PRINCIPLES OF PRACTICE.
POLAR ANTAGONISM.
When the conducting cords are of equal length, as commonly they should be, each of the two poles or electrodes produces a polar effect in the patient directly the opposite of that produced by the other. Also, at any point in either half of the circuit, if it be within the person of the patient, the polar effect produced is the very reverse of what is experienced at the corresponding point in the other half of the circuit. And further; each half of the current produces a polar effect, at every point in the parts of the patient through which it runs, the same in kind, though differing in degree, as is produced immediately under the pole or electrode with which it is connected; yet an effect antagonistic to that which is produced under the other pole, or at the corresponding point in the other half of the current.
IMPORTANCE OF NOTING THE CENTRAL POINT.
From the above observations, it will be plain that, when we wish to bring a diseased organ under the influence of the positive pole, we must carefully place our electrodes so that none of the organ, or none of the diseased part of it, shall appear on the positive[B] side of the central point of the circuit; it being understood that the current moves as nearly in direct lines as the best conducting medium will admit. Or again, if it be desired to bring a diseased organ, or any extended part of it, under the influence of the negative pole, we must first calculate in placing our electrodes about where the central point will come, and then so apply them that no part of the lesion or disease shall appear on the negative[B] side of the central point; otherwise so much of it as lies on that side will come under the force of the wrong pole, and thus be affected in a way the opposite of what was intended. The characteristic influence of each pole is felt throughout its own half of the circuit.
DISTINCTIVE USE OF EACH POLE.
I have said that every disease is preternaturally either positive or negative. I have further said, that the application of either pole to a given part produces an effect the opposite of what would be produced in the same part by a reversal of the poles. The way is now prepared for me to announce THE CENTRAL PRINCIPLE of our system of practice. The reader will bear in mind that all acutely inflammatory or hypersthenic affections are electrically positive in excess—having too much vital action—being overcharged with the electro-vital fluid; and that all paralytic diseases, or those of a sluggish, azoödynamic character, are electrically negative—having too little electro-vital fluid—too little vital action. It is a universal law of electricity that positives repel each other, and that negatives repel each other; but that positives and negatives attract each other. This is a principle of electric action everywhere known, where any thing is known on the subject. We appropriate it practically to therapeutic purposes. Therefore, when I wish to repress or repel inflammation, which is electrically positive in excess, I put the positive pole to it; or, at least, I bring it under that half of the circuit with which the positive pole is connected, and as near to the pole or electrode as possible. And because two positives repel each other, and also because the direction of the current is always from the positive to the negative pole, carrying the electro-vital fluid with it, either I must withdraw my positive electrode, or that excess of electro-vitality in the diseased part which makes it morbidly positive, and thus produces inflammation, must give way. I will not withdraw my positive pole, and therefore the positive inflammation must retreat and be dispersed. In treating this case, I will place my negative electrode either on some healthy part, or, if there be perceptible anywhere in the system a morbidly negative part, as is often the case, I will place my negative pole there. For example: if I am treating for nephritis—inflammation of the kidneys—when I do not perceive any part to be abnormally negative, I manipulate with my positive electrode over the inflamed kidney, having the negative electrode placed at the coccyx—lowest part of the spine. My positive pole repels the positive inflammation from the kidney; or, rather, repels from it that excess of electro-vital fluid which makes it morbidly positive and induces the inflammation, while the negative pole attracts the same towards the coccyx. On its way, it becomes more or less diverted to adjacent nerves; or, if gathered in the healthy part, under the negative pole, it is immediately dispersed by the normal circulation as soon as the electrode is removed. But if I find a spinal irritation, say in one or more of the cervical or dorsal vertebræ, and, at the same time, a stomach affected with chronic dyspepsia, accompanied with constipation of bowels, I will work over the inflamed or irritated spine with my positive pole, because I know from its irritation that there is an excess of electro-vital fluid in the part, making it improperly positive; and, with my negative electrode, I will, at the same time, treat over the stomach, bowels and liver; because I know, from the inaction of these organs, that there is a lack of the vital force—a deficiency of the electro-vital fluid—there, and that, consequently, they are too negative. Adopting this method, I accomplish two objects in the same treatment. First, my positive pole, applied to the spinal disease, repels from it the excess of electro-vital fluid which was there doing mischief; and, second, my negative pole attracts the same, along with the artificial or inorganic electricity, to the stomach and bowels where it is wanted, since negatives attract positives. Or I wish to rouse to action a torpid liver. Now, if I find inflammation, or enlargement of the spleen, as is commonly the case in chills and fever, I place the positive pole upon the spleen, at the left side, just below the false ribs, and the negative pole on the liver, which is best reached immediately below the ribs on the right side, and around backward and upward as far as to the spine. The positive pole repels the excess of electro-vitality away from the positive spleen, and so reduces the improper excitement there, while at the same time it rushes, by attraction, to the negative liver, under the negative pole, and makes that more positive, and so more active. In this way, I change the polarization of the parts, and, in so doing, remove the sustaining cause of the disease. You here perceive that I treat a positive part with the positive pole, so as to repel the excess of electro-vitality from it, and thus repress its excessive action; and that I treat a negative part with the negative pole, so as to attract the electro-vital fluid, along with the current from the machine, to it from under the positive pole, and thus increase the action by making it more positive.
