as a consequence of the many inquiries 
made of me on the subject. These matters will not 
be gone into here as they more properly fall under 
a later portion of this book. 
I have also found that guaiacol may be mixed THE WRITER'S CONTRIBUTIONS. 
49 
in equal parts with sulphuric ether and hydrochlo- 
ate of cocaine be added to any per cent, required 
and this mixture sealed into a cavity will by pressure 
of the evaporating sulphuric ether produce prompt 
local anaesthesia. The process is exactly the same as 
when bleaching teeth by a 25 per cent, sulphuric 
ether solution of peroxide of hydrogen. 
I would here also call the attention of those who 
wish to thoroughly study the subject of electric dif- 
fusion of Medicaments, to the summarization of a 
great deal of experimental work, contained in a 
chapter in this book on electric staining of tissues 
for microscopical examination.1 
So far then as refers to my own contributions to 
the subject treated of in this book their most im- 
portant outcome has been to establish (a) a practical 
procedure for anaesthetizing sensitive dentine by aid 
of electricity and aqueous or guaiacol solutions of 
cocaine, (6) a practical procedure for electrically 
sterilizing dentine or other tissues of or about the 
tooth, (c) of a practical procedure for producing local 
anaesthesia of skin and mucous membrane areas for 
minor and even for major surgical operations, based 
upon a similar initiation by means of new electrodes 
and of combining guaiacol with cocaine. 
And, whatever opinion may be entertained con- 
cerning the use of guaiacol in combination with 
cocaine for the anaesthetization of sensitive dentine 
in preference to an aqueous solution, there is no 
question of doubt as to the fact that its use with 
cocaine upon soft tissues and mucous membranes 
for local anaesthesia is an immense stride in advance 
1 From a paper read at the annual meeting of the American 
Electro-therapeutic Association, New York, Sept., 1894. 50 
CATAPHORESIS. 
and affords results beyond any possibility of success 
attainable by aqueous solutions. In fact, as regards 
soft tissues alone, aqueous solutions of cocaine are 
impracticable while the combination with guaiacol 
solves the problem of electro-local anaesthesia in 
surgery. PART II.-PHYSICS AND PHYSIOLOGY. 
CHAPTER I. 
ELEMENTARY ELECTRICAL PRINCIPLES. 
The historical section of this book has treated of 
a number of questions in a general way and with a 
necessary lack of detail, in some instances, which 
will be supplied as we proceed. 
It is almost needless to say that one reason why 
more physicians and surgeons are not actively em- 
ploying electricity in the cure of disease and as an 
aid in the relief or prevention of suffering is because 
of a conservatism born of lack of knowledge. 
Our older practitioners, appreciating that giant 
strides have been made in recent years in the de- 
velopment of electrical processes, feel that their 
grasp of the underlying principles is not sufficient 
to warrant experimentation by them. This is un- 
doubtedly the proper position to take in relation to 
most of the departments of electro-therapy, for 
much harm can be done by the ignorant application 
of electricity. As careful restrictions should be 
applied to the uninstructed practice of electrical 
methods in the cure of disease as to other methods. 
In that branch of the general subject, however, 
51 52 
CATAPHORESIS. 
dealt with in this volume, the phenomena are so 
simple as to be readily understood. It is safe to 
assume that the reader contemplating the use of 
electricity for the purpose of producing medica- 
mental diffusion is aware of the physiological action 
of a given drug, so it will be our purpose to here 
briefly outline the general principles involved and 
describe the terms employed. Those readers who 
feel themselves fully informed on those points are, 
of course, at liberty to skip this chapter. 
No one has yet been able to demonstrate what 
electricity is. Professor Houston defines it as " that 
thing, matter or force, or both, which produces 
electrical phenomena." But, although we are not 
sure as to the nature of electricity, we know how to 
produce it, and we are aware of many of its char- 
acteristics. 
We know that electricity possesses one predomi- 
nant quality, upon which depends almost every 
electric action. This quality is Pressure ; it gives 
electricity its power to overcome obstacles {resist- 
ance') in its path and to perform useful work. 
Some scientists even consider that electricity pos- 
sesses no other quality than pressure, and that its 
phenomena can be measured in terms of Pressure. 
Various names have been given to this quality be- 
sides Pressure, among which may be mentioned 
Potential, Difference of Potential, Potential Differ- 
ence, Electro-Motive Force and Voltage. A certain 
amount of this Pressure is called a volt, which is 
the unit by which the quality is measured. A volt 
is about the Pressure to be obtained from a single 
cell of that class of batteries known as the Daniell. 
Electrical Pressure may be likened to the press- ELEMENTARY ELECTRICAL PRINCIPLES. 
53 
ure which a column of water exerts on its contain- 
ing chamber. In explaining these points to my 
classes I find the following analogy, which I have 
devised for the purpose, very useful, not only to 
indicate the fundamental importance of Pressure, 
but of the other relations of electric measurements. 
In Fig. 5 we have a vessel, A, containing an amount 
of water which has a " head " or exerts a Pressure 
which we will call 1 volt. The popular conception 
of electricity is that it "flows" as a current 
through a conductor, overcoming such resistance 
as the conductor offers to the passage of the cur- 
rent. If we insert a long pipe of small diameter B 
at the bottom of the vessel A the 1 volt pressure 
will tend to force the water out through the pipe B. 
But owing to the small size of this pipe or conductor 
B, it offers a resistance to the passage of the water. 
We will say that the pipe is of such a size that it 54 
CATAPHORESIS. 
offers an amount of resistance which we will call 1 
ohm. The effect of this resistance is to determine 
the rate of flow of the current of water from the 
flaring end of the pipe (where the resistance ends). 
With the pressure of 1 volt expended upon the re- 
sistance of 1 ohm in the pipe B, we will have a rate 
of floiv of 1 ampere, and if we allow the current to 
flow at this rate for one second we will have allowed 
a quantity to have flowed into the jar C, which is 
called 1 coulomb of electricity. 
It is desirable to keep in mind this distinction be- 
tween amperes and coulombs, or rather, between the 
rate of flow and thequantity which flows in a given 
time. Water may flow from a pipe at the rate of 
10 gallons a minute, but the entire 10 gallons will 
not have flowed from the pipe until the entire min- 
ute has gone by. In the same way we can say that 
a current of electricity is flowing at the rate of one 
coulomb per second (one ampere, in other words), 
but one coulomb of current will not have passed 
through the conductors, unless the one ampere rate 
is continued for one second. 
As is well known, mechanical pressure cannot be 
expended in overcoming resistance without doing 
work. The same is true of electricity. If we ex- 
pend one volt of pressure at the rate of one ampere 
we will be doing work at the rate of one watt. If 
this rate is maintained for one second we will have 
done an amount of work called one joule. In our 
diagram we have inserted a water-wheel to convey 
the idea of work being done. 
We will recapitulate these terms as follows : 
Volt=Unit of pressure or electro-motive force. 
Ohm=Unit of resistance. ELEMENTARY ELECTRICAL PRINCIPLES. 
55 
Ampere-Unit of current strength or rate of current flow 
(usually simply called "current"). 
Coulomb=Unit of quantity of flow. 
Watt=Unitof rate of doing work (Volts X Amperes=Watts). 
Joule=Unit of quantity of work (Watts X seconds-Joules). 
From what has been said it will be seen that there 
is a close inter-dependence between these various 
units. If, for instance, we double the volts expended 
on a given resistance we shall double the amperes. 
If we maintain the number of volts but cut down 
the resistance to one half of its former amount the 
amperes will again be doubled. In the words of 
Ohm's Law the current varies directly as the press- 
ure and inversely as the resistance in a circuit. 
The conventional method of expressing Ohm's Law 
is the algebraic method where C=current (in am- 
peres), E=electro-motive force or pressure (in volts), 
R=resistance (in ohms): 
If 0=5 then R=^ and E=C X R. 
R 0 
It will thus be seen that if we know the amount 
of any two of these terms we can find the third. 
Example 1: How much current will pass through 
a patient if the resistance of the circuit is 1000 ohms 
and the pressure applied is 20 volts ? 
20 
Answer: C=Yqq^=.O2 amperes. 
Example 2: What is the resistance of a circuit 
which includes the patient if .015 amperes flow 
under a pressure of 30 volts ? 
30 
Answer : R=-^-^=2000 ohms. 
Example 3: What pressure will be required to 
force .012 amperes of current through a circuit 
having a resistance of 10,000 ohms ? 56 
CATAPHORESIS. 
Answer : E=.O12 X 10,000=120 volts. 
Example 4: At what rate will work be done in a 
patient by an electric current being expended at the 
rate of .015 amperes under a pressure of 30 volts? 
Answer: .015 amperes X 30 volts=.45 watts.1 
Example 5: How much work will have been done 
by the electricity under the terms of Example 4 if 
the current is permitted to flow for 60 seconds ? 
Answer : .45 watts X 60 seconds=27 joules. 
The engineer who deals with large quantities of 
electric power finds the watt unit inconveniently 
small for his purposes so multiplies it by 1000 and 
calls this amount a kilo-watt. In the same manner 
the electro-therapist, who uses very small currents, 
finds the ampere unit inconveniently large for his 
purposes so divides it by 1000 and calls this amount 
a milliampere. Thus, instead of speaking of, say, 
15 thousandths of an ampere, we call this amount 
of current 15 milliamperes. The usual abbrevia- 
tions for this term are m. a. or ma. 
There is one more simple formula deduced from 
Ohm's Law which will be useful in making various 
calculations and also in gaining an appreciation of 
certain conditions of work. We have seen that one 
expression of the value of E (volts) is E=C X R. 
We have also seen that the number of watts being 
expended equals the volts (E) multiplied by the 
amperes (C). 
Therefore C X R (volts) X C (amperes)=watts ; 
Or C X (C X R)=watts ; 
Or C2 R=watts. 
This means that the work being done in any por- 
1 It may be interesting to have in mind that 746 watts equal 
one electrical horse-power. ELEMENTARY ELECTRICAL PRINCIPLES. 
57 
tion of a circuit equals the square of the current 
passing through the circuit multiplied by the resist- 
ance of the portion of the circuit under considera- 
tion. 
Example 6. If the operator is using electricity 
from a 120 volt electric-light circuit with an exter- 
nal resistance of 5,000 ohms in series with the pa- 
tient, and the milliampere meter indicates the pas- 
sage of 12 milliamperes of current, how many watts 
will be expended in the patient f 
Answer : We must first find the total resistance 
of the circuit and from that subtract the amount of 
resistance in series with the patient: R--10,000 
ohms. 
10,000 ohms (total)-5,000 ohms (in series)- 
5,000 ohms (resistance of patient). 
.012 X .012 (C2) X 5,000 (R)-.72 watts. 
Example 1 : If a resistance of 3,000 ohms is put 
in series with the patient and the positions of the 
electrodes are changed so as to increase the resist- 
ance of the patient to 7,000 ohms, how many watts 
will be expended in the patient ? 
Answer : The total resistance being the same as 
in Example 6 the amount of current will be the 
same, namely, 12 milliamperes ; therefore .012 X 
.012 (c2) X 7,000 (R)-1.008 watts. 
It will thus be seen that the physiological effects 
-including the effect of the current upon the 
patient's sensibilities-will not always be the same 
even though the same number of milliamperes is 
passing through the patient. This is of especial 
importance in dental applications and points to the 
desirability of using a form of external resistance 58 
(called a "rheostat") which will permit of very 
gradual changes in the resistance of the circuit. 
The nerves of the teeth are very sensitive to sudden 
changes in the rate of current flow. 
It should be remembered that the rate of flow is 
the same in all parts of the circuit, but that the rate 
at which power is being expended or work done in 
any portion of the circuit is strictly in accordance 
with the formula above indicated, that watts equal 
the square of the current flowing multiplied by the 
resistance of the part of the circuit under consider- 
ation. 
CATAPHORESIS. CHAPTER II. 
SOURCES OF ELECTRICITY. 
Electricity can be produced or excited or gener- 
ated or developed in a large variety of ways but it 
is only necessary, for the information of those who 
will study this work, to sketch briefly the principles 
which underlie the operation of such sources of elec- 
tricity as may or might be used in connection with 
cataphoric applications. We cannot do better than 
quote from a book, entitled the X-Ray or the Photo- 
graphy of the Invisible,1 as this subject is there dis- 
cussed with care: 
Frictional or Static Electricity.-When 
electricity is excited by friction, two mutual and 
equal phases of excitement are always developed, 
which are called positive and negative charges. 
These two phases have a strong affinity for each 
other and are always trying to come in actual con- 
tact with and neutralize each other. When this is 
accomplished there is a discharge which leaves the 
electrified bodies without any charge of electricity. 
If the charge is sufficiently great it will not be nec- 
1 " The X Ray, or Photography of the Invisible," Part II, chap- 
ter I, by W. J. Morton, M. D., 1 vol. 12mo. Cloth. American 
Technical Book Company, 45 Vesey Street, New York City. 
59 60 
CATAPHORESIS. 
essary for the positive and negative surfaces to come 
in actual contact before there is a discharge, as the 
accumulated potential will force a discharge through 
the air from positive to negative, in the form of a 
bright spark or electric flash like a lightning dis- 
charge on a small scale. 
Whether a substance rubbed by another substance 
will be positively or negatively charged depends on 
the nature of the rubbing substance as well as on 
the nature of the substance rubbed. For instance, 
the following list (from " Ganot's Physics ") gives a 
number of substances, each of which will become 
positively electrified when rubbed by any which fol- 
lows it: 
Positive. 
Cat's-skin, 
Glass, 
Ivory, 
Silk, 
Rock-crystal, 
The Hand, 
Wood, 
Sulphur, 
Flannel, 
Cotton, 
Shellac, 
Rubber, 
Resin, 
Guttapercha, 
Metals. 
Negative. 
Machines have been made upon the principles 
suggested here, whereby powerful charges are pro- SOURCES OF ELECTRICITY. 
61 
duced by the revolution of glass disks arranged with 
proper rubbers, collectors and inducing strips. 
There are a number of these electrical machines, 
some strictly frictional and some so-called " in- 
fluence " machines, 
those best known 
and in use being the 
Holtz and Wims- 
hurst machines. 
Fig. 6 is an illus- 
tion of a Holtz ma- 
chine as modified by 
Wimshurst and 
made by the Gal- 
vano-Faradic Com- 
pany, New York City. 
Chemical Electricity.-Under this head may 
be grouped two very important sources of electricity, 
viz., Primary and Secondary Batteries, which we 
must now learn something about. 
(1.) When plates of two different metals or one 
metal and one non-metallic body (such as carbon) 
are placed in a liquid (called an electrolyte) and the 
two plates are connected together outside of the 
liquid a current of electricity is generated. This 
combination of plates and electrolyte is known as a 
cell of Primary (or Galvanic) Battery. A very sim- 
ple form of primary battery is made by taking a 
plate of copper and one of zinc and immersing them 
partially in a solution of sulphuric acid and water. 
This constitutes the original cell of V olta. " A bat- 
tery " may be made up of one "cell" or two or 
more "cells" connected together. A copper-zinc 
cell is illustrated in Fig. 10 which it would be well 
Fig. 6. 62 
CATAPHORESIS. 
to study a little. When the two wires leading 
from the copper (c) and zinc (z) plates 
are connected the sulphuric acid is de- 
composed, forming hydrogen gas at the 
copper plate and combining with the 
zinc to form sulphate of zinc. The 
electricity developed by this chemical 
action flows from the plate most acted 
on (the zinc in this case) through the 
liquid to the other plate (the copper), and from 
that through the external conductors back to the 
first plate again. This is indicated by the arrows 
in Fig. 7. It will also be noticed that the signs 
plus (+) and minus (-) are used. This indicates 
that the portion of the zinc plate in the liquid 
is positive (+) to the portion of the copper plate 
in the liquid, which is therefore negative (-); 
also that the exposed part of the copper plate is 
positive to the exposed part of the zinc plate, 
which is therefore negative. It is the practice to 
call that plate from which the electricity flows, out- 
side the liquid, the positive pole, and the plate to 
which the electricity returns, outside the liquid, the 
negative pole, and to refer to the plate within the 
electrolyte from which the current starts as the 
positive element and the other plate within the elec- 
trolyte as the negative element. 
A number of different forms of primary batteries 
have been devised but all can be divided into two 
classes, namely, open-circuit and closed-circuit 
batteries. 
The open-circuit class contains those varieties 
which work best when not constantly in use, on 
bell-circuits, hotel-calls and signal-circuits generally. 
Fig. 7. SOURCES OF ELECTRICITY. 
63 
The best of this class of batteries is the " Leclanche " 
which is very widely known and exclusively used. 
The elements used are of zinc and carbon, placed in 
a solution of sal-ammoniac ; the carbon is sur- 
rounded by powdered black oxide of manganese. 
When the Leclanche cell is made to supply elec- 
tricity continuously for any length of time it soon 
" runs down " and will do no more work until given 
a ''rest," but when only used occa- 
sionally and for short periods it is 
very efficient and satisfactory. Fig. 
8 is an illustration of a Leclanche 
cell. Such a cell gives a potential 
of about 1.47 volts. The closed- 
circuit class contains those varieties 
which work best when in constant 
use or when the circuit is normally 
" closed." The best representative 
of this class is the ' ' Gravity " bat- 
tery, which is a modification of the " Daniell " bat- 
tery. The Daniell cell, a sketch of which is given 
in Fig. 9, is made up of zinc and cop- 
per elements separated from each 
other by a cup of porous clay in which 
is put the copper plate surrounded by 
sulphate of copper crystals ; the zinc 
is immersed in dilute sulphuric acid. 
The electromotive force is about 1.072 
volts and is remarkably constant. It 
only differs from the original cell 
Volta in the addition of a porous cup 
in which is placed the copper element and sulphate 
of copper crystals. The serious disadvantage in the 
use of the Daniell cell is the fact that the copper 
Fig. 8. 
Fig. 9. 64 
CATAPHORESIS. 
formed by the chemical processes within the cell is 
gradually deposited in the pores of the porous cup, 
increasing its resistance. This 
trouble is not met with in the Grav- 
ity cell illustrated in Fig. 10. As 
will be seen, the copper strip is at 
the bottom of the jar and the zinc 
wheel or " crowfoot " is near the 
top ; a sulphate of copper solution 
is poured over the copper and a 
quantity of copper crystals are also 
put in and on top of this solution of sulphate of zinc. 
The specific gravity of these two solutions is so dif- 
ferent that the heavier or sulphate of copper solu- 
tion always remains at the bottom. The zinc sul- 
phate solution as a substitute for the sulphuric acid 
of the Daniell's cell gives a somewhat lower voltage 
but makes the action of the cell even more constant. 
(2.) When two plates of the same metal (usu- 
ally some form of lead) are placed in a solution 
which normally does not attack them 
(usually dilute sulphuric acid) no elec- 
trical action takes place. But if a 
current of electricity generated in 
some outside source is allowed to 
pass into one of the plates and then 
through the solution to the other 
plate and back to the source again, we 
set up a chemical action in the solu- 
tion which decomposes it and causes 
a different deposit to be made on each 
of the plates. Fig. 11 shows a cell made up of two 
lead plates immersed in an electrolyte of sulphuric 
acid, into which current is flowing from an out- 
Fig. 10. 
OUTSIDE SOURCE. 
Fig. 11. SOURCES OF ELECTRICITY. 
65 
side source. We notice in this figure the current is 
passing into the plate A then through the elec- 
trolyte to the plate B and out again. The chem- 
ical action spoken of above forms peroxide of 
lead on the plate A (chemists write peroxide of 
lead PbO2) and spongy metallic lead (known by the 
letters Pb) on the plate B. So we see that whereas 
we started by forcing electricity into this cell with 
the plates A and B alike and incapable of them- 
selves setting up an electrical action we now have 
two different elements (PbO2 and Pb) in an electro- 
lyte (H2 S04) capable of acting on them. In other 
words, a cell incapable of generating electricity be- 
comes an active source after electricity has once 
passed through it. If we now con- 
nect this cell to a small electric 
lamp, or other device, as in Fig. 
12, a current of electricity will be 
generated and one atom of oxygen 
(0) of each molecule of the PbO2 
will be transferred from plate A to 
plate B and joining the Pb of plate 
B will form monoxide of lead, PbO, 
and plate A will then also have be- 
come PbO and both plates will be 
alike. When this is accomplished 
over the entire surface of the plates no more 
current will flow from the cell and it will be 
necessary to once more charge the cell from an 
outside source as before if we wish to obtain more 
electricity from it. The peculiarity of such a cell to 
be put into it before any can be obtained from it 
has caused the cell to be named a "Storage" or 
Secondary Battery. Although the effect we obtain 
Fig. 12. 66 
CATAPHORESIS. 
is the same as if the cell was a reservoir in which 
we stored electricity until it was needed we do not 
really store it, for we have seen that what happens 
is for the current to make a primary battery of the 
cell by altering the nature of the elements. What 
we in reality "store" is chemical energy and not 
electricity. If we observe Fig. 11 we will see that 
the charging current is coming into the cell at the 
plate A and passing out at the plate B. In Fig. 
12, however, we see the discharging current comes 
out at the plate A returning to the plate B. In 
other words, a secondary battery discharges in a 
direction opposite to that in which it is charged. 
The potential of a cell of secondary battery is 
about 2 volts. In secondary a batteries, as in pri- 
mary batteries, the potential difference of a cell 
does not depend on the size of the elements but 
on their nature and that of the electrolyte. The 
quantity of electricity to be obtained from a cell of 
any kind of battery is directly dependent upon the 
area of the elements exposed to the electrolyte. 
Induced Electricity.-When we move a loop or 
coil of wire towards or away from a magnet or move 
the magnet towards or away from the loop or coil, 
momentary currents are induced in the coil of wire, 
and these momentary currents will first go in one di- 
rection and then the other, depending on the direc- 
tion of the movement to or fro. These principles were 
discovered in 1831 by Michael Faraday, the noted 
English scientist, and upon them all mechanical gen- 
erators or dynamo-electric machines of the present 
day are constructed. Batteries cost too much to run 
to permit their being largely used for electric light- 
ing or power purposes. It costs much more to burn SOURCES OF ELECTRICITY. 
67 
up zinc in a battery than it does to burn coal m a 
steam-boiler of the same power. 
There are two general classes 
of dynamo-electric machines 
named after the character of 
the currents delivered by each. 
These are (1) alternating cur- 
rent and (2) continuous cur- 
rent dynamos, and a few words may be written 
about each. 
(1.) If we take a loop of wire and mount it on a 
Fig. 13. 
Fig. 14. 
shaft placed between the N and S poles of a magnet, 
as shown in Fig. 13, we have the simplest form of 68 
CATAPHORESIS. 
dynamo. Were we to connect the ends of the loop of 
wire to two metallic rings also mounted on the shaft, 
we can adjust springs or brushes so as to rest on such 
rings, and at the same time be connected to a galvano- 
meter. If we now turn the crank-handle in the direc- 
tion indicated by the arrow, a current will be induced 
in the loop in one direction as it approaches the hori- 
zontal position and in the opposite direction as it 
approaches the vertical position. These currents 
flow through the loop to the rings and collecting 
brushes or springs and thence to the galvano- 
meter and back. Being induced first in one direc- 
tion and then the other they are known as alter- 
nating currents. If we use a number of loops on 
the revolving shaft and a number of pairs of mag- 
net-poles instead of one we will get greater voltage 
when they are properly connected. Fig. 13 is a the- 
oretical dynamo, but Fig. 14 is a practical alternat- 
ing current dynamo capable of supplying many 
hundreds of electric lights or many horse-power to 
electric motors. 
(2.) Were we to take the simple loop of Fig. 13 
and connect its ends to the two halves of a split- 
tube (instead of the rings) as shown in Fig. 15 we 
will find a 
differen t 
character of 
current flow- 
in g to the 
ext e r n al 
circuit which 
may include 
a gal vano- 
meter as before). The mere use of the split-tube in 
Fig. 15. SO Uli UES OF EL ECTRICITY. 
69 
place of the two rings so alters the conditions that 
instead of delivering an alternating cur- 
rent to the external circuit, we deliver a 
continuous current or one which always 
travels in the same direction. This is be- 
cause the two brushes or metal springs 
resting on the split-tube (known as the '' commuta- 
tor ") first press on one-half the tube, and then the 
other half as the shaft revolves, so that although the 
alternating current is still induced in the loops it is 
delivered as a continuous current. This is readily 
Fig. 16. 
Fig. 17. 
seen by referring to Fig. 16 which is a section through 
the commutator and brushes. If the downward 70 
CATAPHORESIS. 
moving half of the loop is positive, the upward mov- 
ing half will be negative, and it will be readily seen 
that the positive 
half in one posi- 
tion will be the 
negative half 
when it reaches 
another position. 
The brushes do 
not revolve but always u collect " the current at 
the best + and - points. Fig. 17 illustrates a 
modern Edison continuous current dynamo similar 
to those in use all over 
the world for lighting 
stores and houses. 
The magnets of all 
modern and practical 
dynamos are made of 
iron wound with wire 
and supplied with elec- 
-1 r i c i t y. The reader 
will recognize that these 
are therefore not per- 
manent magnets but 
electro-magnets. 
In closing this chap- 
ter it should be stated 
that batteries and dyna- 
mos are alikein these re- 
spects: 
(1.) If a greater poten- 
tial is needed than one 
cell or dynamo can give, connect two or more to- 
gether in series as shown in Fig. 18, that is, con- 
Fig. 18. 
Fig. 19. SOURCES OF ELECTRICITY. 
71 
nect the fl- of one unit to the - of the next and the 
remaining X and - to the outside circuit. In Fig. 
18 the total potential would be three times as high as 
if one unit was used, but the amperes or rate of 
current flow will not be increased ; 
(2.) If we want a greater flow of current but at no 
increase of potential we connect our units in paral- 
lel or multiple-arc as shown in Fig. 19. All the fl- 
poles are connected together and all the - poles are 
similarly connected. Here we have the ability to 
obtain three times the rate of flow than if but one 
unit was used ; 
(3.) If we wish 
to obtain more 
potential and 
greater rate of 
flow at the same 
time (without in- 
creasing the size 
of our units) we 
must combine 
the two previous 
methods in the 
multiple-series method of connection as shown in 
Fig. 20. In this case we obtain three times the vol- 
tage and twice the amperage of a single unit. 
Fig. 20. CHAPTER III. 
SIMPLE OR CHEMICAL OSMOSIS. 
Osmosis or Osmose is, broadly speaking, the ten- 
dency in fluids or gases to become equably diffused, 
when in contact. As ordinarily employed in Chem- 
ical Physics, however, it is narrowed down to the 
tendency in fluids of different densities to become 
equably diffused, when separated by a porous parti- 
tion or septum. By " equably diffused " we do not 
mean such an adjustment as will bring the same 
quantity of the mixture on each side of the porous 
partition, but, rather, such a mutual diffusion that, 
if the process is continued for a sufficient length of 
time, there will be a similar chemical mixture on 
each side of the septum. 
For instance, in Fig. 21, we have 
a vessel divided into two compart- 
ments by the septum s. If we 
pour pure water in the compart- 
ment A and an equal quantity of 
strong salty solution in the com- 
partment B, the following action takes place : The 
pure water is of less density than the salty solution 
and has a tendency to pass through the septum s 
from A to B ; at the same time the salty solution 
has a tendency to pass from B to A ; there are thus 
two currents set up, in opposite directions, but the 
Fig. 21. 
72 SIMPLE OR CHEMICAL OSMOSIS. 
73 
fluid of lesser density has this tendency in largest 
measure with the result that there is finally a dif- 
ference of level as in Fig. 22. As 
soon as there is this difference of 
level produced by the action of 
osmosis, there is a filtration from 
the higher to the lower level due 
to the pressure of the column of 
liquid in B, as compared with that in A. Finally, 
after the lapse of sufficient time, these mutual 
actions and reactions result in a perfect admixture at 
the same level as illustrated in Fig. 
23. The facts of prime importance, 
however, are (a) that there is a 
tendency towards diffusion and (&) 
that the predominating tendency 
is from the fluid of lesser density 
to the fluid of greater density ; "to him that hath, 
shall be given." 
Of the two osmotic currents set up, the one which 
is from the fluid of lesser density (as from A to B, 
Figs. 21 to 23) and is directed to the higher level is 
called the endosmotic current and this flow of current 
is called endosmosis; the current which flows from 
the fluid of greater density and is directed to the 
lower level (as from B to A) is called the exosmotic 
current and this flow of current is called exosmosis. 
The rapidity with which diffusion takes place 
varies, according to Graham, with the following 
circumstances : 
(a) With the chemical composition of the fluids, 
the action generally being most rapid with acids, 
next with alkalies and last with fluid albumen, 
gelatine and gums. 
Fig. 22. 
Fig. 23. 74 
CATAPHORESIS. 
(6) With the temperature ; the higher the tem- 
perature the more rapid the action. 
(c) With the relative degrees of concentration of 
the fluids. 
(d) With the difference between the densities of 
the fluids ; the rapidity of action is greater with 
weak than with concentrated solutions when the 
difference in densities is constant. 
Two very pretty and simple experiments may be 
tried as a demonstration of endosmosis and exos- 
mosis, with the use of gases instead of fluids.1 A 
medium sized fish-globe, a very small fish-globe 
which will pass into the larger one, and a piece of 
bladder are the requisites for these experiments. 
The small globe is filled with carbonic acid gas, and 
the bladder, previously moistened, is placed loosely 
over the mouth of the jar and tied so as to render 
the connection between the bladder and the globe 
Fig. 24. 
1 See " Experimental Science," by G. M. Hopkins, 1893, p. 70. SIMPLE OR CHEMICAL OSMOSIS. 
75 
air-tight. A good way to insure a good joint is to 
stretch a wide rubber band around the neck of the 
globe before applying the membrane. The large 
fish globe is filled with hydrogen or illuminating 
gas, and the small globe is placed under it as shown 
in Fig. 24. As the hydrogen passes inward through 
the membrane much more rapidly than the carbonic 
acid passes outward, the membrane is distended 
outwardly. It requires a little time to produce a 
visible effect. If the smaller globe is filled with 
hydrogen and the large one with carbonic acid, the 
membrane will be distended inward, as shown in 
Fig. 25. In this latter case the experiment may be 
performed with the least trouble by placing the 
large globe with its mouth upward, and closing it 
by a plate of glass. 
Fig. 25. CHAPTER IV. 
ELECTRICAL OSMOSIS OR CATAPHORESIS. 
We have thus far noted that there is a tendency 
for fluids to mix, even though separated by a porous 
partition ; also that there are two currents set up 
during the process of diffusion, of unequal strength 
and in opposite directions, and that the most active 
current is from weak to strong solution or from 
lower to higher level. We have also seen that the 
process is a long one, simple osmosis taking place 
very slowly. 
If we now take a vessel similar to that shown in 
Fig. 21, divided by a porous partition and filled 
by water on one side and a saline solution to an 
equal height on the other, as before, we can dip a 
platinum wire in the weak 
fluid, A (Fig. 26), and another 
wire in the strong fluid, B ; 
the wire in the solution A is 
connected to the positive (+) 
pole of our battery and the 
wire in the solution B is con- 
nected to the negative (-) pole. As soon as the 
electrical circuit is completed we notice that what 
required several hours to complete by simple osmo- 
sis was now performed in a very short time. It 
Fig. 26. 
76 ELECTRICAL OSMOSIS OR CATAPHORESIS. 
77 
is apparent at once that electricity has accom- 
plished a definite amount of 
work, as in Fig. 27. If we 
start afresh and reverse our 
electrical connections so that 
the positive (+) terminal of 
our battery is in the com- 
partment B with the strong 
solution, and the negative (-) terminal in the com- 
partment A with the weak solution, we find that 
the predominant osmosis takes place in a direction 
opposite to that of simple chemical osmosis, as in 
Fig. 28. 
The skin and other membranes and tissues of the 
human body may be re- 
garded as septa, and, this 
allowed, it follows that elec- 
tric osmosis may be made to 
take place through such sep- 
ta. Electric osmosis has 
many synonyms; its phe- 
nomena are most frequently spoken of as catapho- 
resis : I prefer the term Electric Diffusion, which 
may be defined as the capacity possessed by an elec- 
tric current for diffusing or transporting liquids 
and whatever they may contain in solution from one 
polarity toward the other, preferably through por- 
ous septa-thus being applicable to the tissues of the 
living body. 
Having, therefore, knowledge of this power of 
electricity, we can vary our solution at the one pole 
or the other, generally the positive pole, to suit our 
needs and project it through tissue where we wish. 
But osmosis alone is not sufficient to explain all 
Fig. 27. 
Fig. 28. 78 
CATAPHORESIS. 
the phenomena of cataphoresis. For example, if a 
small globule of mercury, M, be placed in a glass 
tube such as is shown in Fig. 29, and the tube is 
Fig. 29. 
almost filled with dilute sulphuric acid, we can ap- 
ply the terminals of our battery to the two ends of 
the fluid in the tube. As soon as the circuit is 
complete a current of electricity flows through the 
fluid and we see the globule of mercury elongate and 
move towards the negative pole. If the position of 
the battery-terminals be reversed the direction of the 
current flow is reversed and the globule of mercury 
travels backward. If the tube be inclined toward 
the positive pole the mercury will still be moved 
with the current. If the inclination of the tube be 
still slowly continued a position will be reached at 
which there will be an equilibrium established be- 
tween the impulsive force of the current and the 
weight of the mercury. In a former chapter I have 
also described how I drove particles of graphite into 
my arm by the action of an electric current. An- 
other correlative fact is that in an arc light there 
is a disintegration of particles from the positive ELECTRICAL OSMOSIS OR CATAPHORESIS. 
79 
carbon which are projected toward the negative 
carbon. 
Again, we find that although the almost uniform 
action in cataphoric applications is for the salt or 
other chemical held in solution to be from the posi- 
tive to the negative pole, there are exceptions to the 
rule. Gore, in 1881, found that occasionally the 
flow was from negative to positive, as with a satu- 
rated alcoholic solution of bromide of barium. Dr. 
G. Weiss1 also noted the same fact; employing 
U-shaped tubes filled with solidified gelatine and 
plunged into a solution of eosin, he found that 
under the influence of a current even so small as 
one-tenth of a milliampere the eosin travelled from 
the negative to the positive pole. Methylin blue, 
on the contrary, under the same conditions trav- 
elled in the classical direction from the positive to 
the negative. 
In 1871 Becquerel tried some interesting experi- 
ments with static machines and induction coils to 
determine not only the existence of a transportation 
of particles but the direction in which the transpor- 
tation took place. These are summarized by Tom- 
masi 2 in a very satisfactory manner. 
Becquerel took two pieces of blotting paper, one 
of which he moistened with ferrocyanide of potas- 
sium and the other with sulphate of iron. These 
papers were placed on platinum electrodes and the 
iron-paper was connected to the positive pole of the 
static machine and the potassium-paper was con- 
nected to earth (negative). When the two strips of 
1 "Technique d'electrophysiologie," Paris, 1890 ; p. 130. 
2 See " Traite Theorique et Pratique D'Electrochimie," by 
Donato Tommasi; Paris, 1890 ; page 38. 80 
paper were separated from one to two centimetres 
the machine was put in action and a blue precipi- 
tate was formed on the paper moistened with the 
sulphate, indicating that the electric spark had 
transported ferrocyanide of potassium from the 
negative to the positive pole, where it had reacted on 
the sulphate of iron. It was also found that when 
the direction of the spark was reversed no reaction 
had taken place. Other combinations were exper- 
imented with and the following results noted :1 
CATAPHORESIS. 
