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HOW TO USE A
GALVANIC BATTERY IN MEDICINE
AND SURGERY.
HOW TO USE A
GALVANIC BATTERY IN MEDICINE
AND SURGERY
A Discourse
DELIVERED BEFORE THE HUNTERIAN SOCIETY.
BY
HERBERT TIBBITS, M.D.
FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS IN EDINBURGH; HONORARY MEMBER OF THE
NEW YORK SOCIETY OF NEUROLOGY AND ELECTROLOGY; LATE HONORARY MEDICAL
SUPERINTENDENT OF THE NATIONAL HOSPITAL FOR THE PARALYSED AND
EPILEPTIC, OUEEN’S SQUARE, BLOOMSBURY, AND OF THE MEDICAL
SOCIETY OF LONDON; MEMBER OF THE CLINICAL,
OPHTHALMOLOGICAL, HARVEIAN AND PATHOLOGICAL SOCIETIES; FOUNDER OF, AND SENIOR
PHYSICIAN TO, THE WEST END HOSPITAL FOR DISEASES OF THE NERVOUS SYSTEM;
AND MEDICAL OFFICER FOR ELECTRICAL TREATMENT TO THE HOSPITAL
FOR SICK CHILDREN, GREAT ORMONDE STREET, ETC. ETC.
THIRD EDITION
REVISED, AND INCORPORATING
THREE LECTURES UPON ELECTRO-THERAPEUTICS
DELIVERED BY THE AUTHOR AT THE NATIONAL HOSPITAL
LONDON:
J. & A. CHURCHILL,
11 NEW BURLINGTON STREET.
1886.
NOTE TO THE THIRD EDITION.
This Discourse was first published in compliance with the request of several of those who heard it delivered, and who expressed to me an opinion that busy practitioners might perhaps be glad to have at hand, and in small compass, such information as it contained. It was obviously impossible to do more in so limited a time than to make a general reference to the therapeutic uses of electricity; and the most that I attempted in this direction was to recall to the recollection of my audience those conditions of disease in which the application of electricity would seem—without doubt—to be required; and to indicate the methods of application most generally useful. The construction of apparatus can not be understood from verbal or written description alone; and I appended to the text certain notes, and illustrations of the instruments which I submitted to the Society.
With the Second Edition I incorporated three Lectures which I delivered at the National Hospital for the Paralysed and Epileptic; and to this Edition I have appended such additional matter as I believe will prove useful to the student.
I may add that I have endeavoured, as was said by a deceased physician, “to paint electro-therapeutics not imperfectly, but, as it were, in miniature:” and that while I have carefully revised every page, and have noticed all real improvements introduced to the profession since the First Edition, I have kept the book a small book: and I venture to hope a book easily to be understanded by the multitude of practitioners who ask daily what instruments to use, and when, and especially how, to use them.
These questions I have endeavoured to answer in the following pages, which contain such details, and such details only, as I believe it essential for the practitioner to master.
68, Wimpole Street, W.
December, 1885.
CONTENTS.
Note to the Third Edition.
[LECTURE I.
ELECTRICAL INSTRUMENTS.]
Preliminary Remarks.
The Different Varieties of Electricity.
1. Franklinism.
Method of Generating.
The Plate Machine.
Winter’s Machine.
Carré’s Machine.
The “Bischoff” Gas Engine.
The “Hand Fly-Wheel.”
Accessories Required.
Its Administration.
(a) Electro-Positive Bath.
(b) Electro-Negative Bath.
(c) by Sparks.
2. Voltaism.
Points of Distinction between the Voltaic and Faradaic Currents.
The Essentials of a Voltaic Battery.
The 40-Cell Battery.
The Galvanometer as an aid to the Dosage of Electricity.
3. Faradism. The Essentials of a Faradaic Instrument.
Description of a Faradaic Instrument.
The Combined Hospital Battery.
The Accessories of Electrical Apparatus.
[LECTURE II.
METHODS OF APPLYING ELECTRICITY.]
Résumé of First Lecture.
Generalized Electrization.
The Positive Charge.
The Electric Bath.
General Faradization.
Central Galvanization.
Localized Voltaization and Localized Faradization.
Direct Muscular Electrization.
Indirect ” ”
Different kinds of Rheophores.
Importance of exactitude in administering a Constant Current.
Cutaneous Electrization.
(a) The Electric Hand.
(b) Metallic Conductors.
(c) The Wire Brush.
Electrization of Internal Organs.
(a) of Rectum and Muscles of Anus.
(b) of Bladder.
(c) of Uterus.
(d) of Larynx.
(e) of Male Genitals.
Electrization of Central Organs of Nervous System.
(a) of the Brain.
(b) of the Sympathetic.
(c) of the Spinal Cord.
(d) of the Retina.
(e) of the Auditory Nerve.
Precautions to be observed in all Medical Applications of Electricity.
[LECTURE III.
ELECTRICITY IN DIAGNOSIS AND TREATMENT.]
A.—Electricity in Diagnosis.
Limitation of Electricity in Diagnosis.
Method of Testing Farado-Irritability.
Rule for Strength of Current.
Diagnosis when Irritability is Normal.
diminished.
increased.
diminished to Faradism and increased to Voltaism.
of Peripheral from Central Disease.
of commencing Paraplegia from Locomotor Ataxy.
of Real from Feigned Disease.
Electricity as Proof Positive of Death.
B.—Electricity in Treatment.
Limitation of Electricity as a Remedy.
Franklinization.
(a) in Facial Neuralgia.
(b) in Sciatica.
(c) in Facial Spasm.
(d) in Emotional Aphonia.
(e) in Hysterical Hyperæsthesia.
(f) in Tremor.