But suppose I do what nearly all of the doctors do, who use electricity with any regard to polarity; that is, if treating acutely inflamed eyes, for example, apply the negative pole to the eyes, thinking thereby to make them more negative; or, if treating amaurosis, apply the positive electrode to the affected parts, thinking thereby to make them more positive! I say, suppose I do this same thing, do you not see that, by the fixed laws of electricity, I necessarily increase the evils that I would remedy? Do you not see that, by placing my negative pole on the already overcharged and inflamed eyes, I attract to them yet more of the electro-vital fluid, and so increase their positive condition and aggravate the inflammation? and that, by presenting my positive electrode to the eyes already more or less paralyzed, I repel what little electro-vitality there was there, and so make the nerves all the more negative and dead? And yet, I repeat it, this is precisely the plan of almost all the men who use electricity in therapeutic practice with any regard to its polarization. They treat a positive disease—rather, a hypersthenic disease, (for they seldom know anything of the electrical states of diseased parts), with the negative pole, and an azoödynamic disease, which is negative, with the positive pole!—all directly antagonistic to science and success.
But the great mass of physicians, who attempt to treat electrically, have no knowledge either of the electrical condition of the various forms of disease, nor of the distinctive and peculiar effects produced by either pole of the artificial current; and consequently all their use of this powerful agent is entirely empirical—merely haphazard experiment.
I may have raised an inquiry a few moments since which ought to be answered. I said, in effect, that in treating a positive disease, such, for instance, as acute, inflammatory rheumatism or acute pleurisy, I would use the positive pole on the inflamed parts, and the negative pole on either some healthy part or on a morbidly negative part, if I could find such. So, too, I said I would treat a negative disease, such as amaurosis or torpidity of liver, with the negative pole, placing the positive pole on either some healthy or morbidly positive part. The query may have arisen, "By placing the one pole or the other on a healthy part, do you not derange the normal electro-vital action there, disturbing its healthy polarization?" I answer, yes, for the time being, I do; and if this disturbing force were to be steadily continued for any considerable time, the disturbance would produce manifest and serious disease. But then, a pole or electrode, placed on a healthy part, we generally move, or ought to move, more or less, every few moments, which prevents the establishment of any perverted action in the part; and the moment the electrode is withdrawn, the normal polarization and healthy action are resumed.
USE OF THE LONG CORD.
It is often desirable to bring the entire parts of the patient, through which the current is made to pass, under one and the same kind of influence—such as shall make them all more positive or more negative. Especially is this true in many cases where we wish to run through but a short space. For this purpose, there is frequent advantage in using conducting cords of unequal length. As my views on this point have been disputed in certain quarters, I will endeavor here to place them in such a light that they shall not be rejected for want of being rightly understood.
I have previously remarked[C] that, for practical purposes, it is sufficiently exact to consider the magnetic circuit as extending only from the positive post, around through the conducting cords, the electrodes, and the person of the patient, to the negative post. We will so regard it at present. This circuit may be viewed as one continuous magnet, made up of several sections or shorter magnets placed end to end—the positive end of the first to the negative end of the second, and the positive end of the second to the negative end of the third. In this arrangement, the negative end of the first section is the negative pole of the one whole magnet, and the positive end of the third section is the positive pole of the whole magnet. The minimum quantity of the magnetism is supposed to be at the negative pole, and the maximum quantity at the positive pole; and the quantity is supposed to increase, by regular graduation, from the negative to the positive pole. This being so, the quantity is the same in the positive end of either section and the negative end of the adjoining section, at their point of contact.
Now, in practice, the body of the patient, or so much of it as is embraced between the two electrodes, may be regarded as the second section in this magnet; and the cord connected with the positive post, together with its electrode attached, may be counted the first and most negative section; and the cord connected with the negative post, along with its electrode, may be the third and most positive section. And if this whole magnet be more and more positive, by regular degrees through all the sections, from its negative to its positive end or pole, then the nearer any given part of it, say the second section—the patient's person, may be to its positive pole in the negative post, so much the more positive that section or part will be. And the nearer such part or section may be to the negative pole in the positive post, so much the more negative it will be. If the cords be of equal length, the central point in the circuit or magnet will be in the second section—the person of the patient, midway between the electrodes; and that section will be charged with the mean quantity of the magnetic fluid. The central point will hold exactly the mean quantity. But if the cord in the first section be two yards long, and that in the third section be four yards, then section second—the patient's parts under treatment—will be nearest to the negative pole in the positive post, and consequently will be charged with much less than the mean quantity of the fluid, and will therefore be made so much the more negative. If, on the other hand, the cord in section first be four yards in length, and that in section third be only two yards, then the patient's body—section second—will be brought nearest to the positive pole in the negative post, and of course be charged with much more than the mean quantity of the magnetic fluid, and hence will be made so much the more positive.
It is true that the positive and negative poles of section second—the parts of the patient between the electrodes—will not be reversed by any such changes in the length or relative positions of the conducting cords; nor is such reversal required in those cases where the use of the long cord is indicated. The only change of polarization called for in such cases, is that all the parts through which the current is to pass should, in greater or less degree, be affected alike, as being made more positive or more negative. Of course these parts will be so affected in different degrees—those nearest to the short cord the most; those nearest to the long cord the least.
The class of cases where the use of the long cord is more especially advantageous, comprises those in which it is desirable to run the current out of the patient at the shortest admissible distance from the positive electrode. For example, in treating cynanche tonsillaris, (quinsy), if treating with the positive pole in the mouth, we would not wish to run the current further than to the back of the neck; or, if treating externally, we would not wish to carry the negative electrode further from the positive than from side to side. Here the long cord, with the negative electrode, would be a special advantage in subduing the inflammation. We would not care to increase the inflammatory action, as we should necessarily do on the positive side of the central point, by using cords of equal length.
Again, if treating a case of acute enteritis—inflammation of the intestines—we would not wish, while treating the abdomen with the positive pole, to increase the inflammation in the lower parts, by using equal cords and placing the negative pole at the sacrum or the coccyx. Neither would we wish to reduce the strength of the lower limbs by carrying the negative pole to the feet. Nor, yet again, would we care to endanger the thoracic viscera by running the current from the abdomen up to the dorsal or cervical vertebræ. The true way, in such a case, would be to connect the negative electrode with a long cord, and then to run the current through the inflamed parts, and out somewhere from the lumbar vertebræ to the coccyx, by treating over the abdomen with the positive pole, and placing the negative pole on the lower parts of the spine.
As the cords that accompany the machine from the manufacturer are usually cut about two yards in length, every practitioner should supply himself with an extra cord, of at least three yards, to be used as the long cord.
THE INWARD AND THE OUTWARD CURRENT.
I have already said that when the conducting-cords are of equal length, as for the most part they should be, the central point of the circuit will be in the person of the patient, about midway between the two electrodes. Now, since the current always runs from the positive to the negative pole, and makes its whole circuit in that direction, it will be readily seen that, from the place on the patient where the positive pole is applied, inward as far as to the central point, the direction of the current may properly be said to be inward; and that, from the central point to the place of the negative electrode, where the current comes out, its direction may be said to be outward. When, therefore, a part is treated with the positive pole, or when the part under treatment appears anywhere between the positive pole and the central point, it is not unusual to say, It is treated with the inward current. And when a part is treated with the negative pole, or when it appears between the central point and the negative pole, it is often spoken of as being treated with the outward current.
MECHANICAL EFFECT OF EACH POLE.
The mechanical effect of the forward end of the current, or that part of it which is under the negative electrode, is to relax, expand and weaken; while that of the rear end, under the positive electrode, is to contract and strengthen. A moving ship disperses the waters at its bow, but draws them in at its stern. The bullet shot from a gun, in passing through a plank, leaves the perforation closed where it enters in, but wide open where it comes out. Thus, in physics, the advance end of a moving body tends to disperse the element through which it is passing, while the rear end tends to its contraction. Analogous to this are the mechanical effects of the different ends of an electrical current in the living tissue. When, therefore, we wish to relax a muscle that is unnaturally contracted, as by rheumatism or otherwise, we must bring it under the forward end—the outward current—the negative pole. If we desire to contract ligaments or muscles that are abnormally relaxed, (not atrophied), as in prolapsus uteri, we must subject them to the rear end of the current—the positive pole. Parts that are unnaturally contracted are electrically negative in excess, and need to be made more positive. And parts that are unhealthily relaxed are too positive, and should be made more negative. We make a part more positive by applying to it the negative pole, and more negative by applying to it the positive pole. Parts spasmodically contracted are acute and positive; those permanently contracted are chronic and negative.
RELAXED AND ATROPHIED CONDITIONS.
I alluded, above, to a distinction between a relaxed and an atrophied condition of an organ. There is such a distinction, which should be carefully observed while treating parts so affected. An atrophied muscle or organ becomes soft and flabby from lack of nourishment. But this condition is not properly one of relaxation. It is rather a diminution—a thinning out of atoms, by wasting without replenishment. Such a condition is always negative, and requires treatment under the negative pole. On the contrary, relaxed parts, such as appear in prolapsus uteri, and in the sagging down of the diaphragm, with the thoracic and abdominal viscera, exhibit no lack of nutrition or of vital action. Relaxation is a loosening of atoms from each other, more or less, without loss of aggregate weight; and implies a condition electrically positive in excess, and calls for treatment with the positive pole.
GENERAL DIRECTIONS OF THE CURRENT.
Negative affections, as a general rule, are best treated with the upward-running current—the positive pole being placed at a lower point than the negative. Inflammatory affections, and other plus conditions, for the most part, should be treated with the down-running current, keeping the negative pole at a lower point than the positive. But these rules admit of frequent exceptions, which every practitioner's experience will soon reveal.
The downward current, running with the downward and outward course of the nerves, tends to depletion and weakness, for the reason that it runs off from the system the electro-vital fluid. The upward current, on the other hand, running against the nerves, inward towards their source, feeds the system with fresh electricity, and gives a tonic effect. Yet for this purpose, it must not be too long continued, nor of too severe strength, lest it overtask and irritate the nerve-sheaths.
In treating a paralyzed organ, the current should commonly be run from a healthy part, whether that require it to be directed downwards or upwards. For example: In treating a paralyzed foot or leg, the positive pole should be upon the lower part of the spine—at the coccyx—or even under the sole of the opposite foot. It is best to alternate between these positions. So in treating a paralyzed hand or arm, let the current be run from the upper part of the spine, and frequently also from the opposite hand. With the negative electrode, treat all over the paralyzed parts. Yet it is well, in these cases, often to reverse the direction of the current for a brief period at the close of the sittings, say one to two minutes, for the purpose of rousing the nervous susceptibility, and to prevent exhaustion from too continuously running off the electro-vital fluid.
TREATING WITH ELECTROLYTIC CURRENTS.
For decomposing and carrying off unnatural growths, as fistula, ficus, glandular enlargements and other tumors, it is often best to dilute the electrolytic quality of the galvanic current A B with one or both of the Faradaic currents, as by taking A C or A D instead of A B. But malignant and poisonous affections, as scirrhus and other varieties of cancer, and also cases of infectious virus, demand continually, or with but occasional exceptions, the primary galvanic current A B. ☞In treating these malignant affections, the current should be run through as short a distance of healthy tissue as possible, yet so as fairly to reach the diseased part. And whether this part be brought, for a given time, under the one pole or the other, the opposite pole should be attached to the long cord, so as to throw the central point of the circuit, not in the person of the patient, but out on the long cord, thus bringing the entire organic parts though which the current is passed on one and the same side of the center, and so, under the ruling influence of the same pole.
Those diseases which require the chemical or electrolytic currents should, for the most part, be treated under the negative pole, particularly those which need the galvanic current A B, and also old ulcers and chronic irritation of mucus surfaces. Glandular enlargements not of scirrhous character, and excrescent growths not poisonous, may often be reduced, and perhaps sometimes cured, under the positive pole. But my own experience, even with these affections, is that it is better to treat them under the negative pole until they come to assume, as sometimes they will, an acute state, when the positive pole may be used with success. If, however, it appears desirable to produce a cauterizing effect, this must be done by persistent treatment under the negative pole of a strong A B or A C current, and, if the disease be external, with a small pointed electrode.
POSITIVE AND NEGATIVE MANIFESTATIONS.
Acute diseases are to be regarded as electrically positive, and chronic affections as negative. The exceptions are rare, if any at all. Malignant cholera, which is eminently acute, might by some be considered as an exception. In negative diseases, there is a low degree of electro-vitality. And it has been remarked by careful observers, particularly in the Orient, that cholera rages with greatest destructiveness when no special electric phenomena have for long time appeared in the atmosphere, and when the artificial electrical apparatus could be made to yield its sparks only with difficulty, or not at all. And again, after a thunderstorm, when the electric machine works again freely, the cholera is also found to abate quickly, and sometimes very greatly. The inference drawn from these facts has been that the prevalence of cholera is largely owing to a lack of electricity in the atmosphere, and consequently to a want of the animal electricity or electro-vitality in the system of the patient; and thence it might be concluded that cholera implies a negative condition of the system. I think there is a fallacy in this reasoning. There appears to me to be an unwarrantable assumption in confidently attributing the long absence from the heavens of marked electrical phenomena, and the failure of the electric machine to give its spark, to an unquestioned deficiency of atmospheric electricity. Electrical manifestations take place only when the plus and minus conditions are existing, in relation to each other, somewhat near, or not very remote; and the visible phenomena appear when the positive and negative rush together, so as to produce a polar equilibrium. But suppose a plus condition to exist over a wide region, then, everything being overcharged, the visible phenomena would be as rare and as difficult of attainment as if all around were negative. How, then, can it be inferred, with any certainty, from such data, that there is a deficiency of electricity, rather than an excess of it?
I have not treated a case of cholera; but my own impression of it is, that in the first stage, or during the "rice-water" discharges, the condition of the system is, as in other acute affections, excessively positive; but that, as the collapse comes on, it rapidly subsides into an intensely negative state, thus assuming the chief characteristic of a chronic condition.
In the above remarks, I would not be understood to indicate any doubt that the prevalence of cholera is often aggravated or mitigated by peculiar electrical states of the atmosphere. It appears altogether probable that such may be the fact; and I should presume that electrical treatment, properly administered, would be found eminently successful in this fearful malady.
Again, in chronic rheumatism there might, at first view, seem to be frequent exceptions to the rule last above stated; but the cases alluded to are not such. It is often the fact, during chronic rheumatism, that soreness and severe pain are felt, especially under the presentation of the negative pole, thus showing that these points require to be treated with the positive pole. But, in such cases, although the general disease of the system be chronic and negative, these sore and severely painful points have, for the time, risen in their electro-vital condition, and so become acute and positive. But when chronic rheumatism is attended with only a dull pain, and that chiefly under exercise of the parts, and with little or no increase of pain under an application of the negative pole of the A D current, medium strength, and with no swelling, then the pain, the stiffness and the lameness are all marks of the negative state, and the parts must be treated with the negative pole of the A D current, strongly at first, but diminishing in force, from time to time, as the patient becomes relieved.
Alkaline affections—those causing excessive alkaline secretions—are electrically positive. Acid or acidulous states are negative.
HEALING.
For healing wounds, burns, ulcers, irritation of mucous membranes, and cutaneous eruptions, the A D current is by far the best. Recent wounds, contusions and burns are electrically positive. Old ulcers and irritations are generally negative.
DIAGNOSIS.
To make a correct diagnosis, it is needful to bear in mind the following general principles:
1. Where the organism is in health, the momentary application to the patient of the negative pole of the double Faradaic current B D—the best for diagnostic use—in good medium strength,[D] will be directly felt, yet will cause no pain. Whatever muscular contractions may be produced for the time, they are harmless, and need not be noticed. Wherever the electro-vital fluid is in excess, producing hypersthenia—too much vital action—the part is morbidly positive; and, excepting sometimes in the stomach and bowels, the B D current, of medium force, directed to that part under the negative pole, will produce sharp pain. But where a current of full medium strength can not be felt under the negative pole, there is a morbidly negative state—a deficiency of vital action—a condition of at least partial paralysis—anæsthesia.
2. In a state of health, different persons will have different degrees of sensibility to the electric current, depending on their varied nervous susceptibility. Again, the same person will be much less sensitive to the current when directed to the spine, particularly the lower part of it, and to the stomach, than when directed to most other parts. Also, where bones lie near the surface, the periosteum—the membrane immediately investing the bone—is apt to feel more sensibly under the electrodes than the muscular parts. But these variations soon become so familiar to the practitioner that he finds no difficulty in making the proper allowances for them.
In making an electrical examination, the two following questions present themselves to be answered: First, whether anywhere, and, if so, where is there a morbid electrical state in the body of this patient? Second, what is the electrical condition of that unhealthy part? Is it positive or negative?
These questions being answered, according to the tests just given, the well-instructed practitioner is prepared to go on and treat the patient judiciously, and with success, if success be attainable by any form of medication.
Let me next say, It is best, as a general rule, to make examinations with the negative pole. The reason of this is that, since the current is always more energetic under the negative than under the positive pole, it makes itself more sensibly felt there than under the positive pole. Indeed, it will commonly be felt even to painfulness there, if the part were overcharged and inflamed before. Thus, under the negative electrode, the current readily detects any active disease. But, if we be making the examination with the positive pole, as we come upon any point more or less inflamed, the current, quick as lightning, rushes away from such inflamed part to the part under the stationary negative pole, carrying with it, for the time being, more or less of that excess of electro-vital fluid which was in force at the inflamed point; so that no pain, perhaps, is experienced there; and thus the disease escapes detection.
I am aware that it has been said by some of our practitioners, with, if I rightly remember, the able discoverer of the grand practical principles of our system, Prof. C. H. Bolles, at their head, that it is not quite prudent to use the negative pole in hand for diagnosis, lest we possibly contract the disease from the patient; since, in that case, the current runs from the patient to the practitioner. They think it safer to use the positive pole in hand; so letting the current run from the practitioner to the patient. There is force in this consideration, without doubt, where the patient is affected with a poisonous or malignant disease. And where any thing of this nature is apprehended, I would never examine with the negative pole in hand. But these cases are commonly so manifest, or so easily determined by colloquial inquiry, that examination with the electric current is rarely if ever necessary. And when the disease is plainly not of a poisonous or infectious nature, I do not think there is any danger to be apprehended from the cause stated. I therefore prefer, as a general rule, to examine with the negative pole; and for the reason given above.
The temperature of the room and the adjustment of apparel should be the same as for treatment. To prevent improper chilliness, the room ought to be of such temperature that clothing is not required for bodily comfort—say, from 70 to 80 degrees, Fahrenheit. Seat the patient on a stool or chair, (a stool is most convenient), and yourself at his side, with your machine, ready for use, on a table or bench before him, and a vessel of warm water within easy reach. If the patient be a man we let his trunk be disrobed, giving free access to the back, chest and abdomen. If the patient be a woman, let her be covered with a treating-robe, of which garments the practitioner should keep a supply. They are made much like a lady's plain nightgown; but large and loose, so as to serve ladies of any size, and give ample room to work the electrodes under them. Her skirts should be dropped below the seat, so far that their bands shall lie across her lap.
Let us now suppose the machine to be working. We will take the B D current. Let it be of good medium strength. We regulate the strength by the quantity of fluid in the battery, so far as volume is concerned, and by means of the plunger as respects intensity. The electrodes should be dampened with warm water. Let the sponge-roll, positive cord; that is, the cord connected with the negative post, to another sponge-roll, to be held in the operator's right hand; or, what is better, attach it to a thin, flexible, metallic wristband, (brass is good, but metallic lace—such as is used in trimming regalia, is best), underlaid with wet muslin, and fastened around the right wrist. This brings the operator's hand into the circuit as the negative electrode or pole. Next, pass a moist, warm sponge all over the patient's back. Now, before the back becomes dry, press the points of two fingers firmly, yet not uncomfortably, upon the back of the neck at the base of the skull; thence move gradually downward, by frequent touches of the same firm but gentle character, keeping one finger on each side of the spinous processes, until the whole length of the spine has been, in this manner, passed over. If sharp pain or soreness be felt at any point, note that point; there is inflamed irritation there. Then return up to the right or left shoulder, and pass, in like manner, by frequent touches with one or two fingers, over all parts of the back on that side of the spine, down to the hips. Then, in the same way, examine the shoulder and back on the other side of the spine, noting, as before, every point, if there be any, where soreness and pain appear. After this, pass over the entire neck, then over the front parts of the thorax and abdomen, down to the pelvic bones, everywhere watching for soreness and pain. Next, go to the head. Wet the hair through to the scalp, (because dry hair is a bad conductor,) and change to a very soft B C current. Then go over all the head in the same manner as over the neck and trunk. Better reverse the poles on the head, by transposing the cords in the posts, so as to make the manipulating hand the positive pole. The head is, or ought to be, extremely sensitive. You need not do this, however, if the negative pole can be received on the head without discomfort, as it sometimes can be. Commence on the cerebrum, and then pass to the cerebellum.
If, in the examination of the spine, the practitioner finds it uncomfortable to bear in his fingers a current of sufficient strength to be distinctly felt in that part of the patient, he may use the side-sponge cup on the spine. But let him never use a current on another person which he does not first apply to his own nerves, so as to know its intensity. Indeed, if one prefer to use the side-sponge cup through the whole process, he can do so; although there is advantage in using the fingers, since, by their concentrated impressions, he is more sure to detect disease than by the broader face of the sponge cup.
☞Now, wherever there is found soreness or lancinating pain under the touch, it is sure that the part is preternaturally positive—more or less so, according to the degree of painful irritability. On the other hand, if there be found a part evincing much less than the usual sensibility found in the healthy corresponding part of other patients, it may safely be pronounced torpid or paralytic, more or less. It lacks sufficient electro-vitality—is improperly negative, and needs to be treated with the negative pole.
It will often happen that diseased action is found in parts where the patient was entirely unaware of its existence until the practitioner's fingers or other electrode revealed it. Again, it will sometimes be found that there is no disease whatever in parts where the patient supposed disease to be active. But when we find patients to be especially nervous, it is not always best to tell them immediately just what our examinations have revealed to us—how severely or how little we think them diseased. It is sometimes better to humor, more or less, the patient's own views for a time; lest, by exciting him or her, we make a difficult case out of one that might have been mastered with comparative ease. In this matter discretion should guide us.
But let me say farther, what I deeply feel, that neither do I think it right to persistently conceal from patients, especially those who are dangerously affected, a knowledge of their true condition. In my opinion, physicians often unwittingly incur an awful responsibility in this way, wronging their patients in the most vital and momentous of all interests—the interests involved in a due preparation for death. I believe the true way, in every such case, is for the physician himself, in a kind and soothing manner, to reveal to the patient, little by little, if need be, what he really thinks, or to ask the patient's pastor, or some other calm and judicious person to do it for him. I believe the visits of a discreet and affectionate pastor, or, in the absence of a pastor, of some other mild and Christian friend, to the bedside of the sick is, nine times in ten, not only no embarrassment to the patient's recovery, but positively favorable to it, and ought to be habitually encouraged, rather than restrained, by medical practitioners.