1. Chloride of cobalt4- 
Ferrocyanide of po- 
tassium - 
Brownish-red. precipitate 
on the chloride. 
2. Nitrate of silver + 
Ferrocyanide of po- 
tassium - 
Precipitated on the ni- 
trate. 
3. Nitrate of silver+ 
Bichromate of pot- 
ash - 
Chromate of silver precip- 
itated on the nitrate. 
4. Sulphate of potash 4- 
Chloride of barium - 
Sulphate of baryta precip- 
itated on the sulphate. 
5. Nitrate of silver + 
Chloride of p o t a s - 
sium - 
Precipitate of chloride of 
silver. 
6. Nitrate of silver + 
Chloride of sodium - 
Chloride of silver precipi- 
tated on the nitrate. 
7. Chloride of magnes- 
ium 
Potash 
Neither precipitated in 
either direction. 
8. Sulphuric acid - 
' ' Sunflower paper " + 
The paper is reddened. 
lIn this table the + sign signifies that the solution was con- 
nected to the positive electrode and the - sign signifies a nega- 
tive connection. ELECTRICAL OSMOSIS OR CATAPHORESIS. 
81 
9. Caustic potash + 
Protochloride of 
iron - 
A yellowish-red precipi- 
tate on the potash. 
Tommasi continues: "We see, from these re- 
sults, that the salts transported by the electric dis- 
charges from the negative electrode to the positive 
electrode and not in the other direction are : 
1. Ferrocyanide of potassium ; 
2. Bichromate of potash ; 
3. Chloride of barium ; 
4. Chloride of sodium ; 
5. Chloride of potassium ; 
6. Sulphuric acid ; 
7. Protochloride of iron. 
" The substances which are not transported by 
the electrical discharge, with the current passing in 
either direction, are : 
1. Chloride of cobalt; 
2. Chloride of platinum ; 
3. Nitrate of silver ; 
4. Caustic potash ; 
5. Sulphate of potash, etc." 
These experiments simply show that there are ex- 
ceptions to the general rule that fluids are trans- 
ported in the same direction as the current flow. 
My own experiments teach me that most simple 
fluids, including glycerine, syrup, pure water, etc., 
are conveyed from the positive to the negative of 
the discharging rods of an influence machine across 
a spark-gap. I have also made many experi- 
ments upon the introduction of medicines by static 
electricity, a number of them successful. In this 82 
CATAPHORESIS. 
relation I have used principally the " static induced " 
current from the positive pole. 
In the experiment of the U tube and the mercury 
globule, noted above, it was found that only a very 
small quantity of sulphuric acid was needed in the 
water ; if an excess is used the experiment will not 
succeed. In other words, as has been previously 
indicated, the success of a cataphoric application 
depends upon the electrical resistance of the fluid. 
If the resistance is very high, as in chloroform, sul- 
phuric ether, alcohol, glycerine, etc., little or no 
current is conveyed and no cataphoresis takes place. 
On the other hand, if the electric resistance is too 
low, as in strong saline and acid solutions, much 
current passes but no cataphoric action takes place. 
The obvious deduction is that for therapeutical ap- 
plications the acid and saline solutions must not be 
too strong and that if the other drugs named are to 
be used considerable ingenuity must be exercised to 
secure their transfer or introduction into tissue. 
A series of experiments instituted by the writer 
demonstrated the remarkable fact that substances 
like sulphuric ether, alcohol and chloroform may be 
induced to exercise their specific cataphoric action on 
tissue by incorporating with them a foreign sub- 
stance, or what I have previously spoken of as a 
" fluid electrode." For instance, in the case of a 
hydrogen dioxide twenty-five per cent solution, i. e., 
H2O2, 25 %, and sulphuric ether, 75 %, the H2O2 
solution fails to act until it is incorporated with a 
conducting fluid such as sulphate of soda or chloride 
of sodium. 
To define the true nature of cataphoresis we must 
be able to define the nature of the electric current ELECTRICAL OSMOSIS AND CATAPHORESIS. 
83 
and this we cannot do. Cataphoresis is essentially 
a property of currents. The fact that the transport- 
ing power of the current diminishes, and finally 
ceases, in direct ratio to the diminution of resistance, 
indicates to me that in liquids we have to deal with 
what I have called a ' ' movable " resistance in con- 
tradistinction to what in solids (metals, etc.), might 
be termed "stationary" resistances. From this 
point of view a fluid is projected or moved along in 
bulk simply because it does offer resistance. 
A rough comparison of this view of cataphoresis 
may be made to a belt moving rapidly through a 
trough containing a fluid of slight density. Under 
such circumstances very little fluid will move with 
the belt, but if the friction between belt and fluid is 
increased there will be a greater conveyance. It is 
as if the molecules which do not conduct were en- 
meshed in and among the molecules which do con- 
duct. The non conducting molecules are swept 
along by the current conveyed by the conducting 
molecules. We can conceive of the resistance of the 
fluid in the trough being increased to such an ex- 
tent that the belt cannot move through it. This 
extreme will, of course, also mean no conduction. 
A simple view which may be taken of this pheno- 
menon is that where there is no resistance there will 
be nothing to move. 
Another peculiar feature about cataphoric phe- 
nomena is that the effect of the transported drug 
only reaches about half way from positive electrode 
to negative electrode. This has been previously 
mentioned, but as some may be inclined to question 
the possibility of this condition existing we will 
consider the following experiment: 84 
CATAPHORESIS. 
Take four pieces of glass, and on each place a 
piece of blotting paper 1X2 inches in size, as in Fig. 
30. (See frontispiece.) Moisten each piece of blot- 
ting paper with a solution of sulphate of soda. Then 
place a piece of ozone test-paper of the same size as 
the blotting paper on each piece of blotting paper, 
and the ozone paper in this way will become slightly 
moist with the solution beneath it. We then group 
these four glasses with their papers in pairs, as 
shown in the illustration, with the papers of each 
pair brought in contact with each other. We then 
put a twenty-five per cent, ethereal solution of 
H2O2 on the right-hand paper, which immediately 
become blue, as the white ozone paper gives a bright 
blue reaction to dioxide of hydrogen. In group No. 
1 we notice a very slight discoloration of the left- 
hand paper, but only at the point of contact ; but if 
we apply two electrodes to group No. 2 (positive to 
the right, negative to the left) and pass fifty milli- 
amperes from one to the other the result will be 
most striking and conclusive. The H2O2 solution 
under the electric influence straightway begins to 
invade the previously white paper to the left and 
colors it blue for half of the distance toward the 
negative electrode, and cannot be made to go to a 
greater distance. This demonstration is a simple 
one, and falls right in line with the observations 
made on the interesting phenomena resulting from 
the passage of electricity through bad conducting 
fluids by O. Lehmann.1 He found that with bad 
conducting fluids certain changes start from each 
electrode and meet in the middle where a precipitate 
1 See "Wiedemann's Annalen," Vol. LIL, page 455; also 
"The Electrical Review," London, Oct. 26, 1894, page 419. ELECTRICAL OSMOSIS AND CATAPHORESIS. 
85 
is produced. Solutions of the aniline colors showed 
the phenomena very distinctly. Where a current 
of 70 volts was sent through an aqueous solution of 
Congo red, sharply defined halos were formed about 
each electrode; the halo proceeding from the posi- 
tive was of a beautiful blue color, and that from 
the negative was somewhat paler than the solution, 
though distinctly defined by a darker outline. Both 
halos spread quickly, and finally met in the middle, 
when a dark blue precipitate was suddenly formed 
next to the positive electrode, while the color was 
completely discharged from a corresponding space 
next the negative electrode. Where the dark blue 
and colorless layers met the fluid was thrown into 
violent agitation, while the rest of it remained un- 
disturbed. These observations were made with a 
a microscope, but the phenomena may be seen with 
the naked eye by inserting the electrodes in a block 
of very loose jelly at a distance of about 3| inches 
and turning on the current for about 10 minutes, 
when the halos will meet in the middle and produce 
the precipitate, as in the solution above mentioned. 
When the precipitate is formed a violent agitation 
is observed at the place of meeting inside the mass 
of jelly ; the precipitate is re-dissolved and the gela- 
tine melted by the great heat evolved. 
Lehmann explains these actions by saying that 
the positive and negative electrification of the elec- 
trodes is handed on from molecule to molecule until, 
finally, positively and negatively electrified mole- 
cules stand opposite each other in the middle of the 
fluid or jelly, where they are violently attracted to 
each other. 
In bringing this chapter to a close it is only 86 
CATAPHORESIS. 
necessary to say that although cataphoresis is es- 
sentially a feature of constant or galvanic currents, 
yet it may be produced by static machines (vide 
Tommasi, above) or by the currents from induction 
or spark-coils. In this latter case the currents are 
alternating in character, but, as is well known, 
there is a predominating positive and a predomi- 
nating negative which almost overshadow currents 
which travel in the opposite direction and conse- 
quently we are able to observe cataphoric phe- 
nomena by its use. So far as we have yet deter- 
mined, the continuous current is the only one suit- 
able for practical work. CHAPTER V. 
ELECTROLYSIS AND CATAPHORESIS. 
As Lodge so beautifully shows,1 water may be 
made to travel from place to place only by two 
methods, viz., it may be pumped along pipes, or it 
may be carried about in jugs. In other words, it 
may travel through matter or it may travel with 
matter. Just so it is with heat also ; heat can 
travel only in two ways : it can flow through mat- 
ter, by what is termed "conduction," and it can 
travel with matter, by what is termed " convec- 
tion." For electricity the same is true. Electricity 
can travel with matter by convection or it can 
travel through matter by conduction, but in no 
other known way. 
If we connect the poles of a galvanic battery to- 
gether by a piece of copper wire we get what we 
call a "current." It is a true flow of electricity 
among the molecules of the wire, whatever elec- 
tricity may be. The molecules of copper do not 
flow along but the electricity may be said to flow 
through or among them by conduction. 
If our galvanic battery is connected to a liquid, 
such as a chemical solution of acids, alkalis, salt and 
water, or saline solutions generally (which classifi- 
1 " Modern Views of Electricity," Lodge; London, 1889; page 
65 et seq. 
87 88 
CATAPHORESIS. 
cation includes the tissues of the human body), a 
current of electricity will pass, but in a manner very 
different from that we noticed in the case of the 
copper wire. These fluids are called "electrolytes" 
and when electricity passes through them it is by 
electrolysis. 
Faraday's laws of electrolysis may be summarized 
as follows : 
(1) Electrolytic conduction is invariably accom- 
panied by chemical decomposition and only occurs 
by means of it. 
(2) The electricity does not flow through, but with, 
the atoms of matter, which travel along and convey 
their electrical charges somewhat after the manner 
of a pith-ball statically charged. 
(3) The electric charge belonging to each atom of 
matter is a simple multiple of a definite quantity 
of electricity, and this is an absolute constant quite 
independent of the nature of the particular sub- 
stance to which the atoms belong. 
Electricity is conveyed through an electrolyte in 
what has been called a " double progression of 
atoms " ; when the electricity passes in this manner 
the molecules of the electrolyte are decomposed and 
one set of atoms is positively charged and moves 
from positive to negative element (or electrode) 
while another set of atoms is negatively charged 
and moves from negative to positive element (or 
electrode). Therefore it is by a double progression 
of atoms that the current is transmitted. The pro- 
cess is of the nature of convection, for the atoms act 
as carriers. In electrolysis the charge each atom 
carries is the same, but the speed at which different 
atoms move through the electrolyte varies accord- ELECTROLYSIS AND CATAPHORESIS. 
89 
ing to the character of the atom. Hydrogen travels 
faster than any other kind of atom and the con- 
ductivity of a liquid depends upon the sum of the 
speeds of the two opposite atoms in the compound. 
In general, therefore, acids conduct better than 
their salts. 
Another interesting fact is, that it seems there is 
another action which takes place in an electrolyte 
when electromotive-force is applied to it, independ- 
ent and additional to the double progression of atoms 
above referred to. This is, that apparently but a 
small per cent, of the molecules are decomposed and 
that the remainder of them may be moved along 
with one progression or the other, either from posi- 
tive to negative or from negative to positive. 
Thus, when electrodes holding a drug in solution 
are brought in contact with tissue and an electro- 
motive force is applied to them, there is undoubt- 
edly an electrolytic action set up which tends to and 
does decompose some of the electrolyte ; but, in ad- 
dition, there is a mechanical transfer of the medica- 
ment through the tissue. Again, if we place elec- 
trodes capable of being decomposed in direct con- 
tact with the tissues, and apply the electromotive- 
force, the product of this decomposition is trans- 
mitted through the tissue but only to a point half- 
way between the positive and negative electrodes. 
Or, if we place electrodes (not capable of being 
attacked by the current) in direct contact with the 
tissues, we find that there is a transfer of the fluids 
of the tissues to the negative electrode while the 
tissue in the neighborhood of the positive electrode 
is relatively dry. 90 
CATAPHORESIS. 
Some observers are inclined to credit all the phenomena of 
cataphoric medication to electrolysis, and others claim that elec- 
trolysis has essentially nothing to do with these phenomena. 
According to the theory of Arrhenius, upon solution in water, 
salts (including acids and alkalies), split up or dissociate into 
free electrically charged atoms ; if, for instance, common salt is 
dissolved in water the solution contains salt and the products of 
its dissociation. The ions Na and Cl, the Na charged with 
free positive electricity, the Cl. charged with free negative 
electricity. The undissociated chloride of sodium molecules 
must be regarded as electrically neutral. 
Upon placing electrodes in such a solution, they will exert at- 
traction or repulsion on the free ions, displacing them and causing 
a double progression of ions. This migration of the ions, all con- 
cede, constitutes the familiar electrolytic current or galvanic 
current in an electrolyte. 
The theory of Arrhenius as to the free and electrically charged 
ion advances our views as to the nature of electrolysis and elec- 
trolytic conduction, but I cannot see that we are yet entitled 
to assume that the electrolytic double progression of the ions, 
which occurs in only a small per cent, of the molecules which 
constitute the solution, is, in reality, that movement known as 
cataphoresis or electric diffusion. 
If I were to suggest a view it would be to the effect that the 
directive movement of fluids by electricity is a property of the 
current coincident with electrolysis, but that electrolysis is only 
useful in so far as it insures the existence of a current and al- 
lows of a propulsion of undissociated and electrically charged 
molecules constituting the medicament, along with it. 
This view would involve the relation and behavior of electro- 
statically charged molecules to electrostatically charged tubules 
of small calibre, namely to porous septa.1 However, in the pres- 
ent state of our knowledge, it would seem that we must await 
further research as to the true nature of electric diffusion. In 
the meantime there is one practical result that can easily be 
attained. This is, by careful experimentation, to determine at 
which pole each individual medicament shall be placed. Specific 
directions as to this point are already available, as has been seen , 
in regard to a certain number of remedies. The time is not far 
distant when all the important remedies will be tabulated under 
their appropriate respective polarities for purposes of electric 
diffusion. 
1 See Transactions of the American Electro-therapeutic Asso- 
ciation, 1892, pp. 42, et sequitur, Articles by Dr. A. E. Kennelly, 
Prof. Edwin J. Houston and the author. CHAPTER VI. 
PHYSICAL AND PHYSIOLOGICAL EXPERIMENTS. 
Numerous experiments have been given in detail 
in the three preceding chapters, used there as 
illustrations of the argument being made. Several 
others of a miscellaneous character will here be 
given as of general interest but without any studied 
arrangement. 
Experiment 1. Take a ball of moist clay and in- 
sert in it your positive wire ; put the negative pole 
platinum wire into some other part of the ball of 
clay and turn on the current. It will be found that 
soon the moisture of the clay will be gathering at 
the negative pole and will roll out drop by drop. 
Experiment Insert two platinum needles in a 
piece of raw meat, connecting one to the positive 
and the other to the negative pole. The same 
transfer of the tissue fluids to the negative pole will 
be noticed, as in Experiment 1. 
Experiment 3. This is illustrative of the same 
principle and is quoted by G. N. Stewart. He passed 
a hollow-metallic electrode into the vagina of a liv- 
ing rabbit; when this electrode was negative, fluid 
was forced through it while none appeared when it 
was positive. 
Experiment 4- Take a piece of raw meat and 
91 92 
CA TAPHORESIS. 
stick a copper needle in it and make it a positive 
electrode ; the negative electrode should be a needle 
of any metal placed in the meat some distance from 
the other. When the current is turned on it is seen 
that the copper positive needle is being dissolved 
and that the green oxychloride of copper is being 
diffused through the meat tissues. 
Experiment 5. Take a hard boiled egg and in- 
sert the electrodes as in Experiment 4, and the 
green stain produced by the cataphoric diffusion 
will be even more noticeable than before. Zinc, 
silver, iron or other oxidizable metals may be used 
experimentally in this way. 
Experiment 6. Illustrative of the same principle 
and quoted from Dr. Gautier. He took the uterus 
from a live rabbit and inserted in the same a copper 
sound which he used as a positive electrode. He 
says1: "The deposit of the copper salts on all the 
internal surface of the uterine mucous membrane 
is very noticeable; the penetration of these salts 
into the tissue is complete; the exterior as well as 
the interior is colored an apple green ; one of these 
salts is the insoluble oxychloride of copper ; the 
other is a soluble organo-metallic salt. If we place 
on different points of the region penetrated by this 
soluble salt a plate or sheet of steel or iron, we 
have, after several seconds, a deposit of metallic 
copper on the plate. " 
Experiment Cut a hard-boiled egg length- 
wise and take out the yolk. Place a white section 
in a saucer containing a solution of iodide of 
potassium and fill the hollow of the egg with a 
weak solution of starch water. Connect the solu- 
1 " Technique d'Electrotherapie," Vol. 1, page 174. PHYSICAL AND PHYSIOLOGICAL EXPERIMENTS. 
93 
tion in the saucer with the negative pole and the 
solution in the egg with the positive pole and 
there will be a very pretty illustration of electrical 
osmosis demonstrated by the discoloration of the 
starch-water as the iodine reaches it. 
Experiment 8. Shows a most unique phenomenon 
of the directive power of the electric current (called 
by some writers "Galvanotropism") upon rapidly 
moving ciliated Infusoria, e. g., Flagellata. This is 
quoted from "Electro-Physiology," by W. Bieder- 
mann,1 and the illustration, Fig. 31, is reproduced 
therefrom. 
Fig. 31. 
"If a few drops of hay infusion swarming with 
Paramaecium are placed between clay electrodes 
1 Published by The Macmillan Co., New York, 1896. 94 
CATAPHORESIS. 
upon an object-glass, and traversed by a sufficiently 
strong current, the following effects (as pointed out 
by Verworn) are observed, either with the naked 
eye or with a magnifying lens : ' At closure the 
Paramaecia turn all together as if at the word of 
command, with the anterior pole of the body toward 
the negative electrode, and swim in this direction 
with uniform speed.' 
"Ina short time the anodic side of the drop is 
completely cleared of Paramaecia, not one being 
left behind; the whole mass is crowded to the 
cathode. As long as the circuit is closed the pro- 
tozoa remain thus ; if the current is broken the 
Paramaecia turn instantly with their anterior ends 
towards the anode and swim away in this direction. 
The cathode is quickly deserted and the majority of 
the organisms are now collected around the anode. 
The crowding is, however, by no means so complete 
as that produced at the cathode by make of the cur- 
rent and the Paramaecia soon begin to swim about 
in all directions and in a short time are once more 
uniformly distributed throughout the drop. This 
manoeuvre is repeated as often as the current is 
closed, with the same precision." 
The reader is referred to the chapter on the 
Electric Staining of Tissues for Microscopical Ex- 
amination for further experiments and suggestions 
in this line. PART III.-APPARATUS AND OUTFIT. 
CHAPTER I. 
ELECTRODES FOR MEDICAMENTAL DIFFUSION. 
Although the applications of electric medica- 
mental diffusion are so numerous and their virtues 
so great, the devices needed to obtain excellent re- 
sults are few in number and readily manipulated ; 
moreover, they are comparatively inexpensive. 
The electrodes required for a particular applica- 
tion may be a stock article with the operator or at 
least with the supply-house, but cases may arise 
where it will be necessary to devise or arrange a 
special electrode and here the ingenuity of the 
operator must be called into play. 
In a broad sense, electrodes may vary in size 
from the " liquid electrode" of an electric bath to 
the finest needle. As has already been pointed out, 
the patient may sit on an insulating stool in a bath- 
tub surrounded by a medicament which is acted 
upon by an electric current and diffused through 
the body. Or the scheme of Gartner and Ehrmann 
may be employed, consisting of a large jar or tub 
in which the patient stands immersed, say, to the 
waist, in a medicated solution ; an impervious par- 
95 96 
CATAPHORESIS. 
tition is then snugly fitted around the patient and 
more solution poured on top ; the upper section of 
the bath was of one polarity and the lower compart- 
ment of another ; this arrangement depended for 
its activity on the action of the patient's body as a 
porous septum. 
I have devised in Fig. 32 a special form of elec- 
trode for use in a jar or tub filled with solution, in 
Fig. 32. 
which the patient is more or less immersed. It con- 
sists of a hollow rod of ebonite, perforated down its 
length and capped with a metal connector for the 
battery wire at one end ; a wire of platinum or 
other metal extends through the rod from the up- 
per or connector end to the lower end. The effect 
of this arrangement is to permit a free access of the 
liquid to the metal terminal, and at the same time 
keeps the patient from making a contact there- 
with. 
In Fig. 33 we have an electrode made after the 
plan of Dr. Peterson. As will be noticed, this elec- 
trode is a metal disc 
about 1| inches in 
diameter surrounded 
by a slight rim just 
high enough to ac- 
commodate a round 
piece of blotting paper 
when placed on the metal disc. There is a great disad- 
vantage in the use of such an electrode arising from 
the fact that when it is applied to the skin with 
Fig. 33. ELECTRODES FOR MEDIC AMEN TAL DIFFUSION 
97 
some necessary pressure the medicamental solution 
held by the blotting-paper is squeezed out and the 
paper becoming dry in spots there is a great resist- 
ance formed at the surface of the skin and a " burn " 
or a failure is often the result. The larger the disc 
in this style of electrode, the greater its disadvan- 
tages. 
To overcome these troubles and obtain an elec- 
trode which would keep up its supply of fluid all 
through the application I conceived the idea of per- 
forating the disc with a large number of holes and 
providing a reservoir back of the disc to hold a sup- 
ply of fluid. This arrangement is shown in Fig. 34, 
Fig. 34. 
which illustrates a small electrode with a disc only 
half an inch in diameter. This variety of electrode 
with the long handle and reservoir hack of the disc 
I use in different sizes, but seldom with discs more 
than an inch in diameter. 
I found that in larger electrodes, or in smaller 
electrodes used for powerful drugs like cocaine, etc., 
it was not necessary for me to drill the holes all the 
way through the metal discs but only for about 
or The multiplication of holes permits the 
reserving of a surprisingly large amount of fluid, 
which is fed through the blotting-papers as the 
demand is made for it. This arrangement of parts 
permits the use of very large electrodes and the ap- 
plication of medicaments to very large surfaces 
with the certainty that all parts of the surface will 98 
CATAPHORESIS. 
Fig. 34 b. ELECTRODES FOR MEDICAMENTAL DIFFUSION. 
99 
be affected. Fig. 34 a, shows a face view of one 
of these electrodes 6 inches in diameter, while Fig. 
34 b shows a perspective of an elliptical electrode 5 
Fig. 34 c. 
inches long by 2| inches wide. It will be noticed 
that the terminal for the battery cord is on the side 
of the handle. 
Fig. 34 d. 100 
CATAPHORESIS. 
In Fig. 34 c we have an oblong electrode of this 
same class whose dimensions are 6 inches by 1| 
inches and in Fig. 34 d we have shown another el- 
liptical electrode 4 inches long by 2 inches wide ; in 
this the connection is made at the end of the handle. 
All these electrodes are constantly in use in my 
practice and daily prove their capacity to medicate 
or anaesthetize large areas. 
Another new departure now used in electrodes is 
shown in Fig. 35. This I call the hypodermatic 
Fig. 35. 
injection electrode, and it is to be used in that branch 
of electric medicamental diffusion where a cavity is 
filled with the medicament and then the current is 
applied to it. As will be seen from the illustration 
this instrument consists of a small syringe at whose 
outlet end is a hollow, sharpened needle with a con- 
nector for the battery terminal made a part of the 
same. In action the needle (which is made of plat- 
inum and insulated down to its point) is made to 
puncture the tumor or other tissue to be treated and 
a medicament is forced into the same through the 
needle. When the current is turned on cataphoresis 
takes place. 
Or, the needle is made of copper, zinc, or other 
oxydizable material, insulated to near its end ; a 
weak solution of chloride of sodium, or of hydro- 
chlorate of cocaine is forced into a cavity in order to 
furnish by its decomposition, oxygen or chlorine to 
act upon the metal of the needle in case there is a 
lack of these elements in the tissues. ELECTRODES FOR MEDICAMENTAL DIFFUSION. 
101 
Another special electrode is shown in Fig. 36 ; 
this is for applications to the nose. 
The illustration shows the elec- 
trode in section ; it is made of 
metal covered with ebonite or 
hard rubber as indicated by the 
heavy lines. A fountain syringe is attached to 
the opening at the right and, as will be seen, the 
battery terminal is applied at the connector coming 
out from the side. As the medicated solution passes 
up through one nostril and out the other the elec- 
tricity performs its cataphoric function. 
In Fig. 37 is shown a special electrode of well- 
known form for applications to the ear. The fluid 
medicament is injected into the cavity of the ex- 
ternal meatus and the funnel occluded with ab- 
sorbent cotton and a plug of soft gutta percha. The 
cut shows its construction and its method of opera- 
tion is obvious. 
Fig. 36. 
Fig. 37. 
In Fig. 38, we have an electrode devised by me for 
the treatment of naevi and skin diseases. As will 
Fig. 38. 102 
CATAPHORESIS. 
be seen, it consists of a copper-wire brush which may 
be moved in or out of an appropriate holder. In 
operation the copper brush may be dipped in a solu- 
tion of common salt or hydrochlorate of cocaine and 
applied to the surface to be treated. Naevi are very 
satisfactorily treated by this method. The stain of 
the oxy-chloride of copper forced into the skin is 
most obvious to the sight. 
COLLAPSABLE 
RUBBER BULB- 
TO ELECTRICAL 
CONNECTION' 
TO FOUNTAIN 
SYRINGE-x 
OUTLET- 
INFLATING 
BULBS 
Fig. 39. 
Another most valuable electrode apparatus for the 
treatment of diseases of the uterus and its append- 
ages is shown in Fig. 39. With the ordinary electrode 
for this purpose there is great difficulty in making 
such an application as will do away with a leakage 
of the medicated solution-in fact, it is impossible 
to maintain a tight joint. By the apparatus I have 
devised, however, this difficulty is done away with, 
as will be seen. It consists of a long hollow tube 
with a perforated nozzle on the end and a collapsable 
rubber bulb near such nozzle. Ordinarily the bulb 
is collapsed and can readily be introduced into the 
vagina. If the inflating bulbs are attached to the 
central stem at the right and a slight pressure ELECTRODES FOR MEDICAMENTAL DIFFUSION. 
103 
given, the bulb in the vagina is more or less inflated 
and acts as a perfect stopper. Medicated solutions 
can then be introduced into the vagina from a fount- 
ain syringe and the current being turned on at the 
connector (shown at the right) passes through a 
wire or rod to the inside of the nozzle where it is 
effective upon the " solution electrode" or medicated 
solution inside the vagina. When the application 
is completed a valve on the outlet shown in the illus- 
tration can be opened and the fluid withdrawn and 
then the connection to the inflating bulbs may be 
taken off and the collapsable bulb, is deflated and is 
readily withdrawn. 
Dispersing or indifferent electrodes may be made 
of various sizes and shapes applicable to different 
parts of the body. I prefer to use them made of 
punk or the amadou of the French, which keeps 
moist for a long time and is much superior to any 
form of sponge electrode. CHAPTER n. 
ELECTRODES FOR METALLIC ELECTROLYSIS. 
As we have seen, metallic electrolysis is the action 
which is set up when a soluble electrode is made to 
perforate tissue or is placed in contact with mucous 
membrane and a current is sent through the tissue 
from the same-a "soluble" electrode being one 
which, when attached to the positive pole, is attack- 
ed by oxygen or by chlorine formed at that pole by 
decomposition of the tissue. The newly formed 
metallic salts are then transported into the tissues. 
Active electrodes to be used for this purpose may 
be made of copper, zinc, iron, silver or other attack- 
able metal. Such electrodes are mainly of two 
varieties, needles and bulbs. 
Fig. 40 shows some needles, which may be made 
of any desired metal. I use, preferably, copper, 
zinc, silver, and iron at the positive pole, or alumi- 
num at the negative. These needles should be 
about 1 millimeter in diameter and about 8 centi- 
meters in length, as they will then fit an ordinary 
holder. They may be bare or insulated down to the 
neighborhood of the point, as desired. 
104 
Fig. 40. " Soluble " Needles. ELECTRODES FOR METALLIC ELECTROLYSIS. 
105 
Bulbs may also be made of a variety of metals. 
For convenience they are constructed in sizes of the 
French catheter scale, each bulb capable of being 
attached by a screw-thread to a universal holder. 
Figs. 41 and 42 show sets of bulbs of different 
lengths and diameters. 
Fig. 41. "Soluble " Bulbs. 
Fig. 42. " Soluble " Bulbs. 
It often happens in making applications to the 
rectum, urethral canal, cervical canal and other 
Fig. 43. Protected Soluble Electrodes. 106 
CATAPHORESIS. 
canals, sinuses or cavities, and in the treatment of 
trachoma, that it is undesirable to attack approxi- 
mating surfaces at a single treatment ; again, it 
may be desired to protect a given surface. 
To meet these conditions the writer devised a style 
of bulbs well suited to this class of work. They are 
shown in Fig. 43 and consist of bulbs divided 
longitudinally so as to be one half of metal and the 
other half of ebonite. Fig. 44 shows such a protected 
bulb with its handle. 
Fig. 44. Protected Electrode and Handle. 
The handles for these bulbs may be of different 
shapes for use in special localities. Fig. 45 illus- 
trates two common forms of handle with soluble 
bulbs attached. 
Fig. 45. " Soluble " Bulbs Attached to Handles. 
It is also convenient, at times, to use needles, 
sounds, or other long electrodes, which are supplied 
with an insulating sheath which protects the tissue 
from cataphoric action except at the desired point. 
Fig. 46. Protected Sound of "Soluble" Metal, Copper, Zinc, Iron, etc. Fig. 46 shows one of these protected sounds and 
Fig. 47 shows a nasal electrode protected in the 
same manner. 
ELECTRODES FOR METALLIC ELECTROLYSIS. 
107 
Fig. 47. Protected Nasal Electrode. 
Fig. 48 is an illustration of an olive-tip electrode 
for rectal application. This may be made of any 
metal as desired. 
Fig. 48. Rectal Electrode, Olive Tip. CHAPTER III. 
DENTAL ELECTRODES. 
In dental practice the dispersing electrode is of 
great importance, perhaps more so than in other 
applications because of the sensitiveness of the 
nerves of the teeth and the desirability of keeping 
up a steady flow of current. 
Fig. 49 shows a dispersing electrode made of a 
circular disc of carbon, about three inches in 
diameter, covered with two layers of sheet punk or 
amadou bound at the edges by an insulated wire 
wound in a groove. This electrode may be held 
Fig. 49. Dispersing Electrode, of Carbon covered with Amadou. 
in the hand, or placed upon the cheek, or in some 
other convenient position. Fig. 50 shows a form of 
electrode intended for use on the tongue. It is, 
ordinarily, not so convenient a form as the carbon 
electrode illustrated in Fig 49. 
108 DENTAL ELECTRODES. 
109 
Fig. 50. Electrode for Tongue. 
The standard active electrode for the mouth is 
that shown in Fig. 51. Its chief characteristic is 
the form of disc used, which is about half an inch 
in diameter. This disc is made of carbon or block 
tin and is one-quarter of an inch thick. The carbon 
Fig. 51. Morton's Mouth Cataphoric Electrode. (1 inch diameter.) 
or tin is perforated freely to about two-thirds of its 
depth by drill holes one millimeter in diameter, or 
is perforated completely with a shallow reservoir 
provided behind it to hold an excess of solution. 
The metal disc is surrounded by ebonite, which rises 
as a flange two or three millimeters above the disc 
to form a receptacle for a piece of blotting paper, 
felt or other absorbent material cut to fit the 
receptacle exactly. 
Fig. ®. Morton's Tong-Shaped Duplex Cataphoric Electrode. 110 
CATAPHORESIS. 
The cataphoric electrode devised by me for use on 
the gums, as previously shown, consists of a pair of 
the above partially perforated discs mounted on a 
holder shaped like a pair of tongs, as in Fig. 52. 
This permits an application to be made on each side 
of the gum at the same time. Both discs have a 
ball and socket joint and are of the same polarity. 
The dispersing electrode may be held in the hand, 
or placed elsewhere, and both sides of the gum may 
be treated at the same time. 
The double rubber cup electrode shown in Fig. 53 
had been used by Westlake and others with each 
cup connected to a different pole, and it proved in- 
operative except at one cup. This electrode has 
been recently modified in accordance with the prin- 
ciples incorporated in the electrode shown in Fig. 52 
in the false hope of making it an operative device. 
Each cup has a platinum disc in the bottom and the 
cups may be changed for each patient. 
Fig. 53. Double Rubber Cup Positive Electrode. 
Fig. 54. Single Rubber Cup Electrode. 
Fig. 54 is a single cup electrode made on the same 
general lines as the double electrode in Fig. 53. 
The double cup positive electrode and the single 
cup electrode, Figs 53 and 54, are here reproduced DENTAL ELECTHODES. 
111 
solely for the purpose of expressing my absolute 
condemnation of them as working electrodes. They 
are constructed upon unscientific principles. The 
first requisite of successful cataphoric action is that 
the porous septum holding the absorbed medica- 
ment shall be as thin as possible-it should not be 
thicker than ordinary blotting paper, and the sec- 
ond requisite is that every portion of this septum of 
absorbent material should be in immediate contact 
with the metal back plate. In short, metallic con- 
duction should end as near as possible to where 
cataphoric action is to begin. The faults of the cup 
electrode are that a very small metal plate is used, and 
that this plate is non-perforated, and that, finally, 
its shape invites a thick packing of porous material. 
As a result, the primal cataphoric action is expended 
in the porous material and not in the tissue ; the 
operator fails to benumb the gums, and thencefor- 
ward condemns the cataphoric method. With a 
proper electrode and some experience there can be 
no failure to anaesthetize the gums and deeper tissue, 
but in making an actual experiment of this kind 
before a class at the New York Dental College I 
found that the patient complained of some pain, due 
probably to the tearing out of abscess tissue back of 
the tooth at the moment of extraction. The elec- 
trode had not been applied quite long enough. I 
have found eight minutes to suffice, employing 
guaiacol and cocaine in an eight-per-cent solution, 
dilating it with almond oil, one half. 
Fig. 55. Morton's Tubular Cataphoric Applicater. 112 
CATAPHORESIS. 
Another modification of the reservoir idea as ap- 
plied to an electrode is that illustrated in Fig. 55. 
This electrode is for use in operations on sensitive 
dentine. It consists of a heavy, stiff piece of plati- 
num wire, tubular at its end, and perforated from 
the sides into the tube, so that it may hold an ex- 
cess of the solution. The end of this " applicator " 
is applied direct to the pledget of absorbent cotton 
within the cavity. In place of the tube the applicator 
may be split one or more times, or otherwise ar- 
ranged so as to hold the fluid by capillary attrac- 
tion. This is important, as otherwise the pledget of 
absorbent cotton becomes dry, necessitating a re- 
newal of the anaesthetizing fluid, and thus causing 
an unpleasant turning on and off of the current. 
Fig. 56. Plain Platinum Applicator. 
The usual form of " applicator " is that shown in 
Fig. 56. This is not tubular and possesses no 
reservoir capacity. The end of the platinum wire 
is roughened so as to retain, if desired, a pledget of 
absorbent cotton which may be wrapped about it. 
Both of the applicators shown in Figs. 55 and 56 
can be so changed in form as to reach spots which 
the straight applicators here illustrated could not 
reach. 
To avoid the trouble of holding the electrode in 
place during a considerable time, as well as the 
chance of variable pressure, and therefore varying 
current, " spring electrodes" have been devised 
which, once placed within the mouth, retain their 
fixed positions. DENTAL ELECTRODES. 
113 
Fig. 57 shows such an electrode (devised, I believe, 
by Dr. Van Woert), in situ. The illustration is 
taken from the manufacturer's circular. 
Fig. 57. 
This shows the spring electrode in position, for 
anaesthetizing sensitive dentine pulps for extirpa- 
tion, a shoe-like end resting against the rubber dam, 
and the point on the cotton, saturated with a medi- 
cament in the cavity. 
And here a final word in regard to cataphoric 
electrodes of the ' ' applicator " type for use in the 
cavities of teeth for anaesthetizing or bleaching 
dentine or for the introduction of any medicament. 
Sufficient attention has not been given by oper- 
ators to the question of current density and its in- 
fluence upon the rapidity of cataphoric absorp- 
tion. 
Current density is expressed in terms of the 
quotient of the current strehgth in milliamperes 
divided by the surface of the area of the electrode 114 
CATAPHORESIS. 
in square centimeters. If, for instance, a current 
strength of 15 milliamperes is flowing into the arm 
through an electrode of 5 square centimeters the 
density of the current at the point of application of 
the electrode to the skin is = 3. But enlarge the 
electrode to 15 square centimeters and our quotient 
is1. In other words, the larger the electrode 
at an equal current strength the less the current 
density, that is to say, the less the current strength 
at any given point beneath the electrode. 
We will now take an electrode like the present 
type of applicator, assuming that its point of applica- 
tion is about 1 square millimeter, and that about 1 
milliampere of current is flowing ; our current 
density is | = 1. But supposing this rate of cur- 
rent flow under these conditions is giving pain to 
the patient and causing delay by its inefficiency in 
anaesthetizing the dentine. Let us as a remedy 
increase the size of the applied tip of the applicator 
to 3 square millimeters ; our current density is |. 
The patient is now receiving the same total current 
as before but diffused over a larger area, so that it 
is reduced | at any given sensitive point, and we may 
consequently give three times as much current as 
before and cause but the same amount of pain. 
In this manner much more extensive cataphoric 
work would be accomplished. 
The small cross-sectional area of the electrodes in 
common use as applicators therefore seems to me 
to explain the slowness of producing results and the 
unusual length of time consumed, reported by many 
operators. The cataphoric applicators constructed 
for me by the Galvano-Faradic Co. of New York, 
while retaining the feature of perforation described DENTAL ELECTHODES. 
115 
on page 97 are of sizes which as near as pos- 
sible conform to the ordinary entire cross-sectional 
area of the cavity to be treated. These larger ap- 
plicators furthermore fulfil a requirement which 
I have long insisted upon as essential to good cata- 
phoric work and that is that the entire porous sur- 
face which holds the medicament must be in inti- 
mate contact with the metallic conductor at every 
point and that this same metallic conductor must 
be in as close contiguity as is possible to the tissue 
to be affected. 
The slim needle-shaped applicator must therefore 
in my opinion be abandoned. 
While the tubular and perforated applicator Fig. 
55, will suffice for small cavities it is well to change 
its shape (retaining preferably the tubulation and 
perforation) for use in large cavities. And in this 
instance, since platinum is expensive, block tin or 
graphite may be substituted for a constructing 
material. Tin oxidizes but slightly and is a good 
conductor while graphite (gas carbon) does not oxi- 
dize at all. The applicators here referred to for 
Fig. 58. 
insertion into a needle holder, with or without a 
spring for retaining them in permanent position, 
are illustrated in Fig. 58. They may be made of 
any size. 116 
CA TAPHORESIS. 
Fig. 59 illustrates such an applicator in position. 
A modification of the wire brush electrode, Fig. 38, 
using a slide over fine platinum wires, might easily 
be made. 
Fig. 59. 
Of course the ingenuity of the operator will sur- 
mount any special difficulties if the general principle 
of current density be kept in mind. There is but 
one final precaution which seems almost unnecessary 
to state, and that is that in no event must any part 
of the metallic applicator come into actual contact 
with any part of the dentine to be affected. This might 
easily and thoughtlessly happen should the sugges- 
tion, made elsewhere, to pack in platinum, gold, or 
tinfoil over the porous material within the cavity 
and connect it to the battery terminal, be adopted. 
In the sterilization of the pulp cavity and dentine 
as well as in the treatment of pyorhoea alveolaris, 
etc., the operator will do well to refer to the elec- 
trode termed the hypodermatic injection electrode 
and shown in Fig. 35. CHAPTER IV. 
BATTERIES AND CENTRAL STATION CIRCUITS. 
To a person contemplating the installation of ap- 
paratus for the utilization of the cataphoric pheno- 
mena, the interesting question at once arises : What 
shall be my source of electricity ? If his office is 
equipped with electric lights, or if the electric light 
wires pass his door, he wonders if the central station 
current cannot be utilized. If he is not conveniently 
near electric light wires he wonders what variety of 
galvanic battery to use. These are important ques- 
tions to settle and they should be settled properly. 
We have seen in the chapter on "Sources of 
Electricity," in Part II. of this book, how currents of 
electricity are induced in the dynamos situated in 
the central stations, and that every dynamo is in- 
herently an alternating current generator, but that 
by the application of a device called a "commutator" 
Fig. 60. 
117 118 
CATAPHORESIS. 
the alternating current impulses could be rectified 
or "commuted" into continuous currents. Let us 
consider what happens in a dynamo whose current 
impulses are commuted : If we imagine the " arma- 
ture" of our dynamo to have but one coil it will 
develop an electromotive force which may be repre- 
sented by the curved line in Fig. 60, where the 
horizontal line is the zero line or line of no voltage. 
For the first half revolution of the armature the 
current will flow through the coil in what we will 
call the positive (+) direction ; it begins from zero, 
rises to a maximum and falls to zero again. Then, 
as the armature continues turning for its other half- 
revolution, another current is induced in the coil 
but in the opposite or negative (-) direction. This 
is indicated in our illustration by the curve below 
the zero line. 
If, now, we put a commutator on this armature, 
we will so alter the conditions that the current im- 
pulses will all flow to the external circuit in the 
positive sense, as shown by Fig. 61. 
Fig. 61. 
But suppose we put two coils on the armature, at 
right angles to each other, and connect them in 
series and at the same time commutate them. We 
will then have a condition like that shown in Fig. BATTERIES AND CENTRAL STATION CIRCUITS. 
119 
62 where one electromotive force is superposed upon 
the other. By this is meant that the curve starting 
Fig. 62. 
from 0° represents the voltage induced in one coil 
during one revolution and the curve starting from 
90° represents the voltage of the other coil. But it 
will be seen that this curve does not truly represent 
the conditions, because at some points both coils are 
having current impulses induced in them ; as the 
two coils are in series the sum of the voltages in 
the coils should be taken and plotted out in another 
curve, as in Fig. 63. In this curve it appears that 
Fig. 63. 
the points where there was a double voltage in Fig. 
62 are now the highest points in the curve. With 
one coil we saw there were two waves or fluctua- 
tions per revolution ; with 40 coils there would be 
80 waves or fluctuations. Each fluctuation in the 
latter case would be a small one but it would be a 
fluctuation. For the purposes of incandescent light- 
ing such a current is called a "continuous" current 
and the fluctuations are not noticeable in the lamps 120 
CATAPHORESIS. 
or motors connected to the circuit but if we connect 
a telephone to such a circuit we can distinctly hear 
the hum or buzz produced by the fluctuations. 
We can put a 10-pound weight on a man's head 
without inconveniencing him, but if we hit his head 
a smart tap with a 2-ounce tack-hammer we will 
injure him severely. So, a constant pressure ex- 
erted by a galvanic current on a patient will be 
tolerated where the rapidly pulsating rat-tat-tap of 
the central station current could not be tolerated. 
Many practitioners are using the street circuit as 
a source of supply and are pleased with it, not 
appreciating that anything could be more desirable. 
There are, however, other dangers and inconven- 
iences to be met with in the use of dynamo currents 
(such as lightning, accidental "grounding" of the 
patient and variations in the potential of the lines 
due to variations in load) which, in the opinion 
of the writer, makes it most desirable to use the 
battery. He has employed both and therefore 
speaks from experience. 
If batteries are to be used, which is the best 
variety ? There are three styles largely used, viz., 
the "red-acid," the Leclanche and the "Dry" 
batteries. The " red-acid " battery is one in which 
a solution of bichromate of potash and sulphuric 
acid is the active solution, with zinc and carbon 
elements. This battery, while giving a high voltage 
per cell, rapidly polarizes, especially when much 
used on a " short circuit," or circuit of low-resist- 
ance. The Leclanche battery is almost too well- 
known to need description, being the type of battery 
used for electric bells and similar purposes. Its 
solution is one of sal ammoniac and water ; a BATTERIES AND CENTRAL STATION CIRCUITS 
porous cup containing a carbon plate and pulverized 
peroxide of manganese is placed in the sal ammo- 
niac, forming one pole of the battery, while a zinc 
rod also in the sal ammoniac acts as the other pole. 
The " Dry " battery is a modification of the Laclan- 
che and is very convenient, there being no solution 
to replenish or spill, or glass jars to break. When 
a cell of this class wears out or is used up (they will 
last about a year with ordinary usage), they are so 
inexpensive they can be thrown away with a clear 
conscience. 
For general therapeutic work it is desirable to 
have about 40 cells of battery available for use, and 
for dental work at least 20 cells are needed, though 
it is best to have 40 cells for use in special cases. 
The constant aim of the manufacturers is, as it 
should be, simplicity of apparatus. Several are 
now in a position to supply very convenient boxes 
or cabinets with dry-cells all arranged and con- 
nected, and with special directions for use. 
121 CHAPTER V. 
RHEOSTATS. 
Regulators of potential for purposes of cataphoric 
applications are a necessity, as has been abundantly 
shown. Such regulators should be so arranged 
that they will permit the current admitted to the 
patient to be easily controlled-made greater or less 
at will and by very small amounts at a time. This 
is particularly true in dental practice, as the nerves 
of the teeth are exceedingly susceptible to changes 
in current flow. Sensitive dentine is delicate 
material to operate upon, and it is absolutely essen- 
tial that the regulators should be capable of admit- 
ting the current by very easy stages. The generic 
name for regulators is " rheostat," although they 
are often called by other names, such as "volt- 
selector" or "adapter." 
Fig. 64. Series Relations. 
Broadly speaking, the rheostats on the market to- 
day belong to either one of two classes : (1) instru- 
ments comprising a resistance placed in series rela- 
122 RHEOSTATS. 
123 
tion to the patient, or (2) instruments in which the 
resistance is in shunt relation to the patient. It 
will be understood that when a current of electricity 
passes through two parts of a circuit, one after the 
other, those parts are in series, as are the lamps in 
Fig. 64, and when one part of a circuit is connected 
Fig. 65. Shunt Relation. 
Fig. 66. 124 
CATAPHORESIS. 
as a by-path to another part, so the total current is 
split, or divided, between the two, then the one part 
is arranged as a " shunt " to the other. (SeeFig. 65). 
Both series and shunt rheostats have strong 
advocates, each of whom thinks his own arrange- 
ment is far superior to any other. It will be instruc- 
tive to make a comparison between representatives 
of these two classes that we may draw our own 
conclusions. 
1.-The Clark & Mills Series Rheostat. This 
instrument is shown in Fig. 66 and is made in 
Boston. It consists of an enormous resistance 
(several million ohms) divided up into a large num- 
ber of steps. A diagram of the connections, fur- 
nished by the makers, is shown in Fig. 67 in con- 
nection with other apparatus deemed by them to be 
tME03TXT| 
TQ GROUND^ 
TO GROWNd 
TO PATIENT 
Fig. 67. 
desirable when the rheostat is used on an electric 
light circuit. 
It will be noticed that there is the same arrange- 
ment of resistances and apparatus in each side of 
the circuit, both positive and negative. This the RHEOSTATS. 
125 
makers term a "binary" arrangement and lay 
great stress upon it. As the same amount of cur- 
rent will go through the patient no matter which 
part of the series circuit he is put in, the only ad- 
vantage of the "binary" method of connection 
(outside of a certain symmetry in the arrangement, 
pleasing to the eye) is appreciated if there should be 
an accidental ground connection to the patient ; in 
such a case he might receive the full force of the 
total pressure as it took a short cut through him to 
the earth. In the diagram the fuses are intended 
to act as safety devices, cutting off the supply of 
current in case of an abnormal rush of current. 
The devices to which the ground wires are attached 
are lightning arresters-used when the central sta- 
tion wires are strung on poles in the open air, in- 
stead of being buried underground ; the " inductive 
resistances " are to assist in the same operation. 
The "wall-rheostats" are resistances intended to 
absorb a certain amount of the total voltage leaving 
only a portion of the total to be varied by the oper- 
ator. These resistances, as well as those in the 
variable portion of the apparatus, are made of 
graphite rods with metal tops upon which the neces- 
sary metal contact-shoes travel. At my request, 
Mr. Clark, one of the makers of this instrument, 
has written the following statement concerning it: 
"We claim for our instrument that it is a simple 
series rheostat of high resistance having many fine 
gradations. The series rheostat is the simplest of 
all forms and is the most economical in the use of 
current. This latter point is of comparatively little 
importance when the commercial circuit is used as 126 
CATAPHORESIS. 
the current costs but little, but is of more impor- 
tance in case a battery is used, as the battery is ex- 
hausted more quickly by using a shunt rheostat. 
A rheostat should have a high resistance, so that the 
resistance of the patient shall cut as little figure as 
is possible in proportion to the total resistance of 
the circuit. There are several reasons why this 
should be so. Take two cases : 
'' Case 1. Tooth resistance, contact resistance and 
body resistance is 50,000 ohms. With 10 volts ap- 
plied to patient 0.2 milliamperes will be flowing. 
Now, if better contact is secured at positive or 
negative terminal or if the cotton is dampened or if 
the tooth or body resistance should change so that 
the total resistance of patient should be lowered to 
25,000 ohms, then the current would increase to 0.4 
milliamperes or by 100 per cent. The shock or pain 
might possibly be quite great. 
" Case 2. Tooth resistance, contact resistance and 
body resistance is 50,000 ohms as before. Resistance 
in series with this is 450,000 ohms ; total resistance 
is thus 500,000. With a pressure of 100 volts the 
current flowing would be 0.2 milliamperes or the 
same as in Case 1. If the body, tooth and contact 
resistance now decreases to 25,000 ohms the current 
would now become 0.21 milliamperes or an increase 
of but 5 per cent and no shock or pain would prob- 
ably be observed. 
"If there is a movement of the applicator or when 
there is a poor contact in the circuit, a high voltage 
is of advantage in that it has a tendency to main- 
tain the circuit. If from this reason the circuit is 
kept from being broken the patient is spared a 
shock. A circuit with a high resistance and a high RHEOSTATS. 
127 
voltage with a given current flowing will, when 
broken, give a somewhat greater shock than will be 
given when a circuit is broken that has a low volt- 
age and low resistance and the same current flow. 
" It is the current that does the work and not the 
voltage. A higher voltage may cause a greater 
shock at make and break than a smaller one, but 
with a given current flowing steadily it makes no 
difference to the human system whether there is a 
high resistance and high voltage or a low resistance 
and low voltage. 
" To get a minimum current of 0.02 milliamperes 
with a pressure of 110 volts a resistance of 5,500,000 
ohms is required ; with 220 volts a resistance of 11,- 
000,000 ohms is required ; with 500 volts a resistance 
of 50,000,000 ohms is required. These tremendous 
Fig. 68. 
resistances are to be obtained only with graphite 
resistances which may be very reliable in some 
forms or very unreliable in other forms. About 
the only reliable form of these high resistances 128 
CATAPHORESIS. 
seems to be graphite rods. Secure metallic con- 
tacts should be made to them and the contact-shoe 
should move on these metal contacts." 
1 a. The Van Woert Current Controller.- 
This is a type of the series rheostat and constitutes 
one part of the Van Woert Apparatus for Catapho- 
resis, with cells and a low voltage. 
It is illustrated in Fig. 68. 
The base is of slate, with a raised surface at A, 
the same being covered with a thin layer of graphite ; 
the shoe B resting upon it, and connected with the 
arm C attached to the pinion F. The said pinion 
when turned to the right carries the shoe with it, 
which cuts down the resistance as it passes toward 
the opposite side of the circle, where the metal plate 
is affixed, and connected direct to the outlet. The 
wire shown under the worm-rod D is connected 
with the pinion F, and leads directly to the bat- 
teries. This worm-rod is for connection with a 
gear upon pinion F, which allows of a very slow 
and even movement of the shoe B. By pressing 
upon the lever E the worm-rod is thrown out of the 
gear, to allow of a rapid movement of the shoe by 
turning pinion F. 
As I have elsewhere said, I am in favor of using 
cells rather than the street current and therefore 
advise any good assemblage of parts into a so-called 
Apparatus. Such an outfit must necessarily in- 
clude a medical battery, current controller, milliam- 
peremeter, rheophores and electrodes, and it cer- 
tainly greatly adds to the convenience of the oper- 
ator to have all these parts combined in portable 
form. RHEOSTATS. 
129 
2.-The Wheeler "Fractional Volt-Selector."- 
This instrument is the invention of Mr. Geo. M. 
Wheeler of the Electric Therapeutic Co. of New 
York City, and a good general view of it is given 
in Fig. 69. The base is of solid mahogany, 7| 
inches in diameter ; the body is a metal cylinder 13 
Fig. 69. The Wheeler Fractional Volt Selector. 
inches high and 6 inches in diameter. On the top 
is a knob by which the regulation is effected, two 
binding-posts for the wires to the patient, a two- 
point switch for regulating the maximum voltage 
applicable to the patient, and a dial marked in 
volts with a pointer movable in relation thereto, 
moved by the turning of the knob. Thus, if this 130 
CATAPHORESIS. 
form of rheostat is used on a 110 volt circuit and 
the two-point switch is on the button marked 40' 
volts (the other button being marked 80 volts) the 
pointer on the dial can be moved-by moving the 
round knob-from zero to 40 volts. This means that 
a maximum of 40 volts can be applied to the patient, 
and if the pointer stands at 25 it shows that 25 
volts are available for application to the patient. 
When the little switch is on the 80 volt button the 
readings of the dial must be doubled to get true re- 
sults. This volt-indicating dial is not an electrical 
instrument but a mechanical device standardized 
PERMANENT RESISTANCE 
VARIABLE SHUNT 
C. 
■A0JUSTIN6. 
Knob 
2*Po>*«t 
SjglTCH 2 
>0 PATl ENT. 
Fig. 70. 
according to the known resistance of each step or 
change. The cord and plug on the right are for 
connection to the electric-light circuit, in this in- 
stance, although these instruments are also made 
for use with galvanic batteries. 
The makers of this instrument have furnished 
the writer with a diagram of its interior connections, 
which are published for the first time, being given 
in Fig. 70. 
The resistances are of german-silver w'ire wound 
on spools of fibre. Resistances A and B are wound RHEOSTATS. 
131 
on a spool placed inside another spool wound with 
the resistance C. It will be seen that if the two- 
point switch is on button No. 1. resistances A, B and 
C are all in series and are connected directly from 
+ to - and there is a completed circuit without the 
patient being in circuit at all. If the two-point 
switch is on button No. 2 the resistances A and C are 
in series across the line from + to -. The total re- 
sistance from + to - being less than before, more 
current will flow through the instrument. And 
now for the chief characteristic of this instrument: 
Instead of placing the patient in series with the re- 
sistance, he is connected in shunt relation to the re- 
sistance coil C ; thus, on one side he is connected 
to the negative (-) pole of the battery or other 
source, and on the other side to a travelling contact- 
shoe (moved back and forth by the knob or screw- 
threaded shaft), and the current instead of all going 
through the patient or all through the coil C, is di- 
vided, and only a portion will go to the patient. The 
coil C is wound in notches or spirally-cut grooves in 
its fibre spool, 63 to the inch ; so the contact-shoe, in 
moving from one end of the coil to the other, 
touches successively between 700 and 800 different 
turns of the wire-in other words, there are between 
700 and 800 different possible gradations in current 
flow. To understand clearly what this means, it 
5000' Ohms. 
5ooo Ohms. 
Fig. 71. 132 
CATAPHORESIS. 
will be necessary to cite an example, in which 
Ohm's Law will be of great assistance. 
If we have two resistances, a and b, each of 5000 
ohms, in series, and apply a pressure of 100 volts 
at the terminals (see Fig. 71) there will be a current 
of .01 ampere, 
r z , E 100 volts 100 
for C = =- = -=- = = .01 ampere. 
R Ra + R& 5000 + 5000 1 
If we now place a patient (whom we will call c), 
having a total resistance between contacts of 5000 
ohms, as a shunt around the resistance b we will 
have the arrangement shown in Fig. 72. 
5000 Ohms. 
5000 Ohms. 
C- 5000 
Ohms. 
Fig. 72. 
To determine the total current flow through the 
circuit as a whole under the new conditions we 
must apply a rule derivable from Ohm's Law and 
find the joint resistance of b and c. This rule is 
applied1 in this way : 
R _ R6 X Rc _ 5000 X 5000 _ 25,000,000__ 
60 R6 + Rc 5000 + 5000 10,007T" 
2500 ohms. 
1 This rule is as follows: To find the joint resistance of two re- 
sistances arranged in shunt relation to each other, divide the 
product of their resistances by the sum of their resistances. nil EOST A TS. 
133 
The total current flowing will then be : 
r E 100 100 , 
C " K+K " 5000 + 2500 " 7500 " -0183 
Compare this with current flowing in Fig. 71. 
How much current will flow through the patient 
(c) under these conditions ? If the joint resistance 
of the shunts b and c is 2500 ohms and .0133 ampere 
is flowing through them jointly, the voltage being 
expended on this part of the circuit is : 
E^ = C X = .0133 x 2500 = 33.25 volts. 
Then the current in patient will be : 
qc E6c = 33.25 volts 
Rc 5000 ohms 
.006 ampere or 6 milli- 
amperes. 
What will happen is we shunt the patient around 
only a part of the resistance b instead of all of it ? 
Let us see. If we shift the connection to a point 
5ooo Ohms. 
£=5000 Ohms 
X*25OO 
O«MS. 
Yx2500 
Ohms. 
Fig. 73 
C=SOOO 
: ohms. 
half way along b (as in Fig. 73) so that b is divided 
into two parts, a? and y, each of 2500 ohms, the joint 
resistance of y and c by the above-mentioned rule 
will be 1666 ohms. The total resistance of the 
circuit will then be : Ra 4- Rx + Ryc = 5000 + 2500 + 134 
1666 = 9166 ohms. The current flowing will then 
be (in entire circuit) : 
n E 100 volts 
C = ~ = ---; = .0109 ampere. 
R 9166 ohms 1 
Knowing the current and the joint resistance of 
y and c we can find the volts expended in y and c : 
Eyc = C X Rye =.0109 X 1666 = 17.1594 volts, and 
the current in the patient will be : 
CATAPHORESIS. 
Cc = 11.1594 volts = 
Rc 5000 ohms. 
.0034 ampere or 3.4 
milliamperes. 
We thus see that by shifting the connection 
coining from the patient along the shunt coil in the 
Wheeler rheostat we get variations of voltage (and 
consequently current flow) in the patient's circuit, 
and that these variations of current flow are 
exceedingly small, being less than a quarter of a 
milliampere for each step. 
Mr. Wheeler in writing to me about his instru- 
ment has this to say concerning the advantages 
resulting from its use : 
' ' In applying electricity to sensitive dentine (and 
this also holds good for other applications) we find 
that the resistance of the dentine varies from the 
instant the current is applied, and it is to this great 
change of resistance in the dentine that the pain 
consequent upon using a series rheostat is due. 
' ' The series control method causes pain because 
the aim of the operator is to keep the rate of 
current flow constant, for he knows that fluctuations 
of current flow cause pain to the patient. When 
the current is constant in a circuit the application 
of Ohm's Law shows that the voltage at the RHEOSTATS. 
135 
patient's electrodes varies, and varies in proportion 
to the changes of resistance in the patient. As the 
total energy dissipated in the patient (watts) equals 
the square of the current multiplied by the resist- 
ance of the patient, we see that when the resistance 
of the tooth or its contacts increase, the watts 
dissipated in that tooth increase ; as the operator 
cannot tell how the tooth-structure is varying in 
resistance it is practically impossible for him to 
maintain a non-fluctuating voltage." 
He then shows by a series of calculations, not 
necessary to reproduce here, what is quite apparent 
after a little thought, namely, that by the series 
method the amount of energy (watts) dissipated in 
a tooth is doubled if the resistance of the tooth 
is doubled, while by the shunt method the watts 
are reduced one-half when the resistance of the 
tooth is doubled-if the volts at the electrodes are 
constant in each case. 
In a previous chapter we have seen that the watt 
is the rate at which work is done or energy 
expended ; also that if the rate of expenditure of 
one watt is maintained for one second a quantity 
of work is done or energy expended which is called 
a joule. How is the energy expended in an electric 
circuit ? It is expended or dissipated in the form 
of heat. Incidentally certain effects are produced 
while the energy is being dissipated as heat. For 
example, when a current of electricity is passed 
through an electrolyte there is a transference of 
atoms due to the passage of the current only, and 
the energy dissipated during one second in producing 
that transference is dissipated as heat, and is equal 
to the square of the current passing through the 136 
circuit multiplied by the resistance of the electrolyte 
(joules, per second = C 2 R). 
The electro-therapist must consider that the heat 
dissipated in the patient varies at a different rate 
from the variation in the cataphoretic effect. The 
heat dissipated varies as the square of the current 
flowing through the circuit, while the cataphoretic 
effect varies directly as the current. 
Let us illustrate : If a current is flowing at the rate 
of one ampere through an electrolyte in which the 
terminals are silver elements and the resistance of 
the electrolyte is 10 ohms, there will be a transfer- 
ence of silver from one element to the other of 
1.118 milligrammes per second, and the heat dissi- 
pated in securing this transfer will be (1 ampere) 2 X 
10 ohms = 10 joules per second ; should the current 
rate be increased to 2 amperes there will be a 
transfer of 2.236 milligrammes per second and the 
heat dissipated in securing this transfer will be 
(2 amperes) 2 X 10 ohms = 40 joules per second. 
From a careful consideration of the questions 
involved we may reach the following general con- 
clusions : 
1.-The physiological effect of a given rate of 
current flow through human tissue is the same 
whether high resistances and high initial voltages 
or low resistances and low initial voltages are used, 
providing there are no fluctuations in the current ; 
the heating effect and the cataphoretic effect will 
be the same. 
2. When there is a fluctuation in the resistance 
of the patient the shock is much greater with high 
initial voltage than with low, and greater with a 
series rheostat than with a shunt. 
CATAPHORESIS. RHEOSTATS. 
137 
3. A constant rate of current flow maintained 
through tissue will produce as much pain under 
changes in the resistance of the tissue, whether the 
series or shunt rheostat is used. 
4. A wire coil resistance is much more convenient 
and cleanly than graphite in any form, and far more 
reliable for continued use. 
5. A shunt rheostat uses more current than a 
series rheostat ; this is not important when a shunt 
rheostat is guaranteed not to run a battery down in 
less then a year with ordinary usage. 
6. A shunt rheostat will permit a finer gradation 
in the steps or changes in current applied to the 
patient than in the series variety. 
Because of conclusions 2, 4, and 6, my personal 
preference is for the shunt method of control. CHAPTER VI. 
MILLIAMPERE METERS. 
We have seen from what has already been writ- 
ten that it was exceedingly desirable that the opera- 
tor have some means at hand for determining the 
electrical conditions of his procedures. We have 
also seen that an instrument called a milliampere 
meter has been often referred to as the device which 
should be used for this purpose. A milliampere 
meter is an instrument for determining the rate of 
current flow through a patient, and in that manner 
obtain information as to what is going on inside of 
that patient. In Fig. 74 we have a diagram repre- 
senting a shunt rheostat connected with one set of 
conductors to a source of electricity and with the 
patient through a milliampere meter by another set 
of conductors. We thus have the milliampere 
meter in series with the patient so that the current 
which goes to the patient must also go through the 
milliampere meter and thus make its presence 
known. 
, BATTERY 
RHEOSTAT 
PATIENT. 
Fig. 74. 
138 MILLIAMPERE METERS. 
139 
Some may not think it necessary to have any 
meter, believing that it is only a question of giving 
the patient all he can stand. It is possible that in 
a few isolated cases such a method of procedure 
might be permissible, but in the vast majority of 
cases it would be as unsatisfactory to administer 
electricity in this manner as it would be to feed a 
person drugs in as large quantities as he is willing 
to consent to, rather than give a measured dose cal- 
culated to produce a given result. In addition to 
measuring the rate of current flow the milliampere 
meter fills other important offices. Every variation 
in the resistance of the patient or of the electrode 
contacts is reflected by the meter in its fluctuating 
indication ; every cry of pain or expression of dis- 
comfort on the part of the patient finds an explana- 
tion from the milliampere meter's reading. Its use 
gives the operator the equivalent of a sixth sense, 
for he is able to see, mentally, what is going on 
beneath the surface. An ordinary incandescent 
lamp of 16-candle power burning on an electric cir- 
cuit. having a potential between its two conductors 
of 110 volts requires about one-half an ampere of 
current. But half an ampere, or 500 milliamperes, 
is an enormous amount of current for an electro- 
therapist to use. In almost all classes of general 
applications of electro-therapeutic measures 100 
milliamperes is very rarely exceeded, and in ordi- 
nary practice 20 or 30 milliamperes will be found 
more largely used. Some classes of work require 
very small currents, for if an application of, say, 5 
milliamperes is made, an evil may result which 
would have been escaped had only 2 milliamperes 
been used. Again, in dental work, it is necessary 140 
CATAPHORESIS. 
to work with very minute currents-as low in some 
cases as 0.2 of a milliampere. 
An instrument for use by either general medical 
practitioners, or by members of the dental profession, 
must therefore possess certain characteristics to be 
of value, and we will give a statement of these 
characteristics paraphrased from a report1 of a 
committee which has given most careful considera- 
tion to the subject: 
1. A good meter should have a clear, legible scale, 
fairly uniform over the range, and not crowded at 
different points. 
2. The scale should be so clear that the operator 
can read it while working on his subject. 
3. The internal resistance of the meter should be 
low. 
4. There should be no tendency to overheat with 
the strongest current employed. 
5. The instrument should be capable of indicating 
in all positions. This, however, is only possible in 
those meters not of the galvanometer type, and even 
then a change from the most favorable position is 
at the expense of delicacy of indication. 
6. Any instrument whose indications depend 
directly upon the local magnetic force is objection- 
able, for the reason that its indications are liable to 
be affected by iron in the vicinity or other outside 
magnetic influences. This is true of all instruments 
of the galvanometer type, which is that type in which 
the current to be measured passes, not through 
an armature coil, but around the electro-magnet 
1 See Report of Committee on Meters of American Electro- 
Therapeutic Association in Transactions for 1893, page 18. MILLIAMPERE METERS. 
141 
which influences the position of a magnetic needle 
suspended within its field of force. 
7. The suspension system should be delicate and 
sensitive, and at the same time be unlikely of de- 
rangement in use or shipment. All purchasers of 
meters should demand a guarantee that an instru- 
ment should be delivered at its destination in good 
order. 
8. It is an advantage for the meter to indicate 
with the current passing in either direction. How- 
ever, this is not a consideration which should take 
precedence at the expense of accuracy. A little pole 
changing switch introduced in circuit with the 
meter will enable the operator to always have his 
current to flow in the right direction to his patient. 
9. A meter should be portable and not readily 
broken or put out of order or adjustment. 
A convenient meter for general use is one capable 
of indicating for two different rates of current flow. 
By this is meant the employment of two scales on 
the meter, either one of which may be used at the 
will of the operator. A very excellent arrangement 
is to have one scale read from 0 to 10 milliamperes, 
in steps of tenths of milliamperes and another scale 
to read from 0 to 100 milliamperes in steps of 1 mil- 
liampere. All that is necessary is to turn a button 
and either scale will be in use. 
In concluding this chapter I beg of each operator 
to use a milliampere meter in his operations and find 
what a comfort its use will bring ; also, do not be 
led to believe that it is economy to use a very 
cheap instrument. CHAPTER VII. 
MEDICAMENTS. 
The following laws governing the absorption of 
medicine through the tissues regardless of electricity 
have been formulated (L'Union Pharmaceutique) by 
Professor Lewin, of Berlin : 
1. Every healthy mucous membrane absorbs 
medicaments in direct ratio to the surface in contact 
therewith, barring modifications produced in the 
membrane by the chemical or physical action of the 
medicament. The only exception to this rule is the 
vesical mucous membrane, which has no power 
of absorption, even under the influence of irritant 
agents. 
2. Each unit of mucous surface possesses an ab- 
sorbing power in direct ratio to its own temperature. 
3. The healthy skin does not absorb non-modifi- 
able medicaments which do not irritate it, whether 
applied in aqueous solution or pomades ; under such 
conditions they can never penetrate to the blood. 
But absorption may follow either when the medica- 
ment is caustic and wounds the skin, or when it is 
dissolved in a volatile vehicle such as alcohol, ether, 
chloroform, etc. Certain agents, very finely incor- 
porated in fat, may, after the application of pro- 
longed friction, provoke redness of the skin and 
penetrate the circulatory apparatus. 
142 MEDICAMENTS. 
143 
4. The serous membranes, the muscles and the 
tissues of the parenchymatous organs, behave like 
the mucous membranes. The healthy corneal tissue 
does not absorb. 
5. The respirable gases and the vapors are intro- 
duced into the blood through the lungs. 
6. Wounds absorb just as do the mucous mem- 
branes ; the same is true of corneal ulcerations. 
MM. Linossier and Lannois1 have studied experi- 
mentally the absorption of iodine by the skin, also 
without electricity, and have arrived at the follow- 
ing conclusions : 
Iodine applied by bandages is absorbed by the 
cutaneous surface especially when one has taken 
the precaution to exclude the air from the region 
bandaged. Under these circumstances the quantity 
of iodine eliminated by the urine can reach almost 
a third part of the quantity placed upon the skin. 
Under the conditions of the experiment the pulmon- 
ary absorption is negligible. 
The maximum absorption is at the beginning of 
the application and before the alteration of the skin 
occurs to any considerable extent. 
Other volatile iodine combinations can be absorbed 
in very considerable proportions, and can even be 
employed in this manner for the purpose of general 
iodine medication. 
For instance, following the application of 9 to 10 
grammes of iodide of ethyl (every precaution being 
taken to prevent pulmonary absorption), a quantity 
of iodine corresponding to a gramme of iodide of 
ethyl may be found in the urine. 
In using iodine cataphorically I prefer a solution 
1 " L'Echo Medicale du Nord," Lille, May 2, 1897, page 186. 144 
CATAPHORESIS. 
of iodine in water to the tincture. Water ordinarily 
takes up but one part in five thousand of iodine, but 
by adding a little iodide of potassium aqueous solu- 
tions of any desired strength may be obtained. 
LIST OF MEDICAMENTS. 
A list of a number of the medicaments which 
have been found useful in cataphoretic applications 
is given below. As a general proposition it may be 
stated that all drugs which are themselves con- 
ductors of electricity, or which may be made con- 
ductors by combination with other drugs, can be 
used cataphorically. 
Ether, Chloroform, Aconite, Strichnia, Hydro- 
chlorate of Eucaine, Hydrochlorate of Cocaine, 
Guaiacol, Pilocarpine, Menthol, Aconitia, Onabain, 
Strophanthin, Carbolic Acid, Strychnine, Helleborin. 
Iodide of Potash, Tincture of Iodine and Aqueous 
Solutions of Iodine, Bichloride of Mercury, Iodo- 
form, Salicylic Acid, Salol, Antipyrine, Methyl 
Salicylate, Carbolic Acid, Alcohol, Glycozone, Hy- 
drozone, Pyrozone, Nitrate of Silver, Chloride of 
Sodium, Borolyptol, Witch Hazel, Borine, For- 
maline, Chloride of Zinc, Trichloride of Iodine, 
Pentachloride of Phosphorus, Chloride of Potas- 
sium, Chloride of Platinum, Trichlorphenol, Lysol, 
Pyoktanin, Benzoic Acid, Thymol, etc. 
This list may be indefinitely extended. PART IV.-APPLICATIONS IN MEDICINE 
AND GENERAL SURGERY. 
CHAPTER I. 
SIMPLE CATAPHORESIS. 
By simple cataphoresis we mean what is generally- 
known as " Porret's Phenomenon," or what has 
been previously defined as electrical endosmose- 
the carrying of liquids through human tissues or 
other porous septa by the action of an electric cur- 
rent. This action has long been recognized, but it is 
only in late years that it has received any worthy 
attention-an attention mainly the result of labor- 
atory experiments upon the lower animals and upon 
dead animal tissue. 
Among such experiments, almost unique and 
especially worthy of mention are those of G. N. 
Stewart, physiologist, in Owens College Physio- 
logical Laboratory, Manchester, England. He 
showed that in all animal liquids when separated by 
a porous septum there was an immense transfer- 
ence of water from the positive to the negative 
compartment, also a distinct movement of pig- 
ments and proteids. In one experiment, in an hour 
and a half, with a current of only five milliamperes 
145 146 
the volume of a 3.6 per cent haemoglobin solution 
had diminished 40 per cent in the positive compart- 
ment and increased to a corresponding degree in the 
negative. Another experiment showed that in a 
two hours' electrolysis of bile with a current of 65 
milliamperes, no less than 92 per cent of the water 
had disappeared from the positive compartment, 
which originally contained 10 c. c. of the liquid. 
When 70 grams of rabbit's muscle with no porous 
septum was electrolyzed for 30 minutes by a current 
of 350 milliamperes, the water in the cathodic half 
was found to exceed that in the anodic half in the 
proportion of 48 to 31 and the salts in the proportion 
of 48 to 23. 
In a living rabbit Stewart passed a hollow metal- 
lic electrode into the vagina ; when this electrode 
was a cathode, fluid was forced through it, while 
none appeared when it was an anode. In this case 
it might be queried if the flow was not due to in- 
creased secretion due to the stimulating effect of 
the cathode, but there was little doubt that cata- 
phoresis was the main factor in its production. 
These experiments are not cited to show the pos- 
sibility of cataphoresis, for of this there is no doubt, 
but to show the very large amount of the transfer- 
ence of fluid which may take place in tissue. The 
fluid transfer also includes the removal of the sub- 
stances dissolved in it, mainly salts. The import- 
ance of these latter to the maintenance of healthy 
nutrition is well known. Normally varying from 
one to two per cent, in muscle, nerve and other tis- 
sue, a decided change in the percentage produces a 
marked effect upon their vitality and their nutri- 
tion. 
CATAPHORESIS. SIMPLE CATAPHORESIS. 
147 
The importance of this fluid-conveying power and 
its concomitant deprivation of salts from the tissues, 
both by cataphoric removal and by electrolysis, is 
scarcely yet appreciated. 
The haemostatic and drying effect of the positive 
electrode may well be due to the removal of fluids, 
while the ''liquefying" and "hemorrhagic" effect 
at the negative pole is equally due to cataphoresis. 
Granting the softening effect of the negative pole 
upon urethral stricture, is it not largely due to a 
liquefaction by the flow of fluids to it ? 
In a minor way it has long been noted that the 
eschar at the negative pole was soft and liquid while 
that at the positive pole was dry and hard, also that 
the negative needle in surgical electrolysis is loose 
and free in the tissue, while the positive needle, 
even though of unoxidizable material, was held 
firmly. 
On a larger scale and in general, cataphoric ac- 
cumulation of fluids at the negative pole is indicated 
in the resorption of tumors and of exudations. The 
application of the action to uterine fibroids and to 
inflammatory exudations is obvious. In the former 
case the continuous current produces a contraction 
of the uterus and diminution of the vascular supply 
of the tumor with a loss of its salts. Its nutrition 
becomes impaired and a reduction in size is accom- 
plished. In the latter case the starvation of its 
salts alone is the most important element in caus- 
ing absorption and dissipation. 
The cataphoric action of the current is also indic- 
ated in chronic rheumatic affections of joints and in 
thickening of synovial membranes about the sheaths 
of tendons. 148 
CATAPHORESIS. 
In short, in determining upon what action of the 
current to appeal to in order to accomplish denutri- 
tion and absorption, cataphoresis comes saliently to 
the front. 
This well-known phenomenon of simple catapho- 
resis has long been recognized by the classical writers 
of electro-therapeutics, Erb, Remak, Lewandowski, 
and others, as an essential feature in the production 
of curative results of electro-therapy. But its 
nature was so obscure that it was impossible to dif- 
ferentiate it from other properties of the same cur- 
rent. For this reason Remak invented the term 
"catalysis" including under this heading catapho- 
resis and electrolysis, and incidentally effects upon 
the tissue due to dilatation of blood vessels and 
lymphatics and local increase of bulk in nerve and 
muscle fibres and cells, as well as finer molecular 
changes in vital structures beyond the present power 
of science to define. The sum total of such changes, 
however explainable, results in an alteration of 
nutrition of the tissue-in other words, modifies its 
metabolism. CHAPTER II. 
CATAPHORIC MEDICATION OR ELECTRIC MEDICAMENTAL 
DIFFUSION. 
In the foregoing chapter the phenomenon of simple 
cataphoresis has been considered, and we have seen 
that whatever effect was produced, was due to the 
action of the current only and not to any drug 
which such a current was capable of transporting 
through the tissues. 
That medicinal substances do penetrate the skin 
under the propulsive force of an electric current is 
now beyond doubt. To what extent this method of 
introducing medicine to the human system may be- 
come of practical utility in general medicine, be- 
comes an important question. There are obvious 
reasons why the method cannot compete with the 
introduction of the same medicine into the stomach 
in some cases, and there is also some difficulty in 
measuring accurately the dose administered. But 
there are certain practical and theoretical advan- 
tages in its use, as, for instance, when the tissue to be 
affected is superficial and local. This is often the 
case in diseases of the skin, in ulcerations, lupus 
and cancer, and in superficially situated neoplasms 
like a syphilitic gummata. To avoid the action of 
149 150 
CATAPHORESIS. 
the fluids of the stomach upon medicines is also 
sometimes to be desired, and there is a special effi- 
ciency in drugs introduced into the system in their 
nascent state. 
The diffusive property of the current, taken ad- 
vantage of in connection with human tissue, opens 
out to electro-therapy and general medicine an im- 
mense and fascinating field of study and practice 
and in many important directions points out en- 
tirely new treatments of a great variety of diseases 
thus far not commonly treated in this manner. 
By cataphoric medication we mean the specific 
introduction of drugs or medicaments into living 
tissue ; this may be done in two ways, viz., by 
employing solutions in contact with non-oxidizable 
electrodes or by employing electrodes which are 
attacked by the chemicals formed at either pole by 
the action of the current upon the fluids of the 
tissue and upon the electrodes. The first method 
includes, whether in medicine or dentistry, the gen- 
eral introduction of drugs, electro-cocaine local 
anaesthesia, the anaesthetization of sensitive den- 
tine or of the gums, the bleaching and sterilization 
of teeth, as well as incidentally the removal of 
drugs from the system, termed " cataphoric demedi- 
cation." The second method comprises the electric 
diffusion from soluble electrodes into the tissue. 
It is thought best to speak of these various divisions 
in different chapters and to confine our attention 
here to medication from insoluble electrodes with 
non-anaesthetic drugs held in solution and projected 
from such electrodes into the tissue. 
The fundamental principles upon which the in- 
troduction of medicine into the human tissue by CATAPHORIC MEDICATION. 
151 
cata- or ana-phoresis are based, have already been 
sufficiently dwelt upon in preceding chapters. It 
is sufficient to say here that I do not believe that the 
substances introduced are decomposed by electrolysis, 
and we may relieve ourselves of the confusion de- 
rivable from an appeal to ionization of the medica- 
ment. For these reasons we have refrained from 
quoting the numerous electrolytic theories lately 
advanced. 
It is not, of course, denied that electrolysis oc- 
curs, as I have previously pointed out, but I would 
claim that electrolysis is incidental for purposes of 
current flow, and that this current carries with it free 
and neutral molecules subjected to no electrolysis. 
Dr. Frederick Peterson early 1 published some ex- 
periments on the application of drugs cataphorically 
for the relief of neuralgias, and the following are 
given as characteristic examples in the hope that 
they may be suggestive to others. 
" Cataphoresis in a Case of Supra-orbital Neu- 
ralgia.-Dr. E. C. Seguin kindly placed at my dis- 
posal an obstinate and severe case of right supra- 
orbital neuralgia. L. E., female, aged forty. Du- 
ration of neuralgia, a year and a half. Everything 
tried unavailingly. Suffering every few minutes with 
the usual agonizing pains of the disease. There 
was slight analgesia over right half of the forehead 
and right side of nose, but exquisite hypersesthesia 
of the tactile sense in the same areas, so that a 
slight touch or breath of air was exceedingly pain- 
ful. There was great tenderness on pressure. The 
two-ctm. square anode with a ten-per-cent, solution 
of cocaine was placed in the right supra-orbital 
1 " New York Medical Journal," April 27, 1889. 152 
CATAPHORESIS. 
region over a painful spot, and the eight by twelve 
ctm. sponge and wire cathode in the right palm. 
Nine Grenet cells were used for three minutes, then 
raised to eleven cells for two minutes longer, which 
caused prickling but no pain ; and then raised to 
thirteen cells, which was too painful, and was re- 
duced to twelve cells and continued for five min- 
utes. The whole application lasted ten minutes 
without break of current. There was no neuralgic 
pain during this time and the hyperaesthesia had 
disappeared. There was the expected anaesthesia. 
The patient was completely relieved from pain for 
from four to five hours. 
4 4 A second similar application was made the next 
day in the same case by Dr. Seguin at his office with 
equally gratifying results. 
"Same case and same electrodes as in No. 12. 
Seven Grenet cells, five milliamperes current 
strength, ten-per-cent, solution of cocaine, six min- 
utes' application. Equal relief. 
4 4 Same case and details. Eleven cells, ten-per- 
cent. solution of cocaine, six minutes. Equal 
relief. 
"Same case. Application by Dr. Seguin. Ten- 
per-cent. solution of cocaine, fifteen milliamperes 
current strength, twenty minutes' contact moving 
slowly over different parts of right supra-orbital 
region. Very great relief for five hours. 
44 Same case. Sixteen to twenty cells, ten-per- 
cent. solution of cocaine, five to seven milliamperes 
current strength, nine minutes. Same relief. In 
this case aconitine pushed to its toxic effects did not 
relieve pain. The cataphoric application is still in 
use in this case, and always with the marked re- CATAPHORIC MEDICATION. 
153 
suits mentioned. Latterly several applications of 
the anode with a twenty-per-cent, solution of cocaine 
have been still more distinctly beneficial. On one 
occasion she had eleven hours of perfect freedom 
from pain, the longest interval of relief in a year 
and a half. Whether any actual curative effect 
will be produced it is now too early to determine. 
The patient herself is so convinced of the efficacy of 
this method that she will now try nothing else." 
' ' Relief in a Case of Double Trigeminal Neural- 
gia from Cataphoric Use of a Mixture of Cocaine 
and Aconitine.-E. B., female, aged thirty; excru- 
ciating double trigeminal neuralgia of a year's 
standing, upper two branches. Had tried blisters, 
electricity, and aconitine internally, and once had 
morphine habit. No day without pain. Twenty- 
eight chloride - of - silver cells. Water rheostat. 
Twenty-per-cent solution of cocaine on anode one 
centimeter in diameter to right temple over painful 
spot for twelve minutes. Cathode six by ten centi- 
meters in right palm. Complete anaesthesia and 
analgesia and relief in that side. Same for five 
minutes to left temple with like beneficial result. 
Then four minutes over main trunk of nerve in 
front of right ear with a mixture of equal parts of 
twenty-per-cent, solution of cocaine and the solution 
of aconitine (gr. iv to 1 ounce), causing deep anaes- 
thesia to touch and pain. With this last there was 
slight burning sensation at first, but it subsided in a 
minute or two. Relief from pain experienced for 
several hours." 
" Relief of Dorsal Neuralgic Pains in Locomotor 
Ataxia by Aconitine Cataphoresis.-S. B., male ; a 
case of locomotor ataxia suffering from intense neuralgic pains in the back at mid-dorsal region. 
Cathode on left side of abdomen. Anode one centi- 
meter in diameter with aconitine as in No. 24 to 
region of greatest pain. Fourteen Leclanche cells, 
five to six milliamperes current strength, four 
minutes' application. A white elevated disc larger 
than the area of anode was produced which was 
completely analgesic and anaesthetic for an hour, but 
in which there was a burning - sensation for an 
equal length of time. The neuralgic pains were 
relieved for eight or nine hours. This was tried 
again a few weeks later with ten minims of tincture 
of aconite on the anode, with equal effect. 
The most general form of procedure in securing 
medicamental diffusion is the electric bath. Bossi 
was the first to attempt to introduce medicines into- 
the body by means of the electric bath. 
Gartner and Ehrmann employed the cataphoric 
introduction of mercury by means of the 2 cell bath 
of Gartner.1 He placed from 4 to 6 grams of 
bichloride of mercury in the bath employing about 
100 m. a., for 15 to 20 minutes. An examination of 
the urine showed as much as 0.7, 0.3 and 1.3 m. g. 
of mercury present. Ehrmann employed this method 
in 34 cases of syphilitic diseases, the maximum 
number of baths being 54 in any one case. Toward 
the end of the treatments he employed the baths 
either every day or every other day, reducing the 
bichloride of mercury to 2 grains per bath. 
In Prof. Lang's clinic Kronfeld made use of 
Ehrmann's bath in the manner described. He has 
154 
CATAPHORESIS. 
1 " Elektrodiagnostik und Elektrotherapie," Lewandowski. 
Wien undLiepzig, 1892, p. 448. CATAPHORIC MEDICATION. 
155 
published eight cases in which he cured syphilis. 
(See " Hedley " p. 99.) 
Instead of using a full bath, tubs may be used for 
the feet and legs and basins or jars for the hands 
and arms. The tub employed should be of ■wood or 
porcelain and the medicated solution forming the 
body of the bath is made to constitute a positive 
pole by dipping into it a carbon plate connected to 
the battery. This may be protected by insulating 
material. The negative pole is a rod of brass 
several inches in diameter laid transversely across 
the tub around which may be placed wet towels, 
sponges, punk or similar substances which can be 
held in the hand and brought against the arms so 
as to gain a large surface of contact. 
Those desiring to give extensive attention to this 
branch of cataphoric medication are referred to a 
recent and most admirable treatise upon the general 
subject of electric baths and hydro-electric methods 
in medicine by W. D. Hedley, M. D., of London.1 
Further applications may be made with electrodes 
already described and will most naturally be of 
great variety according to the disease to be treated. 
Cataphoresis has been mentioned as applicable in 
the treatment of consumption, by Dr Crotte. For- 
maldehyde is inhaled in a gaseous form and static 
electricity is at the same time applied to the chest. 
This would seem to be an initiative in a direction 
which may later be followed in a manner which 
will better appeal to our judgment. 
In gynecological practice it is often desirable to 
introduce various remedies, for the purpose of 
1 " The Hydro-Electric Methods in Medecine," by W. D. 
Hedley, M. D., London, 1896. 156 
CATAPHORESIS. 
causing their absorption into the pelvic organs or 
mucous membranes. For general applications no 
better apparatus can be suggested by the writer 
than that illustrated in Fig. 39. The mucous sur- 
faces of the vagina readily absorb iodide of potash, 
iodoform, salicylic acid, salol, watery solutions of 
iodine, mercurials, salts of the alkaloids, etc. For 
more local applications, such as electro-cocaine, local 
anaesthesia of the cervix, the electrode shown in 
Fig. 33, should be employed. 
In the treatment of diseases of the skin, catapho- 
resis would seem to be peculiarly applicable. In 
these diseases absorption is commonly promoted by 
emollients, but absorption would be greatly enhanced 
by the cataphoric power of the electric current. 
For such cutaneous disorders as are commonly 
treated by painting with iodine the use of some of 
the iodine preparations, such as potassium, sodium 
or lithium iodide, iodol or diluted aqueous solution 
of iodine is called for. 
Woodbury reports a case of cutaneous syphilitic 
neoplasm treated by the cataphoric application of 
iodide of lithium1 and Shoemaker2 has employed 
cataphoresis in general cutaneous affections. 
I have employed the cataphoric introduction of 
drugs extensively in the treatment of rheumatic 
and gouty joints. The following case will serve to 
illustrate the general scope of many others. 
April 13, 1894, Mrs. S. A. A., set. 45. Gouty 
knuckles, deformity, pain, existing for about 10 
years : the first and second joints of both hands 
about equally affected. Rubber ''umbrella rings," 
1,1 Medical News," Philadelphia, June, 1890. 
2" Sajons's Annual," 1890. CA TA PHOBIC MEDIC A TION. 
157 
see Part I., Chap. IV., were passed on to each finger 
to cut off the circulation and the fingers dipped up 
to about the level of the rings into a solution of 
Bromide of Lithium. Fifteen milliamperes of cur- 
rent was passed during fifteen minutes, positive elec- 
trode placed in the water. Great relief for 24 hours. 
April 30, May 3, 5, and 7. Same treatment and 
continued improvement. 
May 5. A saturated solution of piperazine was 
placed upon blotting-paper wrapped about the distal 
joint of the index finger (the joint most affected) 
and a piece of platinum foil wrapped about the 
blotting-paper made a positive pole, conveying 10 
milliamperes during ten minutes. 
May 9. Patient reports that this joint feels very 
much better and softer and is smaller. 
May 14. Both lithium and piperazine treatment 
as above described were repeated at intervals until 
June 2, when Tetra Ethyl Ammonia, a few drops 
on blotting paper, was substituted for piperazine. 
The knuckles now presented quite a creditable ap- 
pearance and exhibited scarcely any traces of en- 
largement. In my experience I find that if the 
gouty enlargements of knuckles are soft and of 
recent formation they may be dissipated, while if 
hard and chalky they cannot be dispersed. 
The chloride, benzoate and citrate of lithium are 
all very soluble salts and may be used with the 
positive pole in the above manner. The mercurial 
salts and aqueous solutions of Iodine are well 
adapted for cataphoretic purposes. 
The rhinologist and laryngologist will find the 
method particularly adapted to the treatment of 
many difficulties of the upper air passages which 158 
CATAPHORESIS. 
may require the application of anaesthetics, astrin- 
gents or antiseptics. 
Among other interesting and useful applications 
is that by Dr. P. Aubert,1 of Lyons, of pilocar- 
pine as a sweat-producer. M. Aubert uses for a 
novel purpose the well-known fact that pilocar- 
pine introduced into the system will induce per- 
spiration. He applies a solution of pilocarpine 
at the positive electrode and produces local sudation, 
limited strictly to the area subjected to the treat- 
ment or beneath the electrode. Realizing that the 
sweat is rich in chlorides, and especially chlorides of 
sodium, he is able, by an ingenious method of pro- 
cedure, to obtain what he calls "sweat prints " or a 
record of the points at which sudation has taken place 
or, in other words, the number and disposition of 
the sweat-glands. His method is as follows : He 
induces cataphoric local sudation and then applies a 
piece of clean white paper, free from treatment of 
any kind, to the region where this effect has been 
produced. Each orifice of the sweat glands leaves 
on the paper a minute drop of a chloride solution. 
When the paper is raised and brushed over with a 
weak solution of nitrate of silver the chloride spots 
are acted on and chloride of silver is formed at such 
points. An examination at the light reveals by the 
little black dots of chloride of silver the points 
where sudation has taken place. 
Pilocarpine can only be introduced when in a solu- 
tion with water, alcohol or glycerine. The ques- 
tion arises whether, in applying medicaments cata- 
phorically, it would not be wise to add a little pilo- 
carpine to the solutions and thus help to open up 
1 " Archives d'Electricite Medicale," Nov. 15, 1895, page 441. CATAPHORIC MED IC A TION. 
159 
the sweat glands and make better pathways for the 
introduction of the medicament. 
Conversely to cataphoric medication I will make 
a brief reference at this point to cataphoric de-medi- 
cation. The earliest hint as to the possibilities of 
this procedure was derived from the experiments of 
Vergnes described in Part I., Chapter II. But 
Vergnes's experiments related entirely to the re- 
moval of local metallic deposits from open lesions, 
like, for instance, an ulcer. It occurred to me that if 
metals could be introduced into living tissue that it 
should also be possible to reverse the process or re- 
move them. This I have found to be true. The opera- 
tion can be performed in cases of lead, copper, arsenic 
and other metallic poisoning. The patient is placed 
in a bath as already described, but in place of consti- 
tuting the solution of the bath positive, it is made 
negative, while the positive electrode is a large sheet 
of carbon brought into generous contact with the 
arms and hands. Into the bath solution in the case 
of copper poisoning is allowed to dip a clean sheet 
of iron, say two square feet in dimension. Upon 
turning on the current up to about fifty milliamperes 
and allowing it to flow for about half an hour, 
always within the limits of comfort to the patient, 
it will be found, after the cessation of the treatment, 
that a deposit of copper has occurred upon the iron 
plate. The water of the bath should be slightly 
acidulated with sulphuric acid. 
This treatment of cataphoric de-medication must 
not be confounded with that of introducing iodide 
of potash cataphorically to serve as a solvent to the 
lead salts in the tissues. This of course is perfectly 
feasible, not only in the case of lead but in that of 160 
CATAPHORESIS. 
other forms of metallic poisoning and with other 
reagents. 
In 1896, Dr. Van Marter, who had read of my ex- 
perimentation along this line, brought to my atten- 
tion a severe case of copper poisoning, being himself 
satisfied that the treatment was not only indicated 
but also likely to be successful. The patient was 
admitted to the Post-Graduate Hospital, Feb. 10, 
1896. The case was as follows, and since there exists 
so little literature upon the subject I will cite Dr. 
Van Marter's notes, which include a good deal of 
original investigation on his part, in extenso. 
" N. Greene, colored, worked eight years in fluxing 
room, Ansonia Brass & Copper Co., last three years 
didn't wear sponge, having gotten "used" to the 
fumes. Lost weight and strength steadily, had 
fever, green sweats, colics, chronic cough. Exami- 
nation in Dec., 1895, showed no tubercle bacilli in 
sputum, general bronchitis ; severe laryngitis. On 
examination the vocal chord showed plainly a green 
stain, quite dark and general, blue line on gums ; 
metallic taste in mouth ; hair stained bluish-green. 
His condition was bad, and every indication of tuber- 
cular laryngitis (of which he subsequently died) 
except tubercle bacilli. However, there being no 
question as to cause, and as he agreed to be experi- 
mented on, I sent him to the Post-Graduate Hos- 
pital for Dr. Morton's experiment, which conclu- 
sively proved the correctness of the " a priori " views 
in regard to the electric de-cataphoresis. The man 
was, however, so far gone and so weak that the ex- 
periments were discontinued, and he returned home 
to die slowly in peace. CATAPHOBIC MEDICATION. 
161 
" Chronic copper poisoning occurs in three forms : 
I. That acquired by copper miners and handlers of 
copper-a very mild and evidently harmless form. 
II. That acquired by those who are compelled to 
breathe the fumes of molten copper and its alloys- 
either in smelters or copper and brass foundries, 
this is a very severe and sometimes fatal form of 
poisoning. III. That acquired in the arts from brass 
filings-as seen amongst metal turners. This form is 
dangerous only on account of the mechanical irrita- 
tion caused by the fine particles of brass (or similar) 
metals, inhaled-and deposited without change in 
the respiratory tracts. 
" Form No. II., viz, that acquired in smelters and 
foundries from the fumes of molten copper " flux,'' 
zinc, and allied metals, is a very common form of 
poisoning. I have seen a large number in Ansonia, 
and Derby, Connecticut. It is often fatal-but I 
believe only indirectly so. In these cases, copper was 
the principal but not the only metal concerned : zinc, 
lead, tin, and traces of arsenic exist in the "flux " of 
the various alloys of copper. Clinically the symp- 
toms of chronic copper poisoning are divided into 
three classes, sometimes each class is seen alone, 
sometimes together, the most common being : I. The 
form affecting principally the respiratory organs; 
II. The form affecting principally the abdominal 
organs ; III. That affecting the central nervous 
system. 
"In Class I. the symptoms are those of chronic 
Pharyngitis, Laryngitis, Bronchitis, Asthma and ul- 
timately Emphysema, and very often followed by 
Tuberculosis, assisted by the local irritation. 
" In Class II. the symptoms are usually metallic 162 
CATAPHORESIS. 
taste in month, epigastric pains, giddiness,headaches, 
wasting of body with a daily rise of temperature, 
colics quite frequent, cramps in extremities. 
' ' In Class III. the symptoms are more obscure and 
insidious cramps are common ; disturbances of sen- 
sibility, loss of muscular strength, burning, super- 
ficial pains, reflex activity of legs greatly increased, 
and often the "girdle" pains-in fact all the feat- 
ures of myelitis-this variety was first recognized 
and described by Schlockow, in ' Deutsche Med. 
Wochenschrift,' 1879, page 208. 
Cataphoric medication, on the whole, is pre-eminently due to a 
diffusive effect exerted upon a medicament placed at the positive 
pole, but exceptions to this rule have already been carefully 
noted. In this connection I will refer to the conclusions arrived 
at by Prof. Simon Fubini and Doctor Pierre Pierina of Pisa, in a 
recent clear and exhaustive account of this entire subject.1 As 
the result of these experiments, the authors conclude that: 
1. The constant current determines the passage of certain ele- 
ments through the skin, but for the introduction of some sub- 
stances it is necessary that the current have one direction, and 
for other substances the opposite direction. Therefore the writers 
do not consider the statement that the passage of substances 
through the skin in cataphoresis is always in the direction of the 
current to be of universal application. 
2. The iodine of potassium iodide, the salicylic acid of sodium 
salicylate, and of lithium salicylate penetrate the organism when 
the negative pole is in the aqueous solution of these salts; the 
strychnia of strych. nit., the atropine of atrop. sulph., the qui- 
nine of quin, hydrochi., the cocaine of cocain. hydrochi., the 
lithium of lith. salicyl, pass into the body when the positive pole 
is in the aqueous solution of these salts. 
Dr. Max Aker-Blum of Wilmanstrand, Finland, has also recently 
written an excellent paper 2 on Cataphoric Medication and the 
theory of its electro-chemical action. Dr. Blum investigated es- 
pecially the iodine salts and comes to the conclusion that the 
iodine salt solution should be placed at the cathode. 
1 Sur la Cataphorfise filectrique. Experiences faites sur homme et sur 
plusieurs especes d'animaux, Archives d'Electricite Mfidicale, 15 Aout, 1897. 
See also Treatment, Rehman & Co., Publishers, London, 1897. 
2 See Electrochemishe Zeitschrift, Berlin, June 1,1897, p. 49, for article by 
Rudolf Mewes founded upon Blum's paper. CHAPTER III. 
ELECTRO-COCAINE LOCAL ANAESTHESIA. 
If medicaments held in solution may be diffused 
throughout tissue by the action of a continuous 
electric current, and a drug is employed which when 
used hypodermatically will produce an anaesthetic 
condition, such a condition will be produced in the 
tissue penetrated by such current and solution. 
The portion of this book devoted to the historical 
development of this procedure of electric medica- 
mental diffusion treated in considerable detail of 
the cataphoric use of cocaine to relieve the pain of 
neuralgia. But to use cocaine cataphorically to 
produce a practical local anaesthesia sufficient for 
minor surgical operations is quite another matter, 
and for that reason this branch of the subject is 
here referred to separately. 
Following in the footsteps of Richardson's Voltaic 
Narcotism of 1859 supplemented by Wagner's sug- 
gestion of 1886 to introduce cocaine by electricity, 
many no doubt have sought, but without success, 
this consummation. At each recurring lecture 
upon the subject of cataphoresis at the Post 
Graduate Medical School and Hospital, and as often 
as four times each winter, I have anaesthetized by 
electricity and cocaine a spot one inch in diameter 
163 164 
CA TAPHORESIS. 
upon a patient's arm and transfixed a thick fold of 
the skin by a needle without pain in order to point 
out the availability of the method in surgery. The 
first record of my own I am able to find, and I believe 
it is the earliest extant of the actual performance 
of operations during electro-cocaine anaesthesia, is as 
follows : 
Case 1. Dec. 1, 1891.-A. D., servant, while scrub- 
bing a rough floor a splint of wood about | of an 
inch in length had penetrated the fleshy part of the 
thumb. I anaesthetized an area of one inch in 
diameter, using a block tin electrode, aqueous solu- 
tion of cocaine, 10 per cent., on blotting paper, and 
electricity. Five to six milliamperes of current 
were allowed to flow for 8 minutes. Dr Howard 
Lilienthal cut out the splinter without pain though 
the subject was of a highly excitable temperament. 
In a paper 1 read before the Medical Society of the 
State of New York in February, 1895, I stated that 
" there are few minor operations in surgery that I 
do not now perform under electro-cocaine local 
anaesthesia." 
Illustrative of this practice I append a few cases, 
taken at random from my note-book, containing 
many other similar records. 
Case 2. May 18, 1892.-E. S. Large vascular 
tumor on upper lip. Electrode one inch in diameter. 
Electro-cocaine local anaesthesia, aqueous solution, 
10 per cent., 7 ma., 10 minutes. Anaesthesia com- 
plete. Several iron needle punctures, positive pole, 
caused no pain. Tumor cured. 
Case 3. May 16,1893.-M. H. H. Dermoid cyst. 
Electrode one inch in diameter. Electro-cocaine 
1 " New York Medical Journal, " Apr. 20 and May 4, 1895. ELECTRO-COCAINE LOCAL ANAESTHESIA. 
165 
anaesthesia, aqueous solution. Anaesthesia com- 
plete. Copper bulb positive pole within cyst, 15 
ma., 15 minutes. Cyst cured. 
Case 4. Jan. 28, 1894.-Mr. C. H. H. Warty 
growth at top of nose. Electrode one inch in 
diameter. Aqueous solution of cocaine eight per 
cent., 10 milliamperes, 10 minutes. Zinc needle, 
positive pole. 
Case 5. Feb. 13, 1894.-Mrs. R. Lipoma on neck. 
Electro-cocaine. Anaesthesia, aqueous solution, 10 
per cent, solution of cocaine, 7 ma., during ten min- 
utes. Incision with scalpel and copper bulb in- 
serted, 25 ma., 23 minutes. Lipoma caused to com- 
pletely disappear. 
Case 6. Feb. 21, 1894.-Mrs. DeW. C. Fibroma 
of face. Electro-cocaine anaesthesia, aqueous solu- 
tion, 6 ma, 10 minutes. Each fibroma punctured 
with a tenotomy knife and a very small copper bulb 
sunk into its middle. Each fibroma treated was 
obliterated. 
Case 7. Dec. 3, 1895.-Mr. D. D. S. Lupus, ex- 
tensive infiltration and sclerosis of tissue and ulcer- 
ation involving the angle of the mouth on the right 
side over an area of about two inches across. Also 
separate nodule size of a bean on lower lip. Three 
applications guaiacol-cocaine, 8 per cent, solution, 
one inch electrode, 4 ma., 5 minutes, profound local 
ansesthesia. The entire affected area was treated 
with copper bulbs, positive pole, the bulbs sinking 
deeply into deep holes in the tissue. Size of bulbs, 
one-half of an inch long and one-third of an inch 
wide. Result, complete cure. 
Case 8. April 15, 1896.-Mr. E. H. H. Sycosis 
parasitica. Electrode one inch in diameter. Gua- 166 
CATAPHORESIS. 
iacol-cocaine anaesthesia. Five punctures copper 
needle, 2 ma. each puncture. Result, growth 
killed and no recurrence, nor no scar. 
Case 9. May 5, 1897.-Miss G. L. B. Varicose 
vein on back of neck. Electrode three inches in 
length. Guaiacol-cocaine anaesthesia, two milli- 
amperes, four minutes. Zinc needle, positive pole, 
punctures within and along length of vein. Result, 
perfect, no remaining sign of the blackish disfiguring 
vein. 
Case 10. May 6, 1897.-A. M. L. Protuberant 
naevus on forehead. Electrode one inch in diameter. 
Guaiacal-cocaine, anaesthesia complete. One milli- 
ampere four minutes. Zinc needle, positive pole 
to destroy naevus deeply. Result, no remains of 
naevus, no perceptible scar. 
AQUEOUS SOLUTIONS. 
Electro-cocaine, local anaesthesia by means of 
aqueous solutions of cocaine is then practicable. 
From four to twenty per cent, solutions may be 
employed-an eight per cent, solution is a fair 
average per cent. A piece of blotting-paper is fitted 
to one of the perforated electrodes already described, 
and the solution is filled first into the perforations 
and then dropped upon the blotting-paper, and the 
electrode, constituted positive, is put on the part to 
be affected, with the indifferent (negative) electrode 
placed elsewhere. 
We will take for example the electrode, one inch 
in diameter. With a current strength of eight to 
ten milliamperes (all that is easily bearable by the 
patient) and an eight per cent, solution, at least ten ELECTRO-COCA INE LOCAL ANAESTHESIA. 
167 
minutes will be required to produce local anesthet- 
ization. 
Before making the application the oil should be 
washed from the skin by soap and water. 
GUAIACOL-COCAINE SOLUTIONS. 
Taking again an electrode one inch in diameter 
let us drop into the perforations and upon the blot- 
ting-paper an eight per cent, solution of guaiacol 
and cocaine. Upon applying the electrode (no 
preparation of the skin is required), it will be 
found that on permitting one to three milliamperes 
of current to flow, an anaesthesia more profound 
than by aqueous solutions is produced in from two 
to four minutes. This estimate of time and of cur- 
rent strength is a very conservative one. While in 
the case of aqueous solutions there is often a desire 
to force the current beyond the ability of the patient 
to bear the pain of its initial onset and first con- 
tinuance, in the case of guaiacol-cocaine the patient 
is seldom aware that any current at all is in action. 
Thus the combination of guaiacol and cocaine renders 
the procedure much more convenient and effective. 
The recipe for an eight per cent, solution would 
read : 
Guaiacol (pure) 3 i, 
Cocaine Hydrochlorate gr. v i. 
The percentage may be increased to thirty per 
cent. 
Among the many attempts made by the writer in 
conjunction with Mr. Wm. J. Evans, of McKesson 
& Robbins, to discover an efficient combination of 
guaiacol and cocaine two may be mentioned : 168 
CATAPHORESIS. 
1. The first of these was termed guaiacol-cocaine, 
an apparently true chemical combination between 
cocaine and guaiacol. 
2. Guaiacol sulphonate of cocaine, a combination 
of 61.5 per cent of cocaine alkaloid and 38.5 per 
cent of guaiacol sulphonic acid. 
Finally, the following case from among others of 
its class, such as the incision of a felon, etc., is re- 
ported in full, since it serves to elevate electric medi- 
camental diffusion up and out of a promiscuous mass 
of applications of various drugs for various pur- 
poses, and to place electro-guaiacol-cocaine local 
anaesthesia before the surgical profession as an en- 
tirely practical procedure for minor and even for 
major surgical operations. 
Case 11. Dec. 17, 1897.-Removal of a large pig- 
mented ncevus.1 
In order to dispel any doubts concerning the effi- 
cacy of cataphoric procedures to produce local anaes- 
thesia, both extensively and deeply, I anaesthetized 
in two applications (owing to the relatively small 
size of my electrode, which was only If inches in 
diameter) a skin area beneath the axilla of three 
inches in length and one and a half inches broad. 
The operation was performed at the New York 
Post-Graduate School and Hospital, by Dr. F. N. 
Wilson. The patient was Dr. F. P. Williams. Five 
minutes only were required to anaesthetize the area 
beneath the electrode ; the guaiacol-cocaine solution 
was employed. Two deep linear incisions were 
made, each about three inches long and half an inch 
deep, in such a manner as to include the naevus and 
surrounding healthy skin, and the included piece 
1 Morton : " The Dental Cosmos," Jan., 1896, page 51. ELECTHO-COCAINE LOCAL ANAESTHESIA. 
169 
then dissected up from the sub cutaneous tissues. 
A slight burning sensation of the knife was felt only 
at a certain part of the long incisions which were 
made outside of the anaesthetized area, but the dis- 
secting out was absolutely without pain, as well 
also as the torsion of five small arteries and the in- 
sertion of ten deep stitches to close the gaping 
wound. No pain was produced in procuring the 
anaesthesia. Referring to the torsion of the arteries 
by the clamps, the patient, himself a physician, 
said, " It is funny I can bear that clamp, because 
they usually jump out of the chair," and "I knew 
what he was doing, but it gave me no pain," etc. 
It is noteworthy in this case that the anaesthetic 
effects extended at least one-half an inch deep, and 
that there were no toxic effects of cocaine (a 16 per 
cent solution in guaiacol was used). The absence 
of toxic effects seems to me to be due to the fact 
that the guaiacol holds the cocaine in solution, thus 
localizing its action and preventing its diffusion into 
the circulation. This is of the highest importance, 
since the only objection which could be raised to the 
use of cocaine so extensively and of such strength 
as described in the above instance would be the 
danger of the absorption of a poisonous dose, espe- 
cially in a highly vascular tissue such as the nsevus 
operated upon. No reactionary hyperaesthesia fol- 
lowed the operation, and the wound healed by first 
intention. 
In the chapter on electrodes some are illustrated 
as large as 6 inches in diameter and some 6 inches 
in length by 2 inches in breadth. With electrodes 
of this size I have successfully anaesthetized with 
the guaiacol solution correspondingly large areas 170 
CATAPHORESIS. 
upon the abdomen, back and legs. The time oc- 
cupied was about six to eight minutes. The time, 
the size of the anaesthetic area and the depth to 
which it extends would seem to lead to the opinion 
that in this method we have a procedure superior 
from many points of view to the infiltration and 
older methods of hypodermatic injection of aqueous 
solutions of cocaine. 
Among many experiments tried in December, 
1895, I quote from one relating to erythrophleine 
hydrochlorate. This salt is readily soluble in water. 
It was introduced as a local anaesthetic some years 
ago by Dr. L. Lewin, of Berlin, for operations on 
the eyes. Solution placed on blotting paper in my 
perforated electrode one-third of an inch in diameter 
and electrode held upon the forearm : two milliam- 
peres of current was allowed to pass for seven 
minutes ; complete cutaneous anaesthesia beneath 
the electrode was established ; the reaction was, 
however, slightly painful, unlike that of cocaine. 
Nothing has been said about experiments with 
eucaine and other drugs, because none of them has 
been found as effective as cocaine. 
There is one further observation I would make, 
and this is that in many cases while the sensation 
of pain is totally abolished, the sense of contact or 
touch may yet remain intact. The patient often 
confounds the two sensations. The operator should 
be on his guard against this contingency. 
Great as are the services of electricity to man, no 
service it has yet rendered will be more sympathet- 
ically appreciated than that of aiding in releasing 
him from the thraldom^of pain. It is not impos- 
sible that this new era may arrive. CHAPTER IV. 
ELECTRIC DIFFUSION FROM SOLUBLE ELECTRODES. 
The destructive electrolytic action in human tis- 
sue of either pole of a continuous electric current is 
perfectly familiar. The electrodes are usually of 
metal, and care is taken that they be unoxidizable, 
as is, for instance, platinum or gold, if they are to 
be used at a positive pole, while, if used at the 
negative pole, they may be oxidizable or not. The 
positive pole electrode, when the current is in action, 
forms oxygen and acids out of the tissue itself ; the 
acids are mainly hydrochloric, sulphuric and phos- 
phoric. The negative pole forms hydrogen and 
alkalies, the latter usually caustic soda and potash. 
Each pole is practically a little chemic workshop by 
itself-the one acid, the other alkalin ; the analytic 
and synthetic energy being furnished by the electric 
current and the materials acted upon being furnish- 
ed by the tissue. The resultant and desired destruc- 
tion of tissue is due to a number of factors, chief 
among which are that amount of tissue used to 
make up the newly formed and foreign chemicals, 
the secondary action of these newly formed products 
upon the remaining tissue, and the disruptive ef- 
fects upon the structural composition of the tissue 
of the gases interstitially liberated. And the char- 
171 172 
CA TAPHORESIS. 
acter of the artificially produced lesion and its re- 
sultant eschar is determined, to a great extent, by 
the second of these actions, whether it has been an 
acid or an alkalin corrosion or destruction. The 
lesion resulting at the negative pole is rich in fluids 
(by cataphoresis), and is slower to heal ; it leaves, 
however, a smoother and less contractile cicatrix 
(an important consideration in the removal of facial 
blemishes). The lesion resulting at the positive 
pole is comparatively dry (also by cataphoresis), is 
quicker to heal and leaves a rougher and more con- 
tractile scar. 
It will be observed that in this, the familiar form 
of electrolysis, no account is taken of the nature of 
the active electrode employed except that it be unox- 
idizable, insoluble, and therefore indestructible, and 
that as a consequence reliance for the electrolytic 
effect is based directly upon the characteristic effect 
of the current upon the tissue and not upon its effect 
upon the electrode. Any action of the current upon 
the electrode is, in fact, carefully guarded against. 
But if we turn our attention to the nature of the 
metal which composes the electrode, be it the posi- 
tive or (as I have demonstrated) the negative, an 
entirely new field of investigation and of results is 
opened out to our view. If our positive electrode 
be composed of a metal which is attacked by oxygen 
or by chlorin (formed at that pole out of the tissue), 
then a newchemic compound is formed at the point 
of the application, and we have no longer to deal 
with the effect of the liberated chemicals directly 
upon the tissue, but we are confronted with a new 
effect, viz., that of the newly formed chemic com- 
pounds (metallic salts) upon the tissue. And since, 173 
owing to the nature of human tissue, hydrochloric 
acid is pre-eminently formed at the positive pole, we 
shall find if copper, zinc, iron or other attackable 
metal is the metal employed at that pole, that we 
have formed respectively the oxychlorids of copper, 
zinc, iron, etc., double salts of the metal. 
In this connection we may observe the further 
interesting fact that under the above circumstances 
the action of the current is almost entirely expended 
in decomposing the metal, and that as a consequence 
the undesirable destructive action of the usual elec- 
trolysis is avoided. For, as I have observed in prac- 
tice and as will be seen upon reference to the cases 
in which this method of treatment is applicable and 
peculiarly efficacious, the destructive action of the 
current would be in the highest degree detrimental. 
The object is not to destroy tissue, as by actual 
cautery or by the application of caustics, but to im- 
plant within it and permeate it with the newly 
formed metallic salt. In fact, so distinctive is this 
new method, which is termed by Gautier, its mod- 
ern author, interstitial electrolysis, from common 
surgical electrolysis, that it is unfortunate to use 
the term, electrolysis, at all in relation to it. The 
electrolysis is, as has been pointed out, principally 
of the metal, and but to a very limited extent of 
the tissue. A far more characteristic feature of the 
process is that the product of the electrolized metal 
permeates tissue, and it is for that reason that I 
feel compelled, in speaking of the method, to desig- 
nate it as electric diffusion. 
Another noticeable feature of electric diffusion of 
salts formed from soluble electrodes is that a re- 
markably low current strength suffices to set free 
DIFFUSION FROM SOLUBLE ELECTRODES. 174 
GA TAPHORESIS. 
a large amount of the metallic salt. Here, again, 
is a reason that very little of the usual electrolytic 
destruction of tissue ensues. Gautier, indeed, calls 
attention to this fact, and characterizes this method 
in its gynecologic applications as one of low current 
strength and long sittings, in contradistinction to 
the Apostoli method of high current strength and 
short sittings. In practical work, I have found 
that very low current strength, from 1 to 10 mil- 
liamperes, gives much better results than from 10 
to 50 milliamperes. In this connection it should be 
noted that the electrode loses in weight. Gautier 
has found, as would be expected, that the loss in 
weight is proportional to the current strength and 
the duration of the current flow. 
Again, the solution of the metallic electrode is 
not confined, as thus far supposed, to the positive 
electrode alone. I have found by experiment that 
soluble electrodes may also be employed at the nega- 
tive pole. One of the best of the metals for this 
purpose is aluminium. The extension of metallic 
electrolysis to the negative pole greatly widens the 
field of this new method, since, while at the positive 
pole we have thus far been confined to the oxychlor- 
ids of metals, we now at the negative pole may apply 
to diseased tissue another class of metallic salts. 
Electric diffusion, as the word, diffusion, indicates, 
possesses an obvious advantage over the ordinary 
topical applications of similar or other metallic 
salts of copper, zinc, iron, aluminium or other met- 
als. For it is obvious that not only is the salt dis- 
solved off of the metal, but by another and further 
property of the current it is forced into the tissue in 
a radiating direction around the metallic electrode. DIFFUSION FROM SOLUBLE ELECTRODES. 
175 
In this respect, electric diffusion is remarkably un- 
like the application of the ordinary solutions by a 
brush, spray or injection, or their injection into tis- 
sue by the hypodermatic needle. The solution of 
the salt is not only applied but it is driven in. To 
use a homely simile, a wash or spray is like a nail 
held against a board, while electric diffusion plays 
the part of the hammer which drives the nail home. 
The dissolving action of the electric current upon 
a metallic electrode, constituting a positive pole and 
applied within human tissue, had been noted by 
various authors in relation to the treatment of some 
diseases, particularly tumors, by electrolysis. Both 
Butler and Stevenson and Jones refer to this action 
upon zinc needles and point out the conjoint efficacy 
of the combined destructive action of the current 
and the newly formed chlorid of zinc. 
Butler says : 1 " Electro-puncture is presumed to 
have been performed with needles made of unox- 
idizable material. Should the needle of the positive 
pole be made of material capable of being acted 
upon by the acids set free at this point, the results 
are modified to a great degree. For example, sup- 
pose the positive needle be made of iron, the needle 
becomes dissolved by the acids set free, and the 
phosphate, sulphate and chloride of iron are formed, 
principally the chloride. From this fact we would 
infer that iron needles would be useful where coagu- 
lation of blood is the result aimed at. And there is 
no doubt that they assist in the accomplishment of 
such a result to a considerable extent.* * * Another 
1 " A Text-Book of Electro-Therapeutics and Electro-Surgery," 
by John Butler, M.D., New York. 1880, page 213. 176 
CATAPHORESIS. 
advantage of the operation is, that it is compara- 
tively painless, in some cases entirely so." 
Numerous successful cases have been published by 
French physicians, among whom are MM. Jouslain, 
Gautier, Larat, Imbert de la Touche, Delineau, 
Darier, Bergonie, and Bordier. 
Onimus, of Paris, and Prochownick, of Hamburg, 
appear to have casually used soluble electrodes at 
the positive pole. The latter applied a copper sound 
with a current strength of from 80 to 100 milliam- 
peres in a case of gonorrheal infection of the uterine 
cervical canal. 
But these isolated observations made almost no 
impression upon practice, and it remained for Dr. 
Georges Gautier, of Paris, to grasp the broad idea of 
diffusing metallic salts from soluble electrodes and 
to inaugurate by a series of experiments this new 
system of procedure. 
I have already expressed a preference based upon 
much experience, for low current strength and pro- 
longed time. It is difficult to lay down rules which 
shall apply in so many diverse diseases. In needle 
puncture (copper or zinc needles) I prefer to use no 
more than 2 milliamperes applied at any one site 
for about three to five minutes. In a case of sycosis, 
reported later on this was quite sufficient to cure 
the disease. In lupus, ulcerations, pustules and 
acne this is also quite enough current strength. 
Gautier reports using 50 milliamperes in a case of 
lupus, but I have found the high current strength 
seriously objectionable because of the consequent 
electrolysis of tissue and extension of the time of 
healing. In hypertrophic nasal catarrh with copper 
bulbs, I find about 4 to 8 milliamperes sufficient. In DIFFUSION FROM SOLUBLE ELECTliODES. 
177 
ozena the same ; in trachoma 1 to 2 milliamperes 
and in intra-uterine applications from 10 to 20 mil- 
liamperes ; in gonorrhea 1 to 2 milliamperes. 
No positive rule can be laid down, since much 
depends upon the size of the electrode. In order to 
facilitate accuracy of dosage, I employ copper bulbs 
graduated according to the French scale of catheter 
or other electrodes whose surface area is a known 
quantity. 
The operator may convince himself, if he desires, 
of the great rapidity of the electric diffusion of the 
copper salt by sticking the needle lightly into his 
own skin, or that of a patient, and watching the 
almost immediate formation of a small circular 
area of an apple green color. This is also well seen 
in a small wart or similar growth ; the mass turns 
light green. 
A practical point of importance is to thoroughly 
polish each electrode immediately before using it. 
This is easily accomplished by the aid of a piece of 
fine emery paper. 
The adherence of the electrode to the tissue is a 
peculiarity and a danger. Even with a current 
strength of from 2 to 4 milliamperes this adherence 
is noticeable. Therefore even when low current 
strength is employed as during the application of 
smooth metallic surfaces to mucous membrane, as 
in nasal and throat diseases, in trachoma, urethri- 
tis, etc., the electrode should be kept in slow move- 
ment, either longitudinal or rotatory. In the case 
of needles plunged into tumors and of sounds within 
the uterus this adherence can not be overcome by 
any safe manipulation ; the needle must be loosened 
by reversing the polarity and using from 4 to 8 178 
CATAPHORESIS. 
milliamperes for about five minutes. The adhesion 
is due to the formation of an albuminoid salt of 
copper (where the electrode is of copper.) 
Cases.-I present the records of a few illustrative 
cases. It is needless to say that much has been 
learned as to technique, precision and efficacy in se- 
curing results in individual diseases since my first 
cases were recorded. 
CHRONIC TINNITUS AURIUM. 
Probably there are few minor troubles more an- 
noying to the patient than a chronic ringing in the 
ears ; certainly there is no minor condition more 
difficult of cure. The cases as I have seen them 
are often associated with some degree of catarrhal 
trouble and commonly with tympanic vertigo and 
moderate deafness. 
Case 1.-H. E., age 33; cured. Referred to me 
March, 1893, by Prof. D. B. St. John Roosa, to 
relieve him, if possible, of a most annoying and per- 
sistent ringing in both ears. Five years ago had a 
"dry throat"; had little saliva; mucous mem- 
branes cracked and bled ; was treated by sprays 
for two years with no benefit ; then used antiseptic 
washes. The uvula was elongated and had been cut 
off. Throat never ceased to trouble him. Two 
years ago had the grip, and about this time the 
ringing began. Present condition : weary, "nerv- 
ous," depressed and irritable with much frontal head- 
ache and an almost continual ringing, worse in the 
left ear. The sound is like that of a distant cricket 
or like a sharp whistle ; it worries him most when 
he is tired or when he lies down or after sexual in- 
tercourse. Sleep is often disturbed because he can- DIFFUSION FROM SOLUBLE ELECTRODES. 
179 
not get rid of the sound in his ears. As a rule it is 
worse at night. Has likewise much post-nasal dis- 
charge. Hearing in left ear considerably impaired ; 
has some vertigo. The first treatment to the ears 
and throat was by the static induced current, then 
the sinusoidal, both followed by amelioration in the 
degree of the sound and by intervals when it ceased 
for a few hours. But the progress was not satisfac- 
tory to me, and I determined to treat the catarrhal 
condition first and cure it, before following up 
further applications to the aural region alone. 
March 29.-Electric diff usion, copper bulb, through- 
out the post-nasal and pharyngeal region, 12 mil- 
liamperes five minutes to each side. 
March 31.-Discharges from nose anteriorly and 
posteriorly almost nil; ringing about the same. 
April 3.-Ringing unimproved ; headache better ; 
slight nasal discharge. Repeated treatment. 
April 4.-Raises slightly thick discharge from 
throat ; watery discharge from nose ; ringing same 
as ever. 
April 5.-No discharge. Treatment repeated. 
Reports never felt so well for years, of the catarrhal 
symptoms. Ringing in ears ceased during the treat- 
ment. 
April 7.-Headache ; ringing in ears worse ; no 
nasal discharge. Treatment five minutes, 10 mil- 
liamperes. 
April 8.-For a half hour after rising this morning 
was free from the ringing. 
April 10.-Ringing ceases for long periods; no 
nasal discharge. 
April 13.-Ringing continuous. Treatment same. 
April 14.-Ringing very slight; no headache ; 180 
CA TA PHORESIS. 
very little nasal discharge. Treatment, five min- 
utes, 5 milliamperes. 
April 15.-Much ringing in left ear. 
April 19.-Reports a discharge from the left 
nostril which colored the pillow in the night; a 
good deal of catarrhal trouble ; bright yellow dis- 
charge and intense headache, also that his hearing 
was not so good. Discontinued treatment at the 
patient's request. 
May 3.-Against the patient's desire I persevered 
with electric diffusion, applying the electrode freely 
to his hypertrophied tonsils and post-nasal region on 
the sixth, tenth and thirteenth. The ringing still 
persisted in a marked degree. 
May 19.-Ringing the same ; vertigo. Treat- 
ment same. 
May 25.-Ringing and catarrhal troubles have 
ceased since last treatment. The throat presented 
an almost normal appearance ; the narrowing and 
congestion of the fauces had disappeared ; the tonsils 
were normal in size. One more treatment was given 
and the patient was allowed to cease, as nothing 
further remained to be accomplished. The treat- 
ment by electric diffusion from copper had occupied 
about two months and had been repeated about 
twelve times. 
Jan. 30, 1894.-Patient reports that he has had no 
further ringing in ears and remains well of it, in 
spite of an attack of the " grip" during the winter. 
TRACHOMA. 
With the pathology and histology of this disease 
we have here nothing to do. It is merely a question 
of causing the absorption of the sago-like granula- DIFFUSION FROM SOLUBLE ELECTRODES. 
181 
tions or elevations in the conjunctiva, with the relief 
of the associate symptoms of pain, lachrymation 
and in the acute varieties the mucus discharge. The 
classical treatment is by operative or medicinal 
measures. The former removes the granulations by 
squeezing out their contents ; the latter attempts 
to cause absorption by setting up by various drugs a 
certain grade of inflammatory reaction. It is here 
proposed to treat this obdurate affection by another 
method, viz., the combined action of electricity and 
a nascent metallic salt caused to permeate the 
affected tissue by means of the diffusive property of 
the electric current. This method is very successful. 
The use of electric diffusion in this disease first 
occurred to me in the case of an Italian woman 
under treatment for goitre at my clinic. The case 
briefly follows : 
Case 1.-Jan. 4, 1892, R. P., age 50 ; trachoma 
both lids of both eyes. Extreme photophobia ; in- 
tense corneal vascularity ; excessive lachrymation ; 
trachomatous bodies ("sago grains''); impaired 
vision. Treatment, electric diffusion from a copper 
electrode. An impromptu electrode was formed by 
bending a piece of copper wire into a suitable U- 
shaped loop. The loop was then passed slowly over 
the affected surfaces of the lids, while at the same 
time a current of 2 milliamperes was flowing. The 
reader is referred to later cases for more typical 
results, for the reason that the treatment was inad- 
vertently substituted at times by the use of the 
negative pole. But the cornea cleared, the tracho- 
matous bodies became greatly reduced in number, 
the photophobia was much less, no lachrymation ; 
the vision improved ; the patient could see better and 182 
CATAPHORESIS. 
was able to read. This case simply initiated a 
method which was afterward carried out with more 
care and greater detail in my clinic, by myself and 
my assistants. 
Care in manipulation is requisite. The eyelid 
•should be everted as is usual in applications of the 
sulphate of copper or alum pencils, or the special pro- 
tected electrodes devised by myself may be employed, 
without everting the lids. The electrode should be 
kept very slowly in movement or it will adhere to 
the conjunctiva and cause slight laceration upon re- 
moval, or at least compel the operator to reverse the 
polarity. Any metal, soluble at either pole may be 
employed, but copper and zinc are undoubtedly the 
best. The electrode without current will cause pain 
and with current somewhat more pain. To annul 
the pain, cocaine may be used in the usual manner. 
Case 2.-Acute trachoma, first stage. March 22, 
1893, patient age 11, had purulent conjunctivitis ; 
upper and lower lids of both eyes trachomatous. 
Treatment : Electric diffusion from copper electrode, 
2 milliamperes, one minute to each lid. After the 
first treatment the photophobia almost entirely 
ceased and the granules diminished in size. The pa- 
tient received six applications and was cured. April 
29, 1894, about a year later, reports that he had re- 
mained well. 
Case 3.-July 21, 1893. P., age 21 ; trachoma 
second stage. Referred to the clinic by Dr. Francis 
Valk, of the Ophthalmological Department of the 
Po'st-Graduate Medical School. During one year had 
suffered severely from photophobia, lachrymation 
and pain. Extensive ulceration of cornea and lids 
highly trachomatous. Treatment : Electric diffu- DIFFUSION FROM SOLUBLE ELECTRODES. 
183 
sion from copper electrode, 3 milliamperes. July 
24, patient much better ; no pain ; swelling of lid 
and ptosis of right eye much diminished. Less 
photophobia, soreness and lachrymation, trachoma- 
tous bodies very much softer and less gritty to con- 
tact of electrode. Electric diffusion from copper, 10 
milliamperes from two to three minutes. July 26, 
edema of the lids has entirely disappeared ; slight 
ptosis remains ; no lachrymation; trachomatous 
bodies no longer isolated ; cornea almost entirely 
clear. Same treatment. July 31, after the fourth 
treatment the trachomatous bodies had become en- 
tirely absorbed. Cornea perfectly clear. Dr. Valk 
stated that the result " was 50 per cent, better than 
he could have secured with the classical methods of 
treatment." Six more similar treatments completed 
the patient's cure, with the simple exception that 
some slight conjunctival redness remained as well 
as a moderate sensitiveness to bright sunlight. May 
8, 1894, as the patient has never returned he presum- 
ably has remained cured. 
Case 4.-July 21, 1893, A. D., age 8 ; trachoma, 
second stage. Purulent conjunctivitis with conges- 
tion and edema of the surrounding tissues ; both 
upper and lower lids profusely covered with tracho- 
matous bodies. Five treatments, electric diffusion 
from copper electrode, 3 to 7 milliamperes ; cocaine. 
The first treatment was followed by diminution of 
the mucus discharge ; of the pain, lachrymation and 
photophobia ; the trachomatous bodies softened and 
were gradually absorbed. Cured. 
Case 5.-August 30,1893, W. T., age 16 ; granular 
lids for seven months ; pain ; stiffness of lids; pho- 
tophobia ; morning adherence of lids ; electric diffu- 184 
CATAPHORESIS. 
sion from copper, 3 milliamperes. After twelve 
treatments, case cured by October 30. Applications 
were imperfectly made, owing to the refractory 
nature of the patient. 
Case 6.-Jan. 15, 1894, K. S., age 17 ; native of 
Egypt; trachoma, third stage ; always had weak 
eyes ; began to be troublesome five years ago. Has 
photophobia, lachrymation, constant muco-purulent 
discharge and pain. Can only see as " through 
smoke." Palpebral conjunctiva scarred and white. 
Both lower lids, palpebral conjunctiva, adherent and 
dragging in the eyeball. Cicatricial conjunctivitis. 
Case "incurable." Treatment: Electric diffusion 
from zinc electrode, 5 milliamperes to conjunctivae 
of both eyes. March 9, 1894, reports both eyes 
better; now sees clearly ; lachrymation has ceased ; 
lids are no longer glued together in the morning by 
the mucus discharge. Repeated diffusion from zinc, 
3 milliamperes to lids of both eyes. March 23, 1894, 
adhesions between the conjunctiva and the eyeball 
at the left lower lid were treated with negative 
electrolysis, 1 milliampere. April 18, 1894, pal- 
pebral conjunctivae have assumed a more normal 
appearance. Circulation improved ; less indura- 
tion ; patient regards herself as very well. 
Case 1.-March 23, 1894, M. B., age 11 ; acute 
trachoma, first stage. Lids edematous ; conjunc- 
tivae injected ; lachrymation, upper and lower lids 
of both eyes trachomatous. Treatment : Electric 
diffusion from copper, 1 milliampere. March 26, no 
edema ; conjunctivae lessened; sago grains have 
disappeared ; treatment same. March 28, 1894, 
much better; slight redness of conjunctivae ; no 
mucus discharge, pain or photophobia ; eyes clear DIFFUSION FROM SOLUBLE ELECTRODES. 
185 
and bright, 3 milliamperes to both eyes. April 13, 
1894, cured. 
HYPERTROPHIC RHINITIS AND PHARYNGITIS. 
The class of cases here referred to were of a 
chronic type and exhibited anterior and posterior 
nasal discharge, generally thick and purulent; the 
disturbed sensation of swallowing, due to retained 
secretions in the post-nasal space, narrowing of the 
rhino-pharynx and the characteristic symptoms of 
hypertrophy of the nasal and pharyngeal mucous 
membrane. Struck by the results obtainable in this 
disease by this method, I also called the attention of 
Dr. Clarence C. Rice, of the Department of Laryn- 
gology, Post-Graduate Medical School, to these 
results and he has, he writes, made trial of the 
soluble metallic electrodes in a number of cases 
which he has reported at a meeting of the American 
Laryngological Association in Washington. 
Case 1.-Nov. 27, 1891, B. M., age 15. Ozena. 
One year ago patient contracted an acute catarrhal 
cold ; it continued a month ; since then has had a 
chronic catarrhal condition of the nasal passages. 
Odor began four months ago. There is a greenish 
muco-purulent discharge from the nose, post-nasal 
droppings and a slight irritative cough. Treat- 
ment : Electric diffusion from copper electrode. As 
in the first trial of this method in trachoma, so in 
this case the negative pole was also used. But ex- 
perience soon taught me to confine the treatment to 
electric diffusion from the positive metallic electrode. 
By December 9, after four treatments the discharge 
was less, the odor less noticeable and the respiration 
freer. 186 
CATAPHORESIS. 
January 8, examined by Dr. C. C. Rice, who 
reports deviation of septum toward right; left 
nostril twice the width of the right; middle tur- 
binated bones covered with dry scaly secretions ; 
pharynx dry with hypertrophied ridges on the sides. 
Further treatment by diffusion from copper was 
carried on, 1 milliampere for ten minutes. January 
15 and 18, 5 milliamperes each nostril, also same 
January 20, 22 and 27. Discharge diminished and 
less greenish. February 1, 3 and 5 same treatment. 
Patient, though not cured, is much better; less 
discharge, odor and headache. Improved. 
With the present improvement in methods and 
electrodes I should expect to cure this patient should 
the opportunity present itself. 
Case 2.-August 8, 1893, D. L. G., age 41. Ozena ; 
post-nasal catarrh, atrophic. Has always " taken 
cold" easily. Had catarrh at 13 years of age; at 
18 it had increased a great deal and he began to 
use salt water and a great many other nasal 
douches and "went to a great many doctors." 
His sense of smell became much impaired nine 
years ago, and has been growing worse ever since, 
until at present he cannot detect odors. The pa- 
tient states, though I have had no opportunity 
of verifying his statement, that one year ago he 
had the antrum opened by Dr. Toeplitz, assistant 
to Dr. Knapp, and pus evacuated. This opening is 
still patent and must be plugged twice daily. 
Symptoms : Copious and most offensive anterior and 
post-nasal discharge ; a great many crusts form ; 
the nose bleeds easily ; odor from patient's nose and 
mouth most offensive. Treatment : Electric diffu- 
sion from copper bulbs, Nos. 27 and 29 (Fig. 3) to DIFFUSION FROM SOLUBLE ELECTRODES. 
187 
naso-pharynx, 15 to 25 milliamperes, occupying 
about five minutes. August 11, same treatment. 
Pharynx very much less congested; more dis- 
charge ; patient says he feels very much better. 
August 15 and 23, crusts free themselves more 
easily ; increased discharge from nose and slight 
bleeding after douching ; treatment same. August 
30, patient reports that his condition is very greatly 
improved; the incrustations remarkably dimin- 
ished ; very much less discharge, and that morning 
for the first time in eight years the sense of smell 
had returned to him and he had smelled paint and 
once more enjoyed eating ; there was no offensive 
odor. The patient expressed himself as " 50 per 
cent, better," and stated that no other treatment 
had ever accomplished as much for him. 
Unfortunately, owing to unavoidable circum- 
stances, this patient ceased treatment and has not 
since been heard from. It is to be regretted that 
the same treatment, as might easily be done, should 
not have been tried for the antrum. 
Case 3.-Oct. 21, 1892, A. R., age 9, profuse 
muco-purulent discharge from the nose ; nasal and 
pharyngeal obstruction of one year's duration. 
Treatment: Electric diffusion from copper electrode, 
about five minutes in duration and with a current 
strength varying from 5 to 10 milliamperes. Symp- 
toms began to improve at once, and after fourteen 
treatments, each several days apart, the patient was 
cured. 
Case 4.-April 5, 1893, F. A., age 20 ; hypertro- 
phic rhinitis. Had diphtheria in November, 1891. 
Ever since has had severe catarrhal trouble in 
frontal sinuses and nasal passages, anterior and 188 
CATAPHOUESIS. 
posterior. Profuse, thick, yellowish discharge and 
much dropping of the discharge posteriorly. Feel- 
ing of intense fulness across forehead ; upper lip 
and anterior portions of nose reddened and excori- 
ated. Treatment: Electric diffusion from copper 
electrodes in anterior and posterior nasal passages 
on the left side. April 12, discharge not nearly so 
profuse nor as yellow on the side treated ; less 
redness about the nose and lip. Right side treated 
in same manner as left; 10 milliamperes for five 
minutes. Like many patients of this class he did 
not return and the case merely suffices to point out 
the immediately favorable effect of the first treat- 
ment. 
Case 5.-Mrs. G. W. E., age 34 ; nasal catarrh, 
hypertrophic. Has had catarrh for three years 
with constant "dropping in back of throat," 
heaviness and dulness in head around eyes ; used 
handkerchief constantly ; good deal of nausea. 
April 28.-Electrolytic diffusion to left nostril. 
Positive pole, 3 milliamperes for fifteen minutes. 
May 3.-Feeling of heaviness in head in morning 
gone ; no nausea ; application made to left nostril 
5 milliamperes, ten minutes; nose feels very much 
clearer ; discomfort from application gone in half 
an hour. 
May 5.-Same treatment to both nostrils; is 
feeling a good deal better ; dropping in back of 
throat gone ; scabbing in interior nostril does not 
occur, also diminution in amount of discharge. 
May 9.-Until yesterday felt well; has taken 
cold and amount of discharge has greatly increased ; 
large scab in left nostril; this was treated lo- 
cally. DIFFUSION FROM SOLUBLE ELECTRODES. 
189 
May 15.-Very much less discharge ; 6 milliam- 
peres to each nostril. 
June 24.-About twelve treatments more of same 
strength ; application also made to pharynx and 
naso-pharynx, about 10 milliamperes. Is very 
much better and is troubled but little. Went away 
on vacation at this time, and the last of September 
returned feeling well and nasal symptoms entirely 
relieved. Cured. 
Case 6.-Miss H. J., age 48 ; post-nasal catarrh. 
About fifteen years ago affection began in left side ; 
had ringing in ears and heavy cold ; since has had 
constant buzzing on that side ; ticking of watch not 
heard ; right ear normal. Is not particularly 
susceptible to colds ; hearing is worse with a 
"cold" ; no pain ; has dropping of secretions into 
throat. Appearances, left side, pharynx atrophic ; 
right side, pharynx hypertrophic ; soft palate and 
entire isthmus dusky red. Treatment: Electrolytic 
diffusion 10 milliamperes, applied positive pole 
about six minutes all over pharynx, also through 
left nares 10 milliamperes five minutes. For a few 
minutes the amount used was 20 milliamperes. 
Cured. 
FOLLICULAR TONSILLITIS. 
Case 1.-Oct. 18, 1893, B. G. A., age 15 ; throat 
began to be sore two days previously ; painful and 
swollen ; sense of malaise and nausea; tonsils 
enlarged and grayish-white spots on both. Treat- 
ment : Electric diffusion from copper electrode to 
every spot. 
October 20.-No more trouble with throat. Ton- 
sils normal in appearance except for slight increase 
in their normal redness. 190 
CATAPHORESIS. 
Case 2.-Jan. 18, 1894, F. D., age 18 ; shivering 
and hot flushes, malaise ; temperature 100 ; grayish- 
white spots on tonsil. Treatment: Electric diffusion 
from copper, 10 milliamperes to every follicle as 
well as over entire tonsil. January 17. Patient 
reports that the throat was entirely relieved the 
next morning and to-day feels entirely well. Ton- 
sils about normal in appearance. 
Case 1.-May 4, 1892, A. M., age 30 ; contracted 
disease in December, 1891. For ten months thought 
himself well. Discharge recommenced May 1,1892 ; 
slight, free and painless ; no treatment. 
May 1.-Treatment: Intra-urethral (from neck of 
bladder to entire mucous surface), 2 to 3 milliam- 
peres electric. 
May 11.-Electric diffusion from copper electrode, 
2 to 3 milliamperes. A brass bulb of proper size 
and connected to an insulated stem was passed as 
far as the neck of the bladder, the current turned 
on and the electrode then slowly withdrawn, thus 
bringing under the influence of the cupric and zinc 
diffusion the entire urethral surface. The dispersing 
electrode was placed upon the abdomen. 
May 13.-Patient reports that the discharge has 
entirely ceased. Later on he reported that it never 
returned and he remained cured. 
Case 2.-A. M., March 19, 1893. One year later 
the patient referred to in Case 1, exposed himself to 
a new infection and contracted a severe attack of 
urethritis. Mindful of his previous cure he returned 
for the same treatment. The discharge was profuse, 
whitish and of the usual consistency ; there was 
URETHRITIS. DIFFUSION FROM SOLUBLE ELECTRODES. 
191 
pain upon micturition. Treatment: Electric dif- 
fusion from copper, 4 milliamperes, the electrode 
slowly withdrawn. At one moment when the 
electrode temporarily adhered or "stuck," the 
current was reversed to negative to loosen it. 
March 27.-Reports that he is much better. 
March 29.-Reports to-day complete cessation of 
the discharge after the treatment of the 19th, but 
that he has now a slight relapse from "drinking 
too much." Treatment renewed. 
March 31.-Reports that he is cured. 
It may be noted here that extreme care to prevent 
adhesion of the electrode to the mucous membrane 
must be exercised in these cases. A delicate 
milliampere meter is imperatively necessary, as 
well as a good rheostat. From 2 to 3 milliamperes 
of current is sufficient and the electrode must be 
kept in motion. At least this is the method of 
treating the urethra which has forced itself on my 
attention as essential. It is beyond question the 
great feature of this method, in contradistinction 
to that by injections, that the mucous membrane is 
electrically permeated with any given metallic salt, 
say the chloride of zinc or copper, rather than simply 
superficially washed by a solution of the same salt. 
There is an actual chemic union of the metallic salt 
and the deeper albuminous constituents of the 
tissue. 
TUMORS, ETC. 
Case 1.-May 18, 1892, E. S., age 60 ; vascular 
tumor on upper lip, nine years' standing, increasing 
in size. Three-fourths of an inch in diameter, blu- 
ish cast of color and can be partially emptied by 192 
CATAPHORESIS. 
pressure. Treatment : Electro-cocaine, local anaes- 
thesia ; first punctured by a platinum needle, 
positive pole, 15 milliamperes for ten minutes. 
Upon withdrawing the needle, considerable hem- 
orrhage ensued. It therefore occurred to me to 
insert an iron needle, positive pole, and secure the 
electric diffusion of the oxychlorid of iron-a styptic 
salt. This was done with 15 milliamperes for five 
minutes. There was no hemorrhage upon the 
withdrawal of the needle and the tumor shrunk 
visibly in size. 
May 20.-Tumor more compact; electric diffusion 
from an electrode 25 milliamperes, twenty minutes. 
To withdraw the electrode without tearing tissue, 
the current was reversed at 15 milliamperes for five 
minutes ; no hemorrhage ; needle almost destroyed 
by the action of the current. Tumor contracted. 
May 23.-Tumor reduced one-third in size. This 
patient did not return. 
Case 2.-Feb. 13, 1894, Mrs. R., age 30 ; lipoma, 
one and one-half inches long by one inch wide at 
base of neck. Patient was unwilling to take ether 
to have the growth removed and did not want to 
have a scar. Experimentally, since I knew of no 
previous fatty tumor removed by electricity, I 
consented to try and extirpate it. Operation: 
Electro-cocaine, local anaesthesia, 7 milliamperes, 10 
per cent, solution cocaine for ten minutes. A 
puncture was made with a microscopic trocar and 
the small piece of tissue sent to Dr. H. T. Brooke 
of the Post-Graduate School, Pathologic Laboratory, 
for examination. He subsequently pronounced it 
to be a lipoma. A copper electrode, three-quarters 
of an inch in length and one-sixteenth in diameter was inserted into the puncture made by the trocar, 
the skin being protected by the insulation of the 
stem of the electrode. The electrode thus sunk into 
the centre of the mass of the tumor was allowed to 
remain for twenty-three minutes, with a current 
strength ranging from 10 to 25 milliamperes. The 
resistance to the current flow was great, owing to 
the fatty nature of the growth. At 25 milliamperes 
the patient had violent palpitation of the heart and 
was upon the verge of syncope, owing to the 
presence of the electrode near the great nerve 
trunks. The wound being antiseptic no special 
dressing was applied. 
February 28.-Patient reports that the tumor has 
entirely disappeared. 
May 12.-Patient returned to New York from 
Chicago and presents herself for examination. No 
trace of the growth remains ; a slight red spot, 
rapidly disappearing, marks the site of the puncture. 
Cured. 
Case 3.-May 16, 1893. M. H. H., age 25; wen 
or dermoid cyst. Tumor began six years ago, about 
the size of a pea on the neck below and behind the 
ear. Two years ago it began to increase in size and 
to-day is about one inch and one-quarter in diameter. 
The patient decisively refuses to take an anaesthesia, 
wishes to avoid the scar from an incision, and asks 
to have the tumor removed by the aid of electricity. 
Tumor hard and movable. Treatment : Electro- 
cocaine, local anaesthesia to skin over tumor ; 
puncture made, contents of sac mostly expressed 
and cavity injected with a saturated solution of 
iodide of potash-a non-soluble metallic electrode 
remaining within the sac with the solution; a 
DIFFUSION FROM SOLUBLE ELECTRODES. 
193 194 
CATAPHORESIS. 
current of 15 milliamperes was allowed to flow for 
ten minutes, with the purpose of setting free the 
iodine and obtaining its effect in a nascent state 
upon the lining of the sac. 
May 19.-No soreness. Tumor soft and pliable 
but hardening. 
May 22.-Tumor about two-thirds of its former 
size. 
May 23.-Tumor again filled and the operation 
was a most obvious failure. I resolved to try an- 
other method, viz., electric diffusion from a soluble 
metal. This was done with 20 to 30 milliamperes 
of current for about ten minutes. 
May 31.-Slight serous discharge of an orange- 
yellow color. 
July 1.-Patient not seen again until this date, 
when he returned to state that the discharge had 
quickly ceased and that the tumor had entirely dis- 
appeared, leaving no evidence of the operation. 
Seen May 1, nearly one year later, there has been 
no recurrence. Cured. 
SYCOSIS PARASITICA. 
E. H., age 50. Disease began seven years ago. 
Patient stated that he had tried to pull out an in- 
growing hair and it broke off. A papule formed 
here, and following this a diffuse redness began to 
spread itself in all directions from the site (the left 
side of the face just in front of the ear); at the same 
time papules formed, coalesced and spread outward. 
No pus was formed at first, but after a short time 
the tips of pimples became white and pus was dis- 
charged. This was followed by an exudation of 
serum from the excoriated surface and shortly be- DIFFUSION FROM SOLUBLE ELECTRODES. 
195 
fore it was operated upon discharged in twenty-four 
hours one ounce of serum. He has been everywhere 
and tried every treatment to no advantage until last 
October, the 21st, when he was operated upon at 
the New York Post-Graduate Hospital by Dr. R. Y. 
Morris who removed the skin and subjacent tissue 
over an area in front of the ear about five and one- 
half inches long and two inches wide. Skin grafts 
were then applied which did well till one day about 
a week later he was out in the cold and a portion of 
the ears froze and had to be removed, which left 
when healed a scar two inches long and one inch 
wide in the centre of the wound. All went well 
and the part looked healthy till February last, when 
signs of the old trouble began to show themselves 
in the skin just outside of line of incision, and when 
he presented himself to me the characteristic papules 
had spread themselves over a surface of about three 
inches long by two wide ; in places the tissue was 
covered with small blebs and had a boggy appear- 
ance, into which a needle could be thrust for a dis- 
tance of one-quarter of an inch without producing 
pain or discomfort. 
April 20, he began treatment, which consisted of 
electric diffusion from copper electrodes to 2 mil- 
liamperes, ten to twenty applications, lasting in all 
ten to fifteen minutes, until the green oxychlorid of 
copper gave a distinct coloration to skin and tissue, 
using the positive pole, with the negative in back of 
neck. This was repeated eight times, the last one 
about May 10. The aluminium needle was used 
twice and the negative pole with equally successful 
results. 
May 14.-He came with the skin over lesion show- 196 
CATAPHORESIS. 
ing a normal and healthy condition. Treatment 
ceased, with the injunction to return if there is the 
slightest evidence of recurrence. 
Note.-The alternatives in this case were, I am informed by 
Dr. Morris, further incision or curetting, both of which were 
objectionable, because the cicatrix was already extremely tense 
and no further tissue could well be sacrificed. The effect of the 
electric diffusion method was remarkable. It left behind it al- 
most no observable cicatricial tension, in this respect much un- 
like ordinary electrolysis, and unlike the effects from the knife or 
the curette. 
I have employed electric diffusion from metals in 
a variety of cases not here enumerated. Its action 
upon hemorrhoids has been to cure them in the many 
cases in which I have tried it. I have used it in 
endometritis, cystic degeneration of the cervix uteri, 
in ulcerations of the rectum, in keloid growths, etc. 
I am at present treating lupus and epithelioma with 
thus far favorable results, and have even begun upon 
a case of sarcoma, but it is too early to make any 
report upon this later set of cases. Dr. Gautier has 
reported excellent results in a great variety of gyne- 
cologic procedures and conditions. PART V.-SPECIAL APPLICATIONS IN 
DENTAL SURGERY. 
CHAPTER I. 
ANESTHETIZATION OF SENSITIVE DENTINE. 
The subject of cataphoresis, especially in its rela- 
tion to local anaesthesia of the teeth, is now largely 
occupying the attention of the dental profession. 
Shakespeare says that few men, howevei- great or 
courageous, are able to bear the toothache with 
philosophy. Anything which promises relief is. 
welcomed, and cataphoresis in dentistry bids fair to 
be only second in importance to general anaesthesia ; 
to annul the pain of the patient and to diminish the 
wear and tear upon the nervous systems of both 
patient and operator, is to disarm dentistry of half 
the dread which many of its operations inspire. 
Like the sure effect of slowly-dripping water upon 
the stone beneath it, so the prolonged suffering of 
pain, or the prolonged witnessing of such suffering, 
has a deleterious effect-perhaps greater than the 
sudden and soon-ceasing pain of a tooth-extraction 
for which patients now often appeal to general 
anaesthesia. 
There is unquestionably an extensive field in 
197 198 
CATAPHORESIS. 
dental practice for electricity when the principles 
upon which its employment is based are generally 
understood. It is already in familiar use for certain 
mechanical purposes exemplified in, for instance, 
dental pluggers and drills, and also for cauterization 
and interior illumination. And, as has been noted 
in an earlier chapter, much but unavailing effort 
has been expended in attempts to utilize the electric 
current alone, or upon Richardson's plan of voltaic 
narcotism to annul the pain of tooth extraction. 
Some of these efforts included even efforts to "ob- 
tund," by means of electricity alone, the pain of 
sensitive dentine when operated upon. 
Many nostrums for use as local anaesthetics are 
on the market appealing to the dental practitioner, 
but the Dental Code of Ethics proscribes their use, 
for the general reason that the use of all secret prep- 
arations is wrong, and because they are likely to 
become a menace to life. A most hearty welcome 
has therefore been accorded to the cataphoretic 
method of producing local anaesthesia, and its users 
are already numbered by hundreds. Its applica- 
tions are known to all, and a great good is being 
done by it. 
Considerable attention was given to the anaesthet- 
ization of sensitive dentine in the first part of this 
book, and two cases were cited1 illustrating the pro- 
cedure and demonstrating its usefulness. In the 
second of these cases even the pulp was desensitized, 
the point of an excavator having readily entered 
into the pulp-chamber without any consciousness of 
pain on the part of the patient. 
In these experiments and in all my later work of 
1 See page 42. ANESTHETIZATION OF SENSITIVE DENTINE. 
199 
a similar nature I combined guaiacol with cocaine, 
for I have found that the time required is thus re- 
duced two-thirds, and permits the reduction of the 
current strength about two-thirds ; the most im- 
portant feature of the combination is that the 
guaiacol holds on chemically to the cocaine and thus 
prevents any possible quick absorption into the gen- 
eral circulation with consequent toxic effects. 
It is generally found that ten to thirty per cent, 
solutions of cocaine with guaiacol are best adapted 
for work upon dentine. As has been pointed out, 
guaiacol is perfectly bland in its action, and although 
it has a well-defined odor, it is by no means offen- 
sive ; it is a colorless solution, and it leaves no un- 
desirable after-effects. If, however, the operator 
does not desire to use guaiacol, but prefers to use 
aqueous solutions of cocaine, or, indeed, any other 
practical anaesthetic agent, what is here said applies 
with the same force. 
In applying electricity to a tooth there should be 
careful discrimination as to the character of appli- 
cator employed. In small cavities the tubular and 
perforated applicator, whether straight or bent, or 
blunt or sharp at its end, is advised ; in large cavi- 
ties the spatulate form or some form of large ap- 
plicator is essential. These applicators may be 
adapted to handles for the hand or to springs which 
automatically hold them in place. In this connec- 
tion I would again call especial attention to the fact 
that the cross-sectional area of the applicator must 
nearly equal the cross-sectional area of the cavity to 
be treated. 
It must be remembered that every movement of 
the electrode, and every addition of solution varies 200 
C'21 TA PHO HEATS. 
the resistance of the patient's circuit, and, therefore, 
varies the amount of current flowing through the 
tooth. Until anaesthesia is effected each such varia- 
tion of current strength causes pain. I would sug- 
gest that in some cases it would be well to use very 
fine gold or platinum plugging packed lightly into 
the cavity over cotton which carries the medica- 
ment, with a clamp making connection between the 
metal filling and the rheostat. 
When the current is first applied to the tooth it 
should be in the smallest possible quantity. As the 
patient can bear it the quantity should be gradually 
increased. If it is necessary to renew the medicated 
solution first reduce the current gradually, and ap- 
ply the solution while little or no current is flowing 
and then increase the current flow. So extremely 
sensitive is a sensitive tooth that changes in rate of 
current flow must be made by very easy stages. 
Even when anaesthesia has been obtained a rate of 
two milliamperes is considerable. 
Different observers give very different reports as 
to the current strength employed in their cases. To 
the reports of those who give only the number of 
cells brought into action, or the number of volts in- 
dicated, we can give no advice, since this record is 
of no value for statistical and final deductions. The 
milliamperemeter is as essential to the electro-ther- 
apist as is the yard or rod measure to the surveyor. 
Some excellent practitioners report an inability to 
attain, for instance, more than a maximum current 
strength of ^th a milliampere. This indicates un- 
doubtedly too low an initial voltage in their battery. 
Results as to the rate of flow will also vary accord- 
ing to the varying resistance of teeth and according ANESTHETIZATION OF SENSITIVE DENTINE. 
201 
to a similar variation in the resistivity of the medi- 
cinal substances employed. The chance of inaccu- 
racy in some milliampere meters must also be taken 
into account. But the chief cause for the differences 
in the reported milliampere meter readings and 
indeed a chief cause of slowness in anaesthetization 
or even of failure to anaesthetize properly, is, in my 
opinion, the use of the fine, wire-like and small ap- 
plicator which, according to the law of current den- 
sity, explained in the chapter on Electrodes, fails to 
properly diffuse the cocaine into the dentine. This 
fault can be promptly remedied, as pointed out in 
the above referred to chapter, by employing an ap- 
plicator the area of whose cross section very nearly 
equals that of the cavity to be anaesthetized. This 
point cannot be too strenuously urged, and has not 
yet been taken into account. 
I would remark here that the matter of the first 
importance is to establish the general principle of 
Cataphoric Medication, namely, of cataphoric anaes- 
thetization of sensitive dentine, and that time and 
further experience, together with the adoption of 
standard instruments and standard initial voltage, 
will harmonize results now only apparently contra- 
dictory by reason of insufficient information. 
Dentine is anaesthetized primarily over the radius 
covered by the positive pole, because the current 
passes in the course of least resistance toward the 
apex of the root through the tubuli and pulp canal. 
Thus, the larger the surface covered by the positive 
pole the greater will be the surface anaesthetized and 
the better will be the results obtained. 
The enamel is a non-conductor, so, to obtain an 
entrance for a medicament, it is necessary to place 202 
CATAPHORESIS. 
the electrode upon some exposed portion of the 
dentine. 
Teeth whose dentinal structure is dense, are more 
tedious to anaesthetize than those whose structure is 
less dense, more time being required to produce the 
desired results ; renew the anaesthetizing solution 
from time to time. Watch the milliampere meter 
and see that so much current is not sent through 
the tooth that it will heat. 
Do not break the circuit to your patient by remov- 
ing the electrode from the tooth, with the current 
turned on ; such a procedure will cause an unde- 
sirable shock. 
Considering the short time required to anaesthetize 
dentine it is advisable not to leave the patient during 
the administration, as an accident may occur by the 
patient interfering with the electrodes. Where 
teeth have been previously treated with creosote 
or carbolic acid, as satisfactory results should not 
be expected, as where such agents have not been 
employed, due probably to the fact that these sub- 
stances have acted as coagulants. 
Use a large negative electrode made preferably 
of punk or amadou over a piece of carbon. The 
punk remains moist for a long time and does not 
" burn." 
Before making any applications to the mouth it 
is well to insulate the chair by placing linoleum or 
rubber under its feet ; it is also desirable to keep 
the patient out of reach of gas or water pipes, steam 
radiators or other metallic substances that would 
make a ground connection possible. 
Apply the rubber dam to every tooth operated 
upon ; it is necessary to keep all saliva away from the tooth and the rubber dam serves to insulate it 
admirably. 
Leakage of saliva means leakage of electricity, 
and may easily account for failure or delay. For 
this reason it is important to give careful attention 
to insulation. 
Insulation with the rubber dam depends upon the 
method of application. It is often ineffective, how- 
ever skilfully applied. Unless the dam hugs the 
necks of the teeth closely, leakage occurs, and some- 
times it is impossible to effect this. As has been 
pointed out and illustrated diagrammatically by Dr. 
R. Ottolengui, a cross section of a malformed tooth 
shows leakage of saliva at the concavities.1 
Such places can be dammed with punk, for filling, 
but this will not be sufficient for cataphoresis. For 
the latter they must be packed with soft gutta 
percha (temporary stopping)-, smoothing with cot- 
ton dipped in chloroform. 
If the spaces are small, and it is perhaps best to 
do this in all cases, use chloro-percha around the 
neck of the tooth over the dam. Leakage through 
soft tissue is detected easily by the rapid rise of cur- 
rent flow as indicated by milliampere meter. 
Any metal fillings which might come in contact 
with the electrode, or the wet cotton in the cavity, 
should be covered with chloro-percha or some other 
temporary stopping. If the cavity to be operated 
on is an approximal one, and a filling in the next 
tooth is too close to allow of its satisfactory insula- 
tion, the rubber may be applied only over the tooth 
to be worked on, thus insulating it; or, preferably, 
ANESTHETIZATION OF SENSITIVE DENTINE. 
203 
14' Methods of Filling Teeth," p. 41. 204 
the rubber being already in place, a second dam 
may be applied over the tooth to be worked on, 
which may be removed after anaesthetization. 
In each case the polarity of the terminals should 
be tested with a piece of wet litmus paper or paper 
wet with a saturated solution of iodide of potash. 
Or if all connections remain unchanged the two 
electrodes may be brought into momentary contact 
and the proper direction of the movement of the 
needle of the milliampere meter be noted. 
I would say, try a few cases on your least desirable 
patients at first, use solutions freshly made, and 
large applicators, and, if you will, guaiacol. With 
a brief experience, I believe you will find that in 
cataphoresis the members of the dental profession 
have acquired a procedure which will always sur- 
vive. 
The practical result of a great amount of exper- 
imentation which I have made to find a successful 
obtundent of sensitive dentine, either a simple med- 
icine or combination of medicines, is this, that the 
best results are to be obtained either from a strong 
aqueous solution of hydrochlorate of cocaine or 
a solution of hydrochlorate of cocaine with guaia- 
col, which I was the first to propose. Either of 
these solutions should be freshly made on each 
occasion of use, for the widely known reason that all 
cocaine solutions deteriorate rapidly in anaesthetic 
power. The solutions should be anywhere from 
10 per cent to 30 per cent for sensitive dentine and 
from 4 per cent to 10 per cent for mucous mem- 
branes. When used upon the latter the guaiacol 
solution should be diluted one half by the oil of 
sweet almonds. 
CATAPHORESIS. ANESTHETIZATION OF SENSITIVE DENTINE. 
205 
What I would then advise in place of any fixed 
solutions is the following procedure. Keep on hand, 
for dental work, a bottle of cocaine crystals, a bottle 
of sterilized water and a bottle of pure, colorless 
guaiacol. When ready to operate take a small glass 
plate 3 or 4 inches square and place upon it a few 
crystals of cocaine ; add two or three drops of ster- 
ilized water or guaiacol as desired and heat grad- 
ually over a spirit lamp to a point short of the 
boiling point of the mixture. It is not necessary to 
heat to as high a point when the water is used as 
when guaiacol is employed. It is wise to apply the 
solution before it gets cold, as this may save a slight 
shock in a sensitive tooth. My preference, as has 
already been expressed, is for the guaiacol-cocaine, 
principally because of its greater rapidity of action, 
its sterilizing effect and its reduction of the chances 
of toxic effects from cocaine by preventing its diffu- 
sion to the general circulation ; its only disadvantages 
are its odor-which, with cleanly use, is trifling-and 
its softening effect upon the rubber dam. 
A few cases are now introduced, interesting as to 
general technique and results, or instructive as to 
special points. 
The following cases are contributed by Dr. M. L. 
Rhein. " Case I. Mrs. W., set. about 32. Has had 
such a dread of dental operations that for ten years 
her teeth have been neglected, much to the patient's 
distress. Hearing that I was using cataphoric medi- 
cation for producing desensitization of dentine, she 
applied to me in the spring of '96 to place her mouth 
in proper condition, with the understanding that 
cocaine cataphoresis should be used on all her 
teeth. 206 
CATAPHORESIS. 
" Her nervous dread at the beginning of the first 
sitting can only be realized by the operator who has 
worked for such patients. The first tooth on which 
work was commenced was a superior central incisor 
with a large approximal cavity filled with loose 
debris of food mixed with carious dentine. The 
rubber having been adjusted, the contents of the 
cavity was so sensitive to the touch of an instrument 
that it was impossible even to remove the loose 
debris, which is always desirable. A freshly-pre- 
pared 50 per cent, aqueous solution of cocaine hy- 
drochlorate was introduced and the positive pole 
introduced into the cavity while the cathode was 
conducted through the cheek by means of a sponge 
held securely under the rubber dam holder. The 
current was started with a voltage of through 
the ' Wheeler Fractional Volt Selector ' and by 
gradation raised to 17 volts in the course of twenty- 
five minutes, at which time there was registered | 
a milliampere of current. The application was 
entirely painless unless the voltage was raised too 
rapidly, when a restoration to the previous amount of 
voltage would remove every trace of sensation. At 
the lapse of 25 minutes it was found that I could 
remove the contents of the cavity in any manner 
desired without patient experiencing any sensation. 
The pulp was found to be exposed and also devoid 
of sensation, so that at the same sitting it was re- 
moved entire with a Donaldson nerve bristle with- 
out the patient feeling any sensation and without 
any second application. 
" The patient was so pleased with the result that 
she was eager for appointment, not only to restore 
her teeth to a condition of usefulness but to rid ANESTHETIZATION OF SENSITIVE DENTINE. 
207 
herself of the odontalgia from which she was suffer- 
ing in different parts of her mouth. In the course 
of this work six exposed pulps were removed in this 
way and over twenty teeth operated upon. In every 
case the cataphoric application gave the same meas- 
ure of success as to anaesthetic properties. Some 
of the exposed pulps, however, did not come away so 
kindly, and were followed by hemorrhage which it 
was found difficult to control. This relaxed condi- 
tion of the walls of the capillaries when cocaine is 
used is the one great objection to the removal of 
the pulp in this way, and frequently much time is 
lost in controlling this stubborn hemorrhage. In 
consequence I much prefer, after having cataphor- 
ically desensitized the pulp, to introduce the custom- 
ary arsenical preparation which will produce its 
well-known effect without any perceptible irrita- 
tion. To illustrate this I cite : 
" Case II.-Mr. H., aet. about 40, presented him- 
self with an aching third superior molar which 
was found to have a small pin-head cavity below 
the gum on the anterior approximal surface. The 
introduction of a bristle soon gave evidence of pulp 
exposure. It was Saturday afternoon and patient 
was to leave for Europe on Tuesday. The tooth was 
greatly valued for masticatory purposes. The rub- 
ber dam was carefully applied only to the one tooth, 
a clamp ad j usted high up so as to expose the cavity. 
A solution of gutta percha in chloroform was then 
freely run around the neck of the tooth and over the 
clamp so as to prevent any possible leakage of cur- 
rent. After a 15-minute application of the current 
the cavity was painlessly enlarged and the pulp 208 
CATAPHORESIS. 
freely exposed. An arsenical application was intro- 
duced and cavity sealed. The patient returned on 
Monday having experienced no pain. The cavity 
was then extended so as to get on a direct line with 
the ends of the roots which were then cleansed of 
all the pulp tissue and filled at the same sitting. 
The patient experienced no sensation of any kind. 
" Case III- Master R., aet 12 ; inferior first molar 
decayed on anterior approximate surface and crown. 
A fresh aqueous solution of cocaine hydrochlorate 
was prepared and current turned on. It was with 
extreme difficulty that the voltage could be increased, 
and even after this had become bearable it was 
necessary to increase the voltage to about 60 before 
a registration of f of a milliampere was obtained. 
The resistance of the patient was so great that with 
25 volts of current there was barely Ay of a milliam- 
pere, and although the outer zone of dentine was 
found to be devoid of sensation there was no depth 
to the anaesthetic effect. This patient absolutely 
refused to allow the proper preparation of cavity to 
be made unless it was done painlessly. It required 
over one hour's application of the current with a 
final voltage of between 60 and 70 volts to attain the 
desired result. The tooth was, however, then 
thoroughly prepared without any objection on the 
part of the patient. The other three first molars were 
subsequently treated in the same manner always 
requiring about one hour's application before insen- 
sibility to pain was produced." 
The following case reported by Dr. R. Ottolengui 
is of especial practical interest: 
" The most satisfactory result with cataphoresis, 
within my experience, in a case which all dentists ANESTHETIZATION OF SENSITIVE DENTINE. 
209 
will recognize as affording a crucial test of the pos- 
sibilities of this method of desensitizing sensitive 
dentine, is herewith described. 
" The patient was a young woman, about seven- 
teen, fully developed, large in stature, plethoric, 
cultured, highly educated, and very skeptical as to 
the possibilities of controlling the sensitiveness of 
her teeth by means of cocaine applied in any man- 
ner whatever. She had submitted to hypodermic 
cocaine on two or three occasions, with no anaes- 
thetic effect whatever, and her faith in the drug 
had been completely shattered. The addition of the 
electric current, was an argument of no potency to 
her mind. These facts are worthy of note as indicat- 
ing that neither suggestion, nor expectant faith, 
modified the result. 
" The tooth was the right superior third molar. 
The cavity along the buccal surface, quite large, 
and filled with decalcified dentine of the most sen- 
sitive character. Furthermore, the caries extended 
superficially backward towards the posterior surface, 
a whitish line of decalcified enamel marking the 
limits to which the cavity must be extended. The 
sensitiveness was so extreme that the patient would 
not even tolerate having the cavity dried out with 
bibulous paper. She opposed treatment, and strongly 
urged extraction. 
" After much persuasion she allowed me to pro- 
ceed. With difficulty the dam was placed over the 
three molars, the holes being cut small enough to hug 
the teeth tightly, and far enough apart so that the 
gum septa between the teeth were well covered. As 
an additional precaution against possible leakage, 
the dam around the teeth was smeared with chloro- 210 
CATAPHORESIS. 
percha. Anhydrous crystals of cocaine dissolved 
in water, a highly saturate solution being freshly 
prepared, was placed in the cavity on a pellet of 
cotton. At first it was impossible to permit enough 
flow of current to obtain registration on the mil- 
liampere meter, but after a few minutes one-tenth 
of a milliampere was tolerated without discomfort. 
In ten minutes one fifth of a milliampere was flow- 
ing, and this was maintained for ten minutes longer, 
the current having been continued, in all, twenty 
minutes. Upon attempting to prepare the cavity, 
desensitization was so complete, that the leathery 
decay was readily removed, the bottom of the cavity 
thoroughly scraped,the margins perfected, the cavity 
extended backward around to the posterior surface, 
then up into the occlusal surface, where a large 
amalgam filling was met. This was removed, and 
that cavity fully prepared as a part of the original 
one. It will be recognized that now I had a most 
extensive operation before me, when I state that 
this thorough preparation of the cavity made me 
decide to fill with gold. I consequently dressed the 
tooth with oil of cinnamon, and filled temporarily 
with gutta-percha. At a subsequent sitting the 
tooth was found to be as sensitive as ever, but with- 
out difficulty a gold filling was inserted fully restor- 
ing all of the lost tooth bone. Four months later 
the tooth was comfortable, but responded to tests 
showing that the pulp was still alive and apparently 
healthy, despite the close approach to it made by 
caries. " 
Dr. Edw. C. Briggs, of Boston, Mass., makes the 
following interesting contribution to the subject. 
Dr. Briggs writes : " I give you below a few cases which I have 
hastily noted down, and trust they will prove what 
you want. 
" Case I.-Mr. W. H. B.-Was left superior, first 
molar, crown cavity. I used the G. M. Wheeler 
apparatus, and worked up to twenty volts in fifteen 
minutes, and allowed it to remain at that pres- 
sure for ten minutes, after which, the tooth was 
thoroughly prepared without any sensitiveness, and 
filled with gold. This was an exceptionally sen- 
sitive tooth. 
" Case II.-Miss M. S.-This patient is of a very 
sensitive, nervous organization, and always was 
very difficult to operate upon, and many times I 
have been obliged to hypnotize in order to accomplish 
anything. The cataphoresis worked admirably, 
taking, however, twenty-five or thirty minutes. 
" Case III.-Mrs. W. G.-This was a lower molar, 
and it took about fifteen volts fifteen minutes, which 
sufficed to anaesthetize the tooth ; and prepared 
and filled without sensation. 
" Case IV.-Miss L. H.-In this case it was desired 
to destroy a pulp, and use the tooth for bridge 
work, and, after removing a small gold filling, the 
current was applied in the cavity for about thirty 
minutes, when I was able to drill down to the pulp 
and remove part of it, without any sensation; 
removed the remainder of pulp after an injection 
of cocaine in the syringe. 
" Case V.-Mr. G. L.-This was an excruciatingly 
sensitive cavity in the crown of the molar. The 
patient jeered all the time the current was being 
used, having no faith in any relief. This was run 
extra long, fully half an hour, to make sure ; and 
ANESTHETIZATION OF SENSITIVE DENTINE. 
211 212 
CATAPHORESIS. 
the tooth was prepared and filled without sensa- 
tion. 
" I am giving these cases, as selected, at random, 
and might go on by the score-all pretty much of 
the same description. There is a very small per- 
centage of failures, of which the case L. B. is a sam- 
ple. In this instance, the patient seemed to be ab- 
normally susceptible to electric current, and five 
volts gave so much pain that I was obliged to hold 
it at three volts, and after fifteen minutes, being 
unable to increase the flow of electricity gave it up 
entirely. Such cases are few and far between. As I 
wrote you before, it seems to be only a question of 
time to obtain absolute success, in every case ; but 
it takes enough time to lead one to avoid using it, 
unless the case especially demands it. It is a great 
comfort to patients, however, to know that there is 
something that can be resorted to in time of need." 
Dr. Henry W. Gillett, has reported numerous cases, 
of which the following examples may be given : 
" Case A.-Mr. N., aged twenty-five ; right supe- 
rior second bicuspid, cavity quite sensitive. Treat- 
ment, cataphoresis for ten minutes with twenty-per- 
cent. solution cocaine, not quite one milliampere of 
current passing through the tooth at the end of treat- 
ment. Result, absolute freedom from sensitiveness 
to excavator or bur. 
" Case B.-Mrs. H., aged forty ; left superior bi- 
cuspid, large approximal filling, history and con- 
templated treatment such as had led to a decision 
to destroy the pulp. To do this it was more con- 
venient to approach the pulp through the anterior 
cavity. The dentine was found too sensitive to 
permit drilling. Cataphoresis for fifteen minutes ANESTHETIZATION OF SENSITIVE DENTINE. 
213 
with thirty per cent, cocaine, then drill directly to 
the pulp, which was found much receded. The first 
notice that the pulp had been reached by the drill 
was from hemorrhage, and not from pain. In this 
case a further application was made and pulp re- 
moved painlessly. 
" Case C.-Mr. C.,aged thirty left ; inferior second 
molar, very large corono-mesial cavity. The patient 
refused to allow shaping of cavity, because of sen- 
sitiveness. Cataphoresis for fifteen minutes with 
twenty per cent, cocaine. Result, entire freedom 
from sensitiveness, except in one corner near cervical 
margin. 
" Case D.-Willie M., aged thirteen; mesial cavity 
in inferior first molar, very sensitive. Cataphoresis 
with thirty-per-cent, cocaine for ten minutes. Re- 
sult, complete anaesthesia of dentine for some dis- 
tance, but a second application for six minutes was 
needed for shaping the retaining grooves. 
" Case E.-Mr. C. M., aged twenty, reports his 
teeth as very sensitive, and all cavities, even the 
smallest, prove so. Inferior second molar buccal 
cavity. Applied a twenty-per-cent, cocaine solution 
with electric current for twelve minutes,-seventeen 
volt current for the final third of the period. Re- 
sult : entire absence of sensitiveness in the prepara- 
tion of the cavity. For same patient at same sitting, 
right superior first bicuspid corono-distal cavity, 
twenty-per-cent, cocaine, current for ten minutes, 
reaching a maximum of seventeen volts. Result : 
complete absence of sensitiveness, except for final 
groove cutting. As the patient was anxious to be 
able to say that it had not hurt him at all, a second 
application was made about like the first, and the 214 
CATAPHORESIS. 
cavity completely anaesthetized. One of the most 
competent New York practitioners, in whose hands 
the patient had previously been, assured me after- 
wards that he had used every known remedy with- 
out success in the effort to even relieve the sensitive- 
ness in this case. 
" Case F.-C. Y., aged fifteen ; mesial cavity in 
right central incisor, very sensitive. Fifteen-per- 
cent. cocaine current for eleven minutes up to a 
maximum of twenty-five volts. Result : complete 
anaesthesia of the dentine during the preparation of 
the cavity. Same patient and same sitting. Similar 
cavity in left central; same treatment, and similar 
results. The patient went to sleep during this 
second application, which, when we consider that 
this was his first experience, is good evidence that 
the process is not a painful one. 
The following resume of results quoted from a paper1 by Wes- 
ton A. Price, D. D. S., an able and indefatigable worker, will be 
read at this point with interest. He says : 
I have observed the following results by applying the cocain 
solution as stated above : First. In nearly 1,500 cases, of which 
I have kept a record, the per cent of perfectly successful opera- 
tions has been between 95 and 100, and of late, with the increase 
of experience, all cases have been successful on the second appli- 
cation, if not on the first. Of these fully 100 were cases in which 
the pulp was entirely removed at the time, and in about 200 more 
the pulp was drilled into and partly removed, and a devitalizing 
agent used to complete the destruction. Second. In almost all 
cases of single-rooted teeth the pulp was entirely removed at the 
time. Third. No sensation of pain wTas felt from the devitalizing 
agent applied after using cataphoresis. Fourth. Not a single 
case as yet of a dead pulp from the use of cataphoresis. Fifth. 
No difference has been noted in the time required for varying 
concentrations of cocain or any other agent. Sixth. The average 
time required for all cases was about thirteen minutes. Seventh. 
The amount of current tolerable is determined by the effect of 
1. Read before the American Dental Association, August, 1897. 
Published-The Dental Digest, p. 460, 1897. ANESTHETIZATION OF SENSITIVE DENTINE. 
215 
the cocain on the pulp tissue, and not in the dentin, in a case of 
unexposed healthy pulp. Eighth. The resistance through the 
wet dentin varies all the way from a few thousand to five hun- 
dred thousand ohms. Ninth. The amount of current tolerable 
has been found to vary from one two-hundred thousandths to two- 
thousandths of an ampere, the average being less than two ten- 
thonsandths at the beginning of the operation and four ten-thou- 
sandths at the finish. Of course, where pulps were devitalized a 
very much stronger current was used for the finish, though seldom 
more than that amount was used where the continued life of a 
pulp was expected. Tenth. There are no constant symptoms, 
that will give any indication of the amount of current flowing. 
Each case has a different pain limit. Hence the absolute neces- 
sity of using a milliamperemeter. Eleventh. No effect has ever 
been noted in the tissues beyond the tooth, except where a very 
strong current was used, then slight periostitis. 
The following cases are reported by Dr. F. T. Van 
Woert: 
" FAILURES. 
" 1st Case.-Young woman, twenty-eight years of 
age, nervous temperament, with the right superior 
central pulp exposed. The current was turned on 
gradually from three dry cells, running through a 
saturated solution of cocaine about twenty-five 
minutes, after which four more cells were added, 
and the current standing £ milliampere against 9| 
volts for 1| hrs., after which the pulp was even more 
sensitive than when the operation was begun. 
" 2nd Case.-A little girl, twelve years of age, left 
inferior, first molar, large crown cavity, but no ex- 
posure of the pulp, current of three cells in the cir- 
cuit, which caused intense pain upon the slightest 
movement of the current controller. Later it was 
tried with one cell, and with less than a 40th of a 
milliampere, the patient suffering severe pain nearly 
| of an hour, using a saturated solution of cocaine, 
as in the previous case, the tooth was found to be 
more sensitive than when the operation was begun. 216 
CATAPHORESIS. 
" SUCCESSES." 
1 ' Three cases of extirpation of pulp from the teeth 
of an adult female, at a clinic, before the senior 
class. 
" 1st:-Saturated solution upon full exposure, f 
milliampere of current, seven cells in the circuit, 
time £ hour, pulps removed without the slightest 
sensation. 
"2nd :-Necrosis of the inferior maxilla, involv- 
ing the outer plate from the second bicuspid, to the 
third molar, a suitable tampon was arranged and 
was moistened with a saturated solution of cocaine, 
over this was placed a piece of tinfoil for properly- 
diffusing the current, which was turned on full from 
two dry cells, and maintained for twelve minutes, the 
end of that time there was complete anaesthesia, and 
the operation was proceeded with for ten minutes, 
when the application was renewed three minutes 
longer, and the operation completed." 
The following cases have been reported by Nelson 
M. Chitterling, D. D. S., of Bloomfield, N. J., and 
may be found instructive : 
" Case I.-Young lady presenting sensitive cavity 
in cervix of upper lateral incisor, so sensitive that 
the pressure of her tongue could not be borne. With 
two cells and the current controller at ten, thirteen 
minutes sufficed to render cavity absolutely without 
sensation. 
" Case II-Cavity in cervix of upper lateral was 
anaesthetized in four minutes by use of six cells, 
and excavated without sensation. 
"This case was unusually sensitive, and the pa- 
tient said that she was very susceptible to electricity. ANESTHETIZATION OF SENSITIVE DENTINE. 
217 
" Case III.-Upper bicuspid pulp extirpated with- 
out pain after twenty minutes' treatment. 
" Case IV.-Upper bicuspid pulp removed after 
ten minutes' treatment with eight cells." 
PRESSURE LOCAL ANESTHESIA OF SOFT TISSUES AND 
OF DENTINE. 
It has become a well established practice in dental 
surgery to introduce into the cavity of a tooth 
for the purpose of bleaching it, when the cavity 
admits of it, a twenty-five or other convenient per 
cent, of peroxide of hydrogen held on a pledget 
of cotton and sealed in. It is maintained that, in 
addition to the simple process of imbibition, the 
cocaine is forced into the substance of the dentine 
by pressure due to the evaporation of the ether. In 
this manner teeth can be successfully bleached to 
an extent not possible if the pledget of cotton hold- 
ing the bleaching fluid is not sealed in, except when 
electricity is used. 
It occurred to me that if this same principle could 
be applied to a sulphuric ether solution of cocaine 
that we should possess an extraordinarily simple 
method of anaesthetizing the soft tissues in general 
and sensitive dentine in particular,-a method so 
simple and sure that it would sweep away all the 
labor that has been expended in a certain class of 
cavities, upon the introduction of cocaine by electric- 
ity. 
Since cocaine hydrochlorate would not dissolve 
in sulphuric ether, I dissolved it in guaiacol (making 
a 10 per cent, solution) and then found that I could 
add equal parts of sulphuric ether to the solution 
without precipitating the cocaine. 218 
CATAPHORESIS. 
Experiment I.-June 23, 1897. Taking about 
twenty drops of the above solution I put it in a 
small test tube and inverting the tube I held its 
mouth firmly against the skin of my forearm. At 
the end of five minutes, removing the tube, I tested 
the area of skin comprised within the circle repre- 
sented by the mouth of the tube and found that it 
was perfectly anaesthetized ; it remained anaesthetic 
for five minutes and then gradually recovered sensa- 
tion without any hyperaesthesia to speak of and 
without injury to the skin. 
Further experiments substantiated this result. 
I have also made some experiments with air pres- 
sure by connecting to a rubber tube, itself in con- 
nection with a cylinder of compressed air and a 
gauge, a hollow needle having a shoulder near its ex- 
tremity. Where the cavity permits of it, the solution 
of cocaine is introduced upon absorbent material, 
sealed in with plastic material and then the needle 
thrust through it as far as the shoulder will permit. 
At this point the air pressure is allowed to act. 
By the use of this instrument local anaesthesia is 
promptly obtained. Dr. M. L. Rhein has now an 
instrument of this description in his possession, and 
will as soon as possible make further experiments 
upon dentine and report some cases. CHAPTER II. 
ANESTHESIA OF THE GUMS. 
Under this chapter falls the anesthetization of 
the gums so as to permit of tooth extraction and 
implantation and other similar operations. The 
principles available for this purpose have already- 
been enlarged upon quite fully, and it need only be 
said that the above operations may be successfully 
and painlessly performed by the use of the cata- 
phoric method. 
It is desirable to have the application made on 
both sides of the gum at the same time so as to get 
a perfect effect. If a tooth is to be extracted it is 
also desirable, when possible, to have an application 
made through the cavity of the tooth so as to reach 
the pulp and affect it measurably. 
The two following cases are taken from an article 
by the writer which appeared in the "Dental 
Cosmos" for January, 1896. In the first case the 
patient, a Mrs. , was brought to me by Dr. 
Wm. J. Younger, of San Francisco, who was then 
(Dec. 11, 1895), in New York, that I might try 
guaiacol-cocaine anaesthesia and my new duplex 
positive pole electrode. ( See Fig. 51). The lady was 
remarkably nervous and apprehensive and sensitive 
219 220 
CATAPHORESIS. 
to pain, as she had that morning already undergone 
an implantation of a first right superior bicuspid. 
"In this operation pain had been obtunded in the 
usual manner by hypodermatic injections of a solu- 
tion of cocaine, requiring from fifteen to twenty 
minutes, and a succession of needle pricks. She had 
some after effects from the cocaine, particularly ' a 
bad feeling in the throat.' 
" The tooth implanted at this second operation 
was a superior left first bicuspid. 
" Adjusting the electrode to the gums at the spot 
devoid of a tooth, and packing in at one place (where 
good contact was not established) some absorbent 
cotton saturated with the guaiacol-cocaine solution, 
the current was turned on carefully. The negative 
electrode of the usual type was simply held by the 
patient in her hand. During the first three minutes 
the current strength registered was one-quarter, 
one-half, three-quarters and one and three-quarters 
milliamperes. During the next three and a half 
minutes it was, in slow gradations, increased to 
two and one-half and finally to a limit of three 
milliamperes. The electrical resistance of the 
patient's circuit varied during the operation be- 
tween 6,700 ohms and 7,240 ohms, never remaining 
constant more than thirty seconds at a time. The 
current caused little or no pain, for, if slight 
sensation of pain was felt, the current strength was 
diminished a fraction and then again increased, 
without pain, as ansesthesia progressed. The elec- 
trode was removed in six and one-half minutes and 
the operation proceeded with and finished in an ad- 
ditional eight minutes. The operation need not be 
described, since it is a familiar one, nor need it be ANESTHESIA OF THE GUMS. 
221 
added that it was skilfully done ; during the deep 
incisions and drilling out of bone the patient ex- 
perienced no pain whatever, except when, on one 
occasion, the knife for an instant cut into a region 
which had not been included within the area of 
action of the electrode. 
" The success of the annihilation of the pain may 
be best expressed in the words of the patient : ' I 
never could have believed it could be so painless ; it 
didn't hurt a bit. This is very much easier than the 
syringe.' Dr. Younger stated that he decidedly 
prefered the cataphoric method with guaiacol- 
cocaine to the injection of cocaine solutions. 
" It may be noted that the total current strength 
employed was very small; that one half of the time 
was spent in avoiding pain by raising the current 
strength slowly to a fair working point (here the 
value of the ' fractional volt selector ' was demon- 
strated) ; that no portion of the mouth was an- 
aesthetized except that at the point of application 
of the electrode and that no after effects followed. 
The patient was examined the next day by Dr. 
Younger and the resulting conditions were found to 
be perfectly satisfactory." 
A second case of tooth-implantation was also on 
one of Dr. Younger's patients. In my absence Dr. 
Edward C. Kirk made the anaesthetic application, 
and records and his notes of the case are as follows : 
" The patient was decidedly an unsatisfactory 
individual for a test experiment in one respect, 
namely, that either naturally, or because of the 
physical and psychic impression produced by an im- 
plantation of the day before, he was in a condition 
of abnormally excited nervous sensibility. He gave 222 
CATAPHORESIS. 
expression frequently to exclamations which might 
easily be interpreted as expressions of pain actually 
felt, were it not for the fact that when at least 5| 
milliamperes of current were passing at 40 volts 
pressure, he called formore, when previously at 22 to 
23 volts he complained of ' pressure ' of the electrode, 
showing conclusively that the pain of the current 
was obliterated by the cataphoresis of the guaiacol- 
cocaine solution. 
" The duration of the application to produce 
anaesthesia was six and one-half minutes ; two and 
one-half minutes were occupied in raising the current 
strength in gradations from one-tenth of one mil- 
liampere to four milliamperes ; during the remain- 
ing three and one-half minutes the current strength 
was increased only from four to four and one-half 
milliamperes. Twice the patient complained of a 
sense of compression due to the current. Upon re- 
moving the electrode there was noted a bleaching of 
the mucous membrane over the territory of contact 
(coagulation). There was no sensation in the part 
treated ; anaesthesia was complete at the commence- 
ment of the operation. The patient remarked, ' It 
is nothing to-day to what it was yesterday ' (a. e., by 
the hypodermatic method)." The same solution and 
electrodes were employed in this case as in the other 
case above mentioned. 
Many cases of tooth-extraction might be cited, but 
the method is the same as above stated except that 
at times it is wise to make an application to the 
interior of the tooth as well as to the gum. But I 
do not believe that a proper anesthetization of the 
gums can be effected by aid of the rubber cup- 
shaped electrodes figured Nos. 53 and 54, anp I con- ANESTHESIA OF THE GUMS. 
223 
sider that the numerous cases of failure reported 
are due to the use of these defective electrodes and 
to imperfect methods. The fault of the rubber cup- 
electrode, as has already been pointed out (see chap- 
ter on electrodes), is the smallness of the metallic 
plate within it and the thickness of the porous and 
absorbing material required to be placed within it. 
There is no escape in my opinion, if success is de- 
sired, from the employment of the form of electrode 
I have described in Fig. 51, namely, a perforated and 
feeding electrode of large metallic surface backing 
up a thin porous septum which holds the medicament. CHAPTER III. 
BLEACHING OF TEETH BY CATAPHORESIS. 
With a view of ascertaining if discolored teeth 
could be actually and practically bleached by cata- 
phoric medication, I performed the following ex- 
periments, assisted by Mr. Wm. J. Evans, of Mc- 
Kesson & Robbins. 
The first point was to establish if solutions of 
H2 02 would conduct electricity. 
Experiment I.-H2 O2 twenty-five per cent., plus 
sulphuric ether seventy-five per cent. A few drops 
laid upon a glass plate, platinum wire electrodes 
placed one-half inch apart, forty cells equaling about 
sixty volts, gave only about one milliampere of cur- 
rent, a current strength too small for practical work. 
Similar solutions of the same strength of H2 02 
in chloroform, glycerol, and distilled water give in 
the first two instances no current, and in the latter 
about two milliamperes. 
Experiment VI.-H2 02 twenty-five per cent., plus 
sulphuric ether seventy-five per cent., plus dilute 
sulphuric acid a mere trace, gave twenty milliam- 
peres,-namely, sufficient for practical work if so 
desired. 
Experiment VIII.-H2 O2 twenty-five per cent., 
plus sulphuric ether seventy-five per cent., plus solu- 
224 BLEACHING OF TEETH BY CATAPHORESIS. 
225 
tion of chloride of sodium, afforded electric conduc- 
tion, but the solutions did not mix, and therefore 
were impracticable to work with in that form. 
Experiment XI.-A molar tooth containing a large 
cavity, leaving half of its crown still intact. 
The enamel of the crown was badly discolored by 
organic decomposition ; the central divisions of the 
dentinal tubuli were well exposed ; contrast was 
made by comparing it with another tooth to match 
the color, so that the shade could be determined. 
Cavity packed with absorbent cotton ; rubber dam 
adjusted, and the roots of the tooth imbedded in a 
piece of beef meat. Cotton was tightly wound about 
the platinum wire, constituting the positive elec- 
trode ; the negative was another wire inserted into 
the beef about one inch away from the imbedded 
tooth. 
Solution of chloride of sodium two-fifths of a cubic 
centimeter, and one and three-fifths cubic centi- 
meter of H3 02 twenty-five per cent., water seventy- 
five per cent., made by shaking two parts of pyro- 
zone twenty-five solution with one part of water 
and separating the fluids in a funnel, was dropped 
onto the cotton with a pipette ; the current was 
turned on and very quickly dried it, which was 
indicated promptly by the fall of needle of the mil- 
liampere meter, and more solution was continuously 
added. The darkened portion of the tooth bleached 
perceptibly white within a minute ; current strength 
twenty-five milliamperes. Then about the same 
number of milliamperes was employed during five 
minutes ; the enamel perfectly bleached. The bleach- 
ing action was also evident at the ends of the roots 
of the tooth, the H3 02 having been conveyed there 226 
CATAPHORESIS. 
by way of the open pulp-canals. These latter, there- 
fore, in actual practice, if exposed, should be closed 
by a non-conducting cement. 
Experiment XII.-Two pieces of blotting-paper, 
1X2 inches, each laid on a glass-plate and six bars of 
blue litmus-paper laid across the blotting-paper as 
shown in Fig. 75. 
NO 1 CATAPHORESIS 
NO 2 CONTROL 
MiUiam- 
Bcremctitr. 
Resist- 
ance. 
Battery. 
Fig. 75. 
Two cubic centimeters of twenty-five per cent., 
aqueous solution H2 O2 applied on glass at end of 
blotting-paper ; fifty milliamperes current. Blot- 
ting-paper wet with a weak solution of chloride of 
sodium ; current turned on. Almost immediately 
in No. 1 the litmus-paper at the positive end began 
to bleach, and this bleaching progressed in percep- 
tible steps toward the centre until within four and 
one-half minutes the litmus-paper on the positive 
end (three bars of it) was completely bleached of its 
blue color. The control experiment showed no BLEACHING OE TEETH BY CATAPHORESIS. 
227 
change proving that ordinary diffusion or chemical 
osmosis was not the cause of the result obtained in 
No. 1. 
Experiment XIII.-Four pieces of blotting-paper, 
1X2 inches, two pieces saturated with a decinormal 
solution of permanganate of potassium, U. S. P.- 
this stained them a chocolate color ; two pieces with 
H2O2 SOL. 
NO 1 
CATAPHORESIS 
H2O2 SOL. 
N0.2 CONTROL 
Fig. 76. 
twenty-five per cent, aqueous solution of H3 03. 
Each piece of permanganate paper was brought into 
juxtaposition with each piece of H2 O2 paper. No. 1 
cataphoresis ; No. 2 for control. (See Fig. 76.) 
The H2 O2 pieces of blotting-paper were previously 
moistened with the solution of sulphate of soda ; 228 
CATAPHORESIS. 
fifty milliamperes of current strength were applied 
as indicated by the platinum-electrodes in the illus- 
tration. The encroachment of decolorization of the 
permanganate paper was noticed at once in No. 1 ; 
it progressed steadily, and at the end of five minutes 
had extended about one-third of an inch, thus prov- 
ing cataphoric action, while the control, namely, 
No. 2, showed but a trifling decoloration at the 
point of immediate contact. 
Current strengths were used in these experiments 
which would be excessive if applied to living dentine; 
but this is only a question of degree, and neces- 
sitates the same careful procedure in applying the 
current as would be used by the operator in anaes- 
thetizing sensitive dentine. 
To produce this effect cataphoretically the dioxide 
of hydrogen must come against some part of the 
tooth that is a conductor, and that is the dentine ; 
so there should be a cavity in the tooth that is to be 
bleached ; and, if there is, absorbent cotton contain- 
ing a twenty per cent, solution of dioxide of hy- 
drogen is applied there, and the current is turned 
on. If the pulp cavity is exposed the first effect is 
that the electricity will carry the bleaching agency 
at once down to the end of the root. The canal 
must therefore be sealed up, otherwise most of the 
bleaching agency will be carried down to the root- 
ends and the bleaching will all occur where it is not 
wanted. 
On December 10, 1895, I read a paper before the 
First District Dental Society of the State of New 
York, which treated of this subject broadly. In 
this paper I showed that I had recently discovered 
a very important fact which bore vitally upon the BLEACHING OF TEETH BY CATAPHORESIS. 
229 
procedure of tooth-bleaching. This was a method 
of preparing a twenty-five per cent, aqueous solu- 
tion of "pyrozone," or dioxide of hydrogen, very 
easily. The method was as follows :-Take a glass 
tube and two cubic centimeters of pyrozone, twenty- 
five per cent, ethereal solution, and add to it a cubic 
centimeter of water. Mix it in the tube and put it 
in an evaporating dish in a warm place, and in three 
or four minutes the ether is entirely evaporated and 
there is left an active watery solution of pyrozone 
made very quickly. Otherwise such a strong 
aqueous solution could not be easily obtained. It 
does not retain its qualities any great time as the 
oxygen escapes. But why an aqueous solution ? 
That is one of the important points. If the resist- 
ance of the fluid or medicine that is to be driven in 
cataphorically is too great, no current passes ; and 
if it is too small there is no cataphoresis. A certain 
degree of resistance is wanted to obtain a certain 
effect. An ethereal solution twenty-five per cent, 
dioxide of hydrogen is a bad conductor. If the ap- 
plicator is dipped in a solution of sodium chloride or 
phosphate of soda and then dipped in the twenty- 
five per cent, ethereal solution, we can electrically 
get the pyrozone into the tooth where otherwise we 
could not ; but the aqueous solution is much better. 
There is a difference in this respect, that with an 
ethereal solution nothing can be dissolved in it that 
will make it a conductor and with the watery solu- 
tion such substances can be added. The strong 
aqueous solution is offered as a great advance on 
the ethereal solution for cataphoric application, and 
as an opportunity of getting rid of the clumsy pro- 
cess of covering the applicator with cotton saturated 230 
CATAPHORESIS. 
with some foreign substance like sodium chloride 
or phosphate of sodium. 
If a pledget of cotton be dipped into a solution of 
sodium chloride the chlorine will be set free and 
bleach the tooth, but there are reasons why chlorine 
has a destructive effect on the tissues of the teeth, 
and there are reasons why "pyrozone" is much 
safer and preferable to use. In the instance above 
given electrolysis occurs primarily and cataphoresis 
secondarily. Other applications of this principle will 
suggest themselves to the reader. 
What is the actual method of procedure in apply- 
ing the cataphoretic principle for bleaching I We 
would take an aqueous solution of pyrozone twenty- 
five per cent., and add to it a little phosphate of 
soda to make it, if desired, a good conductor and 
then apply it by the positive electrode to the tooth 
which is to be bleached. The negative dispersing 
electrode being in place the current is turned on 
very gently and before the milliampere meter will 
indicate the passage of any current, the patient will 
probably say, " I feel the current and it gives pain." 
So it does at first, but by leaving the current where 
it is the pain dies away ; the current may then be 
increased and the application can be continued in 
that manner. Half a milliampere, or possibly a 
milliampere of current, will drive the "pyrozone" 
into the dentine of the tooth if the enamel is broken 
at any spot, and cause the desired bleaching effect. 
In conclusion, a differentiation between the 
various stains which call for bleaching should be 
made. 
The most perfect success is when this stain is 
purely from transfusion of blood. If perfectly BLEACHING OF TEETH BY CATAPHORESIS. 
231 
fresh, as where an arsenical application causes 
rupture of the blood vessels in the pulp, the blood 
passing into the tubuli, the color of the tooth may 
be thoroughly restored by merely packing pyrozone, 
25 per cent., into the cavity and sealing it in for 24 
hours more or less. Older blood-stains require a 
more powerful agency ; such is supplied by electricity. 
Metallic stains cannot invariably be removed from 
teeth by any method known. 
Often, in attempting to remove an organic stain, 
a metallic stain may be produced,-hence the neces- 
sity for removing gold or other metal fillings before 
releasing any chlorine in the tooth, otherwise the 
chlorine will act on the gold and there will be 
thrown down a metallic purple stain. 
There are of course numerous organic stains aside 
from those caused by blood transfusion. Putrescent 
pulp causes organic stains, which are removable by 
powerful chlorine liberations, provided no coagu- 
lants have been previously used. 
Failures may be said to be due to two causes- 
First, the stain may be metallic-as from metal 
posts containing nickel ; this stain is green. 
Copper amalgams produce a green copper-colored 
stain ; steel or iron -<e., rust-produces a brown 
stain. Gold, acted on by chemical agents, as for 
instance chlorine, produces a purple stain. Some 
amalgams may throw down a chloride of silver. 
Second, when organic stains have been made per- 
manent by coagulants. In these cases this coagula- 
tion may be quite superficial-if so, remove mechan- 
ically a part of the tooth substance, after which 
the bleaching may be successful. 
In cases when it is important not to remove the 232 
CATAPHORESIS. 
gold filling before bleaching, the gold should be 
coated with chloro-percha, especially if the gold 
filling protrudes into the cavity, as often occurs. 
In this latter case the gold should be protected 
inside of the cavity as well as outside. This point as 
well as others relating to bleaching is exemplified 
in the subjoined case furnished to me by Dr. M. L. 
Rhein. 
Mrs. S., set. about 35. Superior left lateral in- 
cisor very much discolored, history of pulp removal 
10 years prior in San Francisco, at which time root 
was filled and an anterior approximal gold filling 
inserted. This filling was found to be in perfect 
condition and tightly knuckled against the central. 
On either side of the cuspid a bicuspid had been 
permanently bridged into position and were in 
splendid condition. On this account, and taking 
into consideration the perfect condition of the gold 
filling, it was decided not to remove the filling. The 
rubber having been adjusted over the single tooth 
a new opening was drilled into the lateral at the 
palatal ridge until it entered the gutta-percha filling 
in the root. This was found contaminated with a 
slight odor, undoubtedly the product of decomposing 
organic matter in the tubuli. The new opening 
also exposed the gold filling on the inside of tooth. 
This was coated with chloroform and gutta percha, 
not only on the inside but on the outside, so as to 
avoid possibility of any direct action on the gold 
from the current. The cavity was then filled with 
an aqueous 25 per cent, solution of pyrozone, a little 
soft rubber tube slipped over the tooth, ligated at 
neck and ligated around application at cutting edge 
of the tooth, after this bag had been filled with BLEACHING OF TEETH BY CATAPHORESIS. 
233 
pyrozone. The anode was then finally introduced 
into the root of the tooth. Eighty volts of current 
was used in this way without patient experiencing 
any sensation whatsoever. The milliamperage 
amounted at the close to only f and the current 
was kept on for 30 minutes. After one and a half 
years the tooth still retained its new color which 
closely matches the adjoining tooth. 
The current has undoubtedly not only bleached 
the tooth but also made the entire interior of the 
dentine absolutely antiseptic. CHAPTER IV. 
ANTISEPSIS, OR STERILIZATION OF THE TEETH. 
In an address delivered on March 24, 1896, before 
the Philadelphia Academy of Stomatology (at the 
solicitation of Dr. Edward 0. Kirk, Editor of the 
"Dental Cosmos," whose interest in this subject is 
intense), I pointed out to the dental profession the 
importance of looking to the principle of catapho- 
resis as an aid in the sterilization of dentine. This 
would seem to be a field of usefulness quite as exten- 
sive, if not so striking to the imagination, as the 
anesthetization of sensitive dentine. 
There is considerable literature on the general 
subject of sterilization, showing that the proto- 
plasmic fibrille which fill the dentine of the root 
after death of the pulp may undergo putrefactive 
changes and set up an irritative action with result- 
ant pus formation about the root apex. The steril- 
ization of the root is readily accomplished by cata- 
phoresis and inflammatory results obviated. Present 
methods are only partly efficient. 
The problem presents a number of phases. First, 
with regard to the sterilization of carious dentine 
in immediate proximity to the pulp. It has been a 
subject of much discussion whether it is a safe 
operative procedure to permit a layer of carious 
234 ANTISEPSIS, OR STERILIZATION OF THE TEETH. 
235 
(infected) dentine to remain over the pulp as a pro- 
tection to that organ and insert a filling over such 
a layer, or whether the carious process would still 
proceed, even though the cavity of decay was closed. 
The desirability of permitting the carious layer of 
dentine to remain as noted grows out of the neces- 
sity for retaining the vitality of the pulp whenever 
possible. There is in the minds of many operators 
the belief that if the carious stratum of dentine 
covering the pulp can be effectually sterilized, such 
a layer affords the best protection possible for the 
pulp and should not be removed. 
The eminent authority, Prof. W. D. Miller, of 
Berlin, believes (*) the integrity of the peridental 
membrane to be affected by the decomposition of 
organic matter remaining in the tubular structure 
of the dentine of the root after extirpation of the 
pulp and thorough filling of the canal. He says (p. 
350) : "We must bear in mind that the only de- 
composition which could take place in the dentinal 
tubuli is one which might be brought about by 
bacteria ; in other words, putrefactive decomposi- 
tion, or simply putrefaction. In the event of such 
a decomposition of the contents of the tubuli taking 
place, a great variety of substances might be pro- 
duced, chiefly, however, ammonia (N H3) sulphuret- 
ted hydrogen (S H2), Hydrogen (H), carbonic acid 
(C O2), a variety of acid and alkaline substances 
such as formic, lactic, acetic and butyric acids, 
carbonate of ammonia, propylamine, trimethylam- 
ine, etc., and Anally the ptomaines. 
" It must not be supposed, however, that all these 
substances would be produced in any one case. How 
1 See "Dental Cosmos," May, 1890, page 349. 236 
CATAPHORESIS. 
many of them might be formed would depend upon 
whether it were a pure or a mixed infection-i.e., 
whether the tubuli had been invaded by one or more 
kinds of bacteria." 
This decomposition will naturally cause the gen- 
eration of bad-smelling odors, and Prof. Miller says 
(p. 356): "The most probable and, I think, the 
only way in which gases might possibly be supposed 
to penetrate from the decomposing fibrils to the 
pericementum is by a process of diffusion. This, 
naturally, would apply only to such gases as are 
soluble in the fluids of the tubules. That an action 
of this nature does take place will be witnessed to 
by the fact that in drilling into a tooth containing 
a putrid pulp, as we near the pulp-chamber, the 
borings will sometimes be found to have an odor of 
putrefaction. I have not observed, however, that 
this odor could be detected from the more super- 
ficial layers of dentine, though Dr. Jenkins writes 
me that in chalky teeth he has noticed the odor soon 
after boring through the enamel. Now, it is quite 
possible that a similar action, in a diminished degree, 
may take place through the solution and subsequent 
diffusion of gases generated in the tubules them- 
selves, though such an action would always remain 
insignificant when compared with the absorption of 
gases from the pulp itself." 
While Dr. Miller's article on this subject is ex- 
planatory, he does not, however, deal with an im- 
portant outgrowth of it, viz., in cases where death 
of pulp has occurred by natural causes and the 
whole dentinal structure is infiltrated with the 
products of pulp decomposition, ptomaines, mephitic 
gases, etc. In such cases, does not the sealing in of ANTISEPSIS, OR STERILIZATION OF THE TEETH. 
237 
these materials in the dentinal tubuli by means of a 
filling in the root canal offer a menace to the future 
health of the pericemental membrane through the 
gradual osmosis of the tubular contents into the 
structure of the surrounding membrane ? It would 
seem so, and that under these conditions a thorough 
sterilization of the dentine structure of a root is a 
sine qua non for the future usefulness of the tooth. 
The means so far placed at our command are em- 
braced in the use of antiseptics placed in the root- 
canals and diffused by imbibition. 
There are a large number of these antiseptics 
available for the purpose and in an article in the 
"Dental Cosmos" for May, 1891, Dr. Miller states 
that he had tested the following. 
Chloride of zinc ; 
Bichloride of mercury, 5 per cent. ; 
Trichloride of iodine, 5 per cent. ; 
Pentachloride of phosphorus, 5 per cent. ; 
Double chloride of gold and sodium ; 
Double chloride of potassium and platinum ; 
Trichlorphenol; 
Carbolic acid ; 
Lysol; 
Peroxide of hydrogen ; 
Oil of cinnamon ; 
Oil of cloves ; 
Oil of peppermint; 
Oil of wintergreen ; 
Pyoktanin ; 
Resorcin, 10 per cent. ; 
Benzoic acid, 10 per cent, alcoholic solution ; 
Absolute alcohol; 
Thymol, 20 per cent, alcoholic solution. 238 
CA TAPHORESIS. 
In summing up his record of 354 experiments, Dr. 
Miller says : "The complete sterilization of cavities 
of decay, especially such as contain traces, or even 
considerable quantities, of carious dentine, requires 
much more time than we are accustomed to give it." 
Again, " The best results are obtained, as we should 
naturally expect, where rapidity of action is desired, 
by substances which are readily soluble in water." 
Dr. Miller would be inclined to place at the head 
of the list of effective antiseptics for sterilization the 
trichloride of iodine were it not for its acid reaction ; 
a five per cent, solution of bichloride of mercury is 
also powerful, but the use of this drug would seem 
to involve a slight discoloration of the tooth ; perox- 
ide of hydrogen is an agreeable antiseptic and will 
act efficiently, especially where the amount of ca- 
rious dentine is small. 
The ability to bleach a tooth-root throughout, 
cataphorically, by the use of peroxide of hydrogen, 
25 per cent, solution aqueous or ethereal, or by any 
other so-called bleaching agent, is proof positive of 
the thorough chemical sterilization of the root so 
treated. Dr. Miller depended on imbibition for suc- 
cess in his experiments, but if cataphoresis is em- 
ployed as a diffusing agent success will be more 
swift and sure. 
There is, in addition to all this, the possibility of 
carrying medicaments into the peridental membrane 
for the treatment of acute infectious inflammatory 
conditions of that tissue. It seems to me that in 
the application of the cataphoric principle there is 
the promise of not only painless dentistry but of 
absolute thoroughness in the therapeutic treatment 
of pulpless teeth and the many disorders to which ANTISEPSIS, OR STERILIZATION OF THE TEETH. 
239 
they are liable. We may then accept it as a fact, 
and one of prime and novel importance, that elec- 
tricity by reason of its property of cataphoric action 
is a sterilizer of the tooth and of its surrounding 
tissue, and that in the case of a tooth thus sterilized 
alveolar abscess is not likely to occur. In this con- 
nection we will refer to further methods of procedure. 
The hypodermatic syringe electrode, Fig. 35 will 
be found most useful. Zinc or other "soluble" 
hollow needles are introduced into the pulp cavity 
whose dentine is to be cataphorically sterilized and 
then a drop or more of a 2 per cent, solution of 
chloride of sodium or of bichloride of mercury is 
injected, a weak current turned on and the nascent 
oxychloride of the metal, formed gradually and on 
the spot where it is, electrically diffused. Or simi- 
larly, solid needles may be used if care is taken to 
previously inject a few drops of fluid into the pulp 
chamber, the object in both cases being to supply 
artificially for the corrosion, or solution of the 
metal, constituents of tissue like oxygen and chlorine 
not already in sufficient abundance in the dentinal 
tissue to be treated. The apical end of the root 
canal may be plugged by non-conducting material 
in the above procedures if sterilization is desired to 
be confined to the root alone. If, as I often do in 
practice, only a weak solution, 2 to 4 per cent., of 
hydrochlorate of cocaine be used as the injecting 
medium, the same result is attained together with 
the annulment of pain liable to be produced. 
This entire branch of electric medicamental dif- 
fusion is treated most fully elsewhere. See Part 
IV. Chap. IV., and also the next chapter, Part V., 
Chap. V. 240 
CATAPHORESIS. 
Antiseptics which promise the best results for 
electric sterilization from the point of view of both 
their germicidal and their conducting qualities are 
Peroxide of hydrogen (strong aqueous solution, see 
chapter on bleaching of teeth). 
Peroxide of hydrogen (strong aqueous solution 
constituting also a two per cent, solution of chloride 
of sodium. 
Chloride of Zinc. 
Bichloride of Mercury. 
Trichloride of Iodine. 
Formalin. 
And in short many other salts. 
The choice of the antiseptic or medicament to be 
employed is greatly enlarged by using it as I have 
pointed out in Part III., Chap. I., in conjunction 
with a " fluid electrode" as I have called it. 
CASE BY M. L. RHEIN. 
The following is an account of an interesting and 
seemingly convincing instance of the efficacy of 
cataphoretic sterilization of a putrescent dentinal 
tract. 
As the patient is a dentist, skilled in the accurate 
recording of dental data, I am enabled to give the 
history of the case prior to the time when it was 
given into my care, with a certainty which makes 
it reliable. 
About twelve years ago, the right superior central 
incisor received a blow, which broke off the anterior 
corner. As the centrals were much longer than the 
laterals, both teeth were ground off with a corun- 
dum wheel, in order to avoid placing a gold corner. ANTISEPSIS, OR STERILIZATION OF THE TEETH. 
241 
The ground end of the injured central was exqui- 
sitely sensitive for the greater part of two years, 
which proves that the pulp did not immediately die 
as a result of the accident. It, however, did event- 
ually die, because three years ago it suddenly de- 
veloped an acute pericementitis. 
Electric transillumination disclosed the fact that 
the pulp was dead, and an opening was made 
through the palatal plate of enamel, passing into 
the pulp canal. There was an effusion of bloody 
pus-affording temporary relief from pain. 
The tooth was in such a condition at this time 
that it would not tolerate the presence of any of the 
medicated dressing used by the practitioner who had 
the care of the case, unless the outer opening was 
left unsealed. 
These efforts to overcome the disease proved inef- 
fective for several weeks, when the patient left town 
for the summer. About this time much was being 
said in favor of salol as a permanent root filling, and 
at the advice of a dentist residing at the summer 
resort, the patient permitted the root to be filled with 
salol and covered with gutta percha, which was tol- 
erated, and the tooth was practically comfortable 
for over a year, though always responding painfully 
to percussion. 
About this time the pericementitis returned in an 
acute form, and the case came into my hands. Upon 
removing the gutta percha, I found the entrance into 
the canal closed with a mass of salol, which, how- 
ever, was easily removed ; this much wanted root 
filling, having dissolved away sufficiently to be loose 
in the canal, and entirely absent from the upper half 
of the root. 242 
Bloody pus again escaped from the canal, and upon 
exploring, I became satisfied that some pulp tissue 
still remained near the root end, which being still 
attached through the foramen to the inflamed tis- 
sues beyond, responded so to the touch of a broach 
that it became necessary to use cocaine cataphoresis, 
before I could thoroughly cleanse the upper part of 
the root canal, which, however, was finally pain- 
lessly accomplished by this means. 
The next step was to attempt sterilization of the 
dentine itself by cataphoresis. 
The canal was thoroughly syringed with 1 to 500 
solution of bichloride of mercury in peroxide of oxy- 
gen, and an electrode of chemically pure zinc was 
introduced, nascent oxy-chloride of zinc being thus 
forced into the dentinal tubuli, by the electro-chemi- 
cal dissolution of the zinc electrode. 
Usually when simple sterilization of the dentine 
is desired, the end of the root is sealed, so that the 
current cannot escape except through the dentine. 
As there was unquestionably a dormant abscess 
at the end of the root, the electrode was made to 
touch the sides of the canal throughout and passed 
far up into the root, and the end of the canal was 
left unsealed, that medication might also affect the 
diseased tissues in the apical avea. 
This was certainly accomplished, as considerable 
pain followed, increasing in force for several days, 
until it was so bad that | of morphia was exhibited 
to induce sleep. 
1 On the day following, the dressing of oil of myr- 
tle which had been sealed it was removed for a few 
minutes to permit the escape of gas, and it was then 
replaced and tightly sealed again. At the same 
CATAPHORESIS. ANTISEPSIS, OR STERILIZATION OF THE TEETH. 
243 
time an aqueous solution of iodine was applied cata- 
phoretically on the gum. 
From this time the tooth improved rapidly, and 
a complete cure was effected without further treat- 
ment. CHAPTER V. 
DIFFUSION FROM SOLUBLE ELECTRODES. 
It will be recollected that in the chapter on elec- 
tric diffusion from soluble electrodes in Part IV. 
there was an elaborate explanation of the principles 
involved in this method of treatment as applied in 
general medicine. It was shown that if the positive 
electrode is composed of a metal capable of being 
attacked by oxygen or chlorine (formed at that pole 
out of the tissue) then a new chemical compound 
would be formed at the point of application and that, 
this new compound would then be forced into the 
tissue. For example, if a copper needle should be 
the positive electrode the new compound thus man- 
ufactured will be oxychloride of copper and this 
compound is useful as a medicament. 
The principle is applicable in dentistry as well as 
in general medicine, and many applications will sug- 
gest themselves to the practical dental operator. 
With zinc he could use an instrument and pass it to 
a certain spot and with the escharotic and destroy- 
ing salt produced he could secure positive results. 
With copper less active salts are produced. Silver, 
if desired, can be used in the same manner and its 
salts are very active. 
It is very probable that the procedure would be 
244 DIFFUSION FROM SOLUBLE ELECTRODES. 
245 
very useful as an aid in the treatment of pyorrhea 
alveolaris, that distressing and common trouble in- 
volving the formation of pus about the roots of the 
teeth and an attendant inflammation. As is well 
known the ordinary treatment is to remove thorough- 
ly, where possible, all local possibilities for irritation 
and then apply a topical medication with astringent, 
detergent and stimulant drugs such as zinc chloride, 
zinc iodide, carbolic acid, caustic potash, dilute 
sulphuric acid and "pyrozone." In such cases there 
is a possible amelioration but always a probable 
recurrence of trouble. 
If a zinc or copper needle insulated except at or 
near its point was made to penetrate the alveolar 
process and metallic electrolysis started by making 
the needle positive, there would be a diffusion of 
oxychloride of zinc or copper which would act favor- 
ably in allaying the inflammatory condition and 
dispersing the contents of an ulcer. 
Dr. Rhein brought such a case to me and we made 
a copper spatula and passed it into the pocket that 
existed and passed into that tissue the oxychloride 
of copper staining the tissue green. This oxychlor- 
ide of copper accomplished its mission and the result 
was most satisfactory. 
In speaking of this experiment at a meeting of the 
First District Dental Society of the State of New 
York,1 Dr. Rhein said : "When it comes to local 
anaesthesia we can make up our minds very easily ; 
but when it comes to the cure of chronic patholo- 
gical conditions, as we find them in pyorrhea alveo- 
laris and alveolar abcess, we know that a few ex- 
1 Meeting of December 10, 1895. See " Dental Cosmos," March, 
1896, page 228. 246 
CATAPHORESIS. 
periments are insufficient, and a few weeks' or a few 
months' experience is not enough to give us any 
reliable data or information. It opens up a field for 
the more thorough introduction of therapeutic agents 
to the seat we want to reach than anything that 
has been brought to our attention before, and I 
would especially call your attention to the point in 
regard to the use of chloride of zinc in this way. 
The application we get here is the freshly prepared 
zinc oxychloride in its nascent condition, where it 
unquestionably will be far more effective than chlo- 
ride of zinc that has been lying about our offices. PART VI.-APPLICATIONS IN MICRO- 
SCOPICAL WORK. 
ELECTRIC STAINING OF TISSUE. 
At the Fourth Annual Meeting of the American 
Electro-Therapeutic Association, held in New York 
in September, 1894, the writer presented a paper on 
the Electric Staining of Tissues, the principal points 
of which are given below. This paper is reproduced 
because it presents from another and fresh point of 
view general principles as well as a number of 
technical procedures which can be applied in actual 
practice. 
Hitherto the staining processes essential to a dif- 
ferentiation of tissue elements by microscopic exam- 
ination have been effected by direct staining actions 
and chemic reactions. The writer here presents a 
new method of staining, based upon the action of 
electric currents upon the tissue alone, and upon 
chemicals, or staining reagents absorbed by the tis- 
sue or within which they are immersed or brought 
into metallic or other contact. The chemicals may 
be initially staining or non-staining ; the tissue may 
be in sections or in mass. This method thus opens 
out to histologic staining processes the entire field 
of electro-chemistry. 
247 248 
CATAPHORESIS. 
I have found that electricity acts to produce a 
differential stain : 
1. By producing electro-chemic changes (which in 
themselves are stains) in the tissue itself. 
2. By producing electro-chemic changes in tissue 
which give staining reactions to foreign chemic re- 
agents. 
3. By producing chemic decomposition of chemic 
compounds previously absorbed by tissue and ca- 
pable of being decomposed by the current, and thus 
upon decomposition affording a stain consisting of 
one or more of the elements of the compound. 
(Example : iodide of potash, iodine stain) etc. 
4. By a bleaching or by an intensifying reaction 
upon stains previously absorbed by tissue. Example : 
solutions of aniline colors ; methyl blue deepens at 
the anode, pales at the cathode ; congo red, deep 
blue at anode, pale or colorless at cathode ; phe- 
nolphthalein, gives violet stain at cathode in neu- 
tral solution of sodium sulphate. Many colors are 
bleached at cathode. 
5. By producing decomposition of an electrolyte 
in which tissue is immersed and setting free a re- 
agent which in turn acts upon tissue which has been 
otherwise untreated or which has absorbed another 
reagent or simply a stain. 
6. By the electrolytic and cataphoric properties 
of the current upon metals kept in contact with tis- 
sue affording a direct or indirect stain. Example : 
oxychloride of copper (copper at positive pole) direct, 
same of zinc or other metals indirect invisible, but 
developed by reactions, or of silver salts developed 
by light, etc. 
7. By the precipitation of finely divided metals ELECTRIC STAINING OF TISSUE. 
249 
within tissue. Example : salts of silver and of gold, 
black and purple stains. 
8. By the principle of electro plating with solu- 
tions of metallic salts of copper, silver, gold, etc., 
and by other obvious methods which need^not here 
be outlined. 
The peculiarity and novelty in the electric stain- 
ing processes here briefly outlined and all of which 
the writer has tested with success, is that, whereas 
most of the staining processes in practice act simply 
by chemic selection, or chemism, this acts under the 
directive influence of the flow of the electric current, 
and hence selects pathways dependent upon the 
respective conducting capacity for current, of the 
tissue components. That is to say, the electric con- 
ductivity of tissue varies according to its composi- 
tion and the differential stain varies correspond- 
ingly. The parts of a tissue most saline are the best 
conductors ; they therefore are the most acted upon. 
An axis cylinder is, for instance, richer in salts than 
its medullary sheath ; it therefore will conduct the 
most current and will be the most deeply stained, 
or most completely bleached, etc., according to the 
method employed. 
A newly formed connective tissue or a tissue 
formed of recent exudates will be more saline than 
a later stage of the same tissue, and therefore take 
more stain because it conveys more current. The 
same facts hold true of both in normal and in neo- 
plastic growths. This variation of stain according 
to variation of conductivity of tissue affords a new 
basis for differential staining. As a general prin- 
ciple it holds good in any one of the eight methods 
outlined. 250 
CATAPHORESIS. 
I am engaged in further investigations in two other 
directions of study which this method makes possible : 
1. To trace fibrils, fibres, tracts of the same or of 
diverse tissues throughout a tissue mass, as in the 
differentiation of connective tissue, nerve fibres, 
etc. To locate cells and to trace gross tissue ele- 
ments, as for instance, in a frog's leg the muscles, 
nerves, arteries, veins, etc., all of which conduct in 
a varying manner and stain in proportion to their 
conducting power. 
2. To establish by the comparative depth of the 
stain, the relative conductibility of tissues, a ques- 
tion of great importance electro-physiologically and 
in electro-therapeutics. The muscle and the blood 
being the best conductors stain the most deeply. 
A few minor points should be noted : 
a. That when an electro-chemic decomposition 
is established within a tissue, saturated for instance 
by a binary compound like iodide of potassium, the 
staining element set free (iodine), is in its nascent 
state and hence more active. 
b. That tissue acted upon by current is itself 
rendered more active to take a stain. 
c. That the conductivity of the electrolyte or 
fluid in which the tissue is immersed must be care- 
fully considered ; if it is too good a conductor the 
action is confined to the immediate neighborhood of 
the electrodes ; if a less good conductor, the action 
may extend even to a neutral centre. 
d. That the voltage required to effect chemic 
decomposition varies greatly with the reagents em- 
ployed. While volts is required to decompose 
water, copper salts may be decomposed by a small 
fraction of 1 volt. ELECTRIC STAINING OF TISSUE. 
251 
METHODS OF PROCEDURE. 
About a 30 cell battery (for the resistance is often 
high) a rheostat and a milliampere meter are the 
first essential requisites ; fine platinum wire, absorb- 
ent cotton, a shallow platinum dish to connect to 
one or the other pole and the usual chemic and 
staining reagents are further requisites. 
My most satisfactory preliminary experiments 
were made by placing a section or teased specimen 
of fresh tissue upon a microscopic slide beneath the 
usual cover-glass and watching the electric staining 
as it progressed ; fine platinum wire or absorbent 
cotton wet with any required solution constituted 
the electrodes. By using this preliminary method, 
a drop of the staining fluid or of the chemical to be 
decomposed could be conveniently placed at either 
the positive or the negative pole and the reaction 
observed. 
One of my first surprises and disappointments in 
thus watching under the microscope the deposition 
of what to the naked eye appeared to be deep green 
and black stains respectively from metallic copper 
and iron, was to find that the coloration was due in 
reality to amorphous granular mass deposited in the 
tissue, and not to a soluble salt which actually 
stained the tissue. The deposit appeared to be of 
green and black non-crystalline precipitates. This 
fact is interesting in relation to the treatment of 
tumors, ulcers, sinuses, mucous membranes, etc., 
by "metallic electrolysis," so-called, for it would 
thus appear that in this electro-therapeutic proced- 
ure, foreign substances in massive and not in soluble 
form set up irritative reactions. 252 
CATAPHORESIS. 
Several examples, illustrative of many, of treating 
sections are here given. 
The apparatus was as outlined. The prepared 
section was laid in the shallow platinum dish, con- 
nected to the positive or negative pole as desired, 
while the other pole was constituted of a tightly 
rolled tuft of absorbent cotton, cut off squarely at 
one end by scissors, about one inch long and con- 
nected to a platinum wire at the end farthest from 
the section. It will be seen that since the thin sec- 
tion rested upon the platinum, while the cotton 
interposed a considerable length between it and the 
next metallic conductor, the section would be in 
the field of the most intense electrolytic activity 
of the electrolytic circuit. That is to say, if, for 
instance, the action of the positive pole is required, 
it is gained as the platinum plate and the main ac- 
tion of the negative pole is removed to a distance, 
namely to the vicinity of the platinum wire ; or vice 
versa. 
Experiment 1.-A section of spinal cord, preserved 
after the usual manner in bichromate of potassium 
solution, was washed in distilled water and laid 
upon the platinum plate, positive pole, cotton tuft 
negative pole. Diffuse chromic acid stain produced 
with 5 milliamperes of current flowing five minutes. 
Experiment 2.-Stain for amyloid. A section of 
amyloid liver, hardened in alcohol and soaked over 
night in a saturated solution of iodide of potash, 
was washed quickly in distilled water, placed upon 
the platinum plate, positive pole and the cotton tuft 
(negative pole) wet with a 1 per cent, solution of 
common salt applied to it. Current strength 10 
mdliamperes, effect almost instantaneously a deep ELECTRIC STAINING OF TISSUE. 
253 
iodine stain. The specimen is again washed and 
preserved in glycerine. 
Control experiments were made with the same 
specimens treated with solution of biniodide of 
potash (Gram's solution). 
The specimens stained electrically were much 
superior ; they were translucent, like clear amber, 
while the others were comparatively diffuse, cloudy 
and "muddy." 
Other binary compounds, easily decomposible, 
gave in the same manner instantaneous and clear 
stains. There can be no question about the supe- 
riority of the method in this and similar instances. 
Experiment 3. - Similar sections to those in 
Experiment 2 were soaked over night in a mixture 
of iodide of potash and starch water and treated in 
the same manner. While the starch and the iodine 
reacted in the solution outside of the specimen, the 
specimen itself gave simply the iodine reaction. 
Experiment 4. - Similar sections soaked over 
night in a mixture of iodide of potash, sodium chlo- 
ride and starch water also gave simply the same 
iodine reaction. 
Experiment 5. - Amyloid kidney, previously 
hardened in alcohol, was stained in an aqueous solu- 
tion of methyl-blue about five minutes, washed and 
placed on the platinum plate negative pole ; the 
cotton tuft, positive pole ; current strength 10 mil- 
liamperes during ten minutes. Examined micro- 
scopically, the capsule, connective tissue and Mal- 
pighian bodies are very intensely stained as com- 
pared with the rest of the section, which was of a 
brownish red color. Thus the connective tissue and 
the amyloid degeneration retained the blue stam, 254 
CATAPHORESIS. 
while the reticulum and lymphoid cells were not so 
deeply stained and were of another color. The pur- 
suit of this electrolytic process is particularly inter- 
esting in relation to staining bacilli and some of the 
results are most promising. An anodal and cathodal 
compartment, separated by a porous diaphragm, is 
found useful in some cases. 
I have every reason to believe that the introduc- 
tion of this principle of electrolysis in staining spe- 
cimens for microscopic examination will be the 
means of bringing to our view histologic relations 
now unknown to us, and it is in this hope and ex- 
pectation that I venture to call attention to the 
method. INDEX. 
A 
Author's Aim, The, v. 8. 
Acknowledgments, vi. 
Academy of Stoneatology of Philadelphia, vi. 
Anaesthesia, General, Discovery of, 7. 
Anaesthesia, General, Production of, 29, 35. 
Anaesthesia, Local, Production of, 7, 8, 14, 17, 18, 19, 24 et seq., 
34, 42, 43, 45, 47, 197 to 218. 
" Anodal Diffusion," 8. 
" Anaphoresis," 8. 
Arthuis, 11. 
" Archives generales de medecine," References to, 12. 
Adamkiewicz, 17, 18, 19, 34. 
Adamkiewicz's Electrode, 17, 19. 
Aconite, Use of, 14, 144, 153. 
Althaus, Dr. Julius, 15, 22, 34. 
Adopters, Use of, 25, 30, 31, 57. 
Adopters, Varieties of, 30, 31. 
American Academy of Dental Science, 28. 
American Dental Association, 29, 42. 
Author's Contribution, The, 28, 29, 34 et seq. 
Anaemic Cataphoresis, 35, 36. 
American Electro-Therapeutic Association, 38, 39, 49, 141, 247. 
Academy of Medicine, New York, 43. 
Analogy of Water and Electric Systems, 53. 
Ampere, Definition of, 54. 
255 256 
INDEX. 
Alternating Current Dynamos, 67, 117, 118. 
Alternating Currents. 67, 68, 117, 118. 
Amadou Electrodes, 103, 108. 
Absorption of Medicines, Laws governing, 142. 
Aubert, Dr. P., 158. 
Aqueous Solutions of Cocaine, 166, 239. 
Apostoli Method, The, 174. 
Antisepsis, or Sterilization of the Teeth, 234 to 240. 
Antiseptics, List of, 237, 240. 
B 
Baunscheidt Needles for Counter-Irritation, 18. 
Baths, Electric, 21, 22, 34. 
Bleaching of teeth, 27, 28, 29, 41, 224 to 233. 
Bandage, Esmarch, 35. 
Batteries and Dynamos, Similarity between, 70. 
Becquerel's Experiments, 79, 80. 
Biedermann, W., 93. 
Brush Electrode, 101, 116. 
Batteries for Cataphoric Applications, 117 to 121. 
Butler, Dr. John, 175. 
Bergonie, Dr., 176. 
Bordier,Dr., 176. 
Brooke, Dr. H. T., 192. 
Briggs, Dr. E. C., 210. 
C 
" Cataphoresis," 8, 9, 76, 82, 83, 86, 87, 89, 90. 
" Chemish-electrische Heilmethode," References to, 13. 
Cataphoresis in Dentistry, iv, 20, 24 et seq., 42, 47, 48, 108, 197 to 
243. 
Cataphoresis in General Medecine, iv, 13, 19, 20, 21, 22, 23, 28, 95, 
104, 149 to 162. 
Cataphoresis in General Surgery, iv, 9, 14, 35, 36, 50, 95, 104, 163 
to 170. INDEX. 
257 
Chloroform, Use of, 14, 17, 18. 
Cocaine, Use of, 17, 18, 19, 25, 32, 33, 34, 37, 42, 43, 44, 45, 47, 48, 
153, 163. 
Corning, Dr. J. Leonard, 18. 
Cagney, Dr. 19. 
Corrosive Sublimate, Use of, 20. 
Chicago Dental Club, 24. 
Central Dental Association of Northern New Jersey, 30. 
Carcinoma, Treatment of, 38. 
Cases, Dental, 41, 42. 
Conservatism of Physicians, 51. 
Coulomb, Definition of, 54, 55. 
Chemical Electricity, 61. 
Closed-Circuit Batteries, 62, 63. 
Continuous Current Dynamos, 67, 118, 119. 
Commutators, 69, 117, 118. 
Cataphoric.from Non-cataphoric Solutions, 82. 
Cataphoresis a property of Currents, 83, 86. 
Cataphoresis from Static Machines, 79. 86. 
Cup Electrodes, 110. 
Current Density, 116. 
Central Station Circuits, Disadvantages of, 117 to 121. 
Clark and Mills Series Rheostat, 124, 125, 126. 
Catalysis, 148. 
Crotte, Dr., 155. 
Chitterling, Dr. N. M., 216. 
D 
" Dental Cosmos, The," References to, 9, 15, 26, 28, 29, 41, 42, 43, 
48, 168, 219, 234, 235, 237. 
Dental Helix, The, 15. 
Diseased conditions treated cataphorically, 19, 20, 21, 24. 27, 28, 
29, 38, 40, 41, 42, 45, 151, 157, 161, 164, 165. 166, 178, 180, 185, 
189, 190, 191, 194. 
Deafness, Cataphoresis in Labyrinthine, 19. 258 
INDEX. 
Damion, Dr. Leon, 20. 
Destot, M., 20. 
Developments in Dental Surgery, 24. 
" Dental Review," References to, 24. 
Dentine, Obtunding of Sensitive, 24, 25, 26, 27, 28, 30, 31, 32, 33, 
42, 48, 49. 
Dental Society of the State of New York, 26. 
Definitions of Electrical Units, 52. 
Daniell Batteries, 52, 63, 64. 
Dynamos, 67. 
Definition of Simple Osmosis, 72. 
Definition of Endosmosis, 73. 
Definition of Exosmosis, 73. 
Diffusion, Osmotic, Rate of, 73. 
Definition of Cataphoresis, 77, 82. 
Definition of Electric Osmosis, 76. 
Direction of Transfer in Cataphoresis, 78, 79, 81. 
Double Procession of Atoms, The, 88, 89. 
Decomposition of Electrolytes, 88. 
Dispersing Electrodes, 103. 
Duplex Electrodes, 109, 110. 
Dry-cell Batteries, 121. 
Delineau, Dr., 176. 
Darier, Dr., 176. 
E 
Evans, Mr. Wm. J., vi, 41, 45, 167, 224. 
Electric Osmosis, 8, 31, 76. 
Electrolysis, 9, 37, 87, 88, 89, 90. 
Electric Transfer of Particles and Fluids, 8. 
Electric Transportation, 8. 
Electric Medicamental Diffusion, 8, 39, 149 to 162. 
Early Experimenters, 11. 
Electric Endosmose, 12. 
Edison, Mr. Thomas A., 20, 23. INDEX. 
259 
Electric Baths, 21, 22, 34. 
Esmarch Bandage, 35. 
Experiments, 37, 72, 73, 74, 75, 91, 92, 93, 94, 224, 225, 226, 227. 
Electrodes, 23, 27, 44, 47, 82, 95 to 116. 
Electricity, Characteristics of, 52, 53. 
Electro-motive Force, Definition of, 52. 
Edison Dynamos, 69, 70. 
Endosmosis, 73, 74, 75. 
Effective zone in Cataphoric applications, 83, 84. 
Electrolytes, 88. 
" Electro-Physiology," References to, 93. 
Ear Electrode, 101. 
Electro-Therapeutic Co., New York City, 129. 
Erb, 148. 
Electro-Cocaine Local Anaesthesia, 163 to 170. 
Electric Staining of Tissues, 244 to 251. 
Exosmosis, 73, 74, 75. 
" Experimental Science," Reference to, 74. 
F 
First District Dental Association (N. Y.), vi, 43, 228. 
Fabre-Palaprat, 12, 34. 
Flagg, Dr. J. Foster, 15. 
Flemming, Otto, 15. 
Freund, Prof., 33. 
Follicular Tonsillitis, Treatment of, 41. 
Frictional Electricity, 59. 
Fluid Electrodes, 23, 82, 95, 240. 
Faraday, Michael, 88. 
Fractional Volt Selector, 31, 122, 129, 130, 131, 206, 211. 
G 
Gout, Cataphoresis in treatment of, 20, 21. 
Grosheintz, Dr. E.. 20, 33. 
Gartner and Ehrmann, 20, 95, 154. 260 
Guaiacol, Use of, 28, 33, 42, 43, 45, 47, 48, 167, 199. 
Gillett, Dr. Henry W., 29, 30, 31, 32, 33, 42, 212. 
Gelatin, Use of, 37. 
Gautier, Dr. Georges, 40, 173, 174, 176, 196. 
Gonorrhea, Treatment of, 40. 
Galvano-Faradic Co., New York, 61, 114. 
Gravity Batteries, 63. 
Gore's Experiments, 79. 
Graham, 73. 
Galvanotropism, 93. 
H 
Hassenstein, Dr., 13, 34. 
Harris, Dr. A., 19. 
Harveian Society, 19. 
Houston, Prof. Edwin. J., 52. 
Holtz Machines, 61. 
Human Tissues as Porous Septa, 76. 
Hopkins, G. M., 74. 
Hypodermatic Injection Electrode, 100. 116, 239. 
Hemorrhagic Effect at Negative Pole, 146, 147. 
Haemostatic Effect at Positive Pole, 147. 
Hedley, Dr. W. D., 155. 
" Hydro-Electric Methods in Practice," References to, 155. 
I 
Interstitial Electrolysis, 8. 
" Items of Interest," References to, 15. 
Iodide of Potassium, Use of, 12, 13, 37. 
Imbert de la Touche, 20, 176. 
" International Dental Journal," References to, 24, 28, 30, 31. 
International Congress, 19. 
Induced Electricity, 66. 
Ideal Dynamo, An, 67. 
Indifferent Electrodes, 103. 
INDEX. INDEX. 
261 
J 
Joule, Definition of, 54, 55. 
Jouslain, Dr., 176. 
K 
Kirk, Dr. Edward C., vi, 221, 234. 
Klenke, Dr., 13, 34. 
Kennelly, Dr. A. E., 23. 
Kidney Troubles, Treatment of, 21. 
Keloid, Treatment of, 40. 
Kilo-Watt, Definition of, 56. 
Kronfeld, 154. 
Knapp, Dr., 186. 
L 
Laws (Wiedemann's) governing electric diffusion, 13. 
" La Riforma Medica," References to, 18. 
Lumbroso, 18. 
Lawrence, Mr. Newman, 19. 
Lithium, Use of, 20, 23, 37. 
" L'Odontologie," References to, 20. 
Lewandowski, 20, 148. 
Liver Complaints, Treatment of, 21. 
Liebmann, Mr., 33. 
Lupus, Treatment of, 38. 
Leclanche Batteries, 63, 120, 121. 
Liquid Electrodes, 23, 82, 95, 240. 
Lehmann, O., 84, 85. 
Lodge, Dr. Oliver, 87. 
Lewin, Prof., 142, 170. 
Laws governing absorption of Medicaments, 142. 
Linossier, 143. 
Lannois, 143. 
Locomoter Ataxia, Cataphoresis in, 153. 
Lang, Prof., 154. 
Lilienthal, Dr. Howard, 164. 
Larat, Dr., 176. 262 
INDEX. 
M 
McKesson and Robbins, vi, 41, 224. 
Metallic Electrolysis, 8. 
Medicines employed, 14, 142, 143, 144. 
" Medical Times and Gazette," References to, 14, 15. 
Modern Revival, The, 17. 
Mercury, Use of, 13, 21, 22. 
Matteini, 18. 
Malaria, Treatment of, 21. 
McGraw, Dr. D. F., 24, 25, 32, 41. 
Minnesota State Dental Society, 24. 
Minnesota (Southern) District Society, 24. 
Marshall, Dr. J. S., 28. 
Marcus, Dr., 33. 
Milliampere, Definition of, 56. 
Methods of Exciting Electricity, 59. 
Multiple-Arc Connections, 71, 123. 
Multiple-Series Connections, 71. 
" Modern Views of Electricity, References to, 87. 
Milliampere Meters. 138 to 141, 191. 
Morris, Dr. R. Y., 195, 196. 
"Methods of Filling Teeth," Reference to, 203. 
Miller, Prof. W. D., 235, 236, 237, 238. 
Microscopical Work, Applications in, 244 to 251. 
N 
New York Institute of Stomatology, vi, 31. 
" Neurolog. Ctrlbl.", References to, 17, 18. 
"New York Medical Journal," References to, 18, 19, 35, 151. 
Neuralgia, Cataphoresis in, 19, 21, 151, 153. 
New York Post-Graduate Medical School, 37, 40 
Nasal Catarrh, Treatment of, 40. 
Negative Poles and Elements, 62. 
Nasal Electrode, 101. 
Naevi, Treatment of, 168. IFDEX 
263 
o 
Ottolengui, Dr. R., n, 203. 
Osmosis, 8, 11, 72. 
Ozena, Treatment of, 40, 185, 186. 
Ohm, Definition of, 54, 55. 
Ohm's Law, 55, 56, 57, 132. 
Open-circuit Batteries, 62. 
Owens College Physiological Laboratory, 145. 
Onimus, Dr., 176. 
Obtunding of Sensitive Dentine, 198. 
P 
Privati, 11. 
Porret, 11, 145. 
Paschkis, 18. 
Peterson, Dr. Frederick, 19, 33, 96, 151. 
Paralysis, Treatment of, 21. 
Poisoning, Treatment of, 21. 
Pulp, Anesthetization of Dental, 25, 28, 42, 45. 
Pyrozone, Use of, 28, 29, 41, 224 to 233, 245. 
Phillips, Dr. Wendell C., 30. 
Pharyngitis, Treatment of, 40, 185. 
Peroxide of Hydrogen, Use of, 41, 224 to 233, 245. 
Pressure, Definition of, 52. 
Potential, Definition of, 52. 
Primary Batteries, 61, 62, 63. 
Positive Poles and Elements, 62. 
Physical and Physiological Experiments, 37, 72, 73, 74, 75, 91, 92, 
93, 94. 
Paramaecia, 93, 94. 
Porret's Phenomena, 145. 
Pilocarpine, Use of, 158, 159. 
Prochownick, Dr., 176. 
" Pressure, Local Anaesthesia," 217. 
Protected Bulb Electrodes, 105. 264 
INDEX. 
R 
Rhein, Dr. M. L., v, 42, 205, 218, 232, 240. 
Reuss, 11. 
Richardson. Dr. Benj. W., 13, 17, 34, 163. 
Rheumatism, Cataphoresis in treatment of, 20, 21. 
Royal, Mr. A. W., 21. 
Respinger, Dr., 33. 
Resistance of Electrolytes, 38. 
" Revue Internationale d'Electrotherapie," Reference to, 40. 
Rhinitis (Hypertrophic), Treatment of, 40, 185. 
Resistance, Definition of, 52. 
Rapidity of Osmotic Diffusion, 73. 
Reservoir Electrodes, 47, 97. 98, 99, 109, 111, 115. 
Rheostats, 122 to 137. 
Remak, 148. 
Roosa, Prof. D. B. St. John, 178. 
Rice, Dr. C. C., 185. 
S 
44 Substitution," 16. 
Starch-water, Use of, 12. 
Syphilitic Cases, Treatment of, 21, 38. 
Sciatica, Treatment of, 21. 
Society of Arts, 19. 
Skin, Diseases of the, 37. 
Soluble Electrodes, 39, 40, 100, 104, 105, 106, 107, 171 to 196, 244 
to 246. 
Sycosis Parasitica, Treatment of, 41, 194. 
Static Electricity, 59. 
Secondary Batteries, 61, 64, 65, 66. 
Series Connections, 70, 122. 
Spring Electrodes, 112, 113. 
Shunt Relation, 123. 
Series Rheostat, Clark and Mills, 124, 125, 126. INDEX. 
265 
Series Rheostat, Van Woert, 127, 128. 
Shunt Rheostat, Wheeler, 129, 130. 
Shunt Rheostat, Principle of Operation, 131 to 137. 
Stewart, G. N., 145, 146. 
Simple Cataphoresis, 145 to 148. 
Supra-orbital Neuralgia, Treatment of, 151. 
Segain, Dr. E. C., 151, 152. 
Straining of Tissues, Electric, 244 to 251. 
T 
Terms Employed to Express Cataphoric Action, 8. 
" Traite Theorique et Pratique d'Electrochimie," References to, 
13, 79. 
Tommasi, Donato, 13, 20, 79, 81. 
Tooth Extraction, 27, 43, 44, 219 to 223. 
Theory of Movable Resistances, 39. 
Technique d'Electrotherapie, 40, 92. 
Trochoma, Treatment of, 40, 180. 
Tonsillitis, Follicular, Treatment of, 41, 189. 
Tumors, Treatment of, 41, 191. 
Tissues as Porous Septa, 77. 
"Technique d'Electrophysiologie," References to, 79. 
Tongue Electrode, 109. 
Tubular Applicator, Morton's, 111. 
Trigeminal Neuralgia, Double, Treatment of, 153. 
"Text Book of Electro-Therapeutics and Electro-Surgery, Refer- 
ence to, 175. 
Tinnitus Aurium, Treatment of, 178. 
Toeplitz, Dr., 186. 
U 
University of Minnesota, 24. 
Urethritis, Treatment of, 41, 190. 
Units, Electrical, 52. 
Uterine Electrode, 102, 103, 156. 266 
V 
"Voltaic Narcotism," 14, 163, 198. 
Vergnes, 21, 22, 34, 159. 
Volt-Selector, Wheeler's Fractional, 31, 122,129,130,131,206,211. 
Volt, Definition of, 52, 54. 
Volta, 61. 
Verworn, 94. 
Vaginal Electrode, 102, 103, 156. 
Van Woert, Dr., 113, 215. 
Van Woert Current Controller, 127, 128. 
Van Marter, Dr., 160. 
Valk, Dr. Francis, 182, 183. 
W 
Wiedemann, G.. 13. 
Waller, A., 14. 
"Wien. Med. Woch.", References to, 15. 
Wagner, 17, 18, 34. 
" Wiener Med. Presse," References to, 17. 
Weeks, Professor, 24. 
Westlake, Dr. Albert C., 26, 27, 28, 41, 43, 44, 110. 
Wheeler, Mr. G. M., 31, 129,134. 
Watt, Definition of, 54, 55. 
Wirashurst Machines, 61. 
Weiss, Dr. G., 79. 
Wire-Brush Electrode, 101, 116. 
Wheeler Fractional Volt-Selector, 31. 122,129, 130, 131, 206, 211. 
Wilson, Dr. F. N., 168. 
Woodward, Dr. C. A., 214. 
X 
" X Ray " (The), or Photography of the Invisible, 59. 
INDEX. 267 
Y 
Younger-, Dr. Wm. J., 219, 221. 
Z 
" Zeitschrift Wiener Aerzte," References to, 13. 
INDEX.