INEQUALITIES OF THE CIRCULATION.
As a very fruitful source of morbid conditions of almost every nature, abnormities of the circulation of the blood are well worthy our attention. As is the case with dyspepsia, so here likewise patients seldom present themselves for treatment unless some definite secondary pathological condition has supervened. We find these patients complaining of cold hands and feet, irregular and disturbed sleep, occasional local congestions, with vague, usually slight pains here and there, etc., etc. Where organic cardiac disease is at the bottom of the trouble, we cannot of course expect much permanent improvement. Although even here considerable relief is often afforded while the baths are being used, their discontinuance will in all probability be soon followed by a return of the former condition. Where, however, cases are not complicated by organic disease, where we have a “sluggishness” of the circulation, due either to vasomotor inertia or atony of the muscular coats of vessels, the electric bath will be found reliably efficient. I have already ([p. 55]) alluded to this subject, and explained the probable “mode of action” here of the baths. I will now offer some suggestions as to the best method of administering them with a view to equalizing the circulation.
We must here seek to stimulate the vasomotor system, both central and peripheral; to give tone to the coats of vessels, both by direct and indirect electric influence; through counter-irritation to relieve internal congestions, by causing an afflux of blood to the skin. These objects are best attained by means of the galvanic current, which should be employed of sufficient intensity to produce a rubefacient effect. The faradic current acts in the same direction, but far less energetically, if we except the vessels near the surface, the muscular coats of which are probably more efficiently tonicised by this than by the constant current. The faradic current however is applicable here in another way, and for a very important object. I refer to the mechanical counter-action of a sluggish circulation, through the agency of prolonged muscular contraction. This mechanical effect is not of course peculiar to the faradic current; it is shared by gymnastic and other exercises; but obtained in any other way whatsoever (with the exception, perhaps, of massage, which is however much more troublesome as well as inferior, and moreover not always admissible) it involves, in order to produce perfect results, a considerable amount of bodily exertion, often beyond the physical power of persons who are in ill health, and bringing with it the risk of positive injury, through over-exertion, which with the passive contractions obtained by means of the faradic current, is entirely obviated. By administering the general faradic current in the bath, of sufficient intensity to maintain muscular contraction as long as the circuit remains closed, any stagnant blood in the lower extremities will be efficiently forced into the general circulation. After from three to five minutes of this faradization, the surface board may be successively applied for a minute or two each to the arms, abdomen, pectoral and dorsal muscles. I believe the best results can be obtained by first going through the faradic process, then subjecting the patient to general galvanization, as above indicated, and concluding by another but brief faradization.