Note upon Recent Additions to our Knowledge of the Benefit of Franklinization in Diseases of Debility.
Voltaization.
The “Constant Current.”
Possesses an Influence “sui generis.”
Electrization in Neuralgia.
in Fatigue Diseases.
in Electrotonus.
its Resolvent Effects.
in Electrolysis.
in Impotence.
in Gout.
in Rheumatic Arthritis.
in Muscular Rheumatism.
in General Debility.
in Atrophic Paralysis.
in Infantile Paralysis.
in Traumatic Paralysis.
in Lead Palsy.
in Facial Paralysis.
in Wasting Palsy.
in Hemiplegia.
Electrization as a Direct Application to the Brain.
in Spinal Paraplegia.
in Paraplegic Constipation.
in Incontinence of Urine.
in Hysterical Paralysis.
in Locomotor Ataxy.
in Insanity.
in Diseases of Women.
as an Emmenagogue.
in Inertia Uteri.
in Post-partum Hæmorrhage.
in Uterine Neuralgia.
in Sterility.
in Paralysis of Nerves of Special Sense.
Résumé of the General Principles of Electro-therapeutics.
Concluding Remarks.
HOW TO USE A
GALVANIC BATTERY IN MEDICINE
AND SURGERY.
LECTURE I.
ELECTRICAL INSTRUMENTS.
Mr. President and Gentlemen,
Preliminary Remarks.
When your Council did me the honour to ask me to bring before you the subject of Electro-therapeutics, I felt that the invitation was addressed rather to the Hospital to which I am attached than to myself, seeing that to it belongs the merit of having been for some years the pioneer and outpost, so to say, in this metropolis of the scientific and methodical application of electricity to the alleviation and removal of disease; and that we are indebted to one of its distinguished physicians for a remarkable investigation into animal electricity, and the demonstration that much of what we have been accustomed to attribute to a “vital principle” may, in reality, be the effect only of electrical charge and discharge[1] (a valuable contribution to the correlation of the Physical Forces); and to my predecessor for the discovery of the special influence of voltaic currents in certain forms of paralysis.[2]
As it is one of our objects in our practice here to study the scope and the limits of electricity as a remedy in disease, it seemed to me not inappropriate to devote my first Lectures to electro-therapeutics; and the more so, as few medical men have a practical knowledge of the subject; and I fear that the profession generally, through lacking this practical knowledge, are to some extent responsible for the utter and astounding recklessness with which the laity—ever ready to rush in where physicians fear to tread—are prone to apply painful and dangerous electrization, not to themselves, but to their suffering friends; while it is still too common for the medical practitioner (as quoted by Golding Bird upwards of forty years ago) to consider that when his fiat has gone forth “let the patient be electrified,” he has done all that is necessary, while the patient usually carries out this mandate by the purchase of a rotary magneto-electric machine, and by using it according to the directions of its maker, who is generally about as well fitted to teach its application in disease as is the maker of an amputating knife to operate with it!
The almost complete absence in the medical schools of the great hospitals of opportunities for an adequate study of electro-therapeutics, the importance of the subject, and the widespread attention that it is awakening throughout the profession, have also determined me to sketch as briefly as is consistent with clearness the present position of the science and practice of medical electricity, and especially of its practice.[3]
Electricity, Gentlemen, is by no means one of those remedies that, failing to do good, is little likely to do harm. On the contrary, in injudicious hands, it is potent for evil, while the benefit to be derived from it is in exact proportion to the judgment and care with which it is administered. Moreover, the results of its employment are dependent, more than with any other therapeutic agency, upon the methods by which it is applied—methods that should be familiar, not alone to a few specialists, but to every practitioner.
Addressing you who are engaged in active practice, with little time to devote to medical electricity, it will, I think, be more acceptable for me not to weary you with a tedious discourse upon the elementary principles of electricity, for the practical application of these matters concerns rather the instrument-maker than the medical practitioner, and I shall discuss none of them, except incidentally, and with precise reference to their application to medicine. Besides, we know little of them, and I cannot forget that Faraday said that “he once thought he knew something about electricity, but the more he investigated it the less he found he understood it.” Let us then be content with its definition as a “Force,” “pervading all nature, latent in every substance, and liable at any moment to be excited by mechanical or chemical means.”
Nor do I propose to make these Lectures in any sense exhaustive, but, on the contrary, to include in them only such information as is essential, and such as you may readily, and without effort, retain in your memory. I shall direct especial attention to practical points which are of importance to the successful use of electricity; for from non-observance of small details of application many failures have resulted, the treatment getting a measure of discredit, which in strict justice should have attached only to the operator.
In the present Lecture I shall consider instruments, their construction and management, a dry subject, but an essential one, the first requisite of a good workman being complete familiarity with his tools, lacking which he will be the victim of constantly recurring annoyances and difficulties; for although the present position of electro-therapeutics is largely due to improved methods of administration, these methods would be impossible with faulty instruments, while, on the other hand, the most perfect instruments require a certain amount of skill and care in their management, and some acquaintance with at least the mechanical details of their construction; and without this rudimentary knowledge it is also impossible to usefully compare one instrument with another.[4]
My second Lecture will be devoted to the different methods of applying electricity, and my third and last to its uses in the diagnosis and treatment of disease.
Varieties of Electricity.
We make use of three varieties of electricity in medicine.
Firstly, of static or friction electricity, the electricity of glass and amber, appropriately called from its early investigator, Franklinism.
Secondly, of the electricity of chemical action, Galvanism, or better, Voltaism, the “Constant Current.”
Thirdly, of Faradism, the induced currents of momentary duration, which are generated or induced, in a coil of wire by the action upon it, under certain circumstances, of a magnet, or of a Voltaic